Vital
Statistics
Here
are some recommended methods for assessing individual health status,
using individual vital statistics and some simple
mathematics:
BMI
The global
standard for classification of body weight as normal, underweight,
overweight or obese is Body Mass Index (BMI). BMI is calculated by
dividing a person's weight in kilograms by their height in metres
squared. Until recently, the same classification standards have been
used in all parts of the world, to assess and categorise body
weight:
A BMI of 18.5 to 25 is
traditionally classified as normal, 25 to 30 as overweight and
is associated with increased risk of developing weight-related
disorders, and above 30 is classified as obese and at high risk of
developing weight-related illness.
In recent years, experts have
observed that weight-related disorders are more common in some
Asians ethnic groups at BMI levels above 23. An expert group of the
WHO has therefore recommended a lower BMI scale for Asians:
18.5-23 for increasing but relatively low risk of developing
weight- related ill-health; 23-27.5 for increased risk; and
27.5 or more signals high risk.
A disadvantage of the BMI scale
however, is that it may overestimate body fat in athletes and
others, such as Pacific Island ethnic groups, who have a muscular
build. BMI may also underestimate body fat in older persons and
others who have lost muscle mass. Hence, experts recommend the use
of BMI combined with waist circumference or/and waist-to-hip ratio
for a more accurate assessment
Waist
Circumference
Waist
circumference is measured around the narrowest point between
ribs and hips when viewed from the front after exhaling. Waist
circumference is a measure of abdominal fat and a good indicator of
health status, even when the BMI calculation falls within the range
classified as normal. Waist measurements of over 102 cm (40 inches)
in men and over 88 cm (35 inches) in women were set as the global
thresholds for determining increased likelihood of developing
weight-related disorders.
More recently, lower thresholds
for waist circumference have been recommended for Asian populations.
The Working Group on Obesity in China organized a review of the data
on the relationship between BMI, waist circumference and risk
factors of related chronic diseases. Based on this review of
all the evidence collected to date, the Working Group recommended
waist circumferences of over 85 cm for men and over 80 cm for women
in China, as the threshold figures for diagnosis of central or
abdominal obesity (4). These figures have not been recommended
for the whole of Asia but nevertheless, do provide an alternative
scale to the global figures which may not fully take into account
the differences in fat distribution and body composition between
Caucasian and Asians.
Waist-to-Hip Ratio
(WHR)
Waist-to-hip ratio
(WHR) is the ratio of a person's waist circumference to hip
circumference. This measurement can be calculated by dividing waist
circumference by hip circumference.
WHR, like waist circumference is
a tool to assess distribution of body fat. For most people, and
perhaps especially Asian populations, abdominal fat causes more
health problems than carrying extra weight around their hips or
thighs. A WHR of 0.90 or less is considered healthy for men and a
ratio of 0.80 or less is considered a sign of good health for women.
A waist: hip ratio of 1 or higher signals increased risk of ill
health and an indicator that action to shed some body fat from the
tummy would be wise (2).
Signals for
Action
Together, these three
measures of body size, provide some very useful criteria against
which to assess body weight and determine action targets, to
maintain, lose weight or recognize and halt gradual weight gain. It
seems for Asians in particular; an assessment not just of body
weight, but also abdominal fatness is a wise and relatively simple
health check.
Regardless of whether individual
targets are to maintain weight or lose weight, the guidelines to
maximize individual chances for a long and healthy life are the
same:
(1) Establish an energy
balanced diet and lifestyle
Aim to gradually establish a
healthful lifestyle which fits in with other commitments of daily
life, and is based on a low-fat, varied and balanced diet, combined
with regular physical activity. The yo-yo effect of repeated weight
loss and weight gain, which occurs in those who follow a
repeated pattern of dieting to lose weight rapidly, but then
gradually regain the weight lost when they return to old eating
habits, brings its own health risks and makes long term weight
control increasingly more difficult.
(2) Develop Regular
Physical Activity Habits
For adults, thirty to sixty
minutes and for children, sixty minutes every day of moderate
to vigorous physical activity such as brisk walking, or swimming,
helps in weight maintenance and weight loss, and regardless of
body weight, massively reduces individual risk of developing
heart disease, strokes and other chronic disease because of the
benefits it brings to cardiovascular health. An additional incentive
to exercise may come from a study reported in the Journal of the
American Medical Association which found that regular exercise
reduced "intra-abdominal" fat and therefore trimmed waistlines even
in those who lost no weight. Regular exercise also brings many other
benefits, such as improved sleep quality and psychological well
being.
(3) Adopt a heart
friendly diet
Aim for a balanced healthful
diet, including plenty of fruit and vegetables, whole grain
products, low-fat and fat-free products (however take calories into
account), unsaturated soft margarines and oils (such as sunflower,
corn, rape-seed, olive), lean meat, fish and pulses. Health experts
also recommend the following additional measures
-
Restrict
salt and sugar intake
-
Eat
breakfast and make sure to have at least 3 meals per day
-
Use
healthier cooking methods such as steaming, boiling, grilling and
baking instead of deep fat-frying and adding extra fat and develop
healthy cooking skills within your family
-
Restrict
high fat and high sugar foods
-
Drink
at least 6-8 glasses of fluid per day
-
Expect
temptation, so plan don’t ban meals and snacks in advance
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