Central obesity is a clinical term which refers to excessive fat around the abdomen. This condition is a risk factor for many chronic diseases, such as cardiovascular disease and diabetes. One way to determine if a person has central obesity – and to assess the person’s risk for developing chronic diseases - is to measure the waist circumference (WC).
The World Health Organisation (WHO) has set different benchmarks of central obesity based on ethnicity and gender:
| Ethnicity | Gender | Waist circumference (cm) |
| Caucasians | Men | >94 |
| Women | >80 | |
| Asians | Men | >90 |
| Women | >80 |
Excessive abdominal fat can affect body mechanisms and increases the risk of cardiovascular disease and diabetes. For example, as visceral fat, which surrounds the organs in the abdominal region, is located close to the vein which carries blood from the intestinal area to the liver, an excessive amount of visceral fat will release fat to the liver and increase the amount of LDL (bad) cholesterol and lower the HDL (good) cholesterol. Visceral fat will also decrease the ability of insulin to deliver blood glucose to cells, thus resulting in excessive sugar in the blood, eventually causing diabetes.
Waist circumference should be measured at the midpoint between the lower ribcage and the top of the iliac crest (pelvis). A stretchresistant tape should be used to surround the waist comfortably and not too tightly. The person being assessed should be asked to stand straight and to relax (i.e. do not tuck in the abdominal wall), have both hands at the sides, feet positioned close together and standing in a midpoint. The measurement should be taken when exhaling.
To obtain a more accurate result, the measurement can be done twice. If the difference between both measurements is less than 1cm, the average should be calculated. If it is more than 1cm, the measurement should be repeated.
It is widely believed that when predicting a person’s risk of developing chronic diseases, measuring the waist circumference is more useful than measuring BMI alone, as BMI may not be accurate for some groups in the population, such as athletes or people with a large body frame. Therefore, waist circumference is becoming an important measurement in predicting a person’s risk for developing chronic diseases. (For more information, please see patient information Body Mass Index and Body Fat Percentage).
In general, diet and exercise are keys to controlling abdominal fat. Consume a well balanced diet and reduce the amount of fat, sweetened foods and sodium. Increase the intake of dietary fibre including fruits and vegetables, wholegrain products such as oatmeal, brown rice, or wholemeal bread. Taking up moderate-intensity aerobic physical activity for at least 150 minutes throughout week, is also recommended. Before starting any regime, it is always wise to seek the advice from a doctor or a dietitian.