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Updated: Jun 11, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Neck circumference as a screening measure for identifying children with high body mass index
Olubukola O Nafiu1, Constance Burke, Joyce Lee
1Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA. onafiu@med.umich.edu
Insights
Neck circumference (NC) can help identify overweight children. This simple measurement correlates with body mass index (BMI) and can be used for early screening of pediatric obesity.
Area of Science:
- Pediatric endocrinology
- Clinical anthropometry
- Public health
Background:
- Body mass index (BMI) is the standard for assessing childhood overweight, but doesn't measure regional adiposity.
- Neck circumference (NC) is linked to health issues like sleep apnea, diabetes, and hypertension in adults.
- The utility of NC for screening pediatric high BMI is not well-established.
Purpose of the Study:
- To investigate the correlation between neck circumference and BMI in children.
- To identify optimal neck circumference cutoffs for detecting high BMI in pediatric populations.
Main Methods:
- Analysis of anthropometric and clinical data from 1102 children (aged 6-18) undergoing elective surgery.
- Calculation of Pearson correlation coefficients between NC and obesity indices.
- Receiver operating characteristic (ROC) analyses to determine optimal NC cutoffs for high BMI identification.
Main Results:
- Neck circumference showed significant positive correlations with age, BMI, and waist circumference in both genders.
- Correlation strength between NC and BMI increased with age.
- Optimal NC cutoffs for identifying high BMI varied by sex, ranging from 27.0-34.6 cm for girls and 28.5-39.0 cm for boys.
Conclusions:
- Neck circumference is a reliable indicator of adiposity in children.
- NC can effectively screen for overweight and obesity in pediatric populations.
- NC is a simple, reliable anthropometric measure suitable for widespread clinical use in children.
Objectives:
Overweight in children is most commonly described by using BMI. Because BMI does not adequately describe regional (central) adiposity, other indices of body fatness are being explored. Neck circumference (NC) is positively associated with obstructive sleep apnea, diabetes, and hypertension in adults. NC also has positive correlation with BMI in adults. The possible role of NC in screening for high BMI in children is not well characterized. The aims of this investigation were to examine the correlation between BMI and NC in children and to determine the best NC cutoff that identifies children with high BMI.
Methods:
Children who were aged 6 to 18 years and undergoing elective noncardiac surgeries were the subjects of this study. Trained research assistants collected clinical and anthropometric data from all patients. We calculated Pearson correlation coefficients between NC and other indices of obesity. We then determined by receiver operating characteristic analyses the optimal NC cutoff for identifying children with high BMI.
Results:
Among 1102 children, 52% were male. NC was significantly correlated with age, BMI, and waist circumference in both boys and girls, although the correlation was stronger in older children. Optimal NC cutoff indicative of high BMI in boys ranged from 28.5 to 39.0 cm. Corresponding values in girls ranged from 27.0 to 34.6 cm.
Conclusions:
NC is significantly correlated with indices of adiposity and can reliably identify children with high BMI. NC is a simple technique that has good interrater reliability and could be used to screen for overweight and obesity in children.
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