When BMI Doesn’t Measure Up
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When BMI Doesn’t Quite Measure Up
Last month, we did a “Friday Mythbusters” edition of 10almonds, tackling many of the misconceptions surrounding obesity. Amongst them, we took a brief look at the usefulness (or lack thereof) of the Body Mass Index (BMI) scale of weight-related health for individuals. By popular subscriber request, we’re now going to dive a little deeper into that today!
The wrong tool for the job
BMI was developed as a tool to look at large-scale demographic trends, stemming from a population study of white European men, who were for the purpose of the study (the widescale health of the working class in that geographic area in that era), considered a reasonable default demographic.
In other words: as a system, it’s now being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
If you want to know yours…
Here’s the magic formula for calculating your BMI:
- Metric: divide your weight in kilograms by your height in square meters
- Imperial: divide your weight in pounds by your height in square inches and then multiply by 703
“What if my height doesn’t come in square meters or square inches, because it’s a height, not an area?”
We know. Take your height and square it anyway. If this seems convoluted and arbitrary, yes, it is.
But!
While on the one hand it’s convoluted and arbitrary… On the other hand, it’s also a gross oversimplification. So, yay for the worst of both worlds?
If you don’t want to grab a calculator, here’s a quick online tool to calculate it for you.
So, how did you score?
According to the CDC, a BMI score…
- Under 18.5 is underweight
- 18.5 to 24.9 is normal
- 25 to 29.9 is overweight
- 30 and over is obese
And, if we’re looking at a representative sample of the population, where the representation is average white European men of working age, that’s not a bad general rule of thumb.
For the rest of us, not so representative
BMI is a great and accurate tool as a rule of thumb, except for…
Women
An easily forgotten demographic, due to being a mere 51% of the world’s population, women generally have a higher percentage of body fat than men, and this throws out BMI’s usefulness.
If pregnant or nursing
A much higher body weight and body fat percentage—note that these are two things, not one. Some of the extra weight will be fat to nourish the baby; some will be water weight, and if pregnant, some will be the baby (or babies!). BMI neither knows nor cares about any of these things. And, this is a big deal, because BMI gets used by healthcare providers to judge health risks and guide medical advice.
People under the age of 16 or over the age of 65
Not only do people below and above those ages (respectively) tend to be shorter—which throws out the calculations and mean health risks may increase before the BMI qualifies as overweight—but also:
- BMI under 23 in people over the age of 65 is associated with a higher health risk
- A meta-analysis showed that a BMI of 27 was the best in terms of decreased mortality risk for the over-65 age group
This obviously flies in the face of conventional standards regards BMI—as you’ll recall from the BMI brackets we listed above.
Read the science: BMI and all-cause mortality in older adults: a meta-analysis
Athletic people
A demographic often described in scientific literature as “athletes”, but that can be misleading. When we say “athletes”, what comes to mind? Probably Olympians, or other professional sportspeople.
But also athletic, when it comes to body composition, are such people as fitness enthusiasts and manual laborers. Which makes for a lot more people affected by this!
Athletic people tend to have more lean muscle mass (muscle weighs more than fat), and heavier bones (can’t build strong muscles on weak bones, so the bones get stronger too, which means denser)… But that lean muscle mass can actually increase metabolism and help ward off many of the very same things that BMI is used as a risk indicator for (e.g. heart disease, and diabetes). So people in this category will actually be at lower risk, while (by BMI) getting told they are at higher risk.
If not white
Physical characteristics of race can vary by more than skin color, relevant considerations in this case include, for example:
- Black people, on average, not only have more lean muscle mass and less fat than white people, but also, have completely different risk factors for diseases such as diabetes.
- Asian people, on average, are shorter than white people, and as such may see increased health risks before BMI qualifies as overweight.
- Hispanic people, on average, again have different physical characteristics that throw out the results, in a manner that would need lower cutoffs to be even as “useful” as it is for white people.
Further reading on this: BMI and the BIPOC Community
In summary:
If you’re an average white European working-age man, BMI can sometimes be a useful general guide. If however you fall into one or more of the above categories, it is likely to be inaccurate at best, if not outright telling the opposite of the truth.
What’s more useful, then?
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 today’s newsletter!
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, sex, ethnicity, and lifestyle.
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A Urologist Explains Edging: What, Why, & Is It Safe?
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“Edging” is the practice of intentionally delaying orgasm, which can be enjoyed by anyone, with a partner or alone.
On the edge
Urologist Dr. Rena Malik explains:
Question: why?
Answer: the more tension is built up, the stronger the orgasm can be at the end of it. And, even before then, pleasure along the way is pleasure along the way, which is generally considered a good thing—especially for any (usually but not always women, for hormonal and social reasons) who find it difficult to orgasm. It’s also a great way to experiment and learn more about one’s own body and/or that of one’s partner(s), personal responses, and so forth. Also, for any (usually but not always men, for hormonal reasons) who find they usually orgasm sooner than they’d like, it’s a great way to change that, if changing that is what’s wanted.
Bonus answer: for some (usually but not always men, for hormonal reasons) who find they have an uncomfortable slump in mood after orgasm, that can simply be skipped entirely, postponed for another time, etc, with pleasure being derived from the sexual activity rather than orgasm. That way, there’s a lasting dopamine high, with no prolactin crash afterwards ← this is very much tied to male hormones, by the way. If you have female hormones, there’s usually no prolactin crash either way, and instead, the post-orgasm spike in oxytocin is stronger, and a wave of serotonin makes the later decline of dopamine much more gentle.
Question: can it cause any problems?
Answer: yep! Or rather, subjectively, it may be considered so—this is obviously a personal matter and your mileage may vary. The main problem it may cause is that if practised habitually, it may result in greater difficulty achieving orgasm, simply because the body has got used to “ok, when we do this (sex/masturbation), we are in no particular rush to do that (orgasm)”. So whether not this would be a worry for you is down to any given individual. Lastly, if your intent was a long edging session with an orgasm at the end and then something happened to interrupt that, then your orgasm may be unintentionally postponed to another time, which again, may be more or less of an issue depending on your feelings about that.
For more on these things including advice on how to try it, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Mythbusting The Big O ← 10almonds main feature on orgasms, health, and associated myths
- Come Together: The Science (and Art) of Creating Lasting Sexual Connections – by Dr. Emily Nagoski
- Better Sex Through Mindfulness: How Women Can Cultivate Desire – by Dr. Lori Brotto
Take care!
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Unlimited Memory – by Kevin Horsley
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Premise: there are easily learnable techniques to rapidly (and greatly) improve one’s memory. We’ve touched on some of these methods before at 10almonds, but being a newsletter rather than a book, we’ve not been able to go as deeply into it as Horsley!
Your memory is far, far, far more powerful than you might realize, and this book will help unlock that. To illustrate…
Some of the book is given over to what are for most purposes “party tricks”, such as remembering pi to 10,000 places. Those things are fun, even if not as practical in today’s world of rarely needing to even know the actual digits of a phone number. However, they do also serve as a good example of just how much of “super memory” isn’t a matter of hard work, so much as being better organized about it.
Most of the book is focused on practical methods to improve the useful aspects of memory—including common mistakes!
If the book has any flaw it’s that the first chapter or so is spent persuading the reader of things we presumably already believe, given that we bought the book. For example, that remembering things is a learnable skill and that memory is functionally limitless. However, we still advise to not skip those chapters as they do contain some useful reframes as well.
Bottom line: if you read this book you will be astonished by how much you just learned—because you’ll be able to recall whole sections in detail! And then you can go apply that whatever areas of your life you wanted to when you bought the book.
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Is “Extra Virgin” Worth It?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I was wondering, is the health difference important between extra virgin olive oil and regular?❞
Assuming that by “regular” you mean “virgin and still sold as a food product”, then there are health differences, but they’re not huge. Or at least: not nearly so big as the differences between those and other oils.
Virgin olive oil (sometimes simply sold as “olive oil”, with no claims of virginity) has been extracted by the same means as extra virgin olive oil, that is to say: purely mechanical.
The difference is that extra virgin olive oil comes from the first pressing*, so the free fatty acid content is slightly lower (later checked and validated and having to score under a 0.8% limit for “extra virgin” instead of 2% limit for a mere “virgin”).
*Fun fact: in Arabic, extra virgin is called “البكر الممتاز“, literally “the amazing first-born”, because of this feature!
It’s also slightly higher in mono-unsaturated fatty acids, which is a commensurately slight health improvement.
It’s very slightly lower in saturated fats, which is an especially slight health improvement, as the saturated fats in olive oil are amongst the healthiest saturated fats one can consume.
On which fats are which:
The truth about fats: the good, the bad, and the in-between
And our own previous discussion of saturated fats in particular:
Can Saturated Fats Be Healthy?
Probably the strongest extra health-benefit of extra virgin is that while that first pressing squeezes out oil with the lowest free fatty acid content, it squeezes out oil with the highest polyphenol content, along with other phytonutrients:
If you enjoy olive oil, then springing for extra virgin is worth it if that’s not financially onerous, both for health reasons and taste.
However, if mere “virgin” is what’s available, it’s no big deal to have that instead; it still has a very similar nutritional profile, and most of the same benefits.
Don’t settle for less than “virgin”, though.
While some virgin olive oils aren’t marked as such, if it says “refined” or “blended”, then skip it. These will have been extracted by chemical means and/or blended with completely different oils (e.g. canola, which has a very different nutritional profile), and sometimes with a dash of virgin or extra virgin, for the taste and/or so that they can claim in big writing on the label something like:
a blend of
EXTRA VIRGIN OLIVE OIL
and other oils…despite having only a tiny amount of extra virgin olive oil in it.
Different places have different regulations about what labels can claim.
The main countries that produce olives (and the EU, which contains and/or directly trades with those) have this set of rules:
International Olive Council: Designations and definitions of Olive Oils
…which must be abided by or marketers face heavy fines and sanctions.
In the US, the USDA has its own set of rules based on the above:
USDA | Olive Oil and Olive-Pomace Oil Grades and Standards
…which are voluntary (not protected by law), and marketers can pay to have their goods certified if they want.
So if you’re in the US, look for the USDA certification or it really could be:
- What the USDA calls “US virgin olive oil not fit for human consumption”, which in the IOC is called “lamp oil”*
- crude pomace-oil (oil made from the last bit of olive paste and then chemically treated)
- canola oil with a dash of olive oil
- anything yellow and oily, really
*This technically is virgin olive oil insofar as it was mechanically extracted, but with defects that prevent it from being sold as such, such as having a free fatty acid content above the cut-off, or just a bad taste/smell, or some sort of contamination.
See also: Potential Health Benefits of Olive Oil and Plant Polyphenols
(the above paper has a handy infographic if you scroll down just a little)
Where can I get some?
Your local supermarket, probably, but if you’d like to get some online, here’s an example product on Amazon for your convenience
Enjoy!
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How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)
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Each Monday, we’re going to be bringing you cutting-edge research reviews to not only make your health and productivity crazy simple, but also, constantly up-to-date.
But today, in this special edition, we want to lay out plain and simple how to see through a lot of the tricks used not just by popular news outlets, but even sometimes the research publications themselves.
That way, when we give you health-related science news, you won’t have to take our word for it, because you’ll be able to see whether the studies we cite really support the claims we make.
Of course, we’ll always give you the best, most honest information we have… But the point is that you shouldn’t have to trust us! So, buckle in for today’s special edition, and never have to blindly believe sci-hub (or Snopes!) again.
The above now-famous Tumblr post that became a meme is a popular and obvious example of how statistics can be misleading, either by error or by deliberate spin.
But what sort of mistakes and misrepresentations are we most likely to find in real research?
Spin Bias
Perhaps most common in popular media reporting of science, the Spin Bias hinges on the fact that most people perceive numbers in a very “fuzzy logic” sort of way. Do you?
Try this:
- A million seconds is 11.5 days
- A billion seconds is not weeks, but 13.2 months!
…just kidding, it’s actually nearly thirty-two years.
Did the months figure seem reasonable to you, though? If so, this is the same kind of “human brains don’t do large numbers” problem that occurs when looking at statistics.
Let’s have a look at reporting on statistically unlikely side effects for vaccines, as an example:
- “966 people in the US died after receiving this vaccine!” (So many! So risky!)
- “Fewer than 3 people per million died after receiving this vaccine!” (Hmm, I wonder if it is worth it?)
- “Half of unvaccinated people with this disease die of it” (Oh)
How to check for this: ask yourself “is what’s being described as very common really very common?”. To keep with the spiders theme, there are many (usually outright made-up) stats thrown around on social media about how near the nearest spider is at any given time. Apply this kind of thinking to medical conditions.. If something affects only 1% of the population (So few! What a tiny number!), how far would you have to go to find someone with that condition? The end of your street, perhaps?
Selection/Sampling Bias
Diabetes disproportionately affects black people, but diabetes research disproportionately focuses on white people with diabetes. There are many possible reasons for this, the most obvious being systemic/institutional racism. For example, advertisements for clinical trial volunteer opportunities might appear more frequently amongst a convenient, nearby, mostly-white student body. The selection bias, therefore, made the study much less reliable.
Alternatively: a researcher is conducting a study on depression, and advertises for research subjects. He struggles to get a large enough sample size, because depressed people are less likely to respond, but eventually gets enough. Little does he know, even the most depressed of his subjects are relatively happy and healthy compared with the silent majority of depressed people who didn’t respond.
See This And Many More Educational Cartoons At Sketchplanations.com!
How to check for this: Does the “method” section of the scientific article describe how they took pains to make sure their sample was representative of the relevant population, and how did they decide what the relevant population was?
Publication Bias
Scientific publications will tend to prioritise statistical significance. Which seems great, right? We want statistically significant studies… don’t we?
We do, but: usually, in science, we consider something “statistically significant” when it hits the magical marker of p=0.05 (in other words, the probability of getting that result is 1/20, and the results are reliably coming back on the right side of that marker).
However, this can result in the clinic stopping testing once p=0.05 is reached, because they want to have their paper published. (“Yay, we’ve reached out magical marker and now our paper will be published”)
So, you can think of publication bias as the tendency for researchers to publish ‘positive’ results.
If it weren’t for publication bias, we would have a lot more studies that say “we tested this, and here are our results, which didn’t help answer our question at all”—which would be bad for the publication, but good for science, because data is data.
To put it in non-numerical terms: this is the same misrepresentation as the technically true phrase “when I misplace something, it’s always in the last place I look for it”—obviously it is, because that’s when you stop looking.
There’s not a good way to check for this, but be sure to check out sample sizes and see that they’re reassuringly large.
Reporting/Detection/Survivorship Bias
There’s a famous example of the rise in “popularity” of left-handedness. Whilst Americans born in ~1910 had a bit under a 3.5% chance of being left handed, those born in ~1950 had a bit under a 12% change.
Why did left-handedness become so much more prevalent all of a sudden, and then plateau at 12%?
Simple, that’s when schools stopped forcing left-handed children to use their right hands instead.
In a similar fashion, countries have generally found that homosexuality became a lot more common once decriminalized. Of course the real incidence almost certainly did not change—it just became more visible to research.
So, these biases are caused when the method of data collection and/or measurement leads to a systematic error in results.
How to check for this: you’ll need to think this through logically, on a case by case basis. Is there a reason that we might not be seeing or hearing from a certain demographic?
And perhaps most common of all…
Confounding Bias
This is the bias that relates to the well-known idea “correlation ≠ causation”.
Everyone has heard the funny examples, such as “ice cream sales cause shark attacks” (in reality, both are more likely to happen in similar places and times; when many people are at the beach, for instance).
How can any research paper possibly screw this one up?
Often they don’t and it’s a case of Spin Bias (see above), but examples that are not so obviously wrong “by common sense” often fly under the radar:
“Horse-riding found to be the sport that most extends longevity”
Should we all take up horse-riding to increase our lifespans? Probably not; the reality is that people who can afford horses can probably afford better than average healthcare, and lead easier, less stressful lives overall. The fact that people with horses typically have wealthier lifestyles than those without, is the confounding variable here.
See This And Many More Educational Cartoons on XKCD.com!
In short, when you look at the scientific research papers cited in the articles you read (you do look at the studies, yes?), watch out for these biases that found their way into the research, and you’ll be able to draw your own conclusions, with well-informed confidence, about what the study actually tells us.
Science shouldn’t be gatekept, and definitely shouldn’t be abused, so the more people who know about these things, the better!
So…would one of your friends benefit from this knowledge? Forward it to them!
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CBD Against Diabetes!
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝CBD for diabetes! I’ve taken CBD for body pain. Did no good. Didn’t pay attention as to diabetes. I’m type 1 for 62 years. Any ideas?❞
Thanks for asking! First up, for reference, here’s our previous main feature on the topic of CBD:
CBD Oil: What Does The Science Say?
There, we touched on CBD’s effects re diabetes:
in mice / in vitro / in humans
In summary, according to the above studies, it…
- lowered incidence of diabetes in non-obese diabetic mice. By this they mean that pancreatic function improved (reduced insulitis and reduced inflammatory Th1-associated cytokine production). Obviously this has strong implications for Type 1 Diabetes in humans—but so far, just that, implications (because you are not a mouse).
- attenuated high glucose-induced endothelial cell inflammatory response and barrier disruption. Again, this is promising, but it was an in vitro study in very controlled lab conditions, and sometimes “what happens in the Petri dish, stays in the Petri dish”—in order words, these results may or may not translate to actual living humans.
- Improved insulin response ← is the main take-away that we got from reading through their numerical results, since there was no convenient conclusion given. Superficially, this may be of more interest to those with type 2 diabetes, but then again, if you have T1D and then acquire insulin resistance on top of that, you stand a good chance of dying on account of your exogenous insulin no longer working. In the case of T2D, “the pancreas will provide” (more or less), T1D, not so much.
So, what else is there out there?
The American Diabetes Association does not give a glowing review:
❝There’s a lot of hype surrounding CBD oil and diabetes. There is no noticeable effect on blood glucose (blood sugar) or insulin levels in people with type 2 diabetes. Researchers continue to study the effects of CBD on diabetes in animal studies. ❞
~ American Diabetes Association
Source: ADA | CBD & Diabetes
Of course, that’s type 2, but most research out there is for type 2, or else have been in vitro or rodent studies (and not many of those, at that).
Here’s a relatively more recent study that echoes the results of the previous mouse study we mentioned; it found:
❝CBD-treated non-obese diabetic mice developed T1D later and showed significantly reduced leukocyte activation and increased FCD in the pancreatic microcirculation.
Conclusions: Experimental CBD treatment reduced markers of inflammation in the microcirculation of the pancreas studied by intravital microscopy. ❞
~ Dr. Christian Lehmann et al.
Read more: Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes
…and here’s a 2020 study (so, more recent again) that was this time rats, and/but still more promising, insofar as it was with rats that had full-blown T1D already:
Read in full: Two-weeks treatment with cannabidiol improves biophysical and behavioral deficits associated with experimental type-1 diabetes
Finally, a paper in July 2023 (so, since our previous article about CBD), looked at the benefits of CBD against diabetes-related complications (so, applicable to most people with any kind of diabetes), and concluded:
❝CBDis of great value in the treatment of diabetes and its complications. CBD can improve pancreatic islet function, reduce pancreatic inflammation and improve insulin resistance. For diabetic complications, CBD not only has a preventive effect but also has a therapeutic value for existing diabetic complications and improves the function of target organs❞
…before continuing:
❝However, the safety and effectiveness of CBD are still needed to prove. It should be acknowledged that the clinical application of CBD in the treatment of diabetes and its complications has a long way to go.
The dissecting of the pharmacology and therapeutic role of CBD in diabetes would guide the future development of CBD-based therapeutics for treating diabetes and diabetic complications❞
~ Ibid.
Now, the first part of that is standard ass-covering, and the second part of that is standard “please fund more studies please”. Nevertheless, we must also not fail to take heed—little is guaranteed, especially when it comes to an area of research where the science is still very young.
In summary…
It seems well worth a try, and with ostensibly nothing to lose except the financial cost of the CBD.
If you do, you might want to keep careful track of a) your usual diabetes metrics (blood sugar levels before and after meals, insulin taken), and b) when you took CBD, what dose, etc, so you can do some citizen science here.
Lastly: please remember our standard disclaimer; we are not doctors, let alone your doctors, so please do check with your endocrinologist before undertaking any such changes!
Want to read more?
You might like our previous main feature:
How To Prevent And Reverse Type 2 Diabetes ← obviously this will not prevent or reverse Type 1 Diabetes, but avoiding insulin resistance is good in any case!
If you’re not diabetic and you’ve perhaps been confused throughout this article, then firstly thank you for your patience, and secondly you might like this quick primer:
The Sweet Truth About Diabetes: Debunking Diabetes Myths! ← this gives a simplified but fair overview of types 1 & 2
(for space, we didn’t cover the much less common types 3 & 4; perhaps another time we will)
Meanwhile, take care!
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Honeydew vs Cantaloupe – Which is Healthier?
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Our Verdict
When comparing honeydew to cantaloupe, we picked the cantaloupe.
Why?
In terms of macros, there’s not a lot between them—they’re both mostly water. Nominally, honeydew has more carbs while cantaloupe has more fiber and protein, but the differences are very small. So, a very slight win for cantaloupe.
Looking at vitamins: honeydew has slightly more of vitamins B5 and B6 (so, the vitamins that are in pretty much everything), while cantaloupe has a more of vitamins A, B1, B2, B3, C, and E (especially notably 67x more vitamin A, whence its color). A more convincing win for cantaloupe.
The minerals category is even more polarized: honeydew has more selenium (and for what it’s worth, more sodium too, though that’s not usually a plus for most of us in the industrialized world), while cantaloupe has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An overwhelming win for cantaloupe.
No surprises: adding up the slight win for cantaloupe, the convincing win for cantaloupe, and the overwhelming win for cantaloupe, makes cantaloupe the overall best pick here.
Enjoy!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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