Protocol - Hip Circumference - Hip Circumference

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Measurement of the hip girth at the level of the maximum protrusion of the buttocks.

Specific Instructions

The following protocol was taken from the Third National Health and Nutrition Examination Survey (NHANES III).The measurement is recorded to the nearest 0.1 cm.

The Expert Review Panel (ERP) recommends that researchers view the NHANES III video for anthropometric measures. The video includes a measure called Buttocks Circumference that is also hip circumference: http://www.cdc.gov/nchs/video/nhanes3_anthropometry/circumference/circumference.htm.

Notes from ERP:

The notion of recommending replicate measurements comes from the reduction in random errors of measurement and accompanying improved measurement reliability when the mean of multiple measurements is used rather than a single measurement. This improvement in measurement reliability, however, depends on the reliability of a single measurement in the hands of the data collectors in a particular study (Himes, 1989). For example, if a measure like recumbent length in a given study has a measurement reliability of 0.95 (expressed as an intraclass correlation coefficient), taking a second measurement and using the mean of the two in analyses will only improve the reliability to 0.97, yielding only a 2% reduction in error variance for the additional effort. If, in the same study, the reliability of a single triceps skinfold measurement was 0.85, using the mean (including a replicate measurement) would raise the reliability to 0.92 and yield a 7% reduction in error variance, a more than three-fold improvement compared with recumbent length. The intraclass correlation coefficient is specifically recommended here for assessing reliability because it takes account of both random and systematic errors of measurement, whereas the interclass correlation (e.g., Pearson correlation) takes account of only random errors of measurement.

Because the benefits of taking replicate measurements are so closely linked with the existing measurement reliability, it is recommended that as a part of the training of those who will be collecting anthropometry data, a reliability study be conducted that will yield measurement reliability estimates for the data collectors, protocols, settings, and participants involved in that particular study (Himes, 1989). If the measurement reliability for a single measurement is ≥ 0.95, the recommendation is that replicate measurements are not necessary and will yield little practical benefit. If the measurement reliability is < 0.95, the recommendation is to include replicate measurements as prescribed.

If replicate measurements are indicated because of relatively low reliability, a second measurement should be taken, including repositioning the participant. A third measurement should be taken if the first two measurements differ by > 0.5 cm. If it is necessary to take a third measurement, the two closest measurements are averaged. Should the third measurement fall equally between the first two measurements, all three should be averaged.




Buttocks (Hip) Circumference

The SP (study participant) stands erect with feet together and weight evenly distributed on both feet. The SP is holding up the examination gown. The recorder stands in back of the SP and gathers the side seams of the exam pants together above the hips and places the thumb in the fabric to make a fold. The recorder holds the folded sides of the pants snugly while the examiner squats on the right side of the SP and places the measuring tape around the buttocks. The tape is placed at the maximum extension of the buttocks (see Exhibit 1). The recorder then adjusts the sides of the tape and checks the front and sides so that the plane of the tape is horizontal. The zero end of the tape is held under the measurement value. The tape is held snug but not tight. The examiner takes the measurement from the right side and calls it to the recorder.

Figure 1.

Personnel and Training Required

Technicians should be trained in the basic techniques of anthropometric measurements.

Equipment Needs

Flexible measurement tape that exceeds 200 cm.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Physical Examination


Toddler, Child, Adolescent, Adult, Senior


2 years of age and older

Selection Rationale

The NHANES III protocol was selected as the best practice methodology and most widely used protocol to assess hip circumference.



Human Phenotype Ontology Abnormal waist to hip ratio HP:0031818 HPO
caDSR Form PhenX PX020802 - Hip Circumference Hip Circumference 5801215 caDSR Form
Derived Variables

Waist-to-Hip Ratio (WHR)

Process and Review

The Expert Review Panel #1 reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.

Guidance from the ERP includes:

• Replaced the protocol (different source)

• Changed unit of measurement

• Added replicate measure language

Back-compatible: there are changes to the Data Dictionary, previous version of the Data Dictionary and Variable mapping in Toolkit archive (link)

Protocol Name from Source

National Health and Nutrition Examination Survey III (NHANES III), Body Measurements, 1988


National Health and Nutrition Examination Survey III (NHANES III). (1988, October). Body Measurements (Anthropometry). Rockville, MD: Westat, Inc.

General References

Himes, J. H. (1989). Reliability of anthropometric methods and replicate measurements. American Journal of Physical Anthropology, 79(1), 77-80.

Protocol ID


Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX020802030000 What was the hip measurement? Variable Mapping
PX020802040000 What was the hip measurement? N/A
PX020802050000 What was the hip measurement? N/A
PX020802020000 Did the examiner then release the folds of more
the pants and then adjust the tape so that it is on a horizontal plane and held snugly but not pulled tight? show less
PX020802010000 With the subject standing upright with feet more
together and weight evenly distributed, did the examiner gather the fabric of the subject's pants, holding the sides of the pants snugly, before placing the steel measuring tape around the hips, anchoring t show less
Measure Name

Hip Circumference

Release Date

October 1, 2015


Hip circumference is the measurement of the circumference of the hips at the level of the maximum extension of the buttocks.


The most common use of hip circumference is to calculate the waist-to-hip ratio. Waist-to-hip ratio has been associated with risk of a number of chronic conditions, such as type 2 diabetes.


Anthropometrics, metabolic syndrome, Waist-To-Hip Ratio, WHR, NHANES

Measure Protocols
Protocol ID Protocol Name
20802 Hip Circumference - Hip Circumference

There are no publications listed for this protocol.