Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Body composition, energy expenditure and physical activity

Hand length as an alternative measurement of height



Despite the utmost importance of body height in evaluating nutritional status, it is not always possible to obtain its measurement and height may have to be estimated. The objective of the study was to formulate and cross-validate a regression equation to predict height using hand length measurement and also to determine if predicted height (PH) will lead to significant errors when used in body mass index (BMI) calculation.


A cross-sectional study was conducted using a consecutive sample of 465 inpatients (19–91 years), from a university hospital. Participants were randomly divided into a development sample of 311 individuals and a cross-validation one. A linear regression model was used to formulate the equation. Intraclass correlation coefficients (ICCs) for single measures and differences between measured height (MH) and PH and between BMI calculated with MH (BMIMH) and with PH (BMIPH) were determined.


The regression equation for PH is: PH (cm)=80.400+5.122 × hand length (cm)—0.195 × age (years)+6.383 × gender (gender: women 0, men 1) (R=0.87, s.e. of the estimate=4.98 cm). MH and PH were strongly correlated, ICCs: 0.67-0.74 (P<0.001). Differences were small, mean difference±s.d., −0.6±4.4 cm (P0.24). BMIMH and BMIPH were strongly correlated, ICCs: 0.94-0.96 (P<0.001). Differences were small, 0.3±1.7 kg/m2 (P0.10).


The formulated regression equation using hand length, age and gender provides a valid estimation of height and is useful in the clinical context. PH from this regression equation can be used in BMI calculations as misclassification is small.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2


  1. Lee RD, Nieman DC . Assessment of the hospitalized patient. In: Lee RD, Nieman DC (eds) Nutritional Assessment 4th edn Mosby: Chicago, IL, 2007, pp 226–231.

    Google Scholar 

  2. Hickson M, Frost G . A comparison of three methods for estimating height in the acutely ill elderly population. J Hum Nutr Diet 2003; 16: 13–20.

    Article  CAS  Google Scholar 

  3. Brown JK, Whittemore KT, Knapp TR . Is arm span an accurate measure of height in young and middle-age adults? Clin Nurs Res 2000; 9: 84–94.

    Article  CAS  Google Scholar 

  4. Brown JK, Feng JY, Knapp TR . Is self-reported height or arm span a more accurate alternative measure of height? Clin Nurs Res 2002; 11: 417–432.

    Article  Google Scholar 

  5. de Lucia E, Lemma F, Tesfaye F, Demisse T, Ismail S . The use of armspan measurement to assess the nutritional status of adults in four Ethiopian ethnic groups. Eur J Clin Nutr 2002; 56: 91–95.

    Article  CAS  Google Scholar 

  6. Mohanty SP, Babu SS, Nair NS . The use of arm span as a predictor of height: A study of South Indian women. J Orthop Surg (Hong Kong) 2001; 9: 19–23.

    Article  CAS  Google Scholar 

  7. Kwok T, Whitelaw MN . The use of armspan in nutritional assessment of the elderly. J Am Geriatr Soc 1991; 39: 492–496.

    Article  CAS  Google Scholar 

  8. Bassey EJ . Demi-span as a measure of skeletal size. Ann Hum Biol 1986; 13: 499–502.

    Article  CAS  Google Scholar 

  9. Hirani V, Mindell J . A comparison of measured height and demi-span equivalent height in the assessment of body mass index among people aged 65 years and over in England. Age Ageing 2008; 37: 311–317.

    Article  Google Scholar 

  10. Hirani V, Tabassum F, Aresu M, Mindell J . Development of new demi-span equations from a nationally representative sample of adults to estimate maximal adult height. J Nutr 2010; 140: 1475–1480.

    Article  CAS  Google Scholar 

  11. Malnutrition Advisory Group. (eds). The ‘MUST’ Explanatory Booklet. BAPEN: Redditch, Worcestershire UK, 2003.

  12. Cockram DB, Baumgartner RN . Evaluation of accuracy and reliability of calipers for measuring recumbent knee height in elderly people. Am J Clin Nutr 1990; 52: 397–400.

    Article  CAS  Google Scholar 

  13. Han TS, Lean ME . Lower leg length as an index of stature in adults. Int J Obes Relat Metab Disord 1996; 20: 21–27.

    CAS  PubMed  Google Scholar 

  14. Muncie HL Jr., Sobal J, Hoopes JM, Tenney JH, Warren JW . A practical method of estimating stature of bedridden female nursing home patients. J Am Geriatr Soc 1987; 35: 285–289.

    Article  Google Scholar 

  15. Barbosa VM, Stratton RJ, Lafuente E, Elia M . Ulna length to predict height in English and Portuguese patient populations. Eur J Clin Nutr 2012; 66: 209–215.

    Article  CAS  Google Scholar 

  16. Agnihotri AK, Agnihotri S, Jeebun N, Googoolye K . Prediction of stature using hand dimensions. J Forensic Leg Med 2008; 15: 479–482.

    Article  Google Scholar 

  17. Ahemad N, Purkait R . Estimation of stature from hand impression: a nonconventional approach. J Forensic Sci 2011; 56: 706–709.

    Article  Google Scholar 

  18. Rastogi P, Nagesh KR, Yoganarasimha K . Estimation of stature from hand dimensions of north and south Indians. Leg Med (Tokyo) 2008; 10: 185–189.

    Article  Google Scholar 

  19. Chumlea WC, Guo SS, Steinbaugh ML . Prediction of stature from knee height for black and white adults and children with application to mobility-impaired or handicapped persons. J Am Diet Assoc 1994; 94: 1385–1388., 1391, quiz 1389-1390.

    Article  CAS  Google Scholar 

  20. Sofat S . My Vitruvian Man. Acad Med 2009; 84: 1075.

    Article  Google Scholar 

  21. Naini FB, Cobourne MT, McDonald F, Donaldson AN . The influence of craniofacial to standing height proportion on perceived attractiveness. Int J Oral Maxillofac Surg 2008; 37: 877–885.

    Article  CAS  Google Scholar 

  22. Le Floch-Prigent P . [The Vitruvian Man: an anatomical drawing for proportions by Leonardo Da Vinci]. Morphologie 2008; 92: 204–209.

    Article  CAS  Google Scholar 

  23. Singh H, Watt K, Veitch R, Cantor M, Duerksen DR . Malnutrition is prevalent in hospitalized medical patients: are housestaff identifying the malnourished patient? Nutrition 2006; 22: 350–354.

    Article  Google Scholar 

  24. Farrer K, Donaldson E, Blackett B, Lloyd H, Forde C, Melia D et al. Nutritional screening of elderly patients: a health improvement approach to practice. J Hum Nutr Diet 2013, e-pub ahead of print 30 April 2013 doi:10.1111/jhn.12073.

  25. Chumlea WC, Guo S . Equations for predicting stature in white and black elderly individuals. J Gerontol 1992; 47: M197–M203.

    Article  CAS  Google Scholar 

  26. Madden AM, Tsikoura T, Stott DJ . The estimation of body height from ulna length in healthy adults from different ethnic groups. J Hum Nutr Diet 2012; 25: 121–128.

    Article  CAS  Google Scholar 

  27. Cline MG, Meredith KE, Boyer JT, Burrows B . Decline of height with age in adults in a general population sample: estimating maximum height and distinguishing birth cohort effects from actual loss of stature with aging. Hum Biol 1989; 61: 415–425.

    CAS  PubMed  Google Scholar 

  28. Milne JS, Williamson J . A longitudinal study of kyphosis in older people. Age Ageing 1983; 12: 225–233.

    Article  CAS  Google Scholar 

  29. ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enteral Nutr 2002; 26: 1SA–138SA.

    Article  Google Scholar 

  30. Marfell-Jones M, Olds T, Stewart A, Carter L (eds) International Standards for Anthropometric Assessment. International Standards for Anthropometric Assessment: Potchefstroom, South Africa, 2006.

    Google Scholar 

  31. Pederson D, Gore C . Anthropometry Measurement Error. University of New South Wales Press: Sydney, NSW, 1996.

    Google Scholar 

  32. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. World Health Organization: Geneva, 2000.

  33. Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.

    Article  CAS  Google Scholar 

Download references


We thank the Centro Hospitalar do Porto and all ward directors for facilitating the data collection. Rita S Guerra as a Ph.D. student is receiving a scholarship from FCT – Fundação para a Ciência e a Tecnologia under the project (SFRH/BD/61656/2009).

Author information

Authors and Affiliations


Corresponding author

Correspondence to R S Guerra.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Guerra, R., Fonseca, I., Pichel, F. et al. Hand length as an alternative measurement of height. Eur J Clin Nutr 68, 229–233 (2014).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • body height
  • hand length
  • nutritional assessment
  • body mass index
  • prediction

This article is cited by


Quick links