Even at a ‘Normal’ BMI, Belly Fat Raises Health Risks – Everyday Health

Global Health Report: Normal-Weight Abdominal Obesity and its Implications for Sustainable Development Goals

Introduction and Key Findings

A global study utilizing World Health Organization (WHO) data from over 471,000 adults across 91 countries reveals a significant public health challenge. The research indicates that approximately 22% of adults worldwide, despite having a “normal” Body Mass Index (BMI), exhibit abdominal obesity. This condition, termed “normal-weight abdominal obesity,” underscores the critical health principle that fat distribution is a more significant determinant of health risk than overall weight. The global prevalence of abdominal obesity across all BMI categories is estimated at 45%.

Alignment with Sustainable Development Goal 3: Good Health and Well-being

These findings directly impact the achievement of Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. The study establishes a strong association between normal-weight abdominal obesity and an elevated risk of cardiometabolic conditions, which are major non-communicable diseases (NCDs) that SDG Target 3.4 seeks to reduce. The metabolically active nature of visceral (belly) fat, which surrounds internal organs, disrupts normal metabolism by releasing hormones and inflammatory substances, leading to conditions that undermine global health targets.

• High Blood Pressure
• Diabetes
• High Cholesterol
• High Triglycerides

Socio-Economic Determinants and Broader SDG Linkages

The research identifies several risk factors for abdominal obesity that connect to a wider range of Sustainable Development Goals, highlighting the interconnectedness of global development challenges.

1. Poor Nutrition: Consumption of fewer than the recommended daily servings of fruits and vegetables is a key factor. This directly relates to SDG 2 (Zero Hunger), which includes targets for ending all forms of malnutrition and ensuring access to nutritious food.
2. Physical Inactivity: A sedentary lifestyle is strongly linked to this condition, posing a direct challenge to achieving the health and well-being targets of SDG 3.
3. Unemployment: The correlation with unemployment highlights how economic instability impacts health outcomes, linking the issue to SDG 8 (Decent Work and Economic Growth).
4. Education Level: A connection to higher education levels suggests complex socio-economic patterns that may involve more sedentary occupations, indicating a need to integrate health promotion into policies related to SDG 4 (Quality Education) and SDG 8.

Clinical Assessment and Measurement Protocols

The study reinforces the growing consensus that BMI is an insufficient standalone metric for assessing obesity-related health risks, as it does not account for body composition or fat distribution. To better align clinical practice with the prevention goals of SDG 3, a dual-metric approach is recommended, combining BMI with waist circumference to provide a more accurate assessment of cardiometabolic risk.

Recommendations for Public Health Interventions

To address the challenges posed by normal-weight abdominal obesity and accelerate progress towards the SDGs, the following interventions are recommended:

• Update Clinical Guidelines: Public health authorities should promote the combined use of BMI and waist circumference in routine health screenings to better identify at-risk individuals who may be overlooked by BMI measurements alone.
• Promote Lifestyle Modifications: Public awareness campaigns should emphasize that visceral fat is highly responsive to lifestyle interventions. Promoting Mediterranean-style diets and regular physical activity can directly contribute to achieving the NCD reduction targets of SDG 3.
• Integrate Health into All Policies: Addressing the socio-economic determinants requires a multi-sectoral approach. Policies aimed at improving food systems (SDG 2) and ensuring stable employment (SDG 8) must incorporate public health considerations to mitigate the risk of NCDs.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to the following Sustainable Development Goals (SDGs):

• SDG 3: Good Health and Well-being: The central theme of the article is the health risks associated with abdominal obesity, even in individuals with a normal Body Mass Index (BMI). It discusses the prevalence of cardiometabolic conditions such as high blood pressure, diabetes, and high cholesterol, which are non-communicable diseases (NCDs). The article emphasizes the importance of lifestyle interventions like diet and exercise to promote health and well-being.
• SDG 2: Zero Hunger: While not focused on hunger, this goal also aims to end all forms of malnutrition. The article connects abdominal obesity to poor dietary habits, specifically mentioning “Eating fewer than the recommended number of fruit and vegetable servings per day” as a contributing factor. This highlights the issue of poor nutrition, which is a form of malnutrition relevant to Target 2.2.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion of health risks and their underlying causes, the following specific SDG targets can be identified:

1. Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article directly supports this target by investigating the risk factors for major cardiometabolic NCDs (“high blood pressure, diabetes, high cholesterol, and high triglycerides”). It highlights the importance of prevention through lifestyle modifications (“dietary changes and physical activity”) to mitigate these risks.
2. Target 2.2: By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons. The article connects the health issue of abdominal obesity to a specific form of malnutrition: poor diet. It identifies “Eating fewer than the recommended number of fruit and vegetable servings per day” as a factor linked to unhealthy levels of belly fat, thereby addressing the broader challenge of ensuring proper nutrition.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions and implies several indicators that can be used to measure progress towards the identified targets:

• Indicators for Target 3.4 (Reduce mortality from NCDs):
  • Prevalence of abdominal obesity: The article explicitly states that “the global prevalence of abdominal obesity overall is roughly 45 percent.” This can be used as an indicator to track a key risk factor for NCDs.
  • Prevalence of “normal-weight abdominal obesity”: The study found that “nearly 22 percent [of adults] having a ‘normal’ BMI” also have abdominal obesity. Tracking this specific group is an indicator of hidden health risks.
  • Prevalence of physical inactivity: The article lists being “physically inactive” as a factor connected to unhealthy belly fat, implying that the rate of physical activity in a population is a relevant indicator.
  • Prevalence of cardiometabolic conditions: The article links abdominal obesity to higher risks of high blood pressure, diabetes, high cholesterol, and high triglycerides. The incidence and prevalence of these conditions are direct measures of the NCD burden.
• Indicator for Target 2.2 (End all forms of malnutrition):
  • Proportion of population with inadequate fruit and vegetable consumption: The article identifies “Eating fewer than the recommended number of fruit and vegetable servings per day” as a risk factor. This proportion serves as a direct indicator of nutritional quality within a population.

4. Table of SDGs, Targets, and Indicators

Source: everydayhealth.com