Nutrition Science and Everyday Application - beta v 0.1

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INDICATORS OF HEALTH: BMI, BODY COMPOSITION, AND METABOLIC HEALTH 383 expectations. People come in all shapes and sizes, and you have to determine what a healthy size is for you. Yet it’s also worth understanding some of the measures used to estimate body composition, how they can be linked to health, and their limitations. BODY MASS INDEX Body Mass Index (BMI) is an inexpensive screening tool used in clinical and research settings to assess body weight relative to height. Because it takes height into account, it is more predictive of how much body fat a person has than weight alone. However, BMI is not a direct measure of body fat, so it shouldn’t be used on its own to diagnose obesity or the health of an individual. 1 BMI calculations and categories BMI is calculated using the following equations: BMI = [weight (kg)/height (m 2 )] OR BMI = [weight (lb)/height (in 2 )] x 703 The Centers for Disease Control and Prevention has a BMI calculator on its website: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/ bmi_calculator.html For adults, BMI ranges are divided into four categories, which are associated with different levels of health risk: • Underweight – BMI < 18.5 • Normal weight – BMI from 18.5-24.9 • Overweight – BMI from 25-29.9 • Obese – BMI from 30 or higher Obesity is frequently subdivided into categories: • Class 1 obesity: BMI of 30 to < 35 • Class 2 obesity: BMI of 35 to < 40 • Class 3 obesity: BMI of 40 or higher (BMI values are interpreted differently for children, because body fatness changes with age and can be different between boys and girls.) In general, BMI in the “normal” range is associated with better health compared to both underweight and overweight or obese values, because there are risks of carrying both too little and too much body fat. When researchers have looked at BMI and health in large groups of people, they generally find that the lowest risk of disease and of dying younger is in the range of BMI of 20 to 25. As BMI values increase into the overweight and obese ranges,
384 ALICE CALLAHAN, PHD, HEATHER LEONARD, MED, RDN, AND TAMBERLY POWELL, MS, RDN the risk of developing type 2 diabetes, cardiovascular disease and stroke, and even cancer increase, as well as other complications of obesity, such as osteoarthritis. 2,3,4 Carrying extra weight not only puts a mechanical strain on the body, but it also negatively impacts metabolic health and increases inflammation. 5 Limitations of BMI The advantage of BMI is that it’s simple and easy to calculate, but it also has several important limitations. Since it’s only based on weight and height, it doesn’t distinguish between muscle mass and adipose tissue. It’s not unusual for muscular athletes to be classified as overweight based on BMI, but this can be misleading, because they may have little to no excess body fat. On the flipside, BMI can underestimate body fatness in someone with very low muscle mass, such as a person who is elderly and frail. In addition, BMI can’t tell us where body fat is located in the body, and as we’ll learn, this is a major factor determining its impact on health. BMI’s accuracy in predicting body fatness is also affected by biological sex and race—not surprising given the natural diversity in shape and size of human bodies. At the same BMI, women tend to carry more body fat than men. Also at the same BMI, a Black person tends to have less body fat, and an Asian person tends to have more body fat, compared to a white person. This means that a high BMI may overestimate health risk in a Black person and underestimate health risk in an Asian person. BMI is also not useful for estimating body fatness in a pregnant person, because pregnancy weight gain includes placental and fetal tissues. 1 All of this means that BMI is not particularly useful for comparing one individual to another individual or even one population to another, because this one number simply doesn’t account for all of the underlying diversity in factors like body type, muscle mass, biological sex, and race. And for an individual, one BMI measurement at a single point in time may not be all that meaningful—other measurements and clinical assessments are needed to diagnose obesity and more accurately assess disease risk, as we’ll discuss in a moment. BMI is perhaps most useful for tracking changes in body composition over time, whether of a population or an individual. For example, the data on average BMI in the U.S. show a clear increase over the last several decades, and the most likely explanation for that is not that people in the U.S. are all gaining several pounds of muscle each year, but that we’re putting on more fat. On the other hand, someone may have a BMI classified as overweight, but if they’ve been at that BMI their entire adult life and are active and metabolically healthy, that may just be the natural size and shape of their body. MEASURING BODY COMPOSITION A person’s body mass is made up of water, lean body mass (including organs, bone, and muscle), fat, and other components like minerals. The weight on the scale does not distinguish between these different components, but body composition measurements can.
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Nutrition: Science and Everyday App
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Nutrition: Science and Everyday App
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UNIT 3 - MOLECULES OF LIFE: PHOTOSY
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UNIT 9 - VITAMINS AND MINERALS PART
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2 ALICE CALLAHAN, PHD, HEATHER LEON
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About the Authors ALICE CALLAHAN, P
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6 ALICE CALLAHAN, PHD, HEATHER LEON
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Updates Made to OER Date Unit Page
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Introduction to Designing a Healthy
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12 ALICE CALLAHAN, PHD, HEATHER LEO
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Classification of Nutrients Food is
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Introduction to Nutrition Science a
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The Scientific Method Similar to th
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Types of Research Studies and How T
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100 ALICE CALLAHAN, PHD, HEATHER LE
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Finding Accurate Sources of Nutriti
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Who Can You Trust for Nutrition Inf
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UNIT 3 - MOLECULES OF LIFE: PHOTOSY
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Photosynthesis and Metabolism As we
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The Digestive System We just learne
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Introduction to Carbohydrates If so
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Digestion and Absorption of Carbohy
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Glucose Regulation and Utilization
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Sugar: Food Sources, Health Implica
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UNIT 5- LIPIDS 246
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The Functions of Fats Fats serve us
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Lipid Types and Structures Lipids a
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Digestion and Absorption of Lipids
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UNIT 6- PROTEIN 304
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UNIT 8 - VITAMINS AND MINERALS PART
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Dietary Supplements By now you know
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Vitamins and Minerals Involved In F
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Vitamins Important for Vision Visio
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Introduction to Vitamins and Minera
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Introduction to Bone Health The hum
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Calcium: Critical for Bones and Thr
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Vitamin D: Important to Bone Health
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Vitamins and Minerals Involved in B
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Introduction to Nutrition and Physi
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UNIT 11 — NUTRITION THROUGHOUT TH
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Nutrition in Early Infancy Infancy
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Raising Healthy Eaters “Raising a
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