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Lassale, CAuthor

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August 1, 2025
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Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Publicated to: Nutrients. 14 (2): 234- - 2022-01-01 14(2), DOI: 10.3390/nu14020234

Authors:

Bibiloni, MD; Gallardo-Alfaro, L; Bouzas, C; Tur, JA; Waernberg, J; Gonzalez-Gross, M; Serra-Majem, L; Gomez, SF; Homs, C; Benavente-Marin, JC; Oses-Recalde, M; Labayen, I; Zapico, AG; Gusi, N; Sanchez-Gomez, J; Aznar, S; Jimenez-Zazo, F; Marin-Cascales, E; Alcaraz, PE; Gonzalez-Valeiro, M; Sevilla-Sanchez, M; Herrera-Ramos, E; Terrados, N; Pulgar, S; Segu, M; Sistac, C; Lassale, C; Schroder, H
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Affiliations

Ctr Hosp Univ Insular Materno Infantil CHUIMI, Prevent Med Serv, Canarian Hlth Serv - Author
Hosp Mar Inst Med Res, Cardiovasc Risk & Nutr Res Grp - Author
Inst Hlth Carlos III, Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr - Author
Municipal Sports Fdn Aviles, Reg Unit Sports Med Principado Asturias - Author
Probitas Fdn - Author
Ramon Llull Univ, Blanquerna Fac Hlth Sci, Global Res Wellbeing GRoW - Author
San Antonio Catholic Univ Murcia, Fac Sport Sci - Author
Univ A Coruna, Fac Sports Sci & Phys Educ - Author
Univ Castilla La Mancha, PAFS Res Grp, Fac Sports Sci, La Mancha Toledo Campus - Author
Univ Complutense Madrid, Dept Didact Language Arts & Phys Educ - Author
Univ Extremadura, Phys Act & Qual Life Res Grp AFYCAV, Fac Sport Sci - Author
Univ Las Palmas Gran Canaria, Res Inst Biomed & Hlth Sci IUIBS - Author
Univ Lleida, GREpS, Hlth Educ Res Grp, Nursing & Physiotherapy Dept - Author
Univ Malaga, Epi Phaan Res Grp, Inst Biomed Res Malaga IBIMA - Author
Univ Politecn Madrid, Dept Hlth & Human Performance, ImFINE Res Grp - Author
Univ Publ Navarra, ELIKOS Grp, Inst Innovat & Sustainable Dev Food Chain IS FOOD, Dept Hlth Sci - Author
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Abstract

Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% 'increased risk', 9.7% 'high risk', 14.3% 'very high risk'). Participants in the 'very high risk' group were less likely to be females (odds ratio 0.63; 95% CI: 0.52-0.76) and adolescents (0.60; 95% CI: 0.49-0.72), to practice >= 60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57-0.93), and to watch = 60 min/day of MVPA and showed lower adherence to the Mediterranean diet. Conclusions: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring's childhood and adolescence, is associated with low BMI-WHtR disease risk.
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Keywords

Abdominal obesityAdolescentAdolescentsAnthropometryArticleBody massBody weightCaregiverCentral adiposityChildChildrenControlled studyCorrelation analysisCross-sectional studyDiet qualityEducational statusFemaleHealth statusHigh risk populationHumanLifestyleMajor clinical studyMaleMediterranean dietMetabolic riskMotherMulticenter studyObservational studyOdds ratioOverweightPasosPatient compliancePhysical activityPhysical inactivityPrevalenceProgenyQuestionnaireRisk assessmentSchool childSedentary lifestyleSexSpaniardValidityWaist to height ratioWeight

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrients due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 17/88, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-03:

  • WoS: 5
  • Scopus: 8
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-03:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 122.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 122 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 11.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 6 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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