Anthropometric measures to identify the health risk of obesity among European adolescents (System review)

In the last decade, the share of obese adolescents in the European region has been steadily increasing, which is associated with a higher risk and earlier onset of a number of socially significant diseases with a complicated clinical course. Therefore, timely and rapid diagnosis of obesity in adolescents by applying cheap, convenient, non-invasive and reliable indirect methods such as anthropometric indices is crucial in health care settings.

A systematic search and analysis of the available scientific literature was performed to identify relevant articles published over the period between January 2013 and December 2023 in Web of Science, Science Direct, Scopus, Research Gate and PubMed. Seventy full-text publications reporting the application of such anthropometric indices as Body Mass Index, Waist Circumference, Waist-to-Hip ratio and Waist-to-Height Ratio to identify the healthy risk of obesity among European adolescents were considered the most eligible and reviewed in detail. In order to generalize the results and obtain reliable statements, the method of meta-analyses (PRISMA) was applied.
A systematic review covers seventy scientific studies involving 495,251 children and adolescents from twenty-six countries of the European continent. Body Mass Index (BMI) was established to be the leading, most commonly used anthropometric index to identify risk of obesity among adolescents in the European health setting and research. Waist Circumference (WC) and Waist-to-Height Ratio (WHtR) were the next popular indicators of obesity in European adolescents with increasing frequency of application in medical practice and population surveys. Surveys applying anthropometric measurements to determine obesity risk in children and adolescents turned out to be quite heterogenic in terms of sample characteristics, research methods and reported claims.

Body Mass Index, Waist Circumference, Waist-to-Hip ratio and Waist-to-Height Ratio are simple indicators of obesity risk in European adolescents, but with greater practical advantages that determine their widespread use in medical and scientific settings. Until now, BMI has been the leading predictive indicator. In the last decade, the application of Waist Circumference and Waist-to-Height Ratio has grown significantly relying on the scientifically reported good discrimination capabilities. However, it is necessary to actualize and confirm universal international reference cutoff values of the considered anthropometric metrics determining the risk of obesity among European adolescents taking into account not only their age and sex but also stages of puberty and ethnicity, have yet to be actualized and confirmed.