The perfect formula for good health is at the waist

Obesity and overweight are an abnormal or excessive accumulation of fat that can be harmful to health, according to the World Health Organization (WHO). However, it matters more how that weight is distributed in the body than the weight itself. Someone who has excess pounds may have it distributed peripherally, that is to say on the arms, legs, thighs; or centrally, in the abdomen.

The accumulated fat in the abdominal area is visceral fat, which is harmful to health because it is associated with increased cholesterol and triglycerides, and also conditions type 2 diabetes, high blood pressure and thrombosis.

Until now, one of the most widespread indicators for assessing a person's healthy weight was the body mass index (BMI), which results from dividing weight by height by height. It has been used as a nutritional indicator since the early 1980s and, although it makes no distinction between fat and non-fat components of total body mass, it is one of the most widely used measures.

To improve diagnosis, a new guide from the National Institute for Excellence in Health and Care (NICE ), encourages the population to take a tape measure and calculate the waist circumference to prevent and reduce the risk of future diseases. According to experts, a waist circumference less than half the height, is the perfect formula for good health.

Preliminary indications in the updated guide indicate that abdominal fat carries specific health risks and that an effective and simple way to control these risks is for people to measure their abdominal contour at home.

For example, a woman who was 1.63 meters tall (5 feet 4 inches) with a waist circumference of 74 centimeters (29 inches) would have a healthy proportion, but 82 centimeters (32 inches) would bring her to the unhealthy range. A man who is 1.78 meters tall (5 feet 10 inches) would face greater health risks with an abdominal circumference of 91 centimeters (36 inches).

The guide urges health professionals to be “sensitive and positive” by starting conversations about the risks of excess weight and asking permission before raising the issue. “Our committee found that a clear benefit of using the waist-to-height ratio is that people can easily measure it, interpret the results and seek medical advice if they are at increased health risk,” said Dr. Paul Chrisp, director of the British National Institute for Excellence in Health and Care.

According to the indications of British specialists, the healthy ratio of waist to height should be from 0.4 to 0.49. In these parameters there would be no health risks. A ratio of 0.5 to 0.59 conditions people at higher risk of developing diseases, while 0.6 or more implies health risks.

The NICE Institute indicated that using the waist-to-height ratio, together with the BMI, can help provide a practical estimate of “central adiposity”, i.e. the accumulation of fat around the abdomen. These data help assess and predict health risks, such as type 2 diabetes, high blood pressure, or cardiovascular disease.

UK experts added the waist-to-height ratio to their new guidance after analyzing evidence from several studies that showed that, together with BMI, it could be used to assess and predict weight-related conditions across ethnicities and sexes. Meanwhile, there is a long debate in the scientific community about the value of BMI, as it is a less accurate measure of healthy weight in those who are extremely muscular.

This is because BMI does not take into account muscle mass, bone density, overall body composition, which means that athletes with low levels of body fat are often classified as obese.

“Increased fat in the abdomen increases a person's risk of developing several life-limiting diseases, including type 2 diabetes and heart disease. The waist-to-height ratio is a simple and easy-to-use measure that identifies people who are most at risk for health and would benefit from weight-management support to improve their health,” explained Professor Rachel Batterham, a specialist in obesity, diabetes and endocrinology and member of the committee that produced the guide.

Ask permission before talking about weight

“It is important that health professionals seek patient authorization prior to any discussion related to overweight, obesity and central adiposity, and to discuss them sensitively and positively,” British experts warned.

This is important because the stigma associated with obesity has negative effects on people's mental and physical health, which can lead to greater weight gain and make patients less likely to interact with health professionals. “Special sensitivity should be applied to the possible negative impact on people with eating disorders or unbalanced eating,” the professionals suggested.

“Using words and language that avoids stigma and prejudice can help people engage in conversations about obesity and encourage weight loss,” they added.

Obesity is a global public health problem. Two out of three adults in the UK are overweight or obese, and obesity rates have doubled since the 1990s. While official figures show that obesity was linked to more than one million hospital admissions in 2019/20.

KEEP READING: