Canadian Health Measures Survey – Report of physical measurements information sheet

The physical measurements collected at the mobile clinic will help us understand the health status of the Canadian population. They are not meant to be used as medical diagnoses. Please consult your doctor or other health care professional to understand what these measurements mean about your general health or that of your child.

Blood pressure and heart rate

Resting blood pressure

Blood pressure is the force of the blood against the artery walls created by the heart as it pumps blood throughout the body. Resting blood pressure comprises two measurements: systolic pressure (the upper number) is measured when the heart contracts, and diastolic pressure (the lower number) is measured between two heartbeats, when the heart is relaxed.

Elevated blood pressure at a young age is a risk factor for developing high blood pressure later in life.

Resting blood pressure for children and youth is calculated based on age and sex, and then classified as a percentile. The table below lists the resting blood pressure percentile cut-offs along with the respective categories and recommended follow-ups. Blood pressure was not measured on participants aged 3 to 5.

Table 1. Resting blood pressure follow-up guidelines for children and youth aged 6 to 17
Systolic or diastolic percentile Resting blood pressure category Recommended follow-up
Less than 90th percentile Normal Recheck at next check-up
90th to 94th percentile High end of normal range Recheck within the next 2 months
95th to 99th percentile High Recheck within the next week
Above the 99th percentile Very high Recheck at a clinic or hospital emergency room today
Source: National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. 2004.
"Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Pediatrics, Vol. 114, Supplement
Table 2. Blood pressure follow-up guidelines for individuals 18 and older with no history of hypertension
Systolic pressure
(mm Hg)Footnote 1
Diastolic pressure
(mm Hg)Footnote 1
Blood pressure category Recommended follow-up
Below 120 Below 80 Optimal Recheck within two years
120 to 129 80 to 84 Normal Recheck within one year
130 to 139 85 to 89 Normal to high Recheck within two months
140 to 159 90 to 99 Mild hypertension Recheck within one month
160 to 179 100 to 109 Moderate hypertension Recheck within one week
180 and above 110 and above Severe hypertension Recheck today at a clinic or hospital emergency room
Footnote 1

Blood pressure is measured in millimetres of mercury (or mm Hg).

Return to the first footnote 1 referrer

Source: "The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure" 1997.

Resting heart rate

The heart rate is the number of times the heart beats (or contracts), recorded as beats per minute (bpm).

The resting heart rate is an indicator of cardiorespiratory (or aerobic) fitness. It tends to be lower in individuals who are more aerobically fit.

Body composition

Body mass index

The body mass index (BMI) indicates whether a person's weight is appropriate for their height. However, it does not provide information on the distribution of body fat or the composition of the weight (fat, muscle, bone, etc.).

Children and youth who are above a healthy body mass index (BMI) weight range are at risk of developing short- and long-term health problems. They are more likely to have risk factors associated with cardiovascular disease, such as high cholesterol and high blood pressure, or are more likely to develop pre-diabetes and bone and joint problems. They are also likely to be overweight or obese as adults and, therefore, at a greater risk of adult health problems such as coronary heart disease, Type 2 diabetes and certain cancers. Health problems associated with being below a healthy BMI weight range include malnutrition and a tendency to get sick more often.

Unlike adults, BMI for children and youth is calculated based on age and sex, then classified based on the deviation from the mean for the child's age and sex. The tables below list the BMI categories for children and youth aged 3 to 18. The 5-year-olds included in Table 3a are exactly 60 months. Table 3b includes children 61 months and over.

Table 3a. BMI classification for children aged 3 to 5 years
BMI result for the child's age in months and sex BMI classification
Less than or equal to 2 standard deviations below the mean Thin
Greater than 2 standard deviations below the mean and less than or equal to 1 standard deviation Normal weight
Greater than 1 standard deviation and less than or equal to 2 standard deviations above the mean At risk of being overweight
Greater than 2 standard deviations and less than or equal to 3 standard deviations above the mean Overweight
Greater than 3 standard deviations above the mean Obese
Source: World Health Organization. 2008. Training Course on Child Growth Assessment.
Table 3b. BMI classification for children and youth aged 5 to 18 years
BMI result for the child's age (in months) and sex BMI classification
Less than or equal to 2 standard deviations below the mean Thin
Greater than 2 standard deviations below the mean and less than or equal to 1 standard deviation above the mean Normal weight
Greater than 1 standard deviation and less than or equal to 2 standard deviations above the mean Overweight
Greater than 2 standard deviations above the mean Obese
Source: De Onis, Mercedes, Adelheid W. Onyango, Elaine Borghi et al. 2007."Development of a WHO growth reference for school-aged children and adolescents." Bulletin of the World Health Organization, Vol. 85, p. 660 to 667.

Table 3c below applies to individuals 19 years and older. BMI levels and categories for adults do not take age and sex into account. The BMI is not used for pregnant women.

The health problems associated with being overweight or obese include type 2 diabetes, high cholesterol, high blood pressure, coronary heart disease, gallbladder disease, obstructive sleep apnea, and certain cancers. The health problems associated with being underweight include malnutrition, osteoporosis, infertility, and a tendency to get sick more often.

Table 3c. BMI categories and guidelines for individuals 19 years and older
BMI category
(kg/m2)
Classification Risk of developing health problems (BMI only)
Less than 18.5 Underweight Increased
18.5 to 24.9 Normal weight Low
25.0 to 29.9 Overweight Increased
30.0 to 34.9 Obese, class I High
35.0 to 35.9 Obese, class II Very high
40.0 or higher Obese, class III Extremely high
Source: Health Canada. 2003. "Health risk classification according to Body Mass Index (BMI)," The Canadian Guidelines for Body Weight Classification in Adults.

Waist circumference

Waist circumference is measured to assess the health risks associated with abdominal (or stomach) fat.

The health risks associated with a large waist circumference include type 2 diabetes, coronary heart disease, and high blood pressure. The health benefits of a waist circumference below these guidelines include less stress on bones and joints, decreased risk of injury and disability, and better psychological well-being. The guidelines below apply to individuals 19 years and older with a BMI between 18.5 kg/m2 and 39.9 kg/m2. Waist circumference does not provide information on the health risks for adults with a BMI of 18.4 kg/m2 or less or 40.0 kg/m2 or more.

Table 4. Waist circumference guidelines for individuals 19 years and older
Sex Waist circumference associated with increased health risks
Men 102 centimetres (40 inches) or more
Women 88 centimetres (35 inches) or more
Source: Health Canada. 2003. "Health risk classification according to waist circumference," The Canadian Guidelines for Body Weight Classification in Adults

Interpreting the combined BMI and waist circumference measurements

When possible, the body mass index and waist circumference are used to estimate health risks and benefits. If either measurement is missing, the other is used to determine the benefits and risks (Tables 3c and 4).

Table 5. Health risk guidelines for individuals 19 years and older
BMI category
(kg/m2)
Waist circumference, men
(cm)
Waist circumference, women
(cm)
Risk of developing health problems below the waist circumference cut-off Risk of developing health problems at or above the waist circumference cut-off
Less than 18.5 Not applicable Not applicable Increased Increased
18.5 to 24.9 90 or higher 80 or higher Low High
25.0 to 29.9 100 or higher 90 or higher Increased Very high
30.0 to 34.9 110 or higher 105 or higher High Extremely high
35.0 to 35.9 125 or higher 115 or higher Very high Extremely high
40.0 or higher Not applicable Not applicable Extremely high Extremely high
Source: Canadian Society for Exercise Physiology. 2013. Physical Activity Training for Health, first edition.

Densitometry

A dual energy X-ray absorptiometry (DXA) scanner is a fully automated measuring system and is currently the gold standard methodology for analyzing body composition and bone health. It quantifies bone, fat, and lean tissue mass of the body. Three scans will be done – lower back, hip, whole body.

The DXA emits low levels of ionizing radiation while in operation, amounts lower than a typical cross-Canada flight. Still, much like exposure to other sources of radiation, such as natural background radiation in our environment, exposure to radiation has the potential to harm the tissue cells of an individual. To ensure the amount of radiation used is as low as reasonably achievable, the DXA is regularly calibrated, inspected and operated by qualified medical radiation technologists that have received extensive training in the use of the equipment.

Oral Health

Oral health is part of your overall health and it is important to understand the risk factors that can affect your oral health. Risk factors that can affect oral health include age, oral hygiene routine, diet and smoking, diabetes, HIV infections, certain medications and hormonal changes. The health problems associated with poor oral health include cavities caused by tooth decay, gingivitis and periodontitis (gum disease), and oral cancer.

The oral health assessment is not a substitute for a full mouth examination by an oral health professional. There are no x-rays taken nor other diagnostic tools used. Respondents do not receive treatment; however the dentist will outline any potential treatment needs based on the assessment, including a recommended timeframe for follow-up with an oral health professional.

Table 6. Time frame for follow-up with an oral health professional
  No Treatment Needed Regular Treatment Needs Urgent Treatment Needs Immediate Treatment Needs
Time Frame for Follow-up It is prudent to consult with an oral health professional routinely for a full mouth assessment. We suggest you see a dentist in the near future for a full mouth examination. You should see a dentist within the next WEEK to have your mouth re-assessed. You should see a doctor or dentist or go to a clinic or hospital emergency room TODAY to have your mouth re-assessed.

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