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Updated: Jul 12, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Reference values for waist circumference and waist-to-height ratio in Paraguayan children and adolescents
Carolina Bonzi1, Teresa Balboa-Castillo2
1Magíster en Epidemiología Clínica, Universidad de La Frontera, Temuco, Chile.
Objective:
To establish reference values for waist circumference (WC) and waist-to-height ratio (WHR) for Paraguayan children and adolescents aged 7 to 18 years to improve early detection of abdominal obesity.
Methods:
We conducted a cross-sectional study using a nationally representative sample of Paraguayan schoolchildren. The analysis included a total of 12 611 students from public, private, and subsidized educational institutions. We determined reference values using smoothed percentiles for WC and WHR using the lambda-mu-sigma (LMS) method, stratified by age and sex.
Results:
Of the total sample, 52% of participants were female, 81% resided in urban areas, and 68% were enrolled in the public education system. Regarding nutritional status, 36% had malnutrition due to excess BMI for age, and 25% had abdominal obesity. We generated reference values for WC and WHR by age and sex in the form of tables and reference curves. The WC showed a progressive increase with age in both sexes, with higher values in male participants. At age18 years, the 90th percentile for WC reached values close to the WHO metabolic risk thresholds for adults in both sexes.
Conclusions:
This study provides, for the first time, national reference values for CC and WHR for the Paraguayan pediatric population. The generated curves are valuable tools for screening abdominal obesity and can complement nutritional monitoring for the early detection of cardiometabolic risk at an early age.
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