Monday, 4 August 2014

The BMI ( Indicator Of Heart Disease Risk ) is Wrong

After years of throwing terms around like "overweight", "obese", and "morbidly obese", doctors are conceding that the BMI where they derived those terms might actually be wrong. The BMI (Body Mass Index) has been around for almost 100 years, but since 1998, the BMI has been the gold standard that doctors and the government use to determine whether or not a person was fat. To calculate BMI, you divide your weight by the square of your height. For those of us who are not math majors, several websites and charts hanging in our doctors' offices are happy to tell us if we are overweight or obese. For instance, my sister who is 5'9" and a nice, trim, compact 170 pounds is considered overweight.
But new research put out by the Mayo Clinic indicates that the BMI might not be the best indicator for obesity after all. An athletic, muscular man who is 5'10" and 200 pounds comes up "overweight" on the BMI scale because of his muscle mass. Muscle weighs more than fat, so simply using height and weight is not an accurate measure of a person's fitness. BMIs that indicate a person is overweight (25-29) or obese (29 and up) can affect a person's health and life insurance status erroneously.
For years, it has been assumed that those indicated as "overweight" according to the BMI were at a much higher risk of dying from heart related conditions. But the new research that the Mayo Clinic in Rochester, Minnesota, published indicates something quite different. In their study of 250,000 people with heart disease, those with a BMI that indicated overweight status had less chance of dying from heart problems than those with a normal BMI. And people with a normal BMI were less likely to die than people with low BMI. And as expected, severely obese people did have a higher incidence of death from heart-related disease.
The difference in the overweight group is likely to be muscle. People with more muscle are more fit and healthy, but that muscle puts them in the overweight group for their height. Numbers that get tossed around frequently are that 60% of Americans are overweight and half of those are obese. These numbers are based strictly off the BMI, and the group of overweight Americans is likely to be much lower.
But before we all breathe a sigh of relief and down a cheeseburger, bag of potato chips, and a carton of moose tracks ice cream (yum), the study leader did say that the research did not prove that obesity was harmless. Being overweight or obese still carries an increased risk of heart disease, diabetes and certain types of cancers.
So how do we measure the risks? According to experts in the heart health field, the risk of heart disease can be calculated by measuring your waistline. Or even better, by a hip/waistline ratio. (I know, those were two things I never wanted to measure again either). That is because the fat in your abdomen is dangerous fat. Fat packed around the organs in the abdomen is more metabolically active, which means it releases more of the acids that increase heart disease risk and other conditions like high blood pressure and high blood sugar.
To calculate the waist-to-hip ratio (to keep an acronym it's called the WTHR), measure both your waist and hips, and divide the waist size by the hip size. And yes, this indicator realizes the difference between men and women, unlike the BMI. For women, the ratio should be no more than 0.8. In other words, your waist should be smaller than your hips. And for men, it should be 1.0 or less. That means that a man's waist should be the same measurement as his hips or smaller. The beer-and-pizza belly has to go!
And that's where I realize that I need to exercise a bit more and eat better foods. I always coast along at my nice BMI of about 22. But the new WTHR indicator doesn't look so nice. And there is one formula that never fails: eat less than you use. That will take care of BMI, WTHR and any new fat indicators just showing up.

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