Better Than BMI
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BMI is a very flawed system, and there are several more useful ways of measuring our bodies. Let’s take a look at them!
What’s wrong with BMI?
Oof, what isn’t wrong with BMI?
In short, it was developed as a demographic-based tool to specifically chart the weight-related health of working-age European white men a little under 200 years ago.
This means that if you are, perchance, not a working-age European white man in 1830 or so, then it’s not so useful. It’d be like first establishing height norms based on NBA basketball players, and then applying it to the general population, and thus coming to the conclusion that someone who is 6’2″ is very short.
In long, we did a deep-dive into it here, and in particular what things go dangerously wrong when it’s applied to women, non-white people, athletic people, pregnant people, people under 16 or over 65 and more:
When BMI Doesn’t Quite Measure Up
What we usually recommend instead
For heart disease risk and diabetes risk both, waist circumference is a much more universally reliable indicator. And since those two things tend to affect a lot of other health risks, it becomes an excellent starting point for being aware of many aspects of health.
Pregnancy will still throw off waist circumference a little (measure below the bump, not around it!), but it will nevertheless be more helpful than BMI even then, as it becomes necessary to just increase the numbers a little, according to gestational month and any confounding factors e.g. twins, triplets, etc. Ask your obstetrician about this, as it’s beyond the scope of our article today!
As to what’s considered a risk:
- Waist circumference of more than 35 inches for women
- Waist circumference of more than 40 inches for men
These numbers are considered applicable across demographics of age, ethnicity, and lifestyle.
Bonus extra measurement based on the above
Important also is waist to hip ratio.
How to calculate it:
- measure your waist circumference
- measure your hip circumference
- divide the first measurement by the second one
Because it’s a ratio, it doesn’t matter what units you use (e.g. inches, cm, etc) so long as you use the same units for both measurements.
The World Health Organization offers the following chart:
| Health risk | Women | Men |
| Low | 0.80 or lower | 0.95 or lower |
| Moderate | 0.81–0.85 | 0.96–1.0 |
| High | 0.86 or higher | 1.1 or higher |
Source: Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation
This is especially relevant for cardiovascular disease risk:
…and also holds true for all-cause mortality:
Waist-Hip-Ratio as a Predictor of All-Cause Mortality in High-Functioning Older Adults
An ancient contender that’s still more useful than BMI
Remember Archimedes? The (perhaps apocryphal) story of his “Eureka” moment in the bathtub when he realized that water displacement could be used to measure the volume of an irregular shape?
Just like Archimedes (who, the story goes, had been hired to determine the composition of a crown that might or might not have been pure gold), we can use this method to determine body composition, because we have references for how much a given volume of a given substance will weigh, so combing what we know about a body’s weight and volume will tell us about its composition in ways that neither metric could give us alone.
Indeed, it’s one of the commonly-mentioned flaws of BMI that muscle weighs more than fat, and Archimedes’ method not only avoids that problem, but also, actually turns that knowledge (muscle weighs more than fat) to our advantage.
It’s called “hydrostatic weighing” now:
You may be wondering: what about bones? Or internal organs?
The fact is that those are slightly confounding factors that do get in the way of a truly accurate analysis, but the variation in how much one person’s skeleton weighs vs another’s, or one person’s set of organs weigh than another’s, is too small to make an important difference to the health implications.
Lastly…
Hydrostatic weighing isn’t the only way to work out how much of our body is made of fat; if you have for example a smart scale at home (like this one) that tells you your body fat percentage, that is an estimate based on bioelectrical impedance analysis.
It’s less accurate than the hydrostatic method, but easier to do at home!
As to what percentages are “best”, healthy body fat percentages are (assuming normal hormones) generally considered to be in the range of 20–25% for women and 15–20% for men.
You can read more about this here:
Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?
Take care!
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The Best Kind Of Fiber For Overall Health?
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The Fiber Of Good Health
We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Fiber’s important for many aspects of health, not least of all the heart:
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
As well, of course, as being critical for gut health:
Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)
But is all fiber “prebiotic fiber”, and/or are some better than others?
Beta-glucan
A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:
- pectin
- β-glucan
- wheat dextrin
- resistant starch
- cellulose (control)
As for health metrics, they measured:
- body weight
- adiposity
- indirect calorimetry
- glucose tolerance
- gut microbiota
- metabolites thereof
What they found was…
❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.
All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞
If you’d like to read more, the study itself is here:
If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.
It also acts indirectly as a GLP-1 agonist, by the way:
The right fiber may help you lose weight
You may be wondering: what is β-glucan found in?
It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.
Is it available as a supplement?
More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.
As an aside, cordyceps itself has many other healthful properties too:
Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.
Enjoy!
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8 Signs On Your Breast You Shouldn’t Ignore
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Can you name the 8 signs that may indicate breast cancer? This video discusses them, and also shows what they look like on various different skintones:
Stay abreast:
Dr Simi Adedeji bids us watch out for:
- Inverted nipple: a newly inverted nipple (pointing inward or folded) should be checked by a doctor, especially if it’s a recent change.
- Flaky rash: a flaky, itchy, or red rash around the nipple or areola could indicate an underlying issue and should not be dismissed as just a skin condition.
- Tethering: skin pulling or denting, noticeable when raising your arms, may signal a deeper problem.
- Dimpling: skin resembling an orange peel (po orang sign) with dips and accentuated pores could indicate swelling or thickening and requires medical evaluation.
- Redness or heat: unusual warmth, redness, or tenderness in the breast, particularly if not breastfeeding, should be investigated.
- Nipple discharge: any unusual fluid from the nipple (be it yellow, green, milky, clear, or blood-stained) warrants attention, especially if spontaneous or only from one side.
- Change in size: sudden changes in the size or shape of one breast should not be ignored.
- Breast lump: a firm, irregular, or persistent lump in the breast, armpit, or collarbone area should be checked promptly, even if it’s not always harmful.
The above signs may indicate cancer or something else, but none of them are things that should be ignored (even if you get just one sign).
For more on each of these, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Take care!
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Immunity – by Dr. William Paul
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This book gives a very person-centric (i.e., focuses on the contributions of named individuals) overview of advances in the field of immunology—up to its publication date in 2015. So, it’s not cutting edge, but it is very good at laying the groundwork for understanding more recent advances that occur as time goes by. After all, immunology is a field that never stands still.
We get a good grounding in how our immune system works (and how it doesn’t), the constant arms race between pathogens and immune responses, and the complexities of autoimmune disorders and—which is functionally in an overlapping category of disease—cancer. And, what advances we can expect soon to address those things.
Given the book was published 8 years ago, how did it measure up? Did we get those advances? Well, for the mostpart yes, we have! Some are still works in progress. But, we’ve also had obvious extra immunological threats in years since, which have also resulted in other advances along the way!
If the book has a downside, it’s that sometimes the author can be a little too person-centric. It’s engaging to focus on human characters, and helps us bring information to life; name-dropping to excess, along with awards won, can sometimes feel a little like the book was co-authored by Tahani Al-Jamil.
Nevertheless, it certainly does keep the book from getting too dry!
Bottom line: this book is a great overview of immunology and immunological research, for anyone who wants to understand these things better.
Click here to check out Immunity, and boost your knowledge of yours!
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Why STIs Are On The Rise In Older Adults
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Three Little Words
Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:
❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.
These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞
Read more: Managing The Rise In STIs Among Older Adults
That said, there is a gender gap when it comes to the increased risk, for example:
❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞
~ US Dept of Health & Human Services
Source: CDC: | Sexually Transmitted Disease Surveillance
Is abstinence the best preventative, then?
It is inarguably the most effective, but not necessarily the best for everyone.
This is because for most adults, a healthy sex life is an important part of overall wellbeing.
See also: Mythbusting The Big O
Even in this case there is a gender gap in:
- the level of importance placed on frequency of sexual interactions
- what act(s) of sexuality are held to be most important:
❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.
Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).
Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞
Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults
If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:
The National Social Life, Health, and Aging Project: An Introduction
What’s the best preventative, then?
Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.
You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.
Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).
Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.
What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:
- Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
- Hands that are not clean (watch out for bacteria too)
- A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in
Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!
On a related note, see also: How To Avoid UTIs
Recap on the single most important part of this article:
At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.
Take care!
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Early Bird Or Night Owl? Genes vs Environment
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A Sliding Slope?
In Tuesday’s newsletter, we asked you how much control you believe we have over our sleep schedule, and got the above-depicted, below-described, set of responses:
- 45% said “most people can control it; some people with sleep disorders cannot
- 35% said “our genes predispose us to early/late, but we can slide it a bit
- 15% said: “going against our hardwired sleep schedules is a road to ruin”
- 5% said “anyone can adjust their sleep schedule with enough willpower”
You may be wondering: what’s with those single-digit numbers in the graph there? And the answer is: Tuesday’s email didn’t go out at the usual time due to a scheduling mistake (sorry!), which is probably what affected the number of responses (poll response levels vary, but are usually a lot higher than this).
Note: yes, this does mean most people who read our newsletter don’t vote. So, not to sound like a politician on the campaign trail, but… Your vote counts! We always love reading your comments when you add those, too—often they provide context that allow us to tailor what we focus on in our articles
However, those are the responses we got, so here we are!
What does the science say?
Anyone can adjust their sleep with enough willpower: True or False?
False, simply. It’s difficult for most people, but for many people with sleep disorders, it is outright impossible.
In a battle of narcolepsy vs willpower, for example, no amount of willpower will stop the brain from switching to sleep mode when it thinks it’s time to sleep:
❝Narcolepsy is the most common neurological cause of chronic sleepiness. The discovery about 20 years ago that narcolepsy is caused by selective loss of the neurons producing orexins sparked great advances in the field
[There is also] developing evidence that narcolepsy is an autoimmune disorder that may be caused by a T cell-mediated attack on the orexin neurons and explain how these new perspectives can inform better therapeutic approaches.❞
~ Dr. Carrie Mahoney et al. (lightly edited for brevity)
Source: The neurobiological basis of narcolepsy
For further reading, especially if this applies to you or a loved one:
Our genes predispose us to early/late, but we can slide it a bit: True or False?
True! First, about our genes predisposing us:
…and also:
Gene distinguishes early birds from night owls and helps predict time of death
Now, as for the “can slide it a bit”, this is really just a function of the general categories of “early bird” and “night owl” spanning periods of time that allow for a few hours’ wiggle-room at either side.
However, it is recommended to make any actual changes more gradually, with the Sleep Foundation going so far as to recommend 30 minutes, or even just 15 minutes, of change per day:
Sleep Foundation | How to Fix Your Sleep Schedule
Going against our hardwired sleep schedule is a road to ruin: True or False?
False, contextually. By this we mean: our “hardwired” sleep schedule is (for most of us), genetically predisposed but not predetermined.
Also, genetic predispositions are not necessarily always good for us; one would not argue, for example, for avoiding going against a genetic predisposition to addiction.
Some genetic predispositions are just plain bad for us, and genes can be a bit of a lottery.
That said, we do recommend getting some insider knowledge (literally), by getting personal genomics tests done, if that’s a viable option for you, so you know what’s really a genetic trait (and what to do with that information) and what’s probably caused by something else (and what to do with that information):
Genetic Testing: Health Benefits & Methods
Take care!
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Omega-3 Mushroom Spaghetti
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The omega-3 is not the only healthy fat in here; we’re also going to have medium-chain triglycerides, as well as monounsaturates. Add in the ergothioneine from the mushrooms and a stack of polyphenols from, well, most of the ingredients, not to mention the fiber, and this comes together as a very healthy dish. There’s also about 64g protein in the entire recipe, so you do the math for how much that is per serving, depending on how big you want the servings to be.
You will need
- 1lb wholewheat spaghetti (or gluten-free equivalent, such as a legume-based pasta, if avoiding gluten/wheat)
- 12oz mushrooms, sliced (any non-poisonous edible variety)
- ½ cup coconut milk
- ½ onion, finely chopped
- ¼ cup chia seeds
- ¼ bulb garlic, minced (or more, if you like)
- 2 tbsp extra virgin olive oil
- 1 tbsp black pepper, coarse ground
- 1 tbsp lime juice
Method
(we suggest you read everything at least once before doing anything)
1) Cook the spaghetti according to packet instructions, or your own good sense, aiming for al dente. When it’s done, drain it, and lastly rinse it (with cold water), and set it aside.
2) Heat the olive oil in a skillet and add the onion, cooking for 5 minutes
3) Add the garlic, mushrooms, and black pepper, cooking for another 8 minutes.
4) Add the coconut milk, lime juice, and chia seeds, stirring well and cooking for a further two minutes
5) Reheat the spaghetti by passing boiling water through it in a colander (the time it spent cold was good for it; it lowered the glycemic index)
6) Serve, adding the mushroom sauce to the spaghetti:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The Magic of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- The Many Health Benefits of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- If You’re Not Taking Chia, You’re Missing Out
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
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