In today’s society our health and fitness is a very hot topic! People are becoming more and more concerned not just about their appearance but their overall well-being. There have been rising concerns surrounding obesity levels with our younger and older generations in regard to their dietary habits. However in most cases people generally just want to feel more educated about our decisions.
Whether you are big, small, large or tall, most of us have some sort of ideal weight or goal in mind. With the plethora of conflicting information on how to accurately measure ourselves and what to eat, it can be difficult to know what to believe!
BMI (Body Mass Index) was promoted in a 1972 publication of the Journal of Chronic Diseases by Ancel Keys. Keys’ formula is calculated by dividing your weight (kg’s) by the square of your height (meters²). Although Keys’ is widely known for this theory, his studies were derived from Adolphe Quetelet a mathematician & statistician findings from over 150 years ago. Keys’ debated that the formula for BMI was, “if not fully satisfactory, at least as good as any other relative weight index as an indicator of relative obesity”.
If you take into consideration the association between increased weight and the heightened risk of heart disease and diabetes, one might think that a rising BMI could be related to increased mortality but this is not always the case. When comparing people that are underweight with others of normal weight or a slightly elevated BMI, generally underweight individuals have found to have higher rates of mortality. This unforeseen relationship is known as the obesity paradox.
In a recent publication of the Journal of American Medical Association (AMA), researchers found that individuals with the most favourable BMI combined with the lowest rates of mortality has risen from 23.7 to 27 over the past 30 years. Furthermore they also found that the highest rates of mortality were associated with people whom have a BMI of 30 which was previously the marker from being overweight to obese.
Meanwhile the Irish National Dietetic Institute (IDNI) state that:
For individuals that are underweight some of the concerns include infertility issues, osteoporosis and lung disease etc. In the overweight category individuals may experience health issues such as high blood pressure, heart and gallbladder disease, type II diabetes or certain types of cancer. Others in the obese category have an even greater chance of the diseases mentioned above and even higher rates of mortality.
A report compiled by the Irish Heart Foundation shows that “almost two out of five Irish adults (38%) are overweight. Additionally more than one in five (23%) is obese. Likewise one in five teenagers are overweight or obese (11% overweight and 8% obese). As for children, one in ten 5-12 year olds are overweight with a further one in ten being obese. In total, 22% of 5-12 year olds are overweight or obese”.
Similar to the IDNI, the World Health Organisation (WHO) defines a BMI of 20-25 normal along with 25-30 as being overweight. Although some of the new findings from the AMA may question the legitimacy of these categories.
“If this finding is confirmed in other studies, it would indicate a need to revise the WHO categories presently used to define overweight, which are based on data from before the 1990s”
As for the reasons why we are seeing a rise in BMI associated with the lower levels of mortality still needs some further investigation. Perhaps the advances in the treatment of cardiovascular disease for overweight individuals is skewing the results? The big question is what is the relationship between obesity and the increased rates of cancer in respect to mortality? Alternatively could it be a result of weight gain later in life as appose to being overweight from childhood?
It might be more worthwhile to have a multi-faceted approach for individual patients on overall cardio-metabolic health, rather than just BMI. In some cases other measurements of body fat might be better suited, such as waist circumference. Additionally other factors might need to be calculated into the obesity category for people who have high exercise levels such as athletes and frequent gym-goers.
A controversial report in Britain last week from the National Obesity Forum and the Public Health Collaboration created even more confusion by suggesting to eat more fats. In this report they were advocating for a diet which is high in healthy fats and low in refined carbohydrates. Essentially stating that it offers “an effective and safe approach for preventing weight gain and aiding weight loss”.
As we can see there are a lot of considerations when trying to determine an individual’s overall well-being. Although a healthy lifestyle of diet and exercise seem to be at the core of it all. If you have any concerns about your health, you might want to consider seeing a qualified healthcare professional to discuss the best approach for your individual needs.
To calculate your BMI try this tool: http://www.nutritionandhealth.ie/sectors/nhf/nhf.nsf/vPages/Keeping_Fit~bmi-calculator?OpenDocument
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