A groundbreaking study presented at the European Congress on Obesity in Spain highlights that children as young as 10 can exhibit early warning signs of future heart disease through a simple measurement: their waist-to-height ratio. Researchers found that an increasing waist size relative to height in childhood correlates strongly with heightened cardiometabolic risks by the age of 10.
This extensive decade-long study tracked 700 children from birth, conducting 14 clinical assessments. Scientists used the waist-to-height ratio—calculated by dividing waist circumference by height—as the key metric to evaluate central obesity. They also analyzed cardiometabolic risk factors tailored to each child’s age and gender, including HDL cholesterol (“good cholesterol”), triglycerides, glucose levels, blood pressure adjusted for height, and HOMA-IR, an insulin resistance indicator.
Significantly, the study identified three distinct waist-to-height ratio patterns throughout childhood: a stable “reference group” comprising two-thirds of the participants, a “rising then stabilizing” group, and a “slow-rising” group, each representing about one-sixth of the cohort. After adjusting for sociodemographic variables, puberty, physical activity, sleep, and diet, children in the “slow-rising” group showed notably higher cardiometabolic risk scores—0.79 standard deviations above the reference—and elevated cardiovascular risk scores by 0.53 standard deviations.
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Children in the “slow-rising” category exhibited increased systolic blood pressure and higher levels of markers associated with chronic inflammation and metabolic disturbance, including C-peptide, HOMA-IR, GlycA, and hs-CRP. They also had lower HDL cholesterol, indicating early signs of compromised heart and metabolic health. Meanwhile, the “rising then stabilizing” group had lower HbA1c, suggesting better blood sugar control, though they showed modest increases in ApoB, a cardiovascular risk marker.
Dr. David Horner from the University of Copenhagen, lead author of the study, emphasized the importance of current abdominal fat levels: “The amount of belly fat at age 10 is the strongest predictor of children’s heart and metabolic health risk—not just how that fat developed over time.” He further explained that the actual waist-to-height ratio at age 10 mattered most, overshadowing the pattern of fat gain during childhood.
This insight underscores the need to include waist-to-height ratio measurements in standard pediatric assessments. Dr. Horner suggests that focusing on central obesity rather than weight alone allows clinicians to detect children at higher risk more effectively and tailor early interventions to prevent long-term complications.
While adults with excess visceral fat have been linked to diseases such as diabetes, dementia, cancer, and cardiovascular conditions, this research highlights that early monitoring in children could be crucial in combating future health issues. The Cleveland Clinic recommends adults measure waist circumference just above the hip bones to check visceral fat risks, with critical thresholds set at 35 inches for women and 40 inches for men.
In the UK, approximately one in four adults and one in five children aged 10 to 11 are living with obesity. Parents and caregivers concerned about their child’s health should consider consulting a healthcare professional for personalized advice and monitoring.