BMI and Alternatives (waist-to hip ratio)
Obesity epidemics have been widely noted. Less frequently remarked is the degree to which they
are just the logical conclusion of the lifestyle we have collectively adopted. Work, food, suburbs -
the fundamentals of our lives - are no longer calibrated to be in harmony with the human body and
soul, but have been relegated to afterthoughts in struggle for survival in the liberal economy
("greed is good"). They destroy their health and live crazy life when all they try is to reach one high water
mark in the achievements ladder after
Sedentary lifestyle typical for most programmers and system administrators is another
contributing factor in obesity epidemics among professional with those specialties.
It directly or indirectly (as risk factor) leads to
The anser is no. But still is marginally useful almost completely unscientific indicator. Experts
emphasize there’s no real doubt that obesity raises the risk of death as well as serious conditions
like heart disease, stroke and diabetes.
The real question is to what extent and for which categories of people body mass index
(BMI) is a good measure to determine whether someone is overweight. It definitely has glaring
flaws so it should always be supplemented by measuring of
the waist-to-hip ratio
(WHR). BMI it basically is a comparison of height to weight and does not take into account the particular
person Body shape (wide
shoulders, thick bones, etc) and gender of the person. As such it is a pretty blind instrument.
See also Female body shape
- Wikipedia and Body proportions
Body shape - Wikipedia
Classifications of female body sizes are mainly based on the circumference of the bust-waist-hip
(BWH), as in 36–24–36 (inches)
respectively. In this case, the waist-hip ratio is 24/36 = 0.67. Many terms or classifications
are used to describe body shape types:
- V shape: Males tend to have proportionally smaller buttocks, bigger chests
and wider shoulders,
wider latisimuss dorsi and a small waist which makes for a V-shape of the torso.
- Hourglass shape: The female body is significantly narrower in the
waist both in front
view and profile view. The waist is narrower than the chest region due to the breasts,
and narrower than the hip region due to the width of the buttocks, which results in an
- Apple: The stomach region is wider than the hip section, mainly in males.
- Pear or spoon or bell: The hip section is wider than the upper body, mainly
- Rectangle or straight or banana: The hip, waist, and shoulder sections are
In short BMI very unscientific, but still useful measure of obesity, that uses your height
and weight. It is also the most popular.
You can calculate your BMI by dividing your weight in kilograms by the square of your height
in meters. In other words the algebraic expression for BMI is (CDC.gov):
BMI = Kg / (m)2
One variable BMI fails to consider is lean body mass. It is possible for a healthy, muscular individual
with very low body fat to be classified obese using the BMI formula.
If you are a trained
athlete, your weight based on your measured percent body fat would be a better indicator of what you
For those unfamiliar with the “metric" system, listed below are relevant unit conversion factors.
|1 inch = 2.54 cm
||1 meter = 100 cm
||1 lb = 0.45359237 Kg
for example: 220*0.454=99.88 kg
|5 feet 8 inches = 5 ft (12 in / ft) + 8 in = 68 inches
|68 in (2.54 cm / in) = 172.72 cm
|172.72 cm (1 meter / 100 cm) = 1.7272 meters
||What your BMI result indicates
|Less than 19
You are under optimum weight for your height. You could afford to gain a little weight.
|20 - 25
You have a healthy weight for your height.
|26 - 30
You are over optimum weight for your height. You may be facing health problems, so losing some
weight would be a good idea.
||OBESE You are over optimum weight for your height. You may be facing health risks, so see your doctor
to help you achieve a healthier weight.
New research shows that there’s a better, more informative way to figure out if you are overweight
and to supplemnt BMI as "the second opinion". One of such mesures is
the waist-to-hip ratio
(WHR). All it requires for calculation is a measuring tape. For example, an athlete with increased muscle
mass may have a BMI greater than 25 - making him or her overweight on the BMI scale - but a Waist Circumference
measurement would most likely indicate that he or she is, in fact, not overweight.
It's interpretation tables are also gender dependent.
For example if you
have the waist-to-hip ratio 44/44=1.00 classify a male as merely overweight. While BMI ration
of 35 (let's say 5"7 and weight 228) classify the same male person as severely obese. WHR has been
found to be a more efficient predictor of mortality in older people (>75 years of age) than waist
circumference or BMI.
Measuring waist circumference helps screen for possible health risks that come with overweight and
obesity. If most of your fat is around your waist rather than at your hips, you’re at a higher risk
for heart disease and type 2 diabetes. This risk goes up with a waist size that is greater
than 35 inches for women or greater than 40 inches for men. To correctly measure your waist, stand
and place a tape measure around your middle, just above your hipbones. Measure your waist just after
you breathe out.
In the United States a waist circumference of >102 cm(~40") in men and >88 cm(~34.5") in women
or the waist–hip ratio
(the circumference of the waist divided by that of the hips of >0.9 for men and >0.85 for women)
are used to define central obesity.
In the European Union waist circumference of ≥ 94 cm(~37") in men and ≥ 80 cm(~31.5") in non pregnant
women are used as cut offs for central obesity.
A lower cut off of 90 cm has been recommended for South Asian and Chinese men, while a cut off
of 85 cm has been recommended for Japanese men.
In those with a BMI under 35, intra-abdominal body fat is related to negative health outcomes
independent of total body fat.
Intra-abdominal or visceral fat has a particularly strong correlation with
In a study of 15,000 people, waist circumference also correlated better with
Women with abdominal obesity have a cardiovascular risk similar to that of men.
In people with a BMI over 35, measurement of waist circumference however adds little to the
predictive power of BMI as most individuals with this BMI have abnormal waist circumferences.
Risks of Obesity-Associated Diseases by BMI and Waist Circumference provides you
with an idea of whether your BMI combined with your waist circumference increases your risk for developing
obesity-associated diseases or conditions.
Another interesting, but more complex alternative metric is body fat persentage
Another interesting, but more complex alternative is
Body fat percentage - Wikipedia
There are many such calculators on the web. You should prefer government sites.
WeBMI - Health-E-Tools - Quizzes
Researchers say waist-to-hip ratio may paint better picture of fitness
Just last week a study came out showing that being overweight wasn't likely to kill you.
Then yesterday, two more studies were published saying that by packing on only a few extra pounds,
you could significantly increase your risk of premature death.
At first glance, these three studies
might lead to considerable confusion - and a devil-may-care attitude towards weight gain.
But experts emphasize there's no real doubt that obesity raises the risk of death as well as serious
conditions like heart disease, stroke and diabetes.
The real question, says Dr. Donald Cutlip, an associate professor of medicine at the Harvard
Medical School, is whether body mass index is a good measure to determine whether someone is overweight.
The conflicting studies, each based on BMI scores, point out flaws with the common measure, basically
a comparison of height to weight.
New research shows that there's a better, more informative way to figure out if you are overweight
- the waist-to-hip ratio - and all it requires is a measuring tape.
Too buff, too old
The first salvo in the latest obesity debate popped up last week in the British journal The Lancet.
The study found that among patients with heart disease, death was actually less likely if a person
was overweight. And obesity appeared to be downright protective.
The authors of the study pinned the unexpected results on BMI.
"Rather than proving that obesity is harmless, our data suggest that alternative methods might
be needed to better characterize individuals who truly have excess body fat," said the study's lead
researcher Francisco Lopez-Jiminez of the Mayo Clinic College of Medicine.
Cutlip agrees that BMI can be way off, especially when it comes to assessing a particular individual.
The commonly used measure can give a skewed result not only for fit body builders who come out with
a high number because of the extra weight associated with muscle, but also for the elderly, who tend
to have scores that underestimate obesity because they have so much less muscle.
When it comes to large population studies, the measurement usually works well because BMI does
give the right answer when averaged across many people. There were other flaws with the Lancet study,
Still, most of us aren't taking our measurements as part of a big study. We're simply trying to
figure out if we're at a healthy weight or not. And in that case, BMI may not be the best way to
find that out.
The best way to predict heart attack risk and other obesity-related diseases is a measurement
that divides the circumference of your waist by your hips.
If you're a woman, the waist-to-hip ratio should come out as no more than 0.8. Men have
a little more wiggle room: a healthy waist-to-hip ratio for them is 0.95.
This means, if your belly has bulged out enough to catch up to the size of your hips, you should
start worrying about your heart, experts say.
That's because abdominal fat is more likely than fat stored in other spots to lead to changes
in hormone levels and to cause inflammation, which in turn leads to clogged arteries, says Dr.
Gordon A. Ewy, a professor and chief of cardiology at the University of Arizona College of Medicine,
and director of the school's Sarver Heart Center. So, "fat on a woman's hips doesn't seem to increase
risk, whereas a beer belly does," Ewy says.
Fat stored in the belly "is the most dangerous type of fat in our bodies," explains Dr. William
Castelli, director of the Framingham Cardiovascular Institute.
The waist-to-hip measurement is likely to catch people at risk for fat-related diseases who might
otherwise think they were at a healthy weight, based on their BMI scores.
It's quite possible to have an acceptable BMI and still have some belly paunch, says Dr. Louis
Aronne, clinical professor of medicine at the Weill-Cornell Medical College and director of the Comprehensive
Weight Control Program at New York Presbyterian Hospital.
Certain groups of people - those from Japan and south Asia, for example - tend not to become
obese but can have an increased risk of heart disease from storing small amounts of fat around their
waists, Aronne says. "You can be thin and still have too much fat," he adds.
Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in
The New York Times, Newsday, Health magazine, Smart Money and Neurology Now.
© 2006 MSNBC Interactive
Findings: Exercise More Important in Preventing Heart Disease, but Not Diabetes. One researcher
said women "need to be out increasing . . . fitness level and getting back into shape, not just
dropping pounds." (James M. Thresher -- The Washington Post)
Being fit appears to be far more important than being thin for decreasing the risk of heart disease,
while the opposite seems to be the case for diabetes, according to two new studies in women.
One study of more than 900 women with chest pain found that those who were unfit were much more
likely to have a heart attack or stroke than those who were overweight. But the other, a study of
more than 37,000 healthy nurses, found that being fit did little to reduce the huge risk that overweight
women face of developing diabetes.
A study of more than 900 women with chest pain found that those who were unfit were more likely
to have a heart attack or stroke than those who were overweight. One researcher said women "need
to be out increasing . . . fitness level and getting back into shape, not just dropping pounds."
(James M. Thresher -- The Washington Post)
The new studies, published in today's Journal of the American Medical Association, rekindled an
intense debate over the relative risks and benefits of being overweight vs. thin, fit vs. unfit.
"The public is going to throw up its hands in exasperation and say: 'I can't get a straight story
from you scientists. You're telling me to lose weight. You're telling me to exercise. You're telling
me that it doesn't make any difference if I exercise. You're saying it doesn't make any difference
to lose weight,' " said Arthur Frank, an obesity expert at George Washington University. "But no
one is really saying that. The real answer is: 'You should do both.' "
The seemingly conflicting findings may be the result of the different diseases and populations
of women that were studied, with weight perhaps playing a greater role in diabetes and fitness possibly
more important for heart disease, Frank and others said.
"Although closely linked, they are different diseases, and it may be the relative importance of
different risk factors will vary between them," said Lawrence J. Cheskin, director of the Johns Hopkins
Weight Management Center. "The bottom line still is it would be wisest to assume that both body weight
and body fat distribution and fitness are risk factors for both diabetes and heart disease."
With the number of Americans who are overweight and obese increasing rapidly, public health authorities
have been warning that the nation is facing a major public health crisis. But some researchers have
been arguing that the health risks of being overweight have been exaggerated, and that a growing
body of evidence suggests that being sedentary and unfit is a far greater problem.
In the first new study, researchers examined 906 women participating in the Women's Ischemia Syndrome
Evaluation (WISE) study.
On average, women who were deemed unfit based on their activity levels were significantly more
likely to have blocked arteries at the beginning of the study and to go on to suffer a heart attack,
stroke or some other serious cardiovascular problem over the next four years, the researchers found.
Those who were overweight but relatively fit did not have a significantly elevated risk once researchers
accounted for other risk factors, such as diabetes, high cholesterol or high blood pressure.
"For this group of women, their fitness level was much more important than their weight," said
Timothy R. Wessel of the University of Florida College of Medicine in Gainesville, who led the research.
"We wouldn't say your weight doesn't matter -- obesity has been established as a known risk factor
for heart disease. But at least for this group of women their fitness level mattered a whole lot
The findings indicate that people who are concerned about their hearts need to make sure they
are physically active, Wessel said.
"You need to be out increasing your fitness level and getting back in shape, not just dropping
pounds," Wessel said.
Physical activity and fitness may decrease the risk for heart disease through a variety of mechanisms,
including lowering blood pressure, cholesterol and reducing inflammation inside the body, he said.
In the second study, a team led by Amy R. Weinstein of the Beth Israel Deaconess Medical Center
in Boston and colleagues studied 37,878 women in the Women's Health Study, an ongoing study of a
variety of health issues.
Over an average of seven years, women who were overweight were dramatically more likely to develop
diabetes, with their fitness levels appearing to affect that risk only minimally, the researchers
"For diabetes, it looks like being fit does not counter the increased risk of being overweight,"
But proponents of the importance of fitness over fatness said the heart study supports emphasizing
exercise, since it is much more realistic goal for many people.
"It is far easier to get a fat person fit then it is to get a fat person thin," said Glenn Gaesser,
professor of exercise physiology at the University of Virginia. "That is really the bottom line.
Trying to lose weight and keep it off is, if not darn near impossible, then close to it."
Almost everyone can walk to lose weight. You don't have to spend a lot of money or join a gym;
just put on your walking shoes and walk. Walking puts less stress on the knees and ankles than running
and has fewer injuries. Walking to your car is walking, but to lose weight by walking, you'll need
to do more. A leisurely stroll after dinner is a good start. However, to lose weight, you need to
get your heart rate pumping. Walk around the block and then, again, with more intensity. Swing your
arms, extend your stride or carry small weights to burn a few extra calories. Use a pedometer to
monitor your steps and add a few more each day.
2. Set Small Walking Goals for Weight Loss
Write down your walking times and distances in a log book. Keep it visible so that it'll be a
reminder to plan your walks each day. Set times to walk with friends in the neighborhood, at the
park or at the high school track. It's a great way to catch up and workout at the same time. After
you've progressed, shoot for an event like a 5K walk. You'll feel like you've accomplished something
when you get to wear your event t-shirt.
3. Calories In, Pounds Off
Walking is great, but realistically it's a combination of things that will lead to weight loss.
Be aware of what you are eating every day. It's just common sense to know that to lose weight, you
have to burn more calories than you take in. For every 3,500 calories you burn by walking, you'll
lose a pound.
4. Be Selfish About Your Walking Time
Be selfish about your walking time; don't let others sway your commitment to walk. Develop a sense
of "it's my time," so you'll stay on track and keep losing weight. Use an iPod or headphones to motivate
yourself with music. Carry water to stay hydrated and a small towel as your walking workouts get
longer and more intense.
5. Obese Walkers, Just Take It One Step at a Time
People that are considered obese need to improve their health and lose weight more than most people.
They should check with their doctor prior to starting a walking workout. Start slowly to see how
your body is going to adjust to the exercise. If you have trouble at first, do two shorter walks
a day until you've built up stamina to go for a longer walk. Don't give up and don't compare yourself
to others. Just take it one step at a time.
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