Does your BMI really reflect your health status?

Those who are closely watching their weight are familiar with the term BMI, short for body mass index. Body weight in absolute terms cannot be used as accurate measure of obesity for simple reason that there are short people and there are tall people, and weight can therefore vary relative to height. That’s why scientists use BMI, a numerical value of weight in relation to height, calculated as a person’s body weight divided by the square of his or her height, as a diagnostic tool to evaluate weight problems and health status of a person. Weight status based on BMI (usually expressed in terms of kg/m²) is categorized as follows:

• Underweight  - 18.5 and below
• Normal weight - 18.5 to 25
• Overweight - 25 to 30
• Obesity class I - 30 to 35
• Obesity class II - 35 to 40
• Obesity class III - above 40

This has been like this for years but recently, there have been concerns that BMI may not be an accurate way of assessing a person’s true health status.

Based on BMI measurements, almost one-third of the American population is considered overweight, which is the middle range between normal weight and obesity. Excess weight has been identified as a major risk factor in many chronic diseases, including heart disease, hypertension, hyperlipidemia, diabetes, osteoporosis and certain types of cancer.

Several research studies looked at how BMI is related to mortality rates, were surprisingly inconclusive and sometimes contradictory results. Scientists now think that that BMI may not be the right measurement because:

• BMI doesn’t distinguish between different types of fat mass. For example, there is the fat mass which is of important health concerns as it is closely linked to type 2 diabetes. However, there is also lean mass, especially muscle tissue, which reduces health risks.
• BMI does not directly measure the distribution of body fat. Depending on location, fat may have more or less impact on health. Visceral fat or fat at the waist, for example, is more detrimental to health than fat at the hips.

Thus, using BMI as health status indicator does not actually show the complete picture and may miss the health risks that slight overweight may present.

According to lead author Dr. Cora E. Lewis of the University of Alabama at Birmingham

“This larger picture includes important relationships between BMI and other health outcomes, such as cardiovascular disease and its risk factors. Arguably, the most important relationship among the cardiovascular disease risk factors is diabetes, which is significantly more common in overweight than in normal-weight people.”

Considering the increasing number of children who are overweight, health experts are urging researchers and clinicians alike to act now and conduct research that goes beyond just BMI.

Dr. Lewis continues

“Weight gain is progressive and weight loss difficult. Although a young child is unlikely to have a heart attack, overweight children are likely to become overweight or obese adults, which puts them at risk for cardiovascular events as they mature. Achieving and maintaining a healthy body weight is of high importance for all Americans.”

               

School diet program helped children in controlling weight problems

In some parts of the world, children are dying of hunger; in other parts, children are dying from obesity-related health problems. Such irony.

Childhood obesity is becoming a major problem in the developed world. In the US alone, 16.9% of boys and 15.6% of girls aged 6 to 11 years among non-Hispanic whites are overweight. Among non-Hispanic blacks, it’s 17.2% of boys and 24.8%of girls in the same age group. For Mexican Americans, it’s 25.6% of boys and 16.6% of girls. (Source: American Heart Association (AHA)). Obesity is a major risk factor in cardiovascular health as well as type 2 diabetes.

Many studies point to the causes of these weight problems - poor nutrition and lack of exercise. The American Academy of Pediatrics (AAP) and the American Heart Association have issued guidelines on how to clinically monitor and control cholesterol levels in children who are overweight or obese.

However, health solutions that go beyond the clinical settings are necessary to stem this rapidly growing problem.

Schools are one of the ideal places to start with. After all, children spend a large part of their daily routine at school. This study led by the Center for Obesity Research and Education, Temple University examined

the effects of a multicomponent, School Nutrition Policy Initiative on the prevention of overweight … and obesity … among children in grades 4 through 6 over a 2-year period.

1,349 pupils from 10 Philadelphia elementary schools were involved in the study. 5 schools implemented the School Nutrition Policy Initiative and 5 schools did not and served as conrol. The schools who had implemented the policy drastically changed the food available at school, be it at the cafeteria or in the vending machines. Sodas were replaced with fruit juices, low-fat milk, or water. Candies and sweets were banned and snacks were scaled down in terms of fat and sugar content. In addition, rewards in the form of raffle tickets for sports equipment were given to those who made wise food choices. In addition, the pupils were encouraged to perform physical exercises at break times. The children were monitored, their weight and height measured and their eating and exercise habits were checked with a questionnaire. The school staff who organized the study was specially trained in nutrition education.

The schools also stepped on nutrition and health education. Nutrition education is incorporates as much as possible in all school subjects. Special classes were organized not only for the pupils but for teachers and parents as well.

Social marketing on nutrition was also employed. Slogans and posters on healthy lifestyle were posted everywhere.

And here are the results:

The intervention resulted in a 50% reduction in the incidence of overweight. Significantly fewer children in the intervention schools (7.5%) than in the control schools (14.9%) became overweight after 2 years. The prevalence of overweight was lower in the intervention schools. No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years.

This means that after two years, the number of overweight pupils at the five “nutrition-friendly” schools dropped while the number of overweight children in control schools increased. Also fewer new overweight children were observed at the “nutrition-friendly” schools.

Unfortunately, no such significant difference has been observed in the incidence of obesity in the 2 school groups. Also, remission or the tendency to gain back lost pounds did not significantly decrease.

In conclusion, special interventions such as used in this study do help in controlling the problem of overweight among children. However, it doesn’t seem to be enough. Other measures have to be taken including implementation of such initiative earlier. In addition, future initiatives should focus on other aspects of the school environment such as PE classes as well as environments outside the school - at home!

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Weight Loss, Osteoarthritis and Your Christmas Recipes

Tomorrow night will be Christmas Eve and you most likely have your recipes memorized and the ingredients all bought in preparation for the food you will serve your family on Christmas.

What if there is an arthritis patient in your family? Then you have to put that into consideration when planning your meals for the holiday. Not only arthritis, but what if there is a diabetic or an hypertensive person in the family?

If that is the case then I always recommend cooking healthy foods to be on the safe side. Let not be the holidays be an excuse to forget that particular diet you were following in lieu of your condition — diabetes, hypertension, arthritis…etc.

One more thing I would like to remind you of: your weight. If you have arthritis, being overweight or obese is not going to help you. Being close to your ideal weight will surely reduce your risk for osteoarthritis. (Read more about the osteoarthritis-weight association from Johns Hopkins.)

Being overweight is a clear risk factor for developing OA. Population-based studies have consistently shown a link between overweight or obesity and knee OA. Estimating prevalence across populations is difficult since definitions for obesity and knee OA vary among investigators.

Data from the first National Health and Nutrition Examination Survey (HANES I) indicated that obese women had nearly 4 times the risk of knee OA as compared with non-obese women; for obese men, the risk was nearly 5 times greater. (ref. 6) In a study from Framingham MA, overweight individuals in their thirties who did not have knee OA were at greater risk of later developing the disease. (ref. 7)

Other investigations, which performed repeated x-rays over time also, have found that being overweight significantly increases the risk of developing knee OA. (refs. 8 and 9) It is estimated that persons in the highest quintile of body weight have up to 10 times the risk of knee OA than those in the lowest quintile. (ref. 5)

Case in point: mine. Earlier this year, I weighed a whooping 165 lbs. I am barely 5 ft. tall, so I know that is too far from my ideal weight. When my osteoarthritis (OA) symptoms attacked in mid-August, my weight made it even worse. I changed my eating habits and now I weigh 135 lbs. My OA is better, not only due to my changed diet but also because of the meds, vitamins and other therapies I am taking. The symptoms are less and I don’t suffer as much as I used to.

At 135 lbs., by BMI says I’m still a bit overweight. While I am convinced I need to shed more weight, this holiday season is an odd against that goal. Despite that, I am keeping myself from overeating. I definitely do not want to regain all those pounds I lost.

SO. If you are arthritic like me. remind yourself to eat healthier, not only this holiday season but for all times.