Table 1 Standardized procedures of measurements

Blood pressure(BP)

• Measured manually or digitally

• Measure BP after 5–10 minutes of rest. The individual should avoid coffee, tobacco or heavy physical activity 30 minutes prior to the measurement.

• The participant should sit comfortably with the back supported and the feet on the floor (no crossed legs).

• Use a cuff with adequate width.

• For manual measurement, pump up and palpate first the systolic BP to avoid an error record

• (auscultatory gap). Release the air from the bladder with a speed of 2–3 mm Hg/pulse beat. Empty the bladder completely between registrations.

• Use the average of at least two registrations with one minute intervals and read at the nearest even number (to avoid digit preference). For large variations (>5 mm Hg); use the average of more registrations.

• Measure in both arms the first time and choose the arm with highest pressure (difference>10 mm Hg) for further measurements. If the pressure does not vary, use the right arm.

Waist measurement

• Select a point about 2 cm above the belly button (just below the lower rib cage).

Measure with tape after a relaxed exhalation. Make sure the tape has not "hooked" up in the lower back.

• Read throughout cm.

Weight

• Use a calibrated digital scale for medical use.

• The weighing should be done at the same time, preferably in the morning before breakfast.

• Participants must remove shoes.

• Round off to the nearest 0.1 kg.

Height

• Measured in cm, standing fully upright, without shoes or headgear. The back should rest against a wall and the head should be forward.

Blood samples

• The following samples should be taken: LDL cholesterol, HDL cholesterol, triglycerides, HbA1c.

• Must be preceded by a 10-hour fast (water allowed).

• Before sampling, the skin must be cleaned with disinfectant.

• Blood samples are taken with a needle from the vein in the antecubital area.

6-Minute Walk Test

• The test is performed in a corridor on a 30 m distance with as little distraction as possible.

• Mark the starting line on the floor with tape. The distance is then marked every 3 meters, preferably on the wall.

• Repeated tests should be done about the same time of the day to minimize diurnal variation.

• Participants should wear comfortable clothing and appropriate footwear. Walking aids, which are normally used, are permitted.

• The participant should not have done strenuous work two hours before the test.

• Before the test starts, resting heart rate and blood pressure should be measured). Resting heart rate is noted.

• The test includes the estimation of the degree of exertion using the Borg RPE scale [18] and instructions for this are given before the test.

• The instruction to the participant are; go as far as possible during 6 minutes (do not jog or run). Walking speed is up to the participant but the goal is to become exerted by going back and forth. It is allowed to reduce speed or stop and rest (leaning against the wall is allowed), but the clock is running. If the participant for any reason must stop the test, the total walking distance is measured.

• Avoid talking during the test. Do not walk together with the participant.

• Measure the length of the walk by counting each time the participant returns to the starting line.

• Notify the participant when 3 minutes, 1 minute and 15 seconds remain.

• After the test, record heart rate, estimate the degree of exertion and calculate the total walking distance rounded to whole meters.