South Africans know that abdominal fat is linked to heart disease, but many don't know what their waist size should be - and, it seems, doctors can be partly to blame.
Results from the 2005 Shape of the Nations survey, which was conducted in 27 countries, shows that 72% of physicians and 51% of the general public in South Africa know that there's a link between abdominal fat and heart disease. But only 18% of at-risk patients can expect to have their waist circumference measured by their doctor.
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Of people who visit primary-care physicians, 39% are overweight or obese. Measuring waist circumference is thought to be a better indicator of heart disease risk than body mass index (BMI).
Not all fat in the abdomen is the same. Subcutaneous fat is stored directly under the skin while the health threat posed by abdominal obesity is largely due to intra-abdominal fat (adipose tissue) located inside the abdominal region and wrapped around the major organs of the body. This intra-abdominal adipose tissue is acknowledged to impact glucose metabolism and cause abnormal levels of HDL cholesterol and triglycerides.
Obesity is the cause of many serious conditions such as diabetes, cancer and heart disease. Research studies conducted in the United States have shown that obesity is a more serious risk factor for heart disease than smoking.
A high-risk waistline is more than 80cm for women and 94cm for men from Africa, 88cm for women and 102cm for men from North America, and 80cm for women and 90cm for men in Central and Latin America.
"The Shape of the Nations survey findings point to the need for more education and stronger action to safeguard people from the risk of heart disease, which is the leading single greatest cause of death worldwide," says Robert de Souza, CEO of the Heart and Stroke Foundation of South Africa.
How to measure your waist circumference
Take off your shirt and loosen your belt.
Position the tape mid-way between the top of your hip bone and the bottom of your rib cage.
When taking your measurement, you should be breathing normally in order to have your abdomen relaxed so that you can get an accurate measurement.
Keep the measurement in mind, so that you know exactly how normal or bad is your waist size.
- (Edgar do Nascimento, Health24, updated June 2008)
Sources: World Heart Federation; http://www.doh.gov.za
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