Measuring waist circumference

Based on EHES Manual, Part B. Fieldwork Procedures, 2nd edition (2016) Available at: http://urn.fi/URN:ISBN:978-952-302-701-5 These slides be used freely, translated and adapted to national use (e.g. concerning the equipment). However, it is important to keep in mind that no changes should be made to the measurement techniques, which need to be standardized.

Equipment Non-elastic measurement tapes (200 cm and 250 cm) Full body mirror, if feasible

Quality assurance: Checking Daily: Check the condition of the measurement tape visually; if there are cracks or the tape is torn, it should be replaced Monthly: Check the length of the measurement tape by using calibrated length rods; if the measuring tape is stretched, it should be replaced Record the results of checking in the survey log book

Motivate participant Explain why waist circumference is measured Previous measurements may be inaccurate and not comparable to the results from other participants Waist circumference is likely to vary even daily Waist circumference is an indicator of abdominal obesity

Exclusion criteria Waist circumference is not measured, if participant is immobile or in a wheelchair and has severe difficulties in standing straight has problems in the waist area, for example a hernia, stoma bag or recent abdominal surgery, which prevent the proper measurement is pregnant (over 20 weeks) refuses

Clothing The measurement is done on bare skin Ask the participant to reveal the waist, by loosing the belt, lowering the pants/skirt and lifting the shirt If the participant refuses or feels uncomfortable to undress, waist circumference can be measured over light tightly fitting clothing

Posture Ask the participant to stand straight a small gap between the legs weight evenly balanced on both legs arms hanging loosely beside the body

Identify correct measurement place Palpate the waist in order to find the midway between the lower rib margin and the iliac rest If necessary and feasible, mark the place with cosmetic pencil

Check horizontal position of the measuring tape Hold the tape firmly Ask the participant to turn over Move around the participant or Check from the mirror (if available)

Waist measurement Check that the measuring tape is not too tight or too loose You should be able to place one finger between the tape and the participant’s body Ask the participant to breathe normally Read the waist circumference at the end of a light exhale

Our bodies are different It isn’t always easy to find the right measurement place Palpate and check the right place carefully If needed, place the tape over lumpy, flabby areas

Record Measurement to the nearest millimetre If the measurement was done over clothing Pregnancy weeks, if necessary Reasons, if not measured Only measured values, self reported values are not acceptable

Acknowledgements Slides prepared by: Johanna Mäki-Opas, Annamari Lundqvist, Hanna Tolonen, Päivikki Koponen Photographs: Hanna Tolonen Measurement demonstrations by Ulla Leskinen, Liisa Saarikoski and voluntary participants Experiences and feedback from the EHES network have been utilized in the preparation of these slides Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in 2009-2012 through SANCO/2008/C2/02-SI2.538318 EHES and Grand Agreement number 2009-23-01, and in 2015-2017 through Grand Agreement number 664691/BRIDGE Health

Disclaimer The views expressed here are those of the authors and they do not represent the Commission’s official position.