In the past two issues, we’ve discussed the rapidly-increasing childhood obesity epidemic in this country, which has raised questions from our readers. Many were shocked by the statistics, as America has the highest rate of obesity in the world, with 65 percent of all citizens landing above what is deemed a healthy weight. Of that percentage, half are considered obese, with a Body Mass Index (BMI) greater than 30.
A few interesting questions that have been raised over the course of this series: Is it possible to be both overweight AND healthy? And are individuals who fall into their ideal weight range always healthier than their overweight counterparts? These questions made me realize that perhaps I had focused too much on the numbers and had overlooked something in the big picture.
How is good health defined? A recent study published in the Archives of Internal Medicine suggests that about half of all overweight people have normal blood pressure, blood sugar and cholesterol levels, while a surprisingly high 25 percent of participants who were classified as being at their ideal weight suffered from many of the ills associated with obesity. Results such as these fuel the growing debate about the standard methods of calculating whether an individual is overweight.
Currently, health officials rely on BMI, a height-weight ratio. The problem with this measurement is that it makes no distinction between fat and muscle. As a result, many athletes with a high percentage of lean tissue actually fall into the overweight category.
Avoiding the Skinny-Fat Syndrome
Edmond pharmacist Dave Mason is certified in Clinical Nutrition, and often sees patients who fall into a healthy weight range overall but still have high cholesterol, high body fat mass, and perhaps worst of all, a weakened immune system.
“I call these patients ‘skinny-fat,’” said Mason. “Not long ago we had a woman come in who had lost more than 50 pounds on one of the popular weight-loss programs that focuses primarily on calories rather than the overall nutritional makeup of foods. This patient confessed she was not much of a meat-eater, and had chosen to spend her calorie allowance mostly on carbohydrates, many of them processed. “We ran a bio-impedance analysis (BIA) on this patient, and her body fat was at about 55 percent. Her blood sugar and cholesterol were also higher than normal. She hadn’t been getting nearly enough protein, and she probably hadn’t been as physically active as she needed to be, although she lost all this weight.”
Likewise, even though some patients have a higher BMI, they are active, eat well, and have normal blood sugar, cholesterol, and hormone levels, making them in fact healthier than their lighter counterparts. Mason’s pharmacy offers a program called First Line Therapy, which focuses on teaching patients how their calories should be broken down in order to increase muscle mass. “We focus on the glycemic index of foods, and the program actually reduces the risk of developing hypertension and diabetes. Exercise is also a must. We consider it a therapeutic lifestyle program, not a diet. Patients will lose weight, but more importantly, they're going to have better overall health and quality of life.” The program uses BIA to monitor progress, and the diet plan is based on each individual's calculated basal metabolic rate. They encourage fresh whole grain foods, organic fruits and vegetables, and plenty of lean proteins. “Even if a patient only loses 10 pounds during the 12 weeks, when they increase their muscle mass and decrease their fat, they're going to feel a hundred percent better right away,” says Mason.
Risk Factors to Watch
Edmond nurse and mom of three Lori Richards agrees that not everyone needs to be a size six to be healthy. “As long as you’re active and you’re eating well and feeling good, a few extra pounds probably aren’t going to be a problem. In the long run, though, it’s a good idea to try to keep excess weight off.”
On the flip side, she admits she sees plenty of people at their ideal weight who are anything but healthy. “Some people are blessed with a high metabolism, and they can keep the weight off without much effort. If you look at their diet and activity levels, though, they probably have as many, if not more, health risks as people who are overweight.”
While weight loss is an important part of an overall wellness and disease prevention plan, certain risk factors may be more indicative of a potential problem than a higher-than normal BMI. “Patients should pay close attention to family history, especially immediate family and first-degree relatives,” says Richards. A patient with a family history of diabetes or heart disease is five to ten times more likely to develop one of the diseases, regardless of weight. “Waist circumference is a big red flag also,” noted Richards. A waist circumference of greater than 35 inches in women and 40 inches in men indicates an increased risk of developing Type 2 diabetes and heart disease. “Cholesterol and inflammation levels should be monitored at annual physicals in patients over 45, and everyone needs to get 30 minutes of moderate exercise five days a week to prevent disease,” says Richards.
While it might not be all about the numbers—weight, height, body mass index—it’s a good idea to stay aware of your overall health. In general, as long as you are able to exercise regularly, eat a healthy diet, and are under a doctor's care, a few extra pounds likely aren't cause for much concern. Likewise, if you are at a healthy weight already, but find that you struggle with diet and exercise, studies show that your health risks may not be any lower than someone who is overweight. If you have concerns about how to live a healthy lifestyle, take action and contact a healthcare provider for more information.
What ever happened to the food pyramid?
It’s still there, but it’s been radically changed. The updated food pyramid guidelines recognize that one size dietary guidelines do not fit all. The new pyramid guidelines recommend a healthy diet that:
- Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products;
- Includes lean meats, poultry, fish, beans, eggs, and nuts; and
- Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
Enter your personal information for customized healthy eating guidelines. Interactive tools include calorie counters and resources for children. Visit choosemyplate.gov, the site sponsored by the United States Department of Agriculture, for more information.
Shannon Fields is a freelance writer and a Certified Pharmacy Technician at Innovative Pharmacy Solutions.