Evaluating CMR

Clinical Tools

Waist Circumference

Measuring Waist Circumference—Health Care Professionals

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Measure waist circumference with the measuring tape directly on the individual’s skin (Figure 1). Ask the individual to loosen and/or remove any restrictive garments or clothing that would interfere with the measure. The individual should be relaxed with their arms crossed on their chest and their feet shoulder-width apart. To ensure proper landmarking, mark the measurement site (i.e., iliac crest) on the right side of the individual’s body with a horizontal line after determining the correct location. The International Chair on Cardiometabolic Risk recommends that you palpate the iliac crest firmly with your hands and place the landmark at the uppermost border of the iliac crest. The bottom edge of the tape measure should be placed directly level with the landmark. Ensure the tape is horizontal to the floor, is snug without indenting the individual’s skin, and is not twisted or caught on clothing. Measure the waist at the end of a normal expiration to the nearest 0.1 cm.

The literature suggests that waist circumference measures are highly repeatable and that measures between trained technicians are very comparable (14, 15). Proper training helps to position the measurement tape properly and apply constant tension, which ensures an accurate assessment of waist circumference. The use of spring-loaded measurement tapes (Figure 2) can improve accuracy by ensuring that constant tension is applied to the tape while waist circumference is being measured.


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14. Klipstein-Grobusch K, Georg T and Boeing H. Interviewer variability in anthropometric measurements and estimates of body composition. Int J Epidemiol 1997; 26 Suppl 1: S174-80.
15. Ferrario M, Carpenter MA and Chambless LE. Reliability of body fat distribution measurements. The ARIC Study baseline cohort results. Atherosclerosis Risk in Communities Study. Int J Obes Relat Metab Disord 1995; 19: 449-57.