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tamarian
Thu, Aug-05-04, 18:39
Body-Mass Index Is an Unbalanced Scale

By gail johnson

Publish Date: 5-Aug-2004

Everyone knows that being overweight has consequences, like a greater risk of diabetes, high blood pressure, and heart disease. What isn't so clear is what defines "heavy" or "obese", at least in people who aren't of European descent. One of the most commonly used measurements of total body fat is the body-mass index, which is based on a person's height and weight. But here's the rub: the BMI standards are based on studies done on Caucasians. Whether or not those same guidelines can be applied to other ethnic groups isn't clear. That's why a local kinesiologist is launching a multicultural health study.

Scott Lear, who's an assistant professor of kinesiology at SFU, told the Georgia Straight that people of South Asian origin, for example, have historically been perceived as being thin and, consequently, free of heart disease. Using the BMI guidelines in such groups could mean delayed testing--or none at all--for conditions like cardiovascular illnesses and late diagnosis and treatment.

"With the current [BMI] targets, the Asian population is identified [for heart disease] at a later stage; that's the concern," Lear said in a phone interview. "If people are carrying a greater proportion of body fat around their stomach than elsewhere on their body, they're at greater risk as well. The study will either validate or invalidate current targets and will determine the need for population-specific obesity targets. And Vancouver is the ideal spot to do it."

Funded by an initiative of the Institute of Nutrition, Metabolism and Diabetes--a branch of the Canadian Institutes of Health Research, which is the federal government's arm's-length health-research funding agency--the three-year study will involve 800 women and men from South Asian, Chinese, First Nations, and European communities who are apparently healthy and who range in age from 30 to 65. (Punjabi and Cantonese translators will be available.) Participants will be tested at St. Paul's Hospital for their BMI, bone density, muscle mass, cholesterol and insulin levels, and weight distribution, among other factors. They'll be asked about their lifestyle and diet. (For more details, call the Multicultural Health Assessment Trial at 604-806-8866.) Lear stressed that the study will provide people with an analysis of their risk for heart disease but won't provide diagnoses. Participants will receive a copy of the results, which they're encouraged to share with their family doctors.

The study is open to people of all sizes, Lear added. Just because people are large doesn't necessarily mean they are unhealthy, and someone who is lean might not be in good cardiovascular condition. Besides body fat, other aspects that influence well-being include exercise, eating habits, stress levels, sleep patterns, mental health, and the use of alcohol, tobacco, and drugs.

Even though defining a healthy weight can be confounding, it's still better to stay at a stable level than to yo-yo. According to The Complete Home Wellness Handbook: Home Remedies, Prevention, Self-Care (Rebus)--the 2001 encyclopedia by John Edward Swartzberg and Sheldon Margen, editors of the UC Berkeley Wellness Letter--the best way to lose weight is to do so gradually. The authors encourage increasing physical activity while decreasing calories and avoiding fad diets. "While severely restricting fat intake or consuming a low-carbohydrate/high-protein diet can produce a short-term drop of pounds, such a program almost invariably can't sustain permanent weight loss," they write. The two stress that people need to set realistic goals: aim to lose two kilograms (about a pound) a week, maximum.

The importance of maintaining a proper weight can't be understated. According to Statistics Canada's 2003 Community Health Survey, almost 15 percent of Canadian adults are obese, and another 33 percent are overweight. (It used the BMI as its gauge.) North Vancouver~based performance nutritionist Brad J. King says that combating weight problems isn't easy, but he shares tips in his new book, 7 Steps to Awaken Your Body: The Fat Wars Un-Diet Plan (Health Venture, $9.95). In it, he covers in detail such simple yet vital strategies as drinking more water and controlling insulin levels by watching how much fruit and refined grains and sugars you consume.

A FEW MONTHS from now, Vancouverites will be longing for the sunshine and warm weather we're currently experiencing, but when the temperature rises, so do people's crankiness levels. The heat is guaranteed to stick around for a while yet, and that means watching out for heat-related illnesses. Especially prone to maladies like heat rash, muscle cramps, and swelling in the legs and hands are children, older people, and those with chronic health conditions.

Heat exhaustion happens when your body can't produce enough sweat to cool you off. Among the symptoms are headache, nausea, fatigue, weakness, and pale or flushed skin. It can sometimes lead to heat stroke, which occurs when you stop sweating altogether. As a result, your body temperature continues to rise and the condition becomes an emergency. Signs include confusion, unconsciousness, or delirium and red, hot, dry skin.

According to the BC HealthGuide, ways to stay cool include drinking plenty of water and decreasing activity. It also advises eating less protein (which makes the body produce heat during digestion). By contrast, Bowen Island family doctor Anthony Ocana suggests eating fewer carbohydrates. "Carbs generate heat," he said on the line from his HealthSmith Medical Clinic. "That's why, traditionally, people eat salads and fish in the summer and bean soup in the winter. It's a perfect time to go on a low-carb diet. But you need enough carbs to sustain exercise."

Besides commonsense stuff like staying in the shade and getting out for walks early in the morning or after dinner, when the temperature is a bit cooler, Ocana also suggested taking his mom's advice for those instances when the heat is unbearably intense: lie on a tile floor with strips of cucumber peel on your forehead.

http://www.straight.com/content.cfm?id=4177

ceberezin
Thu, Aug-05-04, 22:31
This study is completely bass ackwards. Obesity doesn't cause high blood pressure, diabetes, and heart disease; it accompanies those things because insulin resistance causes all of them. All the din over obesity as a disease has obscured this obvious fact.

As far as the South Asian population is concerned, the results are already in. India, with its largely vegetarian diet, has the highest per capita incidence of heart disease of any nation on Earth. On a personal note . . . On a recent trip to India, what I noticed was that the main issue was adequate calories. People who could not get adequate calories were painfully thin with no muscle tone, while those who did get adequate calories on their high carbohydrate diet tended toward obesity. I also noticed a large amount of people injecting themselves with insulin because Type II diabetes was pandemic. All of this is consistent with what we know are the consequences of a high carbohydrate diet.

Some time ago, I read a very interesting letter to the New England Journal of Medecine from two doctors in Hong Kong. They suggested that the parameters for clinical obesity be racheted downwards for the Asian population since they do not respond to insulin resistance with fat storage the way Caucasian and African populations do. Their point was that Type II diabetes was pandemic in China, and if obesity were defined differently, people might recognize the problem more. So much for the Asian rice based diet.

dannysk
Fri, Aug-06-04, 00:29
" aim to lose two kilograms (about a pound) a week, maximum."

2 kilo is 4.4 lbs. He just got it backwards.

"It also advises eating less protein (which makes the body produce heat during digestion). "

That "heat" is, of course, extra calories being burned.

danny

Trinsdad
Fri, Aug-06-04, 05:44
"a program almost invariably can't sustain permanent weight loss,"

And eating fat free can? I dont know ANYONE that ever maintained weigthloss eating low calorie fat free.

catfishghj
Fri, Aug-06-04, 12:11
He actually said that low fat or low carb cant sustain weight loss. He had the low fat part right, but I have been doing pretty good on low carb.