Objective: This report compares five methods of waist circumference (WC) measurements: 1) the National Heart, Lung, and Blood Institute (NHLBI-WC); 2) the World Health Organization (WHO-WC); 3) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Gulick II Plus tape; 4) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Lufkin tape; and 5) assisted self-measurement over clothes (MESA-assisted).

Method: During 2016, measurements were obtained from 2,297 participants aged 20 and over, who participated in the National Health and Nutrition Examination Survey (NHANES). The mean differences and sensitivity and specificity for abdominal obesity (AO) were calculated between the NHLBI-WC (reference) and the other four WC measurements.

Results: The mean difference between NHLBI-WC and WHO-WC was 0.81 cm for men and 3.21 cm for women ( p ≤ 0.0125 for both); between NHLBI-WC and MESA-WC (Gulick) was –0.68 cm for men ( p ≤ 0.0125) and –0.89 cm for women; between NHLBI-WC and MESA-WC (Lufkin) was 0.02 cm for men and 0.08 cm for women; and between NHLBI-WC and MESA-assisted was –0.71 cm for men and 1.34 cm for women ( p ≤ 0.0125 for both). Sensitivity and specificity for AO, with NHLBI-WC as a reference, for men were greater than 90% for all methods; for women, sensitivity and specificity for AO for MESA-WC (Lufkin) were greater than 90%; for women, WHO-WC, MESA- WC (Gulick), and MESA-assisted methods were greater than 85%.

Conclusion: Aside from the differences between NHLBI-WC and WHO-WC measurements among women, other differences between NHLBI and other protocols were less than or equal to 1.5 cm.

Suggested citation: Ostchega Y, Seu R, Sarafrazi Isfahani N, Zhang G, Hughes JP, Miller I. Waist circumference measurement methodology study: National Health and Nutrition Examination Survey, 2016. National Center for Health Statistics. Vital Health Stat 2(182). 2019.

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