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.
There are more options than just waist circumference though; we delve into them in detail here:
Take care!
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The Joy of Movement – by Dr. Kelly McGonigal
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We know that exercise is good for us. Obviously. We know that that exercise will make us feel good. In principle.
So why is that exercise bike wearing the laundry instead, or the weights bench gathering dust?
Dr. Kelly McGonigal explores our relationship with exercise, both the formal (organized, planned, exercise that looks like exercise) and the informal (ad hoc, casual, exercise that looks like just having a nice time).
Moreover: she starts with the why, and moves to the how. The trick she plays on us here is to get us very fired up on the many tangible benefits that will make a big difference in all areas of our lives… And then shows us how easy it can be to unlock those, and how we can make it even easier.
And as to making it stick? Exercise can be addictive, and/but it’s one of the few addictions that is almost always healthful rather than deleterious. And, there are tricks we can use to heighten that, thresholds that once we pass, we just keep going.
She also looks at the evolutionary tendency of exercise to be connection-building, as part of a community, friend group, or couple.
And, yes, she gives attention also to undertaking exercise when circumstances aren’t ideal, or our bodies simply won’t allow certain things.
In short: if any book can get you shaking off the cobwebs, this is the one.
Click here to check out The Joy Of Movement on Amazon today, and get your body moving!
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Goat Milk Greek Yogurt vs Almond Milk Greek Yogurt – Which is Healthier?
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Our Verdict
When comparing goat milk yogurt to almond milk yogurt, we picked the almond milk yogurt.
Why?
Surprised? Honestly, we were too!
Much as we love almonds, we were fully expecting to write about how they’re very close in nutritional value, but the dairy yogurt has more probiotics, but no, as it turns out when we looked into them, they’re quite comparable in that regard.
It’s easy to assume “goat milk yogurt is more natural and therefore healthier”, but in both cases, it was a case of taking a fermentable milk, and fermenting it (an ancient process). “But almond milk is a newfangled thing”, well, new-ish…
So what was the deciding factor?
In this case, the almond milk yogurt has about twice the protein per (same size) serving, compared to the goat milk; all the other macros are about the same, and the micronutrients are similar. Like many plant-based milks and yogurts, this one is fortified with calcium and vitamin D, so that wasn’t an issue either.
In short: the only meaningful difference was the protein, and the almond came out on top.
However!
The almond came out on top only because it is strained; this can be done (or not) with any kind of yogurt, be it from an animal or a plant.
In other words: if it had been different brands, the goat milk yogurt could have come out on top!
The take-away idea here is: always read labels, because as you’ve just seen, even we can get surprised sometimes!
seriously if you only remember one thing from this today, make it the above
Other thing worth mentioning: yogurts, and dairy products in general, are often made with common allergens (e.g. dairy, nuts, soy, etc). So if you are allergic or intolerant, obviously don’t choose the one to which you are allergic or intolerant.
That said… If you are lactose-intolerant, but not allergic, goat’s milk does have less lactose than cow’s milk. But of course, you know your limits better than we can in this regard.
Want to try some?
Amazon is not coming up with the goods for this one (or anything even similar, at time of writing), so we recommend trying your local supermarket (and reading labels, because products vary widely!)
What you’re looking for (be it animal- or plant-based):
- Live culture probiotic bacteria
- No added sugar
- Minimal additives in general
- Lastly, check out the amounts for protein, calcium, vitamin D, etc.
Enjoy!
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Natto vs Tofu – Which is Healthier?
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Our Verdict
When comparing nattō to tofu, we picked the nattō.
Why?
In other words, in the comparison of fermented soy to fermented soy, we picked the fermented soy. But the relevant difference here is that nattō is fermented whole soybeans, while tofu is fermented soy milk of which the coagulated curds are then compressed into a block—meaning that the nattō is the one that has “more food per food”.
Looking at the macros, it’s therefore no surprise that nattō has a lot more fiber to go with its higher carb count; it also has slightly more protein. You may be wondering what tofu has more of, and the answer is: water.
In terms of vitamins, nattō has more of vitamins B2, B4, B6, C, E, K, and choline, while tofu has more of vitamins A, B3, and B9. So, a 7:3 win for nattō, even before considering that that vitamin C content of nattō is 65x more than what tofu has.
When it comes to minerals, nattō has more copper, iron, magnesium, manganese, potassium, and zinc, while tofu has more calcium, phosphorus, and selenium. So, a 6:3 win for nattō, and yes, the margins of difference are comparable (being 2–3x more for most of these minerals).
In short, both of these foods are great, but nattō is better.
Want to learn more?
You might like to read:
21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)
Take care!
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Eating For Energy (In Ways That Actually Work)
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Snacks & Hacks: The Real Energy Boosters
Declining energy levels are a common complaint of people getting older, and this specific kind of “getting older” is starting earlier and earlier (even Gen-Z are already getting in line for this one). For people of all ages, however, diet is often a large part of the issue.
The problem:
It can sometimes seem, when it comes to food and energy levels, that we have a choice:
- Don’t eat (energy levels decline)
- Eat quick-release energy snacks (energy spikes and crashes)
- Eat slow-release energy meals (oh hi, post-dinner slump)
But, this minefield can be avoided! Advice follows…
Skip the quasi-injectables
Anything the supermarket recommends for rapid energy can be immediately thrown out (e.g. sugary energy drinks, glucose tablets, and the like).
Same goes for candy of most sorts (if the first ingredient is sugar, it’s not good for your energy levels).
Unless you are diabetic and need an emergency option to keep with you in case of a hypo, the above things have no place on a healthy shopping list.
Aside from that, if you have been leaning on these heavily, you might want to check out yesterday’s main feature:
The Not-So-Sweet Science Of Sugar Addiction
…and if your knee-jerk response is “I’m not addicted; I just enjoy…” then ok, test that! Skip it for this month.
- If you succeed, you’ll be in better health.
- If you don’t, you’ll be aware of something that might benefit from more attention.
Fruit and nuts are your best friends
Unless you are allergic, in which case, obviously skip your allergen(s).
But for most of us, we were born to eat fruit and nuts. Literally, those two things are amongst the oldest and most well-established parts of human diet, which means that our bodies have had a very long time to evolve the perfect fruit-and-nut-enjoying abilities, and reap the nutritional benefits.
Nuts are high in fat (healthy fats) and that fat is a great source of energy’s easy for the body to get from the food, and/but doesn’t result in blood sugar spikes (and thus crashes) because, well, it’s not a sugar.
See also: Why You Should Diversify Your Nuts
Fruit is high in sugars, and/but high in fiber that slows the absorption into a nice gentle curve, and also contains highly bioavailable vitamins to perk you up and polyphenols to take care of your long-term health too.
Be warned though: fruit juice does not work the same as actual fruit; because the fiber has been stripped and it’s a liquid, those sugars are zipping straight in exactly the same as a sugary energy drink.
See also: Which Sugars Are Healthier, And Which Are Just The Same?
Slow release carbs yes, but…
Eating a bowl of wholegrain pasta is great if you don’t have to do anything much immediately afterwards, but it won’t brighten your immediately available energy much—on the contrary, energy will be being used for digestion for a while.
So if you want to eat slow-release carbs, make it a smaller portion of something more-nutrient dense, like oats or lentils. This way, the metabolic load will be smaller (because the portion was smaller) but the higher protein content will prompt satiety sooner (so you addressed your hunger with a smaller portion) and the iron and B vitamins will be good for your energy too.
See also: Should You Go Light Or Heavy On Carbs?
Animal, vegetable, or mineral?
At the mention of iron and B vitamins, you might be thinking about various animal products that might work too.
If you are vegetarian or vegan: stick to that; it’s what your gut microbiome is used to now, and putting an animal product in will likely make you feel ill.
If you have them in your diet already, here’s a quick rundown of how broad categories of animal product work (or not) for energy:
- Meat: nope. Well, the fat, if applicable, will give you some energy, but less than you need just to digest the meat. This, by the way, is a likely part of why the paleo diet is good for short term weight loss. But it’s not very healthy.
- Fish: healthier than the above, but for energy purposes, just the same.
- Dairy: high-fat dairy, such as cream and butter, are good sources of quick energy. Be aware if they contain lactose though, that this is a sugar and can be back to spiking blood sugars.
- As an aside for diabetics: this is why milk can be quite good for correcting a hypo: the lactose provides immediate sugar, and the fat keeps it more balanced afterwards
- Eggs: again the fat is a good source of quick energy, and the protein is easier to digest than that of meat (after all, egg protein is literally made to be consumed by an embryo, while meat protein is made to be a functional muscle of an animal), so the metabolic load isn’t too strenuous. Assuming you’re doing a moderate consumption (under 3 eggs per day) and not Sylvester Stallone-style 12-egg smoothies, you’re good to go.
See also: Do We Need Animal Products To Be Healthy?
…and while you’re at it, check out:
Eggs: Nutritional Powerhouse
or Heart-Health Timebomb?(spoiler: it’s the former; the title was because it was a mythbusting edition)
Hydration considerations
Lastly, food that is hydrating will be more energizing than food that is not, so how does your snack/meal rank on a scale of watermelon to saltines?
You may be thinking: “But you said to eat nuts! They’re not hydrating at all!”, in which case, indeed, drink water with them, or better yet, enjoy them alongside fruit (hydration from food is better than hydration from drinking water).
And as for those saltines? Salt is not your friend (unless you are low on sodium, because then that can sap your energy)
How to tell if you are low on sodium: put a little bit (e.g. ¼ tsp) of salt into a teaspoon and taste it; does it taste unpleasantly salty? If not, you were low on sodium. Have a little more at five minute intervals, until it tastes unpleasantly salty. Alternatively have a healthy snack that nonetheless contains a little salt.
If you otherwise eat salty food as an energy-giving snack, you risk becoming dehydrated and bloated, neither of which are energizing conditions.
Dehydrated and bloated at once? Yes, the two often come together, even though it usually doesn’t feel like it. Basically, if we consume too much salty food, our homeostatic system goes into overdrive to try to fix it, borrows a portion of our body’s water reserves to save us from the salt, and leaves us dehydrated, bloated, and sluggish.
For more on salt in general, check out:
How Too Much Salt Can Lead To Organ Failure: Lesser-Known Salt Health Risks
Take care!
Don’t Forget…
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Unfuck Your Brain – by Dr. Faith Harper
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This book takes a trauma-informed care approach, which is relatively novel in the mental health field and it’s quickly becoming the industry standard because of its effectiveness.
The basic premise of trauma-informed care is that you had a bad experience (possibly even more than one—what a thought!) and that things that remind you of that will tend to prompt reactivity from you in a way that probably isn’t healthy. By identifying each part of that process, we can then interrupt it, much like we might with CBT (the main difference being that CBT, for all its effectiveness, tends to assume that the things that are bothering you are not true, while TIC acknowledges that they might well be, and that especially historically, they probably were).
A word of warning: if something that triggers a trauma-based reactivity response in you is people swearing, then this book will either cure you by exposure therapy or leave you a nervous wreck, because it’s not just the title; Dr. Harper barely gets through a sentence without swearing. It’s a lot, even by this (European) reviewer’s standards (we’re a lot more relaxed about swearing over here, than people tend to be in America).
On the other hand, something that Dr. Harper excels at is actually explaining stuff very well. So while it sometimes seems like she’s “trying too hard” style-wise in terms of being “not like other therapists”, in her defence she’s nevertheless a very good writer; she knows her stuff, and knows how to communicate it clearly.
Bottom line: if you don’t mind a writer who swears more than 99% of soldiers, then this book is an excellent how-to guide for self-administered trauma-informed care.
Click here to check out Unfuck Your Brain, and indeed unfuck it!
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Try This At Home: ABI Test For Clogged Arteries
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.
Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.
The Ankle-Brachial Index Test
Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:
- A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
- Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
- High ABI scores (above 1.4) may indicate artery hardening
Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).
If you need a blood pressure monitor, by the way, here’s an example product on Amazon.
Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.
For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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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