BELLY WEIGHT AND NON-COMMUNICABLE DISEASES

Everyone is aware about the rise in diseases like cancers, heart problems, diabetes, etc. over the past two decades. These diseases are called Non-Communicable Diseases (NCD’s) and are caused due to a combination of genetic, physiological, environmental, and behavioral factors. 

Non-Communicable Diseases are a burden globally and account for 71% of the deaths per year globally. Cardiovascular Diseases cause the greatest number of NCD deaths, followed by cancer, respiratory diseases, and diabetes.

Some of the risk factors for NCD’s include genetics, age, physical inactivity, unhealthy diet, tobacco, and alcohol use and being overweight or obese. Yes! Being physically inactive and leading an unhealthy lifestyle can increase your risk of NCDs.

BELLY WEIGHT AND ITS RELATION WITH NCDs

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The fat under the skin is called subcutaneous fat, the type of fat we can pinch with our hands. This subcutaneous fat in the belly is called visceral fat. It surrounds the organs in our abdomen like the stomach, intestines, etc. and is usually protective in function. But what happens when this visceral fat is too much in the body?  

Excess visceral fat or belly fat is also called as Abdominal Obesity. Excess visceral fat is directly linked to non-communicable diseases like cardiovascular diseases, some cancers and diabetes. There have been studies that show clear evidence that increased belly fat or abdominal obesity is a high-risk factor for multiple health complications like diabetes, increased cholesterol which leads to heart problems, etc.

HOW TO MEASURE BELLY FAT?

You may have heard of different ways of measuring body composition like the Body Mass Index (BMI) or other ways like Skin Fold Thickness. The Body Mass Index (BMI) measures the weight in kilograms divided by the height of an individual in meter square. It is an inaccurate tool for measuring NCD risk as it does not define the amount of fat in an individual, but it characterizes people according to their weights.

You will then wonder about which measurement methods help to identify the NCD risk accurately? There are other ways like the CT scans or MRI’s that are reliable and accurate in measuring visceral fat, but these methods are expensive and not easily accessible.

The most widely used, inexpensive ways of measuring visceral fat are Waist Circumference and Waist Hip Ratio.

Waist Circumference (WC)

To measure your waist circumference, you will need a stretch resistant measuring tape. Take the measurement when you are standing with both your feet together and at the end of a normal exhale (after you have breathed out). Make sure to wear thin clothing and repeat the measurement twice to avoid and minimize errors. 

Waist-Hip Ratio (WHR)

Another way of measuring abdominal fat is the waist hip ratio. It is the measure of the waist circumference to the hip circumference. The hip circumference is calculated using a measuring tape at the widest points of the hip, usually the bone prominences. Repeat the measurements twice to minimize errors.

Waist (in inches) / Hips (in inches) = Waist Hip Ratio

The World Health Organization (WHO) has given cut-offs for Waist Circumference that classify the risk factors for Non-communicable diseases. A waist circumference greater than 94 cm for men and greater than 80 cm for women indicates an increased risk for NCDs.

The International Diabetes Federation has given cut-off points for different ethnic groups and the cut off points for South Asians are >90 cm for Men and >80 cm for Women. If your values are greater than the cut offs, visit your health care provider right away to assess your risk status.

Studies claim that an increase in both indices is associated with increased disease risk, and this association is evident in diverse populations. A few studies suggested that waist circumference, waist–hip ratio and waist–height ratio, which reflect abdominal adiposity, are superior to the Body Mass Index (BMI) in predicting CVD risk.

A review by Freemantle, et. al concluded that there is a positive correlation between waist circumference or Waist Hip Ratio and diabetes. It also concluded that reduction in waist circumference can lower the progression of Diabetes and other risk factors for NCDs.

Ways of Reducing Abdominal Fat

Now that we know the causes of NCDS and increased abdominal fat include physical inactivity, unhealthy diet, and other non-modifiable factors like age, let us find out how to reduce our risk of NCDs. To reduce the risk of NCDs, one must reduce the belly weight.

Weight Loss

Bringing about changes in eating patterns and exercise can have a great impact on the abdominal fat. Overweight individuals who lose 10% of their weight decrease their risk for Non-Communicable Diseases (National Institute of Health). Setting realistic goals and starting slow and gradually building up to the goal can help to remain consistent.

Physical Activity

Being moderately physically active for at least 30 – 35 minutes a day for 5 days a week can reduce the risk factors for cardiovascular diseases and other metabolic complications. It also helps to achieve weight loss and to maintain a healthy body weight. Simple exercises like jogging, brisk walking, cycling, etc can help with weight loss. Cardio exercises teamed up with resistance training (like weightlifting, squats, plank, etc) can help the body become stronger and fitter and reduce the risk factors for diseases drastically. Several studies have linked sedentary lifestyle to disease related mortality.

Eating Healthy

Portion control and choice of foods are the effective factors for healthy eating. To achieve weight loss through diet and exercise it is important to consult a professional like Dietitian or the Doctor.

Including a balanced diet that fulfils all nutritional needs is a key aspect of overall health and wellbeing. Studies have suggested that a diet typically high in vegetables, fruits, whole grains, beans, nut and seeds, and healthy oils with adequate protein intake is proven to be effective to reduce abdominal fat along with exercise and providing optimum nutrition to the body.

Non communicable diseases are the leading cause of death worldwide. NCDs are largely preventable by behavioral changes and lifestyle modifications like not smoking, being physically active, consuming a healthy diet and limiting the use of alcohol.

Take home message: Belly weight is an indicator of the risk for NCDs. Having a Waist Circumference or Waist Hip Ratio greater than the cut off can mean there is increased risk for developing non-communicable diseases. It is very essential to control metabolic complications like increased blood pressure, high blood glucose and high cholesterol as they can increase mortality related to NCDs. Consuming a balanced diet, being physically active and managing stress can all lead to positive lifestyle changes and a healthier future! So, get moving and start eating healthy.

References –

1. Non communicable diseases. (n.d.). Retrieved July 2, 2021, from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
2. “The link between food, nutrition, diet and non-communicable diseases” – World Cancer Research Fund International 2nd edition October 2014, The NCD Alliance.
3. CDC. (2021, June 7). Body Mass Index (BMI). Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/assessing/bmi/index.html
4. Abdominal obesity and your health. (2005, September 1). Harvard Health. https://www.health.harvard.edu/staying-healthy/abdominal-obesity-and-your-health
5. Misra, A., Vikram, N. K., Gupta, R., Pandey, R. M., Wasir, J. S., & Gupta, V. P. (2006). Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity. International Journal of Obesity (2005), 30(1), 106–111. https://doi.org/10.1038/sj.ijo.0803111
6. Waist circumference and waist-hip ratio: Report of a WHO expert consultation. (n.d.). Retrieved July 2, 2021, from https://www.who.int/publications-detail-redirect/9789241501491
7. Freemantle, N., Holmes, J., Hockey, A., & Kumar, S. (2008). How strong is the association between abdominal obesity and the incidence of type 2 diabetes? International Journal of Clinical Practice, 62(9), 1391–1396. https://doi.org/10.1111/j.1742-1241.2008.01805.x
8. “Abdominal Obesity”, Erica Bub, Karla Shelnutt, and Gail Kauwell. University of Florida.