Measurement error of waist circumference: gaps in knowledge
Open accessAbstract
Objective: It is not clear whether measuring waist circumference in clinical practice is problematic because the measurement error is unclear, as well as what constitutes a clinically relevant change. The present study aimed to summarize what is known from state-of-the-art research. Design: To identify the magnitude of the measurement error of waist circumference measurements from the literature, a search was conducted in PubMed from 1975 to February 2011. Results: The measurement error may vary between 0·7 cm and 15 cm. Taking a realistic range of measurable waist circumference into account (60–135 cm), we argue that a short-term clinically relevant change in waist circumference of 5 % may lie between 3·0 and 6·8 cm and a maintained clinically relevant change of 3 % between 1·8 and 4·1 cm. Conclusions: Based on these results, we conclude it may be difficult to distinguish clinically relevant change from measurement error in individual subjects, due to the large measurement error and unclear definition of clinically relevant change. More research is needed to address these gaps in knowledge. To minimize measurement error, we recommend using a uniform measurement protocol, training and repeated measurements.
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Despite statistical significance, the exercise-induced waist circumference changes may be of unclear clinical relevance, since the observed average reduction from baseline was 2.8% (95% CI 1.31 to 4.24), which is less than the suggested 3-5% reduction considered clinically significant.
“However, despite statistical significance, the exercise-induced WC changes may be of unclear clinical relevance, since the observed average reduction from baseline was 2.8% (95% CI 1.31 to 4.24), which is less than the suggested 3–5% reduction considered as clinically significant [151].”
From Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis (2019) · cites this paper as [151]
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Cites
Health Measurement Scales: A Practical Guide to Their Development and Use
Streiner, D. L., Norman, G. R., & Cairney, J. (1989) · Cited by 9,595 · see citing works
The metabolic syndrome—a new worldwide definition
Alberti, K. G. M., Zimmet, P., & Shaw, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67402-8 · Cited by 9,352 · see citing works
The metabolic phenotype in obesity: Fat mass, body fat distribution, and adipose tissue function
Goossens, G. H. (2017) · Obesity Facts · doi:10.1159/000471488 · Cited by 8,481 · see citing works
Physical Status: The Use and Interpretation of Anthropometry
Frisancho, A. R. (1996) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.5.830 · Cited by 6,569 · see citing works
Yusuf, S., Hawken, S., Ôunpuu, S., Bautista, L., Franzosi, M. G., Commerford, P., Lang, C. C., Rumboldt, Z., Onen, C. L., Lisheng, L., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67663-5 · Cited by 2,903 · see citing works
Streiner, D. L., & Norman, G. R. (2008) · doi:10.1093/acprof:oso/9780199231881.001.0001 · Cited by 2,631 · see citing works
Terwee, C. B., Mokkink, L. B., Knol, D. L., Ostelo, R. W. J. G., Bouter, L. M., & de Vet, H. C. W. (2012) · Quality of Life Research · doi:10.1007/s11136-011-9960-1 · Cited by 1,978 · see citing works
Self-citationWaist circumference as a measure for indicating need for weight management
Lean, M. E. J., Han, T. S., & Morrison, C. E. (1995) · BMJ · doi:10.1136/bmj.311.6998.158 · Cited by 1,869 · see citing works
When to use agreement versus reliability measures
de Vet, H. C. W., Terwee, C. B., Knol, D. L., & Bouter, L. M. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.10.015 · Cited by 1,801 · see citing works
Self-citationAnthropometric measurement error and the assessment of nutritional status
Ulijaszek, S. J., & Kerr, D. A. (1999) · British Journal Of Nutrition · doi:10.1017/s0007114599001348 · Cited by 1,159 · see citing works
Stevens, V. J., Obarzanek, E., Cook, N. R., Lee, I.-M., Appel, L. J., Smith West, D., Milas, N. C., Mattfeldt-Beman, M., Belden, L., Bragg, C., et al. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-1-200101020-00007 · Cited by 886 · see citing works
Terwee, C. B., Jansma, E. P., Riphagen, I. I., & de Vet, H. C. W. (2009) · Quality of Life Research · doi:10.1007/s11136-009-9528-5 · Cited by 849 · see citing works
Self-citationThe definition of weight maintenance
Stevens, J., Truesdale, K. P., McClain, J. E., & Cai, J. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803175 · Cited by 462 · see citing works
Predicting body composition by densitometry from simple anthropometric measurements
Lean, M., Han, T. S., & Deurenberg, P. (1996) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/63.1.4 · Cited by 362 · see citing works
Ross, R., Berentzen, T. L., Bradshaw, A. J., Janssen, I., Kahn, H. S., Katzmarzyk, P. T., Kuk, J. L., Seidell, J. C., Snijder, M. B., Sørensen, T. I. A., et al. (2007) · Obesity Reviews · doi:10.1111/j.1467-789x.2007.00411.x · Cited by 353 · see citing works
Misra, A., Wasir, J., & Vikram, N. (2005) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2005.01.007 · Cited by 309 · see citing works
Coronary Heart Disease: Reducing the Risk
Assmann, G., Cullen, P., Jossa, F., Lewis, B., & Mancini, M. (1999) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.19.8.1819 · Cited by 228 · see citing works
Moreno, L. A., Joyanes, M., Mesana, M. I., González‐Gross, M., Gil, C. M., Sarría‐Santamera, A., Gutiérrez, Á., Garaulet, M., Pérez-Prieto, R., Sánchez, M. B., et al. (2003) · Nutrition · doi:10.1016/s0899-9007(03)00040-6 · Cited by 205 · see citing works
Bosy‐Westphal, A., Booke, C.-A., Blöcker, T., Kossel, E., Goele, K., Later, W., Hitze, B., Heller, M., Glüer, C., & Müller, M. J. (2010) · Journal of Nutrition · doi:10.3945/jn.109.118737 · Cited by 201 · see citing works
Linking measurement error to minimal important change of patient-reported outcomes
Terwee, C. B., Roorda, L. D., Knol, D. L., de Boer, M. R., & de Vet, H. C. W. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2008.10.011 · Cited by 190 · see citing works
Self-citationVariability in Waist Circumference Measurements According to Anatomic Measurement Site
Mason, C. E., & Katzmarzyk, P. T. (2009) · Obesity · doi:10.1038/oby.2009.87 · Cited by 170 · see citing works
Three ways to quantify uncertainty in individually applied “minimally important change” values
de Vet, H. C. W., Terluin, B., Knol, D. L., Roorda, L. D., Mokkink, L. B., Ostelo, R., Hendriks, E., Bouter, L. M., & Terwee, C. B. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.03.011 · Cited by 148 · see citing works
Self-citationCardona-Morrell, M., Rychetnik, L., Morrell, S. L., Espinel, P. T., & Bauman, A. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-653 · Cited by 147 · see citing works
Nordhamn, K., Södergren, E., Olsson, E., Karlström, B., Vessby, B., & Berglund, L. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801216 · Cited by 131 · see citing works
Reliability of doctors' anthropometric measurements to detect obesity
Sebo, P., Beer-Borst, S., Haller, D. M., & Bovier, P. A. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.06.012 · Cited by 108 · see citing works
Smith, S. C., & Haslam, D. B. (2006) · Current Medical Research and Opinion · doi:10.1185/030079906x159489 · Cited by 98 · see citing works
Agarwal, S. K., Misra, A., Aggarwal, P., Bardia, A., Goel, R., Vikram, N. K., Wasir, J. S., Hussain, N., Ramachandran, K., & Pandey, R. M. (2009) · Obesity · doi:10.1038/oby.2008.635 · Cited by 75 · see citing works
Geeta, A., Jamaiyah, H., Safiza, M. N. N., Khor, G. L., Kee, C. C., Ahmad, A., Suzana, S., Rahmah, R., & Faudzi, A. Y. (2009) · PubMed · Cited by 74 · see citing works
Obesity in Asia Collaboration (2007) · Diabetes Care · doi:10.2337/dc07-1455 · Cited by 69 · see citing works
Wang, J. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.5.902 · Cited by 69 · see citing works
Changes in Waist Circumference and Mortality in Middle-Aged Men and Women
Berentzen, T. L., Jakobsen, M. U., Halkjær, J., Tjønneland, A. M., Overvad, K., & Sørensen, T. I. A. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013097 · Cited by 68 · see citing works
the ATARAO group, Sicotte, M., Ledoux, M., et al. (2010) · BMC Medical Research Methodology · doi:10.1186/1471-2288-10-102 · Cited by 67 · see citing works
Nguyen, T. T., Adair, L. S., Stevens, J., & Popkin, B. M. (2009) · Public Health Nutrition · doi:10.1017/s1368980009991479 · Cited by 56 · see citing works
Panoulas, V. F., Ahmad, N., Fazal, A. A., Kassamali, R., Nightingale, P., Kitas, G. D., & Labib, M. Z. (2008) · Postgraduate Medical Journal · doi:10.1136/pgmj.2008.068825 · Cited by 49 · see citing works
Measurement error and ethnic comparisons of measures of abdominal obesity
Dhaliwal, S. S., & Welborn, T. A. (2009) · Preventive Medicine · doi:10.1016/j.ypmed.2009.06.023 · Cited by 45 · see citing works
Park, J. Y., Mitrou, P., Keogh, R. H., Luben, R., Nj, W., & Khaw, K. (2010) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2010.259 · Cited by 44 · see citing works
Association of physicians’ accuracy in recording with quality of care in cardiovascular medicine
Giorda, C. B., Guida, P., Avogaro, A., Cortese, C., Mureddu, G. F., Corsini, A., Comaschi, M., Manzato, E., Volpe, M., Zito, G., et al. (2009) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e3283317c3f · Cited by 25 · see citing works
Waist-to-hip ratios in Australia: a different picture of obesity
Boyle, C. A., Dobson, A., Egger, G., & Bennett, S. (1993) · Australian journal of nutrition and dietetics · Cited by 22 · see citing works
Voruganti, V. S., Cai, G., Klohe-Lehman, D. M., Jordan, K. C., Lane, M. A., & FREELAND-GRAVES, J. H. (2010) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2010.05.001 · Cited by 20 · see citing works
Verweij, L. M., Proper, K. I., Hulshof, C. T. J., & van Mechelen, W. (2011) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e318222af9b · Cited by 18 · see citing works
Self-citationPająk, A., Szafraniec, K., Janion, M., et al. (2010) · PubMed · Cited by 17 · see citing works
Wang, C., Liu, M.-H., & Chen, Y. (2010) · Perceptual and Motor Skills · doi:10.2466/pms.110.c.1053-1058 · Cited by 13 · see citing works
Alexander, H. G., & Dugdale, A. E. (1990) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1990.tb136975.x · Cited by 13 · see citing works
Low functional status as a predictor of incidence of emotional disorders in the general population
Barbaglia, G., ten Have, M., van Dorsselaer, S., Alonso, J., Vilagut, G., & de Graaf, R. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0803-8 · Cited by 7 · see citing works
WANG, C.-Y., LIU, M.-H., & Chen, Y. (2010) · Perceptual and Motor Skills · doi:10.2466/pms.110.3c.1053-1058 · Cited by 7 · see citing works
Should waist circumference be used to identify metabolic disorders than BMI in South Korea?
Lee, S.-K. (2010) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2010.175 · Cited by 6 · see citing works
Evolution of the human life cycle
Bogin, B., & Smith, B. H. (1996) · American Journal of Human Biology · doi:10.1002/(sici)1520-6300(1996)8:6
Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7
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- Authors
- Verweij, L. M., Terwee, C. B., Proper, K. I., Hulshof, C. T., & van Mechelen, W.
- Affiliations
- Amsterdam Public Health (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Proper, Karin I
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-05-25
- Volume
- 16
- Issue
- 2
- Pages
- 281-288
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC10271771
- OpenAlex
- W2102693640
- Cited by
- 169
- References
- 48
- Citations by year
- 2026: 22 · 2025: 22 · 2024: 19 · 2023: 19 · 2022: 12 · 2021: 9 · 2020: 12 · 2019: 13 · 2018: 7 · 2017: 13 · 2016: 9 · 2015: 3 · 2014: 4 · 2013: 5
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Funders
- ZonMw (120510007)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- waist circumference, measurement error, anthropometry, measurement protocol, abdominal obesity, body composition assessment
- MeSH terms
- Anthropometry, Diagnostic Errors, Humans, Waist Circumference, Obesity, Abdominal
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