My Beef with BMI

I was reading an article yesterday about overweight America that was talking about the issues that Americans face and the poor food choices that we are surrounded with.  It was a really good article until I got to the section that explained how to tell if you, or someone you love, is overweight.  They suggested using the BMI calculation, or Body Mass Index calculation, to tell if you are overweight.  And, as you can tell by the title of this post, I have some issues with that.  But first, I should probably explain what BMI is and how you calculate BMI.

BMI, as I said earlier, stands for Body Mass Index and is a standard way of coming up with a number that tells you if you are underweight, overweight, obese, or at your ideal weight.  BMI takes two factors into account; height and weight.  What happens is that your take your weight (in pounds) and divide it by your height (in inches) squared then multiply that number by 703.  Here's the standard rundown for BMI for a Male and female adult:

Male and Female Adult
0 - 18.5:  Underweight
18.5 - 24.9:  Normal
25 - 30:  Overweight
> 30:  Obese

If you're interested in your own BMI you can go to calculate-bmi.com to see where you come out instead of doing the calculation on your own.

But why do I have a beef with BMI?

One reason. It's far too generic.  Taking into account only the two factors of height and weight is borderline irresponsible.  For example, I had a classmate in chiropractic school who was "ripped" for lack of a better term.  And since muscle weighs quite a bit, he was a little heavier, but by no means unhealthy or overweight.  In fact, he was probably one of the healthiest in our class.  However, according to the BMI calculation, he was almost obese!

If you also don't take into account what your gender is, you're making a big mistake.  Science tells us that women are supposed to have more fat in their bodies than men.  The reason is that women go through much more stress than men in everyday life.  Constant hormonal changes due to menstrual cycles needs slightly more fat stores and it's vital to have more fat stores for pregnancy. 

So what's a better way to tell if you are overweight or in your ideal range?

One slightly better method is called the Waist-to-Hip Ratio.  It is slightly better able to take into account body shape and distribution of weight, which are much better indicators of health.  Click here to calculate your Waist-to-Hip Ratio.

However, possibly the best calculation is to determine your percent of body fat.  Now to get a very good estimation of your percent, it can take quite a few tests and money.  Therefore, it's not the most feasible method.

But, probably the best way to determine if you are of a healthy weight, is to look in the mirror and also to examine your lifestyle.  By leading a life that focuses on healthy eating and regular exercise, you will be hard pressed to get into that obese range.

What's that Noise?

One of the most frequent questions that I get as a chiropractor is what the popping sound is when we do an adjustment.  No, it's not actually "popcorn" like we tell many kids.  There is a physiological explanation to the "pop" or "crack" of a chiropractic adjustment.

First of all, when I explained what a subluxation is in "What is a Subluxation Anyway?", you may recall that, with a chiropractic adjustment, we are basically moving a misaligned bone back into place.  When bones are misaligned like that and "stuck" out of position, they need a little coaxing to get back in place.  And that takes years of training and continual learning to get down pat.  That's called the chiropractic adjustment.

With a chiropractic adjustment, in order to move the bone back in place, the joint that joins the two bones needs to slightly gap apart.  When that happens, little air/gas bubbles rush into the space that has just been opened a little bit and that is when you get the "pop" or "crack" sound.  It's a lot less scary than most people think.  The bones aren't crunching together or grinding against each other.  There isn't any breaking or fracturing happening.  It's simply air rushing into a newly opened space.  When that happens, the bone is more easily able to get back into alignment.

As you can see, it's a pretty simple and gentle occurrence.  The sound is usually what catches people off guard and gives that bit of a fear factor.  And, if you were wondering, why a neck adjustment is so much louder than one in your midback or low back, it's simply an issue of proximity.  Your neck is just simply much closer to your ears.  So it's not that the "pop" in your neck is louder, it's just perceived as louder because your neck vertebrae are right by your ears.

So if you've ever been a little apprehensive about that sound, it's just air/gas bubbles moving around.  Simple as that.

One Key to Perfect Posture

So my topic for this month's Blog Talk at the clinic (on Wednesday the 18th at 6pm) is "The Power of Perfect Posture".  And I thought it would be the ideal time to talk about a much overlooked and essential anatomical feature that has a great deal to do with our posture.  Our feet.

Even though our society as a whole is getting more and more sedentary, we still spend a great deal of time on our feet.  And, our feet play a very vital role in our posture.  I especially think this is an appropriate topic given the fact that it is now flip-flop season in much of the country.  First, a little anatomy.

Did you know that there are not one, not two, but actually three arches in your feet?  It's true.  We not only have the main arch along the inside of the foot, but also one along the outside, and one along the ball of the foot. 
The bad part is that most shoes do NOT provide support of any kind to the former two arches.  Some are very good at giving ample inside arch support but there are few flip-flops that do so.

Since we typically do not get enough support for our multiple arches, most people will have decreased or even collapsed arches.  When this happens, we typically get pronated feet.  It basically means that your flat feet cause your foot to lean toward the middle of your gait.  When this happens, it can have other ramifications.

Anytime that you are on your feet, your body's weight is being supported by your feet and the arches in your feet, or at least the arches that should be there.  So if your feet are pronated, for example, it can put more stress on your ankles, knees, hips, and spine all the way up to the base of your skull.  It's a lot like a building.  It could be perfectly level in the beginning but then ground settling and changes in the earth may cause the building to sit crookedly and over time, even the smallest beams can become warped and cracked.  Therefore, if the base of your body is out of alignment, your spine is more susceptible to imbalances such as subluxations.

So, the moral of the story is, if you have chronic knee, hip, low back, or even neck pain and nothing seems to be helping, it's worth getting your feet looked at.  Because a sturdy foundation can only be good for the weight it supports.