Neck circumference as a complementary measure for identifying excess body weight in children aged from 2 to 9 years

Santos, Daniela dos; Mastroeni, Silmara Salete de Barros Silva; Corrê, Cecilia Burigo; Mastroeni, Marco Fabio

doi:10.1590/1809-2950/e23002124en

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

ORIGINAL RESEARCH • Fisioter. Pesqui. 32 • 2025 • https://doi.org/10.1590/1809-2950/e23002124en linkcopy

Neck circumference as a complementary measure for identifying excess body weight in children aged from 2 to 9 years

Circunferencia del cuello como medida complementaria para estimar el sobrepeso en niños de 2 a 9 años

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Neck circumference (NC) indicates nutritional status and indirectly measures upper body subcutaneous fat, an independent predictor of cardiometabolic diseases. This study aims to analyze the accuracy of NC as a measure to assess excess body weight in children aged from two to nine years according to sex. Sampling included 435 children from the Predictors of Maternal and Infant Excess Body Weight Study, a birth cohort study carried out in Brazil in participants’ homes. Data were collected from January 2012 to October 2021. Participants were subjected to anthropometric assessments. Their demographic and socioeconomic data were obtained. A positive correlation (p<0.05) occurred between NC and weight, height, and body mass index in boys and girls in follow-ups. Except for the one-two-year age group (AUC=0.73; 95%CI 0.65–0.81 for boys and girls), the accuracy of NC in indicating excess body weight in boys and girls equaled 0.80 or higher (AUC: 0.80–0.95; 95%CI: 0.71–1.00). Our findings showed that NC can screen Brazilian children aged two-nine years for excess body weight. However, further studies involving larger sample sizes and other populations are necessary to complement the data in this study.

Keywords
Overweight; Neck; Child; Body Mass Index; Anthropometry

Characteristic	1 ^st Follow-up 2013-2014 (n = 315) Age 1 – 2 years			2 ^nd Follow-up 2016-2017 (n = 217) Age 4 – 5 years			3 ^rd Follow-up 2018 (n = 187) Age 6 – 7 years			4 ^th Follow-up 2021 (n = 144) Age 9 years
	Boys (n = 168)	Girls(n = 147)		Boys (n = 117)	Girls (n = 100)		Boys (n = 100)	Girls (n = 87)		Boys (n = 76)	Girls (n = 68)
	Median (IR)	Median (IR)	p*	Median (IR)	Median (IR)		Median (IR)	Median (IR)	p*	Median (IR)	Median (IR)	p*
Age (months)	16.0 (5.0)	15.0 (6.0)	0.612	54.0 (2.4)	55.2 (2.4)	0.208	77.8 (3.0)	78.0 (2.3)	0.511	113.3 (1.4)	113.7 (1.8)	0.121
Weight (kg)	11.1 (2.1)	10.5 (2.5) ^b	<0.001	17.9 (3.8)	17.3 (3.4)	0.143	22.3 (4.8)	21.9 (4.2) ^f	0.304	32.8 (14.6)	32.8 (12.3)	0.574
Height (cm)	80.1 (6.1)	79.0 (6.3) ^b	0.005	106.0 (7.5)	105.0 (5.6)	0.113	119.8 (6.8)	118.3 (5.5) ^f	0.048	136.1 (8.5)	136.9 (8.9)	0.534
BMI (kg/m2)	17.4 (2.5)	16.7 (2.4) ^b	0.005	15.9 (1.9)	15.8 (2.3)	0.617	16.0 (2.3)	15.7 (2.3) ^f	0.551	17.5 (6.0)	18.1 (4.5)	0.323
NC (cm)	24.3 (2.0) ^a	23.5 (1.7) ^c	<0.001	25.5 (2.0)	25.0 (1.5) ^d	<0.001	26.5 (2.1) ^e	25.5 (1.7) ^f	<0.001	28.8 (3.5)	27.6 (2.7)	<0.001
	n (%)	n (%)b	p**	n (%)	n (%)	p**	n (%)	n (%)f	p**	n (%)	n (%)	p**
Nutritional status (percentile)			0.238			0.597			0.707			0.035
≤85th	94 (56.0)	88 (60.3)		78 (66.7)	73 (73.0)		71 (71.0)	66 (77.6)		51 (67.1)	54 (79.4)
>85th - <97th	31 (18.4)	32 (21.9)		27 (23.1)	19 (19.0)		17 (17.0)	13 (15.3)		6 (7.9)	8 (11.8)
≥97th	43 (25.6)	26 (17.8)		12 (10.2)	8 (8.0)		12 (12.0)	6 (7.1)		19 (25.0)	6 (8.8)

Characteristic	first folow-up 2013-2014 (n=315) Age 1 – 2 years		second follow-up 2016-2017 (n=217) Age 4 – 5 years		third follow-up 2018 (n=187) Age 6 – 7 years		fourth follow-up 2021 (n=144) Age 9 years
	rho	p	rho	p	rho	p	rho	p
	Boys
Age (months)	0.074	0.348	-0.019	0.839	−0.003	0.975	−0.021	0.856
Weight (kg)	0.433	<0.001	0.739	<0.001	0.775	<0.001	0.888	<0.001
Height (cm)	0.166	0.033	0.472	<0.001	0.599	<0.001	0.610	<0.001
BMI (kg/m ² )	0.460	<0.001	0.658	<0.001	0.674	<0.001	0.832	<0.001
Girls
Age (months)	0.135	0.105	−0.059	0.561	−0.074	0.500	0.193	0.115
Weight (kg)	0.529	<0.001	0.554	<0.001	0.709	<0.001	0.858	<0.001
Height (cm)	0.319	<0.001	0.330	<0.001	0.539	<0.001	0.667	<0.001
BMI (kg/m ² )	0.431	<0.001	0.511	<0.001	0.628	<0.001	0.808	<0.001

Age (years)	n	AUC (95% CI)	p	Cut-off (cm)	Sensitivity (%)	Specificity (%)	Youden index	PPV	NPV	LR+	LR-
Males
1-2	165 ^a	0.73 (0.65-0.80)	<0.01	23.9	80.6	53.8	0.34	57.4	78.1	1.74	0.36
3-4	117	0.84 (0.77-0.91)	<0.01	25.6	74.4	70.5	0.45	55.8	84.6	2.52	0.36
6-7	98 ^b	0.89 (0.80-0.97)	<0.01	26.9	85.7	78.6	0.64	61.5	93.2	4.00	0.18
9	76	0.95 (0.88-1.00)	<0.01	29.6	92.0	84.3	0.76	74.2	95.6	5.86	0.09
Females
1-2	145 ^c	0.73 (0.65-0.81)	<0.01	23.2	81.0	49.4	0.30	50.5	78.8	1.60	0.38
3-4	99 ^d	0.80 (0.71-0.89)	<0.01	24.8	85.2	54.2	0.39	41.1	90.7	1.86	0.27
6-7	85 ^e	0.91 (0.84-0.99)	<0.01	25.9	90.0	84.8	0.75	64.3	96.6	5.92	0.11
9	68	0.94 (0.87-1.00)	<0.01	28.9	85.7	85.2	0.70	54.5	95.6	5.79	0.17

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Universidade de São Paulo Rua Ovídio Pires de Campos, 225 2° andar. , 05403-010 São Paulo SP / Brasil, Tel: 55 11 2661-7703, Fax 55 11 3743-7462 - São Paulo - SP - Brazil
E-mail: revfisio@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[1] *Mann-Whitney U test; **X² test. IR: interquartile range; BMI: body mass index; NC: neck circumference.

[2] ^an = 165: data missing for three children whose NC could not be measured.

[3] ^bn = 146: data missing for one child who was not at home on the day of data collection.

[4] ^cn = 145: data missing for one child who was not at home on the day of data collection and another whose NC could not be measured.

[5] ^cn = 145: data missing for one child who was not at home on the day of data collection and another whose NC could not be measured.

[6] ^cn = 145: data missing for one child who was not at home on the day of data collection and another whose NC could not be measured.

[7] ^en = 98: data missing for two children whose NC could not be measured.

[8] ^fn = 85: data missing for two children who were not at home on the day of data collection.