Open Access Research article

Creation of a reference dataset of neck sizes in children: standardizing a potential new tool for prediction of obesity-associated diseases?

Sherri L Katz12*, Jean-Philippe Vaccani23, Janine Clarke4, Lynda Hoey5, Rachel C Colley25 and Nicholas J Barrowman25

Author Affiliations

1 Children’s Hospital of Eastern Ontario, Department of Pediatrics, Division of Respirology, 401 Smyth Road, Room W1444, Ottawa, Ontario K1H 8 L1, Canada

2 University of Ottawa, Faculty of Medicine, Ottawa, Canada

3 Children’s Hospital of Eastern Ontario, Department of Surgery, Division of Otolaryngology, Ottawa, Canada

4 Statistics Canada, Health Statistics Division, Ottawa, Canada

5 Children’s Hospital of Eastern Ontario Research Institute, Clinical Research Unit Ottawa, Ottawa, Canada

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BMC Pediatrics 2014, 14:159  doi:10.1186/1471-2431-14-159

Published: 21 June 2014



Neck circumference (NC), is an emerging marker of obesity and associated disease risk, but is challenging to use as a screening tool in children, as age and sex standardized cutoffs have not been determined. A population-based sample of NC in Canadian children was collected, and age- and sex-specific reference curves for NC were developed.


NC, waist circumference (WC), weight and height were measured on participants aged 6–17 years in cycle 2 of the Canadian Health Measures Survey. Quantile regression of NC versus age in males and females was used to obtain NC percentiles. Linear regression was used to examine association between NC, body mass index (BMI) and WC. NC was compared in healthy weight (BMI < 85th percentile) and overweight/obese (BMI > 85th percentile) subjects.


The sample included 936 females and 977 males. For all age and sex groups, NC was larger in overweight/obese children (p < 0.0001). For each additional unit of BMI, average NC in males was 0.49 cm higher and in females, 0.43 cm higher. For each additional cm of WC, average NC in males was 0.18 cm higher and in females, 0.17 cm higher.


This study presents the first reference data on Canadian children’s NC. The reference curves may have future clinical applicability in identifying children at risk of central obesity-associated conditions and thresholds associated with disease risk.

Epidemiology; Sleep medicine; Neck circumference; Anthropometric measures; Obesity