Measuring Fat
By nature, all humans use comparison to know how they are faring. How well you did on a test, how well you performed a certain task or skill, how well you speak, how much you know and even how healthy you are. Unfortunately, many of us measure our health and how we are doing by our weight. Maybe this is because it is easy to check but the truth is that weight is just one variable of our overall health and honestly, it is better to be thought of as a symptom of a potentially greater problem. Looking even closer, it is not just our weight but our fat or adipose tissue that is cause for concern, and not all adipose tissue is equal. So how should we be measuring our fat?
The first thing that comes to mind when measuring fat is the scale. Although this can be beneficial in determining extreme weight changes, it isn’t always that accurate in smaller weight changes and doesn’t consider muscle, fluid retention and the location of the weight.
Body Mass Index is the typical medical standard of measurement for obesity and is what is looked at most in current medical practices. However, BMI is not perfect either. BMI considers your weight and height and puts it into a formula (specifically weight X 703/ height in inches squared) to determine your category or level of weight. A BMI scale will place you anywhere from under 18.5 which is considered underweight to 18.5-24.9 (normal), 25-29.9 (overweight), 30-34.9 (obese), and 35+ (morbidly obese). The limitations of BMI are that the scoring can be skewed by muscle. In other words, if you have a considerable amount of muscle mass, it could give you a higher BMI, indicating that you are overweight or obese when you are far from it. Conversely, you could also be skinny everywhere except your belly and still be a “normal” weight. BMI can provide a general glance at health but is not all that valuable for determining risk for certain chronic diseases.
This brings us to the distribution of fat or where it is located. We know that abdominal weight is significantly more dangerous to your health and can be a huge risk factor for insulin resistance, diabetes, and other chronic diseases. Abdominal fat is most often made up of what we call visceral fat. This type of fat wraps around our organs and puts us at a much higher risk for disease than subcutaneous fat, which is right beneath the skin and can be pinched with your fingers. In fact, I would argue that if you carry a fair amount of abdominal weight, you are likely already insulin resistant and at the very least, metabolically unhealthy.
If basic scales just give us a picture of overall weight and BMI uses weight to give us an estimate of health, how can we determine the health of our weight distribution? The answer is in our waist to height ratio.
A meta-analysis study from 2008 is one of many that show a waist to heigh ratio as the best indicator for hypertension, diabetes, and dyslipidemia (which is high triglycerides or high cholesterol) while BMI was the poorest discriminator for cardiovascular risk factors. (1)
Your waist to height ratio is your waist circumference measurement around your belly at your umbilicus or “belly button” (with a completely relaxed belly – not “sucking in”) divided by your height in inches. Then move the decimal point two spaces to the right and you have your waist to height ratio. For example, someone with a waist measurement of 35 inches who is 5’6” will be 35/66 = .53030 or 53. Your waist to height ratio is a better indicator of abdominal fat and a better predictor of diabetes, insulin resistance and heart disease risk. It is easy to calculate and more effective than other measurements such as waist to hip.
Here is how you can know where you stand: Women and men <35 are underweight; women with a score of 35-41 (and men 35-42) are extremely thin; women with a score of 42-48 (and men 43-52) are slender and healthy; women scoring 49-53 (and men 53-57) are overweight; women 54-57 (and men 58-62) are obese; and women 58+ (and men 63+) are highly obese.
If you haven’t ever measured your waist to height ratio, I encourage you to try it and see where you fall. If your number is higher than it needs to be, it is a good incentive to develop a plan to start to make some small but impactful changes one at a time so that you can reduce your risk for chronic disease. To learn more about how you can optimize your health, follow me on Instagram or subscribe for free at the bottom of any of my website pages (thehealthandwellnessnp.com) and together, let’s transform your health.
1 – Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008;61:646-653.