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

For additional information, see

Sharma et al, Pediatr Res 2015
Creating .csv spreadsheets

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
AAP 2017 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

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 that "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.

A spreadsheet with comma separated variables (.csv) can be created using the 'Save As' .csv option in Excel and uploaded using the sidebar on the left. Column names must be as shown in the sample .csv file below, but column order is immaterial and additional columns are simply ignored. The variable agemons is age in months; height is in cm; and waist is in cm.

You can of course use date variables to calculate agemons in your spreadsheet. Excel typically returns the differences between two dates in days, and I use the recommended WHO conversion of 30.4375 days per month. If you need assistance, please see our illustrated guide: Creating .csv spreadsheets


Once you've uploaded a dataset and selected your plot options, you must click the Plot Now button on the sidebar to render your plot. If you have not yet uploaded a .csv file, the sample data will be displayed by the plot buttons. If you need to calculate Z scores using the who2007 macro for R , your spreadsheet can also be uploaded to the Z-score calculators listed in the sidebar. The low resolution thumbnail images are rendered at 72 dpi. Right-click (control-click) to copy or save them. To download hi-resolution images for presentation or publication, just click the download button