Skinfolds Measurement Protocols and Standards: A Narrative Review

Skinfold thickness assessment is one of the most widely used anthropometric methods for estimating subcutaneous adipose tissue and overall body adiposity in clinical, epidemiological, and sports settings. Despite its long-standing application, substantial heterogeneity persists across measurement protocols and standardization systems, potentially affecting reproducibility and comparability across studies. This narrative review aims to critically synthesize the historical, conceptual, methodological, and technical development of the main skinfold measurement protocols and standards, systematically compare their characteristics, and examine their methodological and practical implications for research and clinical applications. A targeted bibliographic synthesis of classic textbooks, consensus manuals, and original peer-reviewed studies on surface anthropometry was conducted. Seventeen anatomical skinfold sites and 31 distinct technical descriptions were identified, including 22 site-selection protocols and 9 measurement standards. Five established standards were comparatively analyzed, with emphasis on anatomical landmarking, fold orientation, spatial pinching procedures, and temporal reading control. Similarities were observed in general technical principles, including right-side assessment, perpendicular caliper application, controlled reading time, and maintenance of fold elevation. However, persistent divergences were identified in anatomical definitions, fold orientation, landmark precision, spatial positioning of pinch and caliper jaws, and recommended reading time, with greater heterogeneity at trunk sites than limb sites. Although the reviewed protocols and standards were developed for broad application across age groups, this review primarily reflected their use in adolescents and adults, as skinfold assessment in infants and young children involves additional considerations related to growth dynamics and rapid changes in adipose tissue. Skinfold measurement protocols and standards are not interchangeable and reflect pluralistic, complementary international initiatives rather than a single institutional standardization process.