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Patil, et al.

Figure 1. Receiver operating characteristic curve for the waist circumference, the waist-to-hip ratio, and the waist-to-height ratio for
Indian academy of pediatrics, International obesity task force, and World Health Organization growth charts.

study on Nigerian adolescents, WC also performed better than WHR (Okafor, Ofoegbu, Fasanmade, et al., 2011). The WC
percentile might be an interesting tool to calculate central adiposity because it is the most widely accepted method; it is
also noninvasive and easy to use. For children and adolescents, age-sex-specific separate cutoffs are required to measure
obesity and adiposity due to their physiologically changing body shape.
Among three indices of central obesity, WHtR, and WC appeared useful to identify high central obesity, while WHR
failed to highlight. Visceral adiposity carries a high metabolic risk compared to general adiposity. BMI cannot specify
about central obesity; hence, specific indices such as WHtR and WC were found a representative in the study population.
Furthermore, central obesity indicators are relatively easy to use during busy clinics in the Indian as well as in low- and
middle-income countries setups.
The findings of this present study add weight to the consideration of the central adiposity irrespective of children’s
gender or age group. It could be simply mentioned as “keep your WC to less than half your height” (McCarthy
and Ashwell, 2006). Simply, by considering the WHtR and WC indices for general obesity status is possible to be
predicted. Public health message should be propagated toward the prevention of obesity throughout childhood and
adolescence.
When interpreting the results, the following limitations should be taken into account. First, the present study is based
on children belonging to urban middle-class communities. They may not be representative of the entire city of Mumbai.
Variability across school types such as rural and urban-slum would have different results and would have added values
to such research. More research based on samples of a representative of entire schools in Mumbai or entire India urban
areas is clearly warranted to have a fuller spectrum of our understanding the validity of WHtR and WC in school-age

International Journal of Population Studies | 2018, Volume 4, Issue 2 39