fat or fit?

Fat or fit?

Your Health DR GITA MATHAI

Women often ask, “Do I look fat?” If you feel the need to ask that question you probably have a problem! This question seldom worries overweight men, until their physicians point it out or diagnose lifestyle diseases. All of us want to look good but in reality beauty does not lie in the eye of the beholder; the ideal size and shape is a debatable question and can be calculated with numerical formulae. Various parameters are used by insurance companies to assess health and predict longevity, or, in other words, how fit a person is. The most widely used is the body mass index or BMI (weight in kilograms divided by height in metre squared). Based on this simple formula people were classified into: low (18.5 and below), normal (18.5 to 25.0; Asian value is 23), obese level 1 (25.0 to 30.0), obese level 2 (from 30.0 to 35.0), obese level 3 (from 35.0 to 40.0) and obese level 4 (40.0 and above). But the formula has been found to have many defects. It is accurate for men of medium height, but flawed for women. Athletes have increased muscle mass and this increases their BMI. Very tall or short individuals fall outside the normal range even when they are healthy. Medical professionals sometimes measure the waist alone. If it is more than 35in (89cm) for women and more than 40in (102cm) for men, there is an increased risk of lifestyle diseases. The waist:hip ratio (WHR) can also be used. Ideally, it should be 0.7 for women and 0.9 for men. Women in the ideal range have optimal levels of the female hormone estrogen; this makes them less likely to have menstrual irregularities and more likely to be fertile. The likelihood of developing cancers of the uterus and ovary is also reduced. In men too, normal values indicate better fertility and less likelihood of cancer of the testes or prostrate. An ideal WHR makes both sexes less likely to develop lifestyle diseases. Measurements, statistics and appearance are useful as rough guidelines but health actually means being “fit”, that is, having a flexible body, with efficient heart, lungs, bones, muscles and nervous system. A person in the “overweight” or “obese” range according to the formulae above can actually be fit while a “thin” person may be unhealthy. Fitness means: The person should not use tobacco in any form or drink excessively. Blood pressure, lipid profile and sugars should be normal. The person should be able to move all their joints through their entire range of motion painlessly, both actively and passively. Simple tests to measure fitness at age 30 and above: Seated comfortably in a chair, with arms crossed, they should be able to stand up and sit down approximately 12 times in 30 seconds. Should be able to sprint 100 metres in 20 seconds or less Seated cross legged on the floor, should be able to stand up without using any other part of the body for balance, assistance and support. The primary goal should not be “looking good” but “feeling great”. Weight loss is often difficult, especially after the teenage years. It cannot really be simplified into the formula calories eaten minus calories used. People utilise calories at different rates for the same activities. The BMR (basal metabolic rate) at which their bodies perform basic functions necessary to stay alive varies. This is where genetics comes into play. Some people are inherently more efficient at conserving calories and perform the same functions utilising less energy. Physical activity helps the body maintain healthy levels of insulin and blood sugar. This prevents damage to blood vessels and internal organs such as the heart and kidney. Regular exercise blunts obesity’s ill effects even with little or no weight loss. As fitness is achieved, some amount of weight loss is bound to eventually occur. Together, this increases lifespan and reduces the risk of cancers and other serious illnesses by 20-30 per cent. Achieving fitness should be a lifelong goal. It requires aerobic activity (running, jogging, brisk walking, cycling or swimming) for 30-60 minutes a day, core and muscle strengthening exercises, light weights and yoga or other flexibility exercises for 20 minutes a day. No time for exercise? That just means you will have a lot of time for illness later! Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in