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Updated: Jul 29, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
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Assessment of Child Anthropometry in a Large Epidemiologic Study

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The association between waist-to-height ratio and asthma in U.S. children: a cross‑sectional study from NHANES 1999

Yan Wang1, Lei Li1, Jun Wang2

  • 1Children's Respiratory Department, Yinchuan Maternal and Child Health Hospital Affiliated to Ningxia Medical University, Yinchuan, China.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|April 6, 2026
PubMed

Insights

Central adiposity, measured by waist-to-height ratio (WHtR), is linked to higher asthma odds in U.S. children. This association is nonlinear, with greater risk increases at lower WHtR values, highlighting its importance in pediatric asthma research.

Area of Science:

  • Pediatric Pulmonology
  • Obesity Research
  • Epidemiology

Background:

  • The link between obesity and asthma is known, but central adiposity's role is unclear.
  • Waist-to-height ratio (WHtR) is a key indicator of central adiposity.
  • Pediatric asthma prevalence and its association with adiposity require further investigation.

Purpose of the Study:

  • To investigate the association between WHtR and asthma in U.S. children and adolescents.
  • To explore the nonlinear relationship between WHtR and asthma risk.
  • To identify potential thresholds for increased asthma risk based on WHtR.

Main Methods:

  • Cross-sectional study of 34,957 U.S. children (3-17 years) using NHANES data (1999-2020).
  • Multivariable logistic regression to assess WHtR and asthma association.
  • Generalized additive and two-piecewise logistic regression to analyze nonlinearity.

Main Results:

  • 16.7% of children had asthma.
  • Each 0.1-unit WHtR increase correlated with a 25% higher asthma odds (OR=1.25).
  • Nonlinear relationship identified; risk increased significantly below WHtR=0.467 (OR=1.61) and moderately above (OR=1.18).

Conclusions:

  • WHtR is significantly associated with asthma prevalence in U.S. children and adolescents.
  • The association is nonlinear, indicating a critical threshold for elevated risk.
  • Elevated central adiposity, as indicated by WHtR, increases asthma risk in pediatric populations.
Abstract

Keywords:
NHANESWaist-to-height ratioasthmachildrencross‑sectional study

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