Measuring waist circumference
Waist circumference is used to assess central fat distribution and degree of abdominal obesity.
Measurement is taken in centimeters using a standardized measurement technique.
Waist circumference measurement technique
Accurate measurement of waist circumference is achieved using the following technique:
- Locate the top of the hip bone (iliac crest) and take the measurement just above this bony landmark, just where one finger can fit between the iliac crest and the lowest rib.
- Ensure that the tape measure is positioned horizontally, parallel to the floor.
- Measuring at a level just above the iliac crest, and positioning the tape horizontally, irrespective of whether the umbilicus is above or below the tape, provides the correct waist circumference measurement and should correspond to the maximal abdominal diameter.
- Ensure that the patient is standing erect and has relaxed the abdominal muscles. Measurement is taken at the end of normal expiration.
- Aim to have a snug but not too tight a fit of the tape measure around your waist; do not make compressions in the skin with the tape measure.
- Accuracy can be improved by using a specially designed abdominal circumference tape measure. A constant-tension spring-loaded tape device reduces errors from over-enthusiastic tightening during measurement and improves accuracy and consistency of serial measurements.
It important to recognize when referring to waist circumference measurement, that this should not be considered to be the same as belt size in inches! Men in particular can have a relatively normal belt size, yet can have a significantly increased abdominal circumference above the belt-line.
When measuring waist circumference it is important not to be tempted to measure around the narrower part of the abdomen situated below the umbilicus. Using the anatomical landmark of the iliac crest and ensuring that measurement is taken on a horizontal plane just above this level provides the most accurate, reliable and reproducible technique for waist circumference measurement.
Waist circumference cut-off values
The table below provides waist circumference cut off values to determine those at risk according to sex and ethnicity1:
| Country/Ethnic Group | Male | Female |
|---|---|---|
| European (Europoid) | 94cm | 80cm |
| South Asians | 90cm | 80cm |
| Chinese | 90cm | 80cm |
| Japanese | 90cm | 80cm |
| Ethnic South & Central American | Use South Asian recommendations | Use South Asian recommendations |
| Sub-Saharan Africans | Use European data | Use European data |
| Eastern Mediterranean & Middle East (Arab) populations | Use European data | Use European data |
Screening at risk abdominally obese individuals and supporting attempts at moderate weight and waist reduction is a vitally important aspect of prevention and management of type 2 diabetes and reduction of cardiovascular risk.
References
1. International Diabetes Federation (IDF). www.idf.org