Body mass index (BMI) is one of the most popular ways to measure body composition when it comes to health. However, research indicate that BMI is not the most accurate representation and may have serious limitations in weight distribution, body fat percentage, and different demographics.
Here’s everything you need to know about the BMI and weight measurement alternatives.
What is BMI
He BMI, or body mass index, is a mathematical calculation that estimates a person’s body fat by dividing your weight in kilograms times your height in meters squared (BMI = kg/m2). The results are divided into four categories:
- Underweight (<18.5)
- Normal (18.5 – 24.9)
- Overweight (25 – 29.9)
- Obesity (> 30)
Doctors can use BMI measurements as a screening tool to tell you which category you fall into and whether you are at higher risk for certain health conditions, such as heart disease or diabetes, based on your results.
The BMI was initially created in the 19th century by Belgian mathematician and statistician Lambert Adolphe Quetelet as a way to measure obesity in the general population.
The formula evolved throughout the 1940s, when the Metropolitan Life Insurance Company (MLIC) instituted an ideal weight standard to determine how much to charge customers for insurance based on their health.
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“MLIC developed the idea of a BMI classification to determine what height and weight “people had in relation to their death,” says Fatima Cody Stanford, MD, an obesity physician and scientist at Massachusetts General Hospital. “But the problem with looking at that historical data is that it didn’t include the diverse representation of individuals in the population.”
No, BMI is not always an accurate measure of health.
While BMI might be a quick, affordable and easy way to assess a person’s health, the formula is better suited for information about the general population, according to Stanford. When looking at BMI at the individual level, there are Other factors to consider that this index does not take into account:
1. BMI does not measure body fat percentage
Body fat percentage is the percentage of your body that is fatty tissue compared to your total body mass. This is typically measured with skinfold calipers, bioelectrical impedance, or more accurately through DXA x-rays.
One of the main problems with BMI is that it cannot explain the difference between muscle and fat. Because muscle tissue is denser than fat, many athletes and bodybuilders fall into the overweight ranges according to BMI despite being in optimal athletic health.
“He body fat percentage will provide a better assessment of health “Because disease risk is more closely tied to body fat than body weight,” explains Chika Anekwe, a physician specializing in obesity at Massachusetts General Hospital and an instructor at Harvard Medical School.
2. BMI does not take into account different demographic aspects
When Quetelet originally created the BMI, he drew data from Anglo-Saxon bodies in an entirely European population. Because of this, it is not always an accurate depiction of health for other demographic groups and races.
For example, researchers found that the BMI obesity cutoff for Asian populations actually falls below the standard BMI table. In 2004, the World Health Organization (WHO) found that Asian people at high risk for type 2 diabetes and cardiovascular disease had lower BMIs.
Another large 2004 study of more than 15,000 Chinese adults found that a high risk of cardiovascular disease began with a lower BMI and waist circumference than in Caucasians. This means that when BMI is assessed, people with a high risk of cardiovascular disease are more likely to have a lower BMI and waist circumference than Caucasians.Asian people may be at higher risk for disease in the categories considered healthy or normal on the BMI chart.
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Additionally, Stanford conducted a study in 2020 that concluded that what is considered healthy for black women is higher than the standard BMI chart, For Hispanic and white women, however, the healthy range is lower than the table suggests. For example, when measuring diabetes risk, black women are closer to 33 and the average for white women is closer to 29.
“The key thing to understand is the need to personalize our care for patients,” Stanford explains.
“It’s not a one-size-fits-all approach and We can’t expect everyone to have a BMI of 25For black women, for example, you might see someone with a BMI of 32, but that could actually be very healthy for them, in the context of their entire profile.”
3. BMI does not measure body fat distribution
The Specific location of fat is another important factor when considering overall health, and it is a measure that BMI does not adjust for. Upper body fat around the midsection and visceral fat are more closely linked to health complications, such as cardiovascular disease, than lower body fat around the thighs and buttocks region.
Visceral fat is body fat stored around the abdomen and major organs such as the liver, pancreas, and intestines.
A 2017 study found that People with the same BMI can have very different risk profiles of heart attacks, strokes and diabetes, depending on lifestyle, diet and the location of fat in their bodies.
“If we have fat in our midsection, it’s around our vital organs like the heart or liver, which can confer worse risks,” Stanford warns.
What are the most accurate health indicators?
Anekwe explains that There are more accurate ways to assess health than BMI. These predictors are called the five metabolic risk factors. Together, they can increase your chances of heart disease, stroke, and diabetes.
These measures include:
- Waist circumference: excess fat around the waist. If your circumference is over 80 for a woman or over 94 for a man, you may be at higher risk.
- High blood cholesterol: Overall cholesterol levels above 239 mg/dL in men and women may pose a higher risk for health conditions.
- Elevated triglycerides: a type of fat found in the blood that can increase when you consume more calories than you burn. A high triglyceride level is greater than 200 mg/dL.
- High blood pressure:When the blood flowing through the blood vessels is too high, it is also known as hypertension. High blood pressure is 140/90 mmHg.
- High blood sugar:blood sugar levels consistently above 125 mg/dl in adults, also known as hyperglycemia.
Conclusion
Although measuring your body mass index can be a quick and easy way to assess your health, There are numerous risks that the BMI does not address, such as different demographics, weight distribution and body fat percentage.
To more accurately understand your health, metabolic factors such as Blood pressure and waist circumference may better predict your overall risk for certain conditions.
If you are concerned about your BMI or weight, it is perfectly normal and safe to consult your doctor to better understand what is healthy for you and your body, individually.
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Tags: Health, Healthy Living