Reliability and criterion validity of self-measured waist, hip, and neck circumferences

Abstract

BackgroundWaist, hip, and neck circumference measurements are cost-effective, non-invasive, useful markers for body fat distribution and disease risk. For epidemiology and intervention studies, including body circumference measurements in self-report surveys could be informative. However, few studies have assessed the test-retest reliability and criterion validity of a self-report tool feasible for use in large scale studies.MethodsAt home, mothers of young children viewed a brief, online instructional video on how to measure their waist, hip, and neck circumferences. Afterwards, they created a homemade paper measuring tape from a downloaded file with scissors and tape, took all measurements in duplicate, and entered them into an online survey. A few weeks later, participants visited an anthropometrics lab where they measured themselves again, and trained technicians (n = 9) measured participants in duplicate using standard equipment and procedures. To assess differences between self- and technician-measured circumferences, duplicate measurements for participant home self-measurements, participant lab self-measurements, and technician measurements each were averaged and Wilcoxon signed-rank tests conducted. Agreement between all possible pairs of measurements were examined using Intraclass Correlations (ICCs) and Bland-Altman plots.ResultsParticipants (n = 41; aged 38.05 ± 3.54SD years; 71 % white) were all mothers that had at least one child under the age of 12 yrs. Technical error of measurements for self- and technician- duplicate measurements varied little (0.08 to 0.76 inches) and had very high reliability (≥0.90). Intraclass Correlations (ICC) comparing self vs technician were high (0.97, 0.96, and 0.84 for waist, hip, and neck). Comparison of self-measurements at home vs lab revealed high test-retest reliability (ICC ≥ 0.87). Differences between participant self- and technician measurements were small (i.e., mean difference ranged from −0.13 to 0.06 inches) with nearly all (≥93 %) differences within Bland-Altman limits of agreement and <10 % exceeding the a priori clinically meaningful difference criterion.ConclusionsThis study has demonstrated a simple, inexpensive method for teaching novice mothers of young children to take their own body circumferences resulting in accurate, reliable data. Thus, collecting self-measured and self-reported circumference data in future studies may be a feasible approach in research protocols that has potential to expand our knowledge of body composition beyond that provided by self-reported body mass indexes.

Arm Circumference-to-Height Ratio as a Situational Alternative to BMI Percentile in Assessing Obesity and Cardiometabolic Risk in Adolescents

“…In contrast, many other measures of total adiposity, such as dual-energy x-ray absorptiometry, are more difficult than BMI to obtain in ordinary survey and clinical settings, and most importantly, in homes, precluding self-monitoring. Further, measuring central obesity using waist circumference per guidelines by minimizing the effects of clothing, respiration, and stomach content and palpating iliac crest and costal margin accurately may prove difficult [ 39 ]. It may also raise ethical and cultural concerns due to intrusiveness, especially in the context of surveillance programs.…”

Abdominal and gluteofemoral size and risk of liver cancer: The liver cancer pooling project

“…Participants who self‐measured were provided specific instructions, which usually included a measuring tape and an illustration demonstrating exactly where on the body to measure. Prior studies have reported self‐measured waist and hip circumference to be accurate and reproducible . To examine possible effect modification by measurement method in the current analysis, results were stratified by method.…”

Self-Reported vs. Measured Height, Weight, and BMI in Young Adults

“…Body Mass Index (BMI) is a widely used measurement to examine weight status of the average population as it is an accessible and cost-effective tool, only requiring height and weight measurements in order to identify individuals as underweight, normal weight, overweight, obese, and severely obese [ 9 ]. Additional anthropometric measurements such as waist, hip, and neck circumferences are also used to assist with assessing overall weight and body fat distribution [ 10 ]. Various types of physical measurements (i.e., height, weight, BMI, waist circumference) are often self-reported for convenience, particularly in large sample studies, or in dissemination and implementation research where researchers are unable to visit participants to take measurements.…”