Good news! You may not be obese after all.
One month ago, the American Medical Association formally rejected Body Mass Index (body weight in kilograms divided by the square of height in meters) as the main way to assess overall wellness – only a mere 191 years since the man who devised it did.
In 1832, Lambert Adolphe Jacques Quetelet developed the BMI to give an overall picture of the homogeneous Belgian population’s overall health, for social planning purposes, not as a diagnostic tool for individuals.
But for better or worse, people aren’t homogeneous.
“People with the same BMI, same pants size and same belt notch have different amounts of fat and muscle,” explained Dr. Vijaya Surampudi, assistant director of UCLA’s weight management program.
Men have more muscle mass and less fat mass than women – and muscles are denser than fat. This is why a 250-pound, 6’3” NFL running back’s BMI (32.88) will mark him as obese as a shorter, fatter couch potato. Based on BMI alone, both will be labeled as pre-diabetic and at risk for heart disease, even though at least one will be neither.
As people age, body fat mass increases as muscle mass declines.
African Americans’ bodies have less fat but more muscle mass, so their BMIs often end up in overweight/obese territory.
People of Asian descent are likelier to develop high blood pressure, diabetes, and other conditions related to obesity at lower BMIs. This is why the World Health Organization set its cutoff for obesity at 25 – 5 points lower than for non-Asians.
Even people of the same ethnicity have different ages, genetics, sexes, cholesterol, inflammation and blood sugar levels, heart rates, blood pressures, and medical histories. And even within one person’s body, bone and muscle weigh more than fat, and fat around the stomach is a higher mortality risk factor than fat around the hips and buttocks.
One literal measure that takes account of this is waist-to-hip ratio, which the European Association for the Study of Diabetes recommends as a replacement for the BMI. If you have a tape measure and a minute or two, you can calculate what yours is. Just measure your waist at its narrowest point, usually just above your belly button. Next, measure your hips across the widest part of your buttocks. Then divide your waist measurement by your hip measurement to get the ratio.
For women, 0.8 or less is a low risk score, 0.81 to 0.85 moderate, and 0.85 and over high. For men, the numbers are 0.95 or less, 0.96 to 1, and 1 or higher.
Of course, the differences between different people are more than physical. We all have different likes and dislikes, different things we enjoy or hate doing, different diets, different values, different hobbies and interests.
That’s why, when it comes to senior care, a one-size-fits-all package won’t work.
At Senior Insights, we strive to do better than that for our clients. Much better. We recognize that like people of all ages, seniors are individuals, with their own personal needs, wants, outlooks, values, activities, and lifestyles. So we start with a thorough three-part needs assessment which covers everything – from physical, psychological and mental status to mobility issues and nutritional needs to personal likes and dislikes to legal wishes – with clients, their caregivers and their families. Then, and only then, do we custom-design a holistic, coordinated care plan based on what we’ve learned.
So please contact us to learn more about senior care management that’s custom-measured to your needs.