Abdominal Obesity and the Rise in Non-communicable Diseases

The prevalence of non-communicable diseases (NCDs) in the country has been rising. For instance, the prevalence of Diabetes has been rising sharply over the past few years in Central region with the most affected counties, Nyeri, Nyandarua, Murang’a and Kirinyaga, having prevalance rates of 12.6%, 10% 10% and 5.6% respectively (source).

Globally, NCDs are accountable for 63% of deaths and out of these, 80% occur in the middle and low income countries. Current projections show that by 2020, deaths caused by non-communicable diseases will be highest in Africa.

It's further projected that mortality from NCDs will have surpassed that from communicable diseases, neonatal and maternal deaths by 75% by 2030 in this region.


Prevalence of Non-Communicable Diseases in Kenya

In Kenya, more than 50% of the patients admitted in hospitals suffer from NCD. It’s also responsible for more than 55% of deaths. Overall in the national mortality, cardiovascular diseases are the leading cause of death with rates ranging from 6.1% to 8%. Cancer is next accounting for 7% of the mortality followed by diabetes. (source)

More recent statistics from the WHO (below) indicate Cancers have taken the helm.
Mortality in Kenya (Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO])

These statistics point to a bigger problem, one that will only get worse should appropriate actions not be taken. But before we head there, what exactly are Non-communicable diseases?



Non Communicable Diseases (NCDs)

NCDs are simply diseases that cannot transmitted from one person to the other. Out of all non-communicable diseases, the following account for 75% of all mortality caused by NCDs:
  • diabetes
  • cancer
  • cardiovascular diseases
  • respiratory illness


Risk Factors of NCDs

Obesity is one of the risk factors for the above diseases. However, of late it's becoming quite common to see people with normal BMIs suffer from NCDs too. The reason for these could be attributed to the location of the obesity.

Central or abdominal obesity is one of the risk factors for NCDs that's classified under metabolic syndrome (a group of risk factors that increases the risk for diabetes, stroke and heart diseases).

Other metabolic risk factors that increase the risk of a normal person having NCDs include:
  • reduction in good cholesterol (HDL - high density lipoprotein)
  • elevated triglycerides levels
  • insulin resistance
  • hypertension
  • elevated blood glucose level




What is Abdominal Obesity?

Abdominal Obesity also referred to as Central Obesity is the deposition of fat around the abdominal cavity (region between your diaphragm and waist). Consuming a lot of calories than what the body needs, prompts it to store the excess as fat in adipose tissues (under the skin and around vital organs) to use as a source of energy.

Excessive abdominal fat can indicate that the subcutaneous adipose tissue (under the skin) is not able to serve as a reservoir which can be used to supply calories when the intake of energy is excessive or when there is a reduction in energy expenditure.

Consequently, if the intake exceeds expenditure, the fat accumulates around vital organs like liver, lungs, kidney, pancreases and other important organs around the abdominal area. This fat deposition alters the normal function of these organs increasing the risk for NCDs.

The main contributing factors for abdominal obesity are:
  • a sedentary lifestyle
  • physical inactivity (lack of exercise)
  • poor nutrition
  • inheritance
  • age
  • sex


Do you have Central Obesity?

Waist Measurement
Central obesity is determined by taking a waist-hip ratio measurement. A waist-hip ratio of more than 80cm in females and 90cm in males is inidcative of central obesity. Therefore, it's important to consider including waist-hip ratio measurements when taking BMI since on its own it cannot discriminate between the location of fat.

Consequently, BMI may erroneously indicate a person with abdominal obesity to be of normal weight (assumption: healthy) and a person with more fat below the abdomen (e.g. hips in women) or more muscles in relation to height as overweight or obese (assumption: unhealthy). This nuance cannot be overstated.
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