Plotter: Waist circumference charts, NHANES III 5-19 years

Direct data entry version

For additional information, see

Sharma et al, Pediatr Res 2015

Plot Options


CPEG Shiny Apps:

Z Calculators (Zapps™)
WHO igrowup Z-scores 0-5y
WHO 2007 Z-scores 5-19y
WHO Z-scores 0-19y
CDC Z-scores 0-20y
NHANES III Waist Z 5-19y
NIH/NHLBI BP Z-scores 2-18y
Preterm Z-scores 22-50 weeks
Plotters for spreadsheet data
Growth chart plotter 2-19y
Growth chart plotter 0-2y
Waist circumference charts 5-19y
Preterm charts, 22-50 weeks
Plotters for direct data entry
Growth chart plotter 2-19y
Growth chart plotter 0-2y
Waist circumference charts 5-19y
Preterm charts, 22-50 weeks

For questions or comments, contact us

Atul Sharma
Dan L. Metzger

This page is running on a Shiny server that allows the statistical package R to plot growth on the CPEG-GCEP 2015 Waist Circumference Growth Charts based on data from NHANES III. For additional details, see our published description in Pediatic Research, 2015 This Shiny application is designed for direct data entry rather than uploaded .csv files. Once you enter your data here, you can download the .csv file for use with the other plotters and Z-score calculators in the sidebar.

Please note that waist circumference is measured at the level of the iliac crest in the mid-axillary line following the so-called 'NIH' protocol. In a Canadian context, Jennifer Patry-Parisien and colleagues (2012) at Statistics Canada published a formal comparison of alternate measurement protocols and noted, based on recommendations from an expert panel, the Canadian clinical practice guidelines on the management and prevention of obesity in adults and children suggested that practitioners use the National Institutes of Health (NIH) method to measure WC. Two years later, the Canadian Society for Exercise Physiology (CSEP) adopted the NIH method as part of the measurement protocols in the Canadian Physical Activity and Fitness Lifestyle Approach.

Although many investigators use a simple threshold (e.g. 0.5-0.6) for waist:height ratio in adults, it should be clear from the charts below that normal values in children vary by age and sex. For this reason, we recommend the use of growth charts, z-scores, or percentiles for comparing waist:height ratios in this age group.

Enter Data

Dates must be entered using the format yyyy-mm-dd and are stored as days since Jan 1, 1970. To calculate age in months, we use the WHO recommended conversion of 30.4375 days per month. Height is in cm and Waist circumference is in cm.

After entering your selections, click Add Data to add the new data point to your dataset. The full dataset will be updated and displayed below. When ready, click Plot Now to plot the dataset.


Saved Dataset

This will remain blank until at least one data point is added by clicking Add Data .

Growth Charts

Once a dataset has been created, click Plot Now to render the charts. The sidebar provides plot options and a choice of charts.



Once you're happy with your data and plot options, click on the appropriate Download button to download hi-resolution graphics for publication or presentation. You may also download a .csv spreadsheet with the dataset you entered for use with our .csv plotters or Z score calculators Zapps™. Although age in months (agemons) is the actual variable of interest for these applications, I include the dates of birth (DOB) and visit (DOV) in the format '2000-12-30'; however, depending on your local setup, I can't guarantee that Excel will display them in this format.