By the Numbers: Health Measurements that Matter (and a few that do not

Having recently undergone the annual health screening, I felt that a conversation about the validity of those numbers and the importance placed on certain numbers by some health practitioners would be appropriate. Full disclosure: this is part rant but it is meant to be informative and thought-provoking if not educational. This is a rant of purpose, not the random and angry thoughts of uneducated person. As a personal trainer, body and blood measurements are topics that I often discuss with clients. So to keep this real, I am going to share my actual numbers with you as a form of case study because numbers never tell the full story. Fair warning; if your numbers not within healthy ranges you should seek help from a qualified medical professional.

For the purpose of this conversation we will discuss height, weight, Body Mass Index (BMI), and waist circumference as measurements of body composition as well as looking at blood pressure and resting heart rate. We will also look at the Total Cholesterol, HDL (Good Cholesterol), LDL (Bad Cholesterol), Triglycerides, and blood sugar levels as tested by a blood sample.

So let us begin with an understanding of my body composition according to this health screening I stand at 5’7”, weigh 194lbs, BMI is 30.4, and my waist circumference is 34.5”. I find it interesting that I lost an inch of height in the past year. It is strange to be shrinking at the age of thirty-one. Here I am thinking that I am still the 5’8” I have been since I was thirteen. I weigh 194lbs which makes me heavy for my height according to the BMI scale.  If you are not familiar with BMI is a measurement of your height to weight ratio.  According to the BMI chart, at my height a healthy weight would between 125 to 158lbs. So I am 36lbs over weight.  Apparently I need to rediscover my twelve-year-old body because that was the last time I weighed in at 158lbs. Maybe the muscle that I have developed from lifting all of the heavy weight makes me unhealthy? By the way, the BMI measurement is endorsed by the CDC as a part of a health assessment, which may be why your personal doctor uses this flawed method.

Dear BMI,

You say that I am obese but I can see my abs. Your validity as a health assessment is nullified.

Sincerely,

I lift

I am being slightly facetious but I am making a point here. Judging a person’s health based upon the BMI is a flawed method because it does not account for body composition. There is no consideration for how much or how little body fat may be present. My BMI classifies me as being obese, but at 10% body fat I am not. On my 194lb body, only 19.4lbs of that is fat. Really nurse? You are going to straight-faced suggest I lose some weight? In my opinion, the BMI scale should be thrown away a measurement of health and replaced with body fat testing.  Perhaps actually telling people the exact number of pounds on their body that comes from fat may help motivate them to be a little healthier. At best the BMI measurement offers an incomplete picture of a person’s health. At worst, it discriminates against people like me that have a passion for repeatedly picking up heavy things.

Another incomplete tool in assessing body composition is the waist circumference measurement. Yes there are some negative health implications for men with waists measuring larger than 40 inches and women measuring more than 35 inches (as a man at 34.5 inches I am safe). But, the hip to waist ratio is a better predictor. The waist to hip ratio measures how big the waist is in relation to the hips. Ideally the waist should only measure 0.90 for men and 0.7 for women, or, 90 and 70% the measurement of the hips. When the percentage of the waist measurement is greater than the hips, the risk for obesity related health problems skyrockets.

Assessing blood pressure and pulse rate is the beginning of looking at the aspects of health which cannot be seen with the eye. Blood pressure is a tricky thing because it can and will fluctuate based upon many factors, like a night of poor sleep (my body decided I needed to be awake between 1:45am and 2:30am that night of my health screening), or, your emotional state, such as biting my tongue after being rudely told to lose weight. So my personal reading this time of 138/77, which is high for me. But it is not troubling because it has never been that high. Sleep deprivation and aggravation easily account for this reading. From what I learned assisting with research in college, blood pressure can vary so easily that using a single blood pressure reading is an incomplete picture of the true state of blood pressure. Blood pressure readings should be conducted at least three times to establish a baseline. If a single reading is not considered adequate for health research than how is a once a year reading considered good medical practice? In case you are wondering, yes, I know how to use a sphygmomanometer. Apparently, what passes from solid medical practice differs from what happens in a research lab. But that is none of my business. A healthy resting pulse (heart) rate is between 60-100 beats per minute, athletes tend to be on the lower end of this spectrum. Mine is 55 bpm. Healthy hearts do not have to beat as often to circulate blood through the body.

Blood work numbers are a different animal. Unlike body composition measurements blood work numbers are indicator of the internal health of the body. Bad numbers point to serious health problems coming down the road. Blood tests commonly measure total cholesterol, HDL (good-it makes testosterone) cholesterol, LDL (bad-artery-clogging cholesterol), triglycerides, and blood glucose levels. The chart below shows you my results compared with the healthy standard. Blood work numbers can have many implications, for the sake of brevity; the discussion of those implications is very simple. As you can see, my blood work numbers are healthy despite the BMI scale saying I am obese.

Measurement	My Results	Health Standard	Health Implications
Total Cholesterol	163	< 200mg/dl	Healthy Hormonal balance, low risk of heart disease
HDL (Good) Cholesterol	68	>40mg/dl (for men)	Viagra free since 1983
LDL (Bad) Cholesterol	80	< 130 mg/dl	No heart attacks headed my way
Triglycerides	75	< 150 mg/dl	My body regulates fat for destruction not construction
Blood Sugar	86	< 100mg/dl	No diabetes in my future

Feel like the numbers are a little overwhelming? Be more concerned with numbers from a blood test than body composition. Unhealthy body composition is an outward reflection of an inward diseased condition. What you see in the mirror is less important that what can be seen in your blood. So what are the numbers that really matter; all of them, because they can all be controlled and improved with healthy diet and regular exercise. Except for BMI, it is flawed and discriminatory to the point of stupidity. The key to understanding health by numbers is to evaluate yourself by them without allowing the numbers to define your sense of self-worth. You are always more than a number.