Very important, since it strongly determines the impact of obesity on health. Fat deposition may be central
(mostly in the trunk) or peripheral (mostly in the extremities).
Central obesity has a bihumeral diameter greater than the bitrochanteric diameter; subcutaneous fat has a “descending” distribution, being mostly concentrated in the upper half of the body (neck, cheeks, shoulder, chest, and upper abdomen).
Peripheral obesity has instead a bitrochanteric diameter greater than the bihumeral diameter;
subcutaneous fat has an “ascending” distribution, being mostly concentrated in the lower half of the
body (lower abdomen, pelvic girdle, buttocks, and thighs).
Men tend to have central obesity, whereas women have peripheral obesity. Upper and central body fat
distribution (especially if intra-abdominal rather than subcutaneous) is a greater predictor of insulin
resistance and cardiovascular risk than BMI alone. It also has higher association with hypertension, diabetes,
atherosclerotic cardiovascular diseases, and other chronic metabolic conditions (metabolic syndrome).
For example, a waist-to-hip ratio ≥1.0 is considered an “at risk” indicator for both men and women,
confirming that an apple shape (extra weight around the stomach) is more dangerous than a pear shape
(extra weight around hips or thighs). Subjects judged to be lean by BMI alone may be very insulin resistant if their body fat is centrally distributed.
(mostly in the trunk) or peripheral (mostly in the extremities).
Central obesity has a bihumeral diameter greater than the bitrochanteric diameter; subcutaneous fat has a “descending” distribution, being mostly concentrated in the upper half of the body (neck, cheeks, shoulder, chest, and upper abdomen).
Peripheral obesity has instead a bitrochanteric diameter greater than the bihumeral diameter;
subcutaneous fat has an “ascending” distribution, being mostly concentrated in the lower half of the
body (lower abdomen, pelvic girdle, buttocks, and thighs).
Men tend to have central obesity, whereas women have peripheral obesity. Upper and central body fat
distribution (especially if intra-abdominal rather than subcutaneous) is a greater predictor of insulin
resistance and cardiovascular risk than BMI alone. It also has higher association with hypertension, diabetes,
atherosclerotic cardiovascular diseases, and other chronic metabolic conditions (metabolic syndrome).
For example, a waist-to-hip ratio ≥1.0 is considered an “at risk” indicator for both men and women,
confirming that an apple shape (extra weight around the stomach) is more dangerous than a pear shape
(extra weight around hips or thighs). Subjects judged to be lean by BMI alone may be very insulin resistant if their body fat is centrally distributed.