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More evidence to dispute the use of BMI

I have always had a dislike for BMI or Body Mass Index.

As an example, a client of mine who has a heart condition and hypertension has been instructed by his physicians to lose weight ever since he was first diagnosed.  He is an active middle aged man that has never weighed less than 180 lbs, even in his 20's when he was attending university and working highly physical jobs like landscaping.  He is 5'11 and going by BMI, should weigh 150-170 lbs.  He has gone from 200 lbs to 180 lbs in the last few months.  For an individual like this, the use of BMI is crazy.  BMI doesn't tell us anything about his actual body composition - lean body mass versus fat.  An alternative would be to us skin fold testing, which has its benefits and drawbacks as well. 

My preference - waist circumference.  It's easy and tells you a whole lot more about the actual health risk associated with the weight you are carrying.  I measure half way between the bottom of the ribs and the top of the hips, on the skin and with arms relaxed, waistband out of the way.  For males, we see increased health risk over 102 cm, for females over 88 cm. It can be used in combination with actual body weight so tell a little bit more about where you are losing your weight.

Dr. Sharma has also discussed the limited use of BMI in clients with Heart Failure - read his article here.

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