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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Does PRP Work For Hair Loss?
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Dr. Ankit Gupta takes us through the details of this hair loss remedy for androgenic alopecia.
The bald truth
Platelet-Rich Plasma (PRP) is a controversial treatment for androgenic hair loss.
What it involves: blood is drawn and separated using a centrifuge. PRP—including growth proteins and hormones—is extracted from the blood; about 30 ml of blood is needed to produce 5 ml of PRP. This is then injected directly into the scalp. As this can be painful, local anaesthetic is sometimes used first. This usually involves monthly sessions for the first 3 months, then booster sessions every 3–6 months thereafter.
Does it work? Research is young; so far 60% of trials have found it worked; 40% found it didn’t. When it works, effectiveness (in terms of hair restoration) is considered to be between 25–43%. Results are inconsistent and seem to vary from person to person.
In short, this doctor’s recommendation is to consider it after already having tried standard treatments such as finasteride and/or minoxidil, as they are more likely to work and don’t involve such exciting procedures as injecting your own blood extracts back into your head.
For more on all of this, plus links to the 13 papers cited, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Hair-Loss Remedies, By Science
- Hair Growth: Caffeine and Minoxidil Strategies
- Gentler Hair Health Options
Take care!
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How to Change – by Katy Milkman
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Sometimes it seems that we know everything we should be doing… We have systems and goals and principles, we know about the importance of habits, and we do our best to live them. Yet, somehow, life has other plans for us and things don’t quite come together they way they did in our genius masterplan.
So, what happened? And more importantly, what are we supposed to do about this? Katy Milkman has answers, right from the start.
Sometimes, it can be as simple as when we try to implement a change. It’s not that there’s a “wrong time” for a good change, so much that there are times that are much more likely to succeed than others… and those times can be identified and used.
Sometimes we’re falling prey to vices—which she explains how to overcome—such as:
- Impulsivity
- Procrastination
- Forgetfulness
- Laziness
We also learn some counterintuitive truths about what can boost or sabotage our confidence along the way!
Milkman writes in a compelling, almost narrative style, that makes for very easy reading. The key ideas, built up to by little (ostensibly true) stories and then revealed, become both clear and memorable. Most importantly, applicable.
Bottom line: this is a great troubleshooting guide for when you know how everything should be working, but somehow, it just doesn’t—and you’d like to fix that.
Click here to check out “How To Change” on Amazon, and get those changes rolling!
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How Not to Die – by Dr. Michael Greger
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Dr. Greger (of “Dr. Greger’s Daily Dozen” fame) outlines for us in cold hard facts and stats what’s most likely to be our cause of death. While this is not a cheery premise for a book, he then sets out to work back from there—what could have prevented those specific things?
Some of the advice is what you might expect: eat green things and whole grains, skip the bacon. Other advice is less well-known: get a daily dose of curcumin/turmeric, take it with black pepper. Works wonders. If you want to add in daily exercises, just lifting the book could be a start; weighing in at 678 pages, it’s an information-dense tome that’s more likely to be sifted through than read cover-to-cover.
If you’re a more cynical sort, you might note that since the book doesn’t confer immortality, but does help us avoid statistically likely causes of death, logically it significantly increases our chances of dying in a statistically unlikely way. (Ha! Your mental exercise for today will be decoding that sentence )
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From Painkillers To Hunger-Killers
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.
Here’s this week’s selection of health news discoveries, the science behind them, what they mean for you, and where you can go from there:
Killing more than pain
It’s well-known that overuse of opioids can lead to many problems, and here’s another one: messing with the endocrine system. This time, mostly well-evidenced in men—however, the researchers are keen to point out that absence of evidence is very much not evidence of absence, hence “the hidden effects” in the headline below. It’s not that the effects are hard to see—it’s that a lot of the research has yet to be done. For now, though, we know at the very least that there’s an association between opioid use and hyperprolactinemia in men. The same research also begins to shine a light on the effects of opioid use on the hypothalamic-pituitary system and bone health, too:
Read in full: The hidden effects of opioid use on the endocrine system
Related: The 7 Approaches To Pain Management
Gut microbiome dysbiosis may lead to slipping disks
These things sound quite unconnected, but the association is strong. The likely mechanism of action is that the gut dysbiosis influences systemic inflammation, and thus spinal health—because the gut-spine axis cannot really be disconnected (while you’re alive, at least). It’s especially likely if you’re over 50 and female:
Read in full: Are back problems influenced by your gut?
Related: Is Your Gut Leading You Into Osteoporosis?
The Internet is really really great (for brains)
It’s common to see many articles on the Internet telling us, paradoxically, that we should spend less time on the Internet. However… Remember when in the 90s, it was all about “the information superhighway”? It turns out, the fact that it’s more like “the information spaghetti junction” these days doesn’t change the fact that stimulation is good for our brains, and daily Internet use improves memory, because of the different way that we index and store information that came from a virtual source. While there are parts of your brain for “things at home” and “things at the local supermarket”, there are also parts for “things at 10almonds” and “things at Facebook” and so forth. You are, in effect, building a vast mental library as you surf:
Read in full: Daily internet use supercharges your memory!
Related: Make Social Media Work For Your Mental Health
Fall back
Around this time of year in many places in the Northern Hemisphere, the clocks go back an hour (it’s next weekend in the US and Canada, by the way, and this weekend in most of Europe). Many enjoy this as the potential for an extra hour’s sleep, but for night owls, it can be more of a nuisance than a benefit—throwing out what’s often an already difficult relationship with the clock, and presenting challenges both practical and physiological (different processing of melatonin, for instance). Here be science:
Read in full: Why night owls struggle more when the clocks go back
Related: Early Bird Or Night Owl? Genes vs Environment
Can you outrun your hunger?
It seems so, though benefits are strongest in women. We say “outrun”, though this study did use stationary cycling. To put it in few words, intense exercise (but not moderate exercise) significantly reduced acylated ghrelin (hunger hormone) levels, and subjective reports of hunger, especially in women:
Read in full: Study finds intense exercise may suppress appetite in healthy humans
Related: 3 Appetite Suppressants Better Than Ozempic
Take care!
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The Simple Six – by Clinton Dobbins
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We at 10almonds don’t believe in keeping things a mystery, so…
“The Simple Six” are:
- the squat
- the goblet squat
- the hinge
- the kettlebell swing
- the push
- the push-up
- the kettle-bell press
- the pull
- the chin-up
- the gait, and
- walking.
Ok, we’re being a little glib here because to be fair, those are chunked into six groups, but the point is: don’t let the title fool you into thinking the book could have been an article; there’s plenty of valuable content here.
That said, it is a short book (64 pages), but with an average of 10 pages per exercise type, it’s a lot more than for example we could ever put into our newsletter.
Bottom line: we know that 10almonds readers like simple, clear, evidence-based, to-the-point health information, and that’s what this book is, so we do recommend it.
Click here to check out The Simple Six, and streamline your workouts!
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CBD Oil’s Many Benefits
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.
CBD Oil: What Does The Science Say?
First, a quick legal (and practical) note:
CBD and THC are both derived from the hemp or cannabis plant, but only the latter has euphoriant psychoactive effects, i.e., will get you high. We’re writing here about CBD derived from hemp and not containing THC (thus, will not get you high).
Laws and regulations differ far too much from place to place for us to try to advise here, so please check your own local laws and regulations. And also, while you’re at it, with your doctor and/or pharmacist.
As ever, this newsletter is for purposes of education and enjoyment, and does not constitute any kind of legal (or medical) advice.
With that in mind, onwards to today’s research review…
CBD for Pain Relief
CBD has been popularly touted as a pain relief panacea, and there are a lot of pop-science articles out there “debunking” this, but…
The science seems to back it up. We couldn’t find studies refuting the claim (of CBD as a viable pain relief option). We did, however, find research showing it was good against:
Note that that latter (itself a research review, not a single study, hence covering a lot of bases) describes it matter-of-factly, with no caveats or weasel-words, as:
“CBD, a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects”
As a quick note: all of the above is about the topical use of CBD oil, not any kind of ingestion
CBD for Anxiety/Depression
There’s a well-cited study with what honestly we think was a bit of a small sample size, but compelling results within that:
A study published in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test.
Compared to placebo…
- Those who received 300mg of CBD experienced significantly reduced anxiety during the test.
- Those who received either 150mg or 600mg of CBD experienced more anxiety during the test than the 300mg group
- This means there’s a sweet spot to the dosage
There was also a clinical study that found CBD to have anti-depressant effects.
The methodology was a lot more robust, but the subjects were mice. We can’t have everything in one study, apparently! There is probably a paucity of human volunteers to have their brain slices looked at after tests, though.
Anyway, what makes this study interesting is that it measured quite an assortment of biological markers in the brain, and found that the CBD had a similar physiological effect to the antidepressant imipramine.
CBD for Treating Opioid Addiction
There are a lot of studies for this, both animal and human, but we’d like to put the spotlight on a human study (with the participation of heroin users) that found:
❝Within one week, CBD significantly reduced cravings, anxiety, resting heart rate, and salivary cortisol levels. No serious adverse effects were found.❞
This is groundbreaking because the very thing about heroin is that it’s so addictive and the body rapidly needs more and more of it. You might think “duh”, but most people don’t realize this part:
Heroin is attractive because it offers (and delivers) an immediate guaranteed “downer”, instant relaxation… with none of the bad side effects of, for example, alcohol. No nausea, no hangover, nothing.
The problem is that the body gets tolerant to heroin very quickly, meaning your doses need to get bigger and more frequent to have the same effect.
Before you know it, what seemed like an affordable “self-medication for a stressful life” is very much out of control! Many doctors have personally found this out the hard way.
So, it’s ruinous:
- first to your financial health, as the costs rapidly spiral
- then to your physical health, as you either suffer from withdrawal or eventually overdose
Consequently, heroin is an incredibly easy drug to get hooked onto, and incredibly difficult to get back off.
So CBD offering relief is really a game-changer.
And more…
CBD has been well-studied and found to be effective for a lot of things, more than we could hope to cover in a single edition here.
Some further reading that may interest you includes:
- CBD against Diabetes in mice / in vitro / in humans
- CBD against neurological diseases (in general, in humans)
- CBD against arthritis in mice / in humans
- CBD specifically against the pain of rheumatoid arthritis / of osteoarthritis
Let us know if there’s any of these (or other) conditions you’d like us to look more into the CBD-related research for, because there’s a lot! You can always hit reply to any of our emails, or use the feedback widget at the bottom
Read (and shop, if you want and it’s permitted where you are):
10 Best CBD Oils of 2023, According to the Forbes Health Advisory Board
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