877 scale

Participants’ weight (kg, to the nearest 100 g) and height (cm, to the nearest 0.1 cm) were measured using the Seca 877 Scale (Seca) and Holtain Stadiometer (Holtain Limited). Measurements were performed in light clothing and without shoes or heavy outerwear. BMI was calculated as follows: weight (kg)/(height [m])². Mid-upper arm circumference was measured to the nearest 0.1 cm using a measuring tape at the midpoint between the acromion process and the olecranon. Waist circumference was taken to the nearest 0.1 cm using a measuring tape at the midpoint between the lowest palpable rib and the top of the iliac crest. Each anthropometric measurement was taken in triplicate, and the average of all 3 measurements was used.
DXA (Hologic Inc) was used to determine fat and lean mass, analyzed as “whole body less head.” This method was chosen for consistency given that many young women wear hair weaves and beads that are not easily removed [18 (link)]. The scan was conducted by trained radiographers following daily quality control checks. Percent body fat was calculated using DXA-derived fat mass, in (kg/total body weight) × 100. FMI was calculated using fat mass (kg)/(height [m])², which gives a superior estimate of body fat index than BMI because it distinguishes between lean and fat mass, unlike when using total body weight.

Parents completed a demographic questionnaire that included questions about their citizenship, monthly household income and composition, household size, highest level of education, occupational group, and time spent working per week. With this information, we calculated the weighted net equivalence income according to the Organisation for Economic Co-operation and Development (OECD) scale [38 ] and socioeconomic status (SES), a multidimensional index computed as the sum score of points from the parental data [39 (link)]. With this information, a classification of low, medium, and high social status became possible.
Additionally, parents reported their body weight, body height, and age, as well as their child’s age. Parental BMI was categorized as follows: BMI ≥ 25.0 kg/m² to 29.9 kg/m² as overweight and BMI ≥ 30 kg/m² as obese. Trained study staff measured each participating child’s height and weight in the kindergarten classrooms using a calibrated SECA 877 scale and a portable stadiometer. Measurements were taken while the child was in light clothing and no shoes. Age-specific percentile values were calculated using the Centers for Disease Control (CDC) [40 ] guidelines. Children who had a BMI percentile between the 85th and 95th percentiles for age and sex, were classified as overweight, and those at, or above, the 95th percentile were classified as obese.

Smoking status was classified as non-smokers and current smokers. Physical activity was assessed using the Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) questionnaire [19 (link)] and was classified into 2 categories: achieving the international norm for recommended physical activity (at least 30 minutes of moderate- and high-intensity activity per day on at least 5 days per week) or not. Height was measured without shoes with a portable stadiometer (Seca 217) to the nearest 0.1 cm. Weight was measured in light clothing with a Seca 877 scale to the nearest 0.1 kg. Body mass index was calculated as weight (kg) divided by height squared (m²). Blood pressure (BP) was measured using a validated automated digital BP device (WatchBP Home; Microlife AG) on the left arm in a seated position after the person had been seated for at least 5 minutes. Both anthropometrics and BP were measured twice, and the mean of the 2 measurements was used in the analyses. Hypertension was defined as systolic BP ≥ 140 mmHg, and/or diastolic BP ≥ 90 mmHg, and/or being on antihypertensive medication treatment, and/or self-reported hypertension.

Resting systolic and diastolic blood pressure was measured sitting after 10 minutes of rest with a calibrated automated blood pressure monitor (Welch Allyn, Germany). Blood pressure was automatically measured three times by the monitor, and the average value of the two last measurements was used. Resting heart rate was measured, after 10 minutes of rest in supine position, using electrocardiogram. Height was measured to the nearest centimetre and body weight was measured to the nearest 0.1 kg using a Seca 877 scale (Seca Corp, Germany). Body mass index was calculated as body weight in kilograms divided by the square of height in meter. Waist circumference was measured to the nearest half centimetre, using a measuring tape at the height of the umbilicus.

Anthropometrics are measured using standard procedures (National Health and Nutrition Examination Survey, III, 1988–94. National Center for Health Statistics, [37 ]). Both height (using the SECA 213 stadiometer) and weight (using the SECA 877 scale) are measured without shoes or heavy clothes to the nearest 1 mm and 0.1 kg respectively. Body Mass Index (BMI) is calculated as weight/height squared (kg/m2) and Z-scores from age- and sex specific reference values. The right arm, right wrist, waist and hip circumferences are recorded to the nearest 0.1 cm using a measuring tape.

A detailed manual with instructions for all adult measurement techniques, the methods for multicentre standardisation of those measures, and the procedures for the calibration and maintenance of equipment have been published elsewhere.33 (link)
34 (link)
35 All documentation, protocols, data collection forms, and electronic transfer strategies are available at www.intergrowth21.org. Briefly, the women’s height and weight were measured in duplicate with a Seca 264 stadiometer and Seca 877 scale (Seca, Germany), respectively, on study entry between 9 and 13⁺⁶ weeks’ gestation. A first trimester body mass index (BMI) was calculated and categorised as normal weight (18.50-24.99) or overweight (25.00-29.99), according to the WHO definition.36 The same standardised methods and clinical procedures were used to measure maternal weight every five weeks (plus/minus one week) until delivery, so that the possible ranges after recruitment in which weight was measured were 14-18, 19-23, 24-28, 29-33, 34-38, and 39-42 weeks’ gestation.35