Calculations of A Body Shape Index can help predict those at risk of dying

A Body Shape Index: The Newest Risk Factor

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

CALCULATIONS OF A BODY SHAPE INDEX CAN HELP PREDICT THOSE AT RISK OF DYING

You don’t need a calculator to tell if you are fat. Standing naked in front of a full length mirror will do. But you do need a calculator to figure out if your body size and shape put you at risk of premature death. The new measurement, called A Body Shape Index (ABSI), requires a square root, a cube-root and some long division to predict who has a “hazardous body shape.”

And you thought stepping on the bathroom scale was scary!

This new index was developed by researchers at The City College of New York. They wanted to overcome weaknesses in the other measurements now used by health professionals to determine who, among the rapidly growing overweight and obese population, is most likely to suffer complications from their fatness. This latest tool will allow them to identify those most likely to die from their excess weight.

What Measurements Have We Used?

The widely used calculation of Body Mass Index(BMI) is based solely on height and weight. It cannot account for fat distribution or muscle mass, which can be quite different between any two people of the same height, especially a man and woman who are both 5′ 10″. It’s better at assessing obesity in populations, not individuals.

Waist circumference does a good job of identifying fat deposits around the visceral organs, but it cannot tell how tall or well-proportioned you are. A waist circumference of 32 inches may be fine for a very tall woman, but not a very short one.

What’s Different About A Body Shape Index?

ABSI is based on both BMI and waist circumference. When used to follow more than 14,000 Americans adults over five years it was better than BMI or waist circumference in predicting who would die of any cause during that time period among men, women, and blacks, but not Mexicans. It was also a reliable way to predict who was more likely to die when other factors that significantly increase your risk, such as cigarette smoking, high blood pressure and diabetes status, were considered.

Losing weight by any means will lower your BMI, and shrinking or redistributing fat deposits will give you a smaller waist circumference. Those steps will also decrease your risk of developing diabetes, heart disease, and certain cancers. What we don’t know yet is what changes are needed in the ABSI to delay dying.

While waiting for further research on ABSI, you can always take a look in a full length mirror after your next shower. It’s another good way to see if you have any body shape issues to address.

For more updates on obesity research:

Use these checklists to see if you are developing diabetes

Are You Developing Diabetes?

This post was written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

USE THESE CHECKLISTS TO SEE IF YOU ARE DEVELOPING DIABETES

One of the biggest threats of gaining 20 pounds is the increased risk of developing diabetes. Twenty pounds is all it takes to go from a healthy body mass index (BMI) of 21 to an unhealthy one of 25. That is the point on the BMI chart when you are considered overweight.

Being overweight is a risk factor for developing type 2 diabetes in both children and adults.

Why the Disconnect Between Overweight and Diabetes?

When I was in private practice, many of my new clients who had gained 20 pounds came in saying they didn’t like the way they looked or how their clothes fit — as if that was all that was at stake. When I was writing The Wedding Dress Diet, many of the brides-to-be I talked to admitted they would probably gain 20 pounds after they got married — as if it didn’t matter.

Obviously, the connection between being overweight and diabetes had not hit home because whenever I asked anyone how they felt about getting diabetes, they shuddered. Being a little pudgy was one thing, having diabetes was quite another.

Sadly, the message still has not sunk in. Nearly 26 million Americans now have diabetes and three times that many are pre-diabetic – people with elevated blood glucose levels that are not quite high enough to be diagnosed as diabetes. That’s 75 million people who almost have diabetes!

If you or someone you know is concerned about developing diabetes, use the checklists below recognize the risks and warning signs, then get the help you need to prevent or treat it.

Who is At Risk of Developing Diabetes?

  • Overweight or obese with a BMI of 25 or higher
  • Waist circumference greater than 35 inches in men and 32 inches in women
  • Woman who had gestational diabetes or gave birth to a baby weighting more than 9 pounds
  • Low HLD cholesterol of 35 mg/dL or less
  • High triglyceride level of 250 mg/dL or more
  • High blood pressure of 140/90 mmHg or greater
  • Family history of diabetes in parents or siblings
  • Low physical activity level of exercising less than 3 times a week

Early Warning Signs of Diabetes

  • Blurry, clouded vision – once blood sugar is lowered, vision returns to normal
  • Increased thirst and hunger – not satisfied after drinking or eating
  • Frequent urination – 20 or more times a day
  • Always tired, weak, fatigued – even after sleeping since cells can’t get the energy they need
  • Sudden, unexplained weight loss –the body is breaking down muscle and fat for energy

Tests Used to Diagnose Diabetes

  • Fasting blood glucose: 126 mg/dL or greater on 2 separate tests. Blood sample is taken after not eating or drinking anything for at least 8 hours, but not more than 16 hours
  • Casual blood glucose: 200 mg/dL or greater. Blood sample used is taken at any time regardless of last meal
  • Glucose tolerance test: 200 mg/dL at the 2-hour reading. Blood glucose is tested after fasting, then a sweet liquid containing a known amount of sugar is consumed and blood glucose is tested periodically for up to two hours.
  • Glycated hemoglobin (A1C): 6.5% or greater. Used to tell blood glucose control over the previous 2-3 months.

Goals for Treating Diabetes

  • Maintain blood glucose levels as close to normal as possible with changes in diet and exercise and, if needed, medication
  • Lose at least 10% of body weight to improve symptoms, maintain a BMI of 25 or less to eliminate diabetes

Dietary Objectives for Diabetes

  • Eat meals and snack at the same times every day
  • Distribute total calories evenly among meals, don’t skip meals or eat just one or two big meals
  • Increase soluble fiber content in meals from oatmeal, oat bran, beans, lentils, barley, flax seed, nuts, apples, pears, oranges celery, and carrots.
  • Control the type of carbohydrates eaten by choosing “whole grain” breads and cereals over refined grains, raw and cooked vegetables and whole fruits instead of juice.
  • Limit the amount of carbohydrate to 45-60 grams per meal, including carbohydrates from added sugars
  • Pay attention to all of the ingredients in “sugar free” foods and those made with sugar substitutes
  • Use healthier fats and oils, such as olive and canola oil, and limit saturated fat and trans fat to reduce heart disease risk

See these related stories on diabetes.

  • Fast Eaters Have Greater Risk of Diabetes Than Slow Eaters
  • A Secret Weapon to Help Control Diabetes: Barley
  • Tired All the Time? 11 Reasons Why (Besides Lack of Sleep)

Reflections on Obesity and the Weight of the Nation

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

A REGISTERED DIETITIAN’S VIEW OF OBESITY CONTRASTS WITH HBO’S WEIGHT OF THE NATION

While awaiting the heavily promoted premier of the HBO documentary, Weight of the Nation, I took the time to reflect on what I have learned about obesity in my 35 years of experience treating people who are overweight or obese. It just so happens my career spans the same trajectory as the epidemic, but I’m pretty sure I am not to blame!

Much has changed in this country since the mid-1970’s when obesity rates began to soar, and it all matters. But it is also true that no one thing is more important than any other in bringing about this unprecedented weight gain among Americans of every race, class and region.

I cannot offer all the mind-numbing statistics, frightening graphics, and challenging expert opinions of a high-tech television production, but I can tell you some things that need to be said.

What Obesity Is Not

All obesity is not same. Every person who reaches the benchmark to be classified as obese got there in his or her own way. It’s the result of a complex interplay of personal biology, environment, and lifestyle, where no two situations are exactly the same because no two people are exactly the same. This becomes even more apparent as the epidemic spreads around the world.

Obesity is not curable. There are many different factors that play a causal role in developing obesity and there no cure for it. Once you become obese, you must spend the rest of your life treating it or risk becoming even fatter or dying of the chronic diseases that accompany it.

 

Obesity is not easy to diagnose. Weighing a person and measuring their height is easy. Using those figures to calculate body mass index (BMI) is also easy. But deciding if someone is obese based on their BMI is not. More sophisticated measurements are needed to determine what the percentage of fat is in the body and where it is located to fully understand whether someone is at risk due to their body size and composition.

 

Obesity is not easy to prevent or treat. The best advice medical science has to offer as a means to prevent obesity is to maintain a state of “energy balance.” That advice is difficult to follow. It requires knowing precisely how many calories you consume every day (over a lifetime) and how much energy you expend every day to offset them. These are intangible values. Once you become obese, you are expected to create an energy imbalance by expending more calories than you take in. Only at this point, your body has a whole new way of dealing with energy that defies the mathematics of using calorie control to achieve weight control.

Obesity is not a plague. Obesity spread very quickly in the last three decades, but it is not a scourge that must be routed out by any means possible. Drastic measures have been proposed to “fix” the way we grow, distribute, and sell food in this country, while the obese have been scrutinized, marginalized, and penalized for their weight. In the panic to find a solution we have lost sight of the fact individuals become obese and it is individuals who need help dealing with it.

I hope I can look back 35 years from now and reflect on all that we learned about obesity to lift this weight from our nation.