Thursday, April 21, 2011

Challenging the BMI...The Bogus Medical Indicator

The Body Mass Indicator, used by the military, nutritionists, dieticians, your primary doctor, and even your insurance company, is used to calculate how much visceral fat you carry on your body.  The more visceral fat you carry, the more likely your are of having health complications.  The calculation is a rather simple one,  weight (in kilograms) divided by height (in meters) squared.  Any number above 25 is considered overweight, and over 30 is obese. This formula was developed by a statistician, Adolphe Quetelet, in Belgium in the early 19th century.   His calculations were used to measure obesity in the Caucasian male population of Belgium using statistical data to determine the average body size.  Today, a century and a half later, his formula is used here in the United States as a tool to indicate the health of American individuals, which therefore impacts our medicine, employment, marketing, and mainly, consumer's pocketbook.

To calculate your BMI, go to
http://www.nhlbisupport.com/bmi/

Thus, I challenge the BMI as an effective tool for measuring health!  From all of my research over the past seven years, using biology, chemistry, physics, and mathematics, I discovered that the BMI is completely irrelevant when measuring how much visceral fat an individual carries.
  • One, calculating the mass of an object is simply calculating how much a substance is acted upon by gravity, i.e. a bowling ball will have more mass than a tub of butter.  
  • Two, measuring the mass of two different substances against each other is not dependent upon volume, nor the amount of space which the objects take up, i.e. one-thousand pounds of feathers filling a football stadium vs one-thousand pounds of bricks filling a 6x8 pickup bed.  
  • Three, anyone with intelligence can figure out that different pedigrees of the same species have different proportions of substance, i.e. a St. Bernard has more hair and subcuntaneous fat (the fat underneath the skin) than a Great Dane of equal mass.  
  • Four, since the human body is prone to daily fluctuations in liquid retention, chyme (digested food) volume, and gut contents, measuring exact percentage of fat within the body is extremely hard to do no matter how complex the formula is.  
  • Five, using statistics against Quetelet's formula, the heights outside of the normal 19th-century, Belgium males' range are skewed as much as 5% on either side, which means that most NBA players are automatically put into the overweight to obese category, while people under 4'0" are generally put in the underweight category.    
Moreover, the BMI does not indicate the health of an individual!  BMI is moot when it comes to evaluating healthiness of a person because muscle, water and mineral content, bone mass, skin and organ tissues, and adipose tissue vary from person to person.  Any idiot would know that an extreme male body builder with 3% body fat would be much heavier than a petite female with 23% body fat of the same height.  Body fat percentage and BMI are completely two different things. To calculate body fat percentage, the mass of the individual is divided by the mass of adipose tissue. The only way to accurately calculate BFP, is through the Duel X-Ray Absorbancy machine, plethysmography, or Infra-Red Interactance.  BFP is otherwise calculated by using as a rough guesstimate via the Brozek formula (among others), which is based on statistical averages of the human body composition.

Why is the BMI used?  Because it is easy.  Your insurance company knows that people carrying more than 26% of body fat for men and 32%  of body fat for women, have an increased chance of health problems than people with less body fat.  Because people want to be PC and because society has gotten relatively dependent on quick fixes and shortcuts, the BMI is used to estimate your health.  Pulling the BMI formula out of an adjusters pocket is the quickest way of determining the amount you must pay to keep your insurance so that they do not lose money on your health issues (regardless if you have any or not).  The bigger your BMI number, the more your premium is, if your accepted at all.  Your doctor uses the BMI because he (or she) has, on average, 5 minutes to diagnose your complaints and prescribe a treatment.  He (or she) does not care about you five minutes after you walk out of their office.  A doctor does not evaluate your specific needs, how "healthy" you are, or how healthy you say your are; because at the end of the day, they have seen 30-40 people just like you, with complaints just like you had, and then they go home thinking about what is for dinner and spending time with their family.  To a normal medical doctor, who went to normal medical school and works in a normal primary health clinic, calculating your BMI is the easiest and quickest formula to determine whether you are unhealthy or not.  A doctor might take a look at you, but ultimately your BMI is going to determine the direction of the conversation, (regardless of the fact that you just ran a marathon or sat on the couch all weekend).  
Moreover, the military and other government agencies use the BMI in the same fashion to quickly calculate how much fat you have to lose in order to be healthy. Your promotions count on your BMI, along with your pay and perceived work ability, therefore impacting what privileges you get, if any. But, as I demonstrated before, BMI cannot determine body fat percentage, nor the health of the individual.  So, for those soldiers and government workers who are above the BMI because they have more muscle mass than average, they find themselves working harder and making more sacrifices than their genetically thin counterparts.

So, how do you really determine your health?  There are many ways to do that. You can demand for an accurate BFP, however most insurance companies do not pay for these.  You can request to see a fitness coach who knows how to use skin fold calipers to determine your BFP, and some gyms offer bio-electric fat analyzers.  But, no matter what your size, or how much fat you have on you, the most important thing is that you maintain a healthy lifestyle.  I have met some people, and I am sure you know somebody, who have some of the most unhealthiest habits, such as smoking and eating junk food, but still fall into the normal BMI category.  Thus, putting to rest my argument about the BMI as a good indicator for health.   

To make it easy for you, (here we go with the shortcuts again) I have devised a simple "yes or no" test to determine how healthy you are.  Answer these 20 questions with "Yes" or "No."  Then add up your "Yes's" and multiply that amount by 5.

1. Do you smoke?
2. Do you drink more than 4 alcoholic beverages per week, or more than 1 per day when you do drink?
3. Do you sit for more than 6 hours per day, (commuting, working, relaxing, etc.)
4. Do you eat mostly processed foods, foods with sugar or high fructose corn syrup, or foods with dyes?
5. Do you take medication for any persistent medical condition?
6.  Do you drink soda, diet soda, or artificial juice more than 4 times per month?
7.  Do you eat white processed breads, cereals, or products made from white flour?
8.  Do you fall asleep on the couch while watching TV during the day?
9.  Do you wear a pant size more than 14 for women or 34 for men?
10. Do you get winded going up 2 flights of stairs, (about 14 steps)?
11. Do you eat more grains than vegetables?
12. Do you eat dairy at 2 or more meals per day?
13. Do you feel stressed, overworked, or burnt out?
14. Do you have less than an associates degree?
15. Do you sleep less than 6 hours per night?
16. Do your ankles, feet, or hands swell?
17. Do you feel fatigued in the afternoon?
18. Do you take energy drinks to recharge?
19. Do you spend more than 30 hours per week watching TV or on the computer?
20. Do you have someone in your life who you love and reciprocates your love, (friend, family, pet, etc.).

If you scored between:
  • 0 and 15, you are very healthy.  Keep it up.
  • 20 and 35, you are moderately healthy but need to consider some adjustments.
  • 40 and 60, think about making improvements to your lifestyle to add years to your life.
  • 65 and 80, consider making drastic modifications to your lifestyle before it is too late.
  • 85 and 100, your chances of early death are very likely. Making improvements to your health now will decrease your chance of a painful, early death.

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