Monday, October 17, 2011

Is the Body Mass Index the Best Measure for Health?

There's a photo of plus size model, Tara Lynn, on the cover of French Elle causing quite a stir on Facebook. To date, more than 224,000 people "Liked" the image, more than 156,000 shared the image, and more than 71,000 commented on the image.

So what?

That's a fair question. Although Tara's nude with her arms in strategic places, the image in isolation probably wouldn't have inspired me to write this article. What held my attention was the accompanying caption. The person who posted this image describes a gym that asked its patrons whether they want to be a mermaid or a whale. Not only does she choose to be a whale, she includes her Theory on Weight Gain, "We women, we gain weight because we accumulate so much wisdom and knowledge that there isn't enough space in our heads, and it spreads all over our bodies. We are not fat, we are greatly cultivated. Every time I see my curves in the mirror, I tell myself: 'How amazing am I?!'"

Because you cannot judge health from appearance alone, the purpose of this article is to determine whether the body mass index (BMI) is the best measure for health. According to the Centers for Disease Control and Prevention (CDC), approximately 33 percent of U.S. adults and 17 percent of children and adolescents aged 2 to 19 are obese. For the purpose of clarity, the CDC adheres to the common definition of obesity as a BMI of 30 or higher. For scoping purposes, this article will focus on the term obesity because medical research directly correlates obesity to other degenerative health conditions such as heart disease, diabetes, hypertension, and some cancers.

Many factors contribute to obesity such as heredity, environmental circumstances, and personal choices. Genetic disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome directly lead to obesity. Cushing's disease, polycystic ovary syndrome, and medicinal drugs such as steroids and some antidepressants may also cause weight gain.

Regardless of the catalyst, weight gain is directly attributable to consuming more calories than a person's level of physical activity level is able to burn. Put differently, the Law of Thermodynamics states one must burn more calories than one consumes to lose weight. Our body converts what we eat and drink into energy and burns that energy throughout the day, even while at rest. We burn calories at varying metabolic rates. As such, individuals have varying daily caloric intake requirements to maintain normal bodily functions-again, based on how quickly we burn the calories we consume, our heredity, individual environmental circumstances, and our personal preferences for weight loss, balance, and gain. Hence, if a person has a sedentary lifestyle, the slower metabolism yields a lower caloric intake requirement.

Speaking generally, health is a state of being free of illness or injury while being of sound mind. Let's take this further. Health is a measurement of efficiency in the body's functions, including cardiorespiratory and metabolic efficiency. The National Academy of Sports Medicine (NASM) recommends aerobic exercise 5 days a week for 30 cumulative minutes per day while maintaining a heart rate between 65 and 90 percent of the person's maximum heart rate. By cumulative, this means you can work out 3 times at 10 minutes each session to accumulate 30 minutes for the day. Some ways to do this include walking the neighborhood (and take your family with you), setting up shop outdoors (play badminton in the backyard, tag, and hide and seek), and walking the stairs to do laundry and household chores.

Unfortunately, the difference between our vehicle's gas tank and our stomachs is that our gas tanks can only hold a limited amount of gas. If we try to put too much gas in the tank, the excess amount will overflow. However, our stomachs not only accept excessive amounts of food, our bodies actually adapt to the excessive food by storing the additional calories as fat. Fat, in and of its self, is not unhealthy. Our bodies rely on fat as an energy source, and interestingly enough, our bodies rely on fat as another means to protect our organs.

At age 27, Tara Lynn is a size 16 at 5' 9". She has a bust size of 38 inches, her waist is 32 inches, hips are 46 inches, and she weighs approximately 220 pounds (depending on your source). With these measurements, her BMI is 32.5 while her waist-to-hip ratio is 0.696 (i.e., pear shape, and visually, many consider this nearly perfect: 0.7 for women and 0.9 for men).

Again, so what? Is she healthy or not? Without further information (e.g., Physical Activity Readiness Questionnaire and fitness assessment), we shouldn't try to make that determination. However, her BMI is indicative of being at risk for heart disease, diabetes, hypertension, and some cancers, and as such, she needs to monitor her cardiorespiratory health proactively.

No one should gauge his or her health on appearances alone. Tara Lynn supports this and is aware that she will help to mitigate her health risks by remaining active. As long as she continues to moderate the nutrition in her diet and remain physically active, she will continue to counter the health risks associated with a higher BMI.


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