Central obesity, a prominent feature of metabolic syndrome and obesity contributes to premature mortality from all cause of death, including cardiovascular disease (CVD) and cancer, but obesity is not included in standard multi variable risk assessments because of major imperfections in its measurement. Body mass index (BMI) performs poorly as a predictor of death except in very large population cohorts.The more recent emphasis on assessing central obesity by measuring Waist circumference has been supported by data that suggest superior prediction of CVD.