Central Obesity and Normal-Weight Central Obesity Among Adults Attending Healthcare Facilities in Buffalo City Metropolitan Municipality, South Africa: A Cross-Sectional Study

Abstract

Background: Central obesity (CO) confers a significant threat on the cardio-metabolic health of individuals, independently of overall obesity. Disparities in the measures of fat distribution lead to misclassification of individuals who are at risk of cardio-metabolic diseases. This study sought to determine the prevalence and correlates of central obesity and normal-weight central obesity among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: A cross-sectional survey of 998 adults carried out at the three largest outpatient clinics in BCMM. Overall and central obesity were assessed using BMI, waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR). The WHO STEPwise questionnaire was used for data collection. Normal-weight central obesity was defined as CO among individuals with normal weight, as assessed by BMI. Results: The mean age of participants was 42.6 (±16.5) years. Prevalence of CO was 67.0, 58.0 and 71.0% by WC, WHR and WHTR, respectively. Prevalence of normal-weight central obesity was 26.9, 36.9 and 29.5% by WC, WHR and WHTR, respectively. Central obesity was significantly associated with hypertension but not associated with diabetes among those with normal weight (by BMI). Conclusion: The prevalence of central obesity among the study participants is high, irrespective of the defining criteria. One in three adults of normal weight had central obesity. Body mass index should therefore not be used alone for clinical assessment by healthcare workers in the study setting.