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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How to Be Your Own Therapist – by Owen O’Kane
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Finding the right therapist can be hard. Sometimes, even just accessing a therapist, any therapist, can be hard, if circumstances are adverse. Sometimes we’d like therapy, but want to feel “better prepared for it” before we do.
Owen O’Kane, a highly qualified and well-respected psychotherapist, wants to put some tools in our hands. The premise of this book is that “in 10 minutes a day” one can give oneself an amount of therapy that will be beneficial.
Naturally, in 10 minutes a day, this isn’t going to be the kind of therapy that will work through major traumas, so what can it do?
Those 10 minutes are spread into three sessions:
- 4 minutes in the morning
- 3 minutes in the afternoon
- 3 minutes in the evening
The idea is:
- To do a quick mental health “check-in” before the day gets started, ascertain what one needs in that context, and make a simple plan to get/have it.
- To keep one’s mental health on track by taking a little pause to reassess and adjust if necessary
- To reflect on the day, amplify the positive, and let go of the negative to what extent is practical, in order to rest well ready for the next day
Where O’Kane excels is in explaining how to do those things in a way that is neither overly simplistic and wishy-washy, nor so arcane and convoluted as to create more work and render the day more difficult.
In short, this book is a great prelude to (or adjunct to) formal therapy, and for those for whom therapy isn’t accessible and/or desired, a great way to keep oneself on a mentally healthy track.
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Afterwork – by Joel Malick and Alex Lippert
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Regular 10almonds readers may remember that one of the key unifying factors of Blue Zones supercentenarians is the importance of having purpose, sometimes called ikigai (borrowing the Japanese term, as a nod to the Okinawan Blue Zone).
The authors are financial advisors by profession, but don’t let that fool you; this book is not about retirement financial planning, but rather, simply addressing a problem that was often presented to them while helping people plan their retirements:
A lot of people find themselves adrift without purpose at several points in life. Often, these are: 1) early twenties, 2) some point in the midlife, and/or 3) retirement. This book addresses the third of those life points.
The authors advise cultivating 10 key disciplines; we’ll not keep them a mystery; they are:
- Purpose
- Calendar
- Movement
- Journaling
- Faith
- Connection
- Learning
- Awareness
- Generosity
- Awe
…which each get a chapter in this book.
A note on the chapter about faith: the authors are Christians, and that does influence their perspective here, but if Christianity’s not your thing, then don’t worry: the rest also stands on its own feet without that.
The general “flavor” of the book overall is in essence, embracing a new period of enjoying what is in effect the strongest, most potentially impactful version of you you’ve ever been, as well as avoiding the traps of retirement “sugar rush” and “retirement drift”, to define, well, a more purposeful life—with what’s most meaningful to you.
The style of the book is self-help in layout, with occasional diagrams, flowcharts, and the like; sometimes we see well-sourced stats, but there’s no hard science here. In short, a simple and practical book.
Bottom line: if your retirement isn’t looking like what you imagined it to be, and/or you think it could be more fulfilling, then this book can help you find, claim, and live your ikigai.
Click here to check out Afterwork, and indeed live a future that’s worthy of dreams!
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Swordfish vs Tuna – Which is Healthier?
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Our Verdict
When comparing swordfish to tuna, we picked the tuna.
Why?
Today in “that which is more expensive is not necessarily the healthier”…
Considering the macros first, swordfish has more than 8x more total fat, about 9x more saturated fat, and yes, more cholesterol. On the other hand, tuna has more protein. An easy win for tuna.
In terms of vitamins, swordfish has more of vitamins A, B5, D, and E, while tuna has more of vitamins B1, B2, B3, B6, and B12. A marginal win for tuna, unless you want to weight the other vitamins more heavily, in which case, more likely a tie, or maybe even an argument for swordfish if you have a particular vitamin deficiency on that side.
When it comes to minerals, swordfish has more calcium and zinc, while tuna has more iron, magnesium, manganese, phosphorus, potassium, and selenium. A clear win for tuna.
One other thing: they’re both very rich in mercury, and while tuna is bad for that, swordfish has nearly 3x as much.
In short, both have a good spread of vitamins and minerals, and both are quite tainted with mercury, but in relative terms, there’s a clear winner even before considering the very different macros, and the winner is tuna.
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught: Important Differences
Take care!
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The Philosophy Gym – by Dr. Stephen Law
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If you’d like to give those “little gray cells” an extra workout, this book is a great starting place.
Dr. Stephen Law is Director of Philosophy at the Department of Continuing Education, University of Oxford. As such, he’s no stranger to providing education that’s both attainable and yet challenging. Here, he lays out important philosophical questions, and challenges the reader to get to grips with them in a systematic fashion.
Each of the 25 questions/problems has a chapter devoted to it, and is ranked:
- Warm-up
- Moderate
- More Challenging
But, he doesn’t leave us to our own devices, nor does he do like a caricature of a philosopher and ask us endless rhetorical questions. Instead, he looks at various approaches taken by other philosophers over time, and invites the reader to try out those methods.
The real gain of this book is not the mere enjoyment of reading, but rather in taking those thinking skills and applying them in life… because most if not all of them do have real-world applications and/or implications too.
The book’s strongest point? That it doesn’t assume prior knowledge (and yet also doesn’t patronize the reader). Philosophy can be difficult to dip one’s toes into without a guide, because philosophers writing about philosophy can at first be like finding yourself at a party where you know nobody, but they all know each other.
In contrast, Law excels at giving quick, to-the-point ground-up summaries of key ideas and their progenitors.
In short: a wonderful way to get your brain doing things it might not have tried before!
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Collard Greens vs Kale – Which is Healthier?
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Our Verdict
When comparing collard greens to kale, we picked the collard greens.
Why?
Once again we have Brassica oleracea vs Brassica oleracea, (the same species that is also broccoli, cauliflower, Brussels sprouts, various kinds of cabbage, and more) and once again there are nutritional differences between the two cultivars:
In terms of macros, collard greens have more protein, equal carbs, and 2x the fiber. So that’s a win for collard greens.
In the category of vitamins, collard greens have more of vitamins B2, B3, B5, B9, E, and choline, while kale has more of vitamins A, B1, B6, C, and K. Nominally a 6:5 win for collard greens, though it’s worth noting that while most of the margins of difference are about the same, collard greens have more than 10x the choline, too.
When it comes to minerals, collard greens have more calcium, iron, magnesium, manganese, and phosphorus, while kale has more copper, potassium, selenium, and zinc. A genuinely marginal 5:4 win for collard greens this time.
All in all, a clear win for collard greens over the (otherwise rightly) established superfood kale. Collard greens just don’t get enough appreciation in comparison!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score? ← another reason it’s good to mix things up rather than just using the same ingredients out of habit!
Take care!
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Staying Strong: Tips To Prevent Muscle Loss With Age
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Dr. Andrea Furlan, specialist in physical medicine and rehabilitation with 30 years of experience, has advice:
Fighting sarcopenia
Sarcopenia is so common as to be considered “natural”, but “natural” does not mean “obligatory” and it certainly doesn’t mean “healthy”. As for how to fight it?
You may be thinking “let us guess, is it eat protein and do resistance exercises? And yes it is, but that’s only part of it…
Firstly, she recommends remembering why you are doing this, or because understanding is key to compliance (i.e. your perfect diet and exercise program will mean nothing if you don’t actually do it, and you won’t do it enough to make it a habit, let alone keep it up, if the reasons aren’t clear in your mind).
Sarcopenia comes with an increased risk of falls, reduced physical capacity in general, resultant disability, social isolation, and depression. Of course, this is not a one-to-one equation; you will not necessarily become depressed the moment your muscle mass is below a certain percentage, but statistically speaking, the road to ruin is laid out clearly.
Secondly, she recommends being on the lookout for it. If you check your body composition regularly with a gadget, that’s great and laudable; if you don’t, then a) consider getting one (here’s an example product on Amazon), and b) watch out for decreased muscle strength, fatigue, reduced stamina, noticeable body shape changes with muscle loss and (likely) fat gain.
Thirdly, she recommends more than just regular resistance training and good protein intake. Yes, she recommends those things too, but also getting enough water (can’t rebuild the body without it), avoiding a sedentary lifestyle (sitting leads to atrophy of many supporting and stabilizing muscles, you know, the kind of muscles that don’t look flashy but stop you falling down), and getting good sleep—vital for all kinds of body maintenance, and muscle maintenance is no exception (there’s a reason bodybuilders sleep 9–12 hours daily when in a gaining phase; you don’t need to do that, but don’t skimp on your 7–9 hours, yes, really, even you, yes, at any age).
Lastly, she recommends continuing to learn about the topic, as otherwise it’s easy to go off-track.
For more information on all of the above and more, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Protein: How Much Do We Need, Really?
- Resistance Is Useful! (Especially As We Get Older)
- Resistance Beyond Weights
- HIIT, But Make It HIRT ← this is about high-intensity resistance training (HIRT); confusing the muscles like one confuses the heart in HIIT, which thus yields improved results
- Sleep: Yes, You Really Do Still Need It
Take care!
Don’t Forget…
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