Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children


  • Nayera E. Hassan Biological Anthropology Department, National Research Centre, Dokki, Cairo
  • Abeer Atef Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), New Children’s Hospital, Faculty of Medicine, Cairo University, Cairo
  • Sahar A. El-Masry Biological Anthropology Department, National Research Centre, Dokki, Cairo
  • Amany Ibrahim Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), New Children’s Hospital, Faculty of Medicine, Cairo University, Cairo
  • Mones M. Abu Shady Child Health Department, National Research Centre, Dokki, Cairo
  • Muhammad Al-Tohamy Biological Anthropology Department, National Research Centre, Dokki, Cairo
  • Iman H. Kamel Child Health Department, National Research Centre, Dokki, Cairo
  • Galal Ismail Ahmed Elashry Biological Anthropology Department, National Research Centre, Dokki, Cairo



neck circumference, body mass index, children, fat distribution, blood pressure


BACKGROUND: Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored.

OBJECTIVES: To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children.

SUBJECTS AND METHODS: This is a cross sectional study, included 50 obese subjects, aged 7 - 12 years recruited from Endocrine, obesity and Metabolism Pediatric Unit at Children Hospital, Cairo University and 50 healthy children, age and sex matched. All children were subjected to blood pressure assessment (systolic SBP and diastolic DBP), and anthropometric assessment (body weight, height, neck circumference (NC), waist (WC) and hip (HC) circumferences, and skin fold thicknesses at three sites: biceps, triceps and sub scapular. BMI [weight (kg)/height (m2)] was calculated.

RESULTS: In healthy females, significant associations were detected between NC and SBP, DBP and all anthropometric measurements. However, in healthy males NC was not significantly associated with BMI, SBP and DBP. In the obese group; both sexes; insignificant association was found between NC and SBP, DBP, BMI and skinfold thickness.

CONCLUSION: NC is related to fat distribution among normal healthy female children. However, this relation disappears with increasing adiposity. The results do not support the use of NC as a useful screening tool for childhood obesity.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation, WHO: Geneva, 3–5 Jun 1997.

Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. JAMA. 2008;299(20): 2401–2405.


Nielsen LA, Nielsen TR, Holm JC. The Impact of Familial Predisposition to Obesity and Cardiovascular Disease on Childhood Obesity. Obes Facts. 2015;8(5): 319-328.


Rumińska M, Majcher A, Pyrżak B, Czerwonogrodzka-Senczyna A, Brzewski M, Demkow U. Cardiovascular Risk Factors in Obese Children and Adolescents. Adv Exp Med Biol. 2015 Oct 10. [Epub ahead of print].


Millar S, Perry IJ, Phillips CM. Surrogate measures of adiposity and cardiometabolic risk – why the uncertainty? A review of recent metaanalytic studies. J Diabetes Metab. 2013.

Obesity: preventing and managing the global epidemic—report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894: i–xii, 1–253.


Hatipoglu N, Ozturk A, Mazicioglu MM et al. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr. 2008; 167:383–389.


Ozturk A, Budak N, Cicek B, et al. Cross-sectional reference values for mid-upper arm circumference, triceps skinfold thickness and arm fat area of Turkish children and adolescents. Int J Food Sci Nutr. 2008;12:1–14.

Fitch KV, Stanley TL, Looby SE, Rope AM, Grinspoon SK. Relationship between neck circumference and cardiometabolic parameters in HIV-infected and non-HIV-infected adults. Diabetes Care. 2011;34:1026-31.

PMid:21378212 PMCid:PMC3064017

Yang L, Samarasinghe YP, Kane P, Amiel SA, Aylwin SJ. Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO grade III obesity. Clin Endocrinol (Oxf). 2010;73:197-200.

Alfif J, Diaz M, Paez O, Cufaro P, Rodriguez P, Fabreguesmtsac G, Magni R, Nucci S, Rodriguez M, Marin MJ. Relationship between neck circumference and hypertension in the National Hypertension Registry (the RENATA study). Rev Argent Cardiol. 2012;80:275-279.

Ghali I, Salah N, Hussien F, Erfan M, El-Ruby M, Mazen I, Sabry M, Abd El-Razik M, Saad M, Hossney S, Ismaail and Abd El-Dayem S (2008). Egyptian growth curves for infants, children and adolescents. Published in: Crecerenelmondo. Satorio A, Buckler JMH and Marazzi N. Ferring Publisher, Italy, 2008.

Hiernaux J, Tanner JM. Growth and physical studies. In: Human Biology: guide to field methods. Eds. Weiner JS, Lourie SA. IBP. London, Blackwell Scientific Publications: Oxford. U.K., 1969.


Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoğlu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009;28(1):46–51.


Seidell JC, Kahn HS, Williamson DF, Lissner L, Valdez R. Report from a Centers for Disease Control and Prevention Workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr. 2001;73:123-6.


Diaconis P, Gupta S. (ed.). Group Representations in Probability and Statistics. IMS Lecture Notes - Monograph Series, 11 Institute of Mathematical Statistics, Hayward Ca., 1988.


Wang Y, Monteiro C, Popkin BM. Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China and Russia. Am J Clin Nutr. 2002;75:971-7.


Fredriks AM, van Buuren S, Fekkes M, Verloove-Vanhorick SP, Wit JM. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr. 2005;164:216-22.


Gillum RF. Distribution of waist-to-hip ratio, other indices of body fat distribution and obesity and associations with HDL cholesterol in children and young adults aged 4–19 years: the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord. 1999;23:556–563.


Owens S, Gutin B, Ferguson M, et al. Visceral adipose tissue and cardiovascular risk factors in obese children. J Pediatr. 1998;133:41–45.

LaBerge RC, Vaccani JP, Gow RM, Gaboury I, Hoey L, Katz SL. Inter- and intrarater reliability of neck circumference measurements in children. Pediatr Pulmonol. 2009;44:64–69.


Hatipoğlu N, Mazıcıoğlu MM, Kurtoğlu S, Kendirci M. Neck circumference: an additional tool of screening overweight and obesity in chilhood. Eur J Pediatr. 2010;169:733-739.


Nafiu OO, Burke C, Lee J, Voepel-Lewis T, Malviya S, Tremper KK. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics. 2010;126(2):e306–10.


Mazicioglu MM, Kurtoglu S, Ozturk A, Hatipoglu N, Cicek B, Ustunbas HB. Percentiles and mean values for neck circumference in Turkish children aged 6-18 years. Acta Paediatr. 2010;99(12):1847-53.


Hingorjo MR, Qureshi MA, Mehdi A. Neck circumference as a useful marker of obesity: A comparison with body mass index and waist circumference. J Pak Med Assoc (JPMA). 2012;62(1):36-40.


Hoda A. Atwa HA, Fiala LEM, Handoka NM. Neck Circumference as an Additional Tool for Detecting Children with High Body Mass Index. J Am Sci. 2012;8(10):442-446.

Coutinho CA, Longui CA, Monte O, Conde W, Kochi C. Measurement of neck circumference and its correlation with body composition in a sample of students in São Paulo, Brazil. Horm Res Paediatr. 2014;82(3):179-86.


Ferretti Rde L, Cintra Ide P, Passos MA, de Moraes Ferrari GL, Fisberg M. Elevated neck circumference and associated factors in adolescents. BMC Public Health. 2015;15:208.

PMid:25880196 PMCid:PMC4351829

Daniels SR., Khoury PR, Morrison JA. The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender. Pediatrics 1997;99(6): 804–807.

Kim Y, Lee JM, Laurson K, Bai Y, Gaesser GA, Welk GJ. Accuracy of Neck Circumference in Classifying Overweight and Obese US Children. ISRN Obes. 2014;2014: 781841.

Kuciene R, Dulskiene V, Medzioniene J. Association of neck circumference and high blood pressure in children and adolescents: a case–control study. BMC Pediatrics. 2015;15:127.

PMid:26383844 PMCid:PMC4574610



How to Cite

Hassan NE, Atef A, El-Masry SA, Ibrahim A, Abu Shady MM, Al-Tohamy M, Kamel IH, Ahmed Elashry GI. Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children. Open Access Maced J Med Sci [Internet]. 2015 Nov. 25 [cited 2022 Aug. 15];3(4):558-62. Available from:



A - Basic Science

Most read articles by the same author(s)

1 2 3 > >>