Saturday, April 3, 2010

What your body mass index IS NOT TELLING YOU

Patients With 'Normal' BMI Battling Health Problems Associated With Obesity

Mumbai: At 17 years, Rujuta Durake was overweight but not obese. Her Body Mass Index (BMI) was 26—a figure that does not warranty the need for metabolic surgery. But not only did Rujuta undergo a gastric bypass, doctors also diagnosed her with Type 2 diabetes, a disease usually associated with obesity. Her doctors found an unusually high percentage of fat deposits around the teenager's liver and intestine. 

    "Traditionally, a BMI of 30 and above is a sign of obesity. Though Rujuta's BMI was 26, her body fat percentage was 49%, much higher than the normal limit, which is 22% for women,'' said Dr Dr Shashank Shah, bariatric surgeon at L H Hiranandani Hospital. There are many people like Rujuta, who suffer from health problems associated with obesity even though their BMI does not indicate it. It's little wonder, then, that doctors are insisting that BMI can't be the only tool to measure obesity. 
    "While BMI is an accepted measurement of obesity, it doesn't measure adiposity—a status that incorporates phys
iological and anatomical parameters and provides a more complete measurement of a person's metabolism,'' said DrMuffazal Lakdawala, bariatric surgeon, Saifee Hospital. 
    Also, a patient's obesity level can vary depending on com
position, gender, etc. "The BMI reading of a man and woman who each weigh 75 kg will throw up the same figure. It does not take into account that while the man will have a higher fat percentage in his upper abdomen area, the women is most likely to have fat deposits around the hips. Only the male patient is likely to have problems such as diabetes and high cholesterol,'' said Dr Shah, who advocates the need for a Dual Energy X-ray Absorptiometry (DEXA) scan to get an accurate measure of fat density. 
    Sanjay Hon, 48, was suffering from obesity-related medical problems including hypertension, diabetes and high cholesterol. This, despite the fact that his BMI was 28. His body fat, however, was a high 40%. "The doctors informed me that my abdomen had deposits of fat,'' said Sanjay, who had to undergo metabolic surgery. "I managed to shed 23 kg and my cholesterol levels are normal,'' he added. 
    But the BMI is an affordable indicator of the problem. "A DEXA scan cost up to Rs 1,500 per scan. The BMI is still a good marker to help a person understand where he or she stands. Further course of action can be taken from there,'' said Dr Ramen Goel, bariatric surgeon, Bombay Hospital. 
Measuring Obesity 
What Is BMI 
Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women. It is calculated as absolute weight (kg) divided by height (m sq). 
    According to the 1991 National Institute of Health consensus, the cut-off criteria for an obesity surgery is a BMI 40 or 35 with comorbidity (problems like diabetes, etc). The reason BMI is used for screening the health of a patient is due to the strong correlation between being overweight/ obese and having health problems 
But What About Body Fat? 
According to doctors, obesity calculation should now be carried out through skin-fold thickness measurement, body fat scan, dual energy X rays, CT scan and MRI . The American Journal of Clinical Nutrition published a study showing that body-fat percentage may be a better measure of weight-related diseases than BMI. Doctors now believe that BMI limits be reduced, and other parameters like body fat percentage be considered for measuring obesity 
Some parameters suggested by the medical community 
Metabolic surgery be considered as a treatment option for obesity in Asians above a BMI of 32 
Asians whose BMI is 30 and waist circumference more than 80 cm in females and more than 90 cm in males, should be considered for obesity surgery 
Key Numbers 
Among Asians, 
20-22% 
body fat is normal for women 
For men, the limit is 17%


Thursday, April 1, 2010

The Amazing Cucumber


This information was in The New York Times several weeks ago as part of their "Spotlight on the Home" series that highlighted creative and fanciful ways to solve common problems.

1. Cucumbers contain most of the vitamins you need every day, just one cucumber contains Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5,Vitamin B6, Folic Acid, Vitamin C, Calcium, Iron, Magnesium,Phosphorus, Potassium and Zinc.

2. Feeling tired in the afternoon, put down the caffeinated soda and pick up a cucumber.  Cucumbers are a good source of B Vitamins and Carbohydrates that can provide that quick pick-me-up that can last for hours.

3. Tired of your bathroom mirror fogging up after a shower?  Try rubbing a cucumber slice along the mirror, it will eliminate the fog and provide a soothing, spa-like fragrance.

4. Are grubs and slugs ruining your planting beds?  Place a few slices in a small pie tin and your garden will be free of pests all season long.  The chemicals in the cucumber react with the aluminum to give off a scent undetectable to humans but drive garden pests crazy and make them flee the area.

5. Looking for a fast and easy way to remove cellulite before going out or to the pool?  Try rubbing a slice or two of cucumbers along your problem area for a few minutes, the phytochemicals in the cucumber cause the collagen in your skin to tighten, firming up the outer layer and reducing the visibility of cellulite.  Works great on wrinkles too!!!

6. Want to avoid a hangover or terrible headache?  Eat a few cucumber slices before going to bed and wake up refreshed and headache free. Cucumbers contain enough sugar, B vitamins and electrolytes to replenish essential nutrients the body lost, keeping everything in equilibrium, avoiding both a hangover and headache!!

7. Looking to fight off that afternoon or evening snacking binge? Cucumbers have been used for centuries and often used by European trappers, traders and explorers for quick meals to thwart off starvation.

8. Have an important meeting or job interview and you realize that you don't have enough time to polish your shoes?  Rub a freshly cut cucumber over the shoe, its chemicals will provide a quick and durable shine that not only looks great but also repels water.

9. Out of WD 40 and need to fix a squeaky hinge?  Take a cucumber slice and rub it along the problematic hinge, and voila, the squeak is gone!

10. Stressed out and don't have time for massage, facial or visit to the spa?  Cut up an entire cucumber and place it in a boiling pot of water, the chemicals and nutrients from the cucumber will react with the boiling water and be released in the steam, creating a soothing, relaxing aroma that has been shown to reduce stress in new mothers and college students during final exams.

11. Just finished a business lunch and realize you don't have gum or mints?  Take a slice of cucumber and press it to the roof of your mouth with your tongue for 30 seconds to eliminate bad breath, the phytochemcials will kill the bacteria in your mouth responsible for causing bad breath.

12. Looking for a 'green' way to clean your faucets, sinks or stainless steel?  Take a slice of cucumber and rub it on the surface you want to clean, not only will it remove years of tarnish and bring back the shine, but it won't leave streaks and won't harm your fingers or fingernails while you clean.

13. Using a pen and made a mistake?  Take the outside of the cucumber and slowly use it to erase the pen writing, also works great on crayons and markers that the kids have used to decorate the walls!!

GRAPES Prevent Heart Disease

Each tiny grape is packed with a mix of compounds that stop heart disease.  They prevent the build-up of "bad" cholesterol widen blood vessels so blood can easily pass through and reduce the risk of blood clots that can lead to a heart attack.  Just one cup of purple grapes or 8 oz of purple grape juice a day will get you the benefits.
 
Help Prevent Breast Cancer
 
A study shows one cup of purple grapes a day is enough to load your body with compounds that keep breast tissue free of too much estrogen, a key cause of breast tumors.
 
Whiten teeth!
 
Grapes contain malic acid, which clogs the pores in the surface of your teeth to prevent stains from embedding in you tooth while removing surface discoloration as you chew says Elisa Mello, DDS., assistant clinical professor at New York University