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Patients, physicians should take note of ethnicity-specific Body Mass Index (BMI) guidelines
Since BMI originated with the measurements of European men, we know that it leaves a wide range of people out of the equation.
While body mass index (BMI) as a body composition assessment tool has long had its critics, recent research has highlighted a new potential drawback in that it could prevent people of certain ethnicities from having their risk for Type 2 diabetes assessed earlier. A psychologist and weight management specialist at a top American hospital, Cleveland Clinic, stresses the importance of physicians and patients being aware of different cut-off points based on their ethnicity.
Leslie Heinberg, PhD, MA, explains that recently, researchers in the U.K. discovered that the cutoff BMI number associated with a higher risk of Type 2 diabetes varies between different patient populations. For example, a BMI of 30 or above was linked to a higher risk for white people. For Black people, the cutoff number was 28 or above. For South Asian people it was 23.9 or above and for the Middle Eastern population, the BMI cutoff was 26 or above.
The problem? Some healthcare providers might only be making recommendations for diabetes-related lifestyle changes or treatment options based on the risk level for white people. This means that other populations might not get the medical interventions they need in time.
Here, Dr. Heinberg, explains why BMI is still used and gives some tips for how people of color can make sure they’re on the right track despite the discrepancies.
Where did BMI come from?
The formula for calculating body mass was the creation of a Belgian mathematician, astronomer, sociologist and statistician named Lambert Adolphe Jacques Quetelet. Quetelet wasn’t focused on studying obesity when he developed what was first known as the “Quetelet Index” (your weight in kilograms divided by the square of your height in meters, or Kg/M²). He was looking at years of crime data that he compiled to link crime to social conditions. In doing so, he noticed a relationship between an adult’s height and weight.
In 1972, American physiologist Ancel Keys gave the Quetelet Index a new name as he thought the formula was a good way to identify obesity. He referred to it as the body mass index.
“It’s a ratio that takes height into account because taller people weigh more than shorter people,” says Dr. Heinberg. “It was developed more for actuarial tables and to determine which people are at a higher risk for mortality. It’s something that makes sense when you look at a very large population.”
Dr. Heinberg adds that today, many organizations and businesses still rely on BMI when it comes to providing things like insurance or medical procedures.
The drawbacks of BMI
Dr. Heinberg says that BMI can be a pretty blunt instrument for health because it leaves a lot of physical attributes out of the equation.
“It doesn’t take into account a lot of things about an individual. You can ask somebody for their height and weight and it becomes a very easy assessment in comparison to a full and comprehensive evaluation. When we think about an individual’s health and their health risks, taking their background information into account is helpful. But when you’re looking at a million people, you just can’t do that.”
Other physical signs of health risks
While BMI is one way of measuring risks, Dr. Heinberg says there are other physical clues to watch out for.
“We do know things like waist circumference, waist-to-hip ratio and where you hold excess weight might play an even more important role when it comes to metabolic diseases,” she says.
For instance, if you have an apple body shape or a pear shape, the excess abdominal weight of an apple shape is associated with more cardiovascular risks and metabolic disease. “Also, with things like obstructive sleep apnea, neck circumference seems to be important. It all goes way beyond just BMI.”
How people can advocate for their health
Since BMI originated with the measurements of European men, we know that it leaves a wide range of people out of the equation. However, since it is just one piece of information, Dr. Heinberg recommends getting the full picture of your health.
“What’s helpful about this study is that it helps illustrate that BMI should not just be used to determine if someone is healthy, unhealthy, lean or obese. Instead, it should be considered as another vital sign. If a provider sees someone with an elevated BMI, particularly if they are from a population that is at higher risk for Type 2 diabetes, that should suggest doing some lab work and making additional assessments. It would also be good to discuss any factors that can keep a patient out of that pre-diabetic or full diabetic range.” These factors might include sleep habits, stress management, dietary changes and increased physical activity.
If you already know that your family has a history of diabetes, high blood pressure or other health concerns, discuss it with your provider. The more information they have, the better equipped they are to monitor your health and help you manage any conditions.
The main thing to keep in mind about BMI
Dr. Heinberg says the other important message when it comes to BMI or weight is that you do not have to lose a large amount of weight to improve your health.
“There’s this unfortunate message that everyone has to be within this little window. But even a small amount of weight loss — around 2.5kg to 4.5kg — is associated with really significant improvements in metabolic risk or cardiovascular risk.”
NewsMakers
For weight loss, where food comes from may matter as much as how it is processed
Processed and ultra-processed animal foods tended to track with weight gain, and minimally processed plant foods with weight loss, although these associations were weaker. Ultra-processed plant foods were not associated with weight change.
Eating more meat, fish, eggs, and dairy products was associated with weight gain even when those foods were minimally processed, according to a study from the Physicians Committee for Responsible Medicine published in Nutrition Research. Minimally processed plant foods, such as fruits, vegetables, whole grains, and beans, showed the opposite pattern.
“Ultra-processed foods get most of the blame for weight gain, but our results suggest we also need to ask whether a food comes from a plant or an animal,” says lead author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee. “A chicken breast is minimally processed. So is an apple. In our study, they did not move the scale in the same direction.”
The researchers analyzed data from a randomized crossover trial in which 62 adults with overweight followed a Mediterranean diet, rich in olive oil, fish, and nuts, and a low-fat vegan diet for 16 weeks each, separated by a four-week washout. Participants kept three-day diet records, and every food was classified by degree of processing, using the NOVA system, and by whether it came from a plant or an animal.
Compared with the Mediterranean diet, the vegan diet cut minimally processed animal foods by 135 grams per day more and raised minimally processed plant foods by 202 grams per day more. Processed animal and plant foods also fell more on the vegan diet. Across both diets, eating more minimally processed animal foods was linked to weight gain; this was the strongest association in the analysis and the only one to remain statistically significant after correction for multiple comparisons.
Processed and ultra-processed animal foods tended to track with weight gain, and minimally processed plant foods with weight loss, although these associations were weaker. Ultra-processed plant foods were not associated with weight change.
In the main trial, published in 2022, participants lost an average of 6 kilograms (about 13 pounds) on the vegan diet, with no change on the Mediterranean diet. Minimally processed plant foods are high in fiber and water and low in calorie density, which helps people feel full on fewer calories.
“If you want to lose weight, fill your plate with beans, vegetables, fruits, and whole grains, and leave the animal products off,” says Dr. Kahleova. “The degree of processing still matters, but it is not the whole story.”
NewsMakers
Mindfulness and self-compassion can alleviate premenstrual symptoms
It is estimated that PMS affects approximately 20-30% of menstruating people, while PMDD impacts 3-8%. The scale of the problem is significant, yet the psychological factors that protect against the development of these symptoms have not been thoroughly investigated.
A kind attitude toward oneself and practicing mindfulness can improve functioning in individuals who experience severe premenstrual symptoms, according to a study by psychologists from SWPS University and Jagiellonian University.
Premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD), cause distressing psychological and physical symptoms, including mood swings, fatigue, concentration difficulties, headaches, and muscle pain. These ailments occur during the second phase of the menstrual cycle and interfere with daily functioning, affecting education, work, relationships, and overall quality of life.
Up to 30 percent of women affected
It is estimated that PMS affects approximately 20-30% of menstruating people, while PMDD impacts 3-8%. The scale of the problem is significant, yet the psychological factors that protect against the development of these symptoms have not been thoroughly investigated.
The study, published in “Psychology and Psychotherapy: Theory, Research and Practice”, is part of a broader project analysing potential mechanisms and factors that may protect against the onset of PMS and PMDD. In a new study, Rachela Antosz-Rekucka, PhD, a psychologist at the Institute of Psychology at SWPS University, and Katarzyna Prochwicz, PhD, a professor at the Institute of Psychology of the Jagiellonian University, analysed factors that might protect against the onset of severe premenstrual symptoms. They examined variables such as the sense of coherence, mindfulness skills, and self-compassion, and investigated their relationship with past trauma, perceived stress levels, and symptoms of premenstrual disorders.
The study involved 228 participants aged 18 to 52. They were asked about their past experiences with premenstrual symptoms, and a part of the group subsequently tracked their symptoms over the course of two menstrual cycles.
Self-compassion and mindfulness help alleviate symptoms
The results suggest that higher levels of certain psychological resources can moderate the negative effect of stress and trauma on the severity of menstrual cycle-related symptoms.
Specific psychological attitudes may noticeably reduce the impact of daily stress on the severity of premenstrual symptoms. These include a kind attitude toward oneself and the acceptance of difficult moments, known as self-compassion. This approach helps women to navigate the challenging phases of their cycle more easily, even during times of intense nervous tension, says Rachela Antosz-Rekucka of SWPS University, who conducted the study as part of her doctoral research at the Jagiellonian University.
Practicing mindfulness (directing one’s attention to the present moment without judgment or worry) can also offer relief. In the context of PMS and PMDD, refraining from judging one’s own emotional reactions is particularly helpful, as it prevents the magnification of perceived discomfort. Furthermore, individuals with a strong sense of coherence cope better with rising premenstrual stress.
Past trauma and premenstrual symptoms
For individuals with a history of trauma, the ability to precisely describe their internal states and feelings, combined with the capacity to avoid judging their own emotional reactions, can help mitigate the negative impact of that trauma on premenstrual symptoms.
Psychological resources boost stress resilience
The results of the study could be significant for many people who menstruate. These findings could pave the way for modern therapeutic programs based on approaches such as mindfulness training or self-compassion-focused therapy, potentially reducing the reliance on medication.
The study suggests that more understanding, mindful, and compassionate attitude towards oneself may benefit individuals with severe premenstrual symptoms. PMS and PMDD are chronic conditions, which is why interventions such as mindfulness-based therapy, compassion-focused therapy, or strategies oriented at enhancing the sense of coherence, may help individuals navigate their conditions more effectively, and possibly increase their overall quality of life, Rachela Antosz-Rekucka emphasises.
NewsMakers
Music can enhance the flavor of your food
The brain does not create flavor based solely on signals from the tongue.
The moment we take a sip of our morning coffee or our first bite of lunch, the brain begins interpreting what we taste. Is it sweet? Sour? Or something else entirely?
But the brain does not create flavor based solely on signals from the tongue. That is the finding of a new study from the Department of Food Science, published in the scientific journal Scientific Reports.
“When music reaches the ears at the same time as we are eating, we can see that the brain responds more strongly than when taste is experienced without music,” says first author and postdoctoral researcher Alberte Baggesgaard Seeberg from the Department of Food Science.
Using brain scans, the researchers show that music can activate some of the same brain regions involved in processing taste.
“This tells us that flavour is not simply a property of food. Flavor is an experience created by the brain,” says senior author and associate professor Janice Wang.
A breakthrough in brain imaging
This is the first time researchers have used brain imaging to show what happens in the brain when it processes taste. In the study, they used functional magnetic resonance imaging (fMRI), which measures activity in different parts of the brain by detecting changes in blood flow.
“This allows us to move beyond simply asking people about their experiences, which has been the approach in previous studies. With brain scans, we gain a biological window into what happens when the senses interact,” says Alberte Baggesgaard Seeberg.
While participants lay in the scanner, their brain activity was measured under different conditions. In some cases, they listened only to music. In others, they tasted flavor solutions. In some trials, music and taste were presented simultaneously. This enabled the researchers to compare how the brain responds to sound and taste separately and in combination.
The results clearly showed that certain brain regions were more active when participants listened to music while tasting one of the two flavor solutions.
“We can see that flavor is constructed by the brain and not only by the taste buds. What determines flavor is not limited to what happens on the tongue. It emerges through the integration of multiple senses,” says Janice Wang.
The findings build on previous studies showing that music can enhance particular taste perceptions. For example, slow pop music with harmonious tones may enhance sweetness. Until now, however, this has only been investigated through behavioral studies in which participants rated flavours with and without music.
Shaping flavor experiences could improve wellbeing
According to the researchers, the new knowledge could be used to design better eating experiences in a range of settings, including restaurants, canteens and hospitals.
“For people who are at risk of malnutrition, something as simple as music could potentially improve the eating experience. There is a great deal we can do, often at very little cost, to improve quality of life for some people,” says Alberte Baggesgaard Seeberg.
Janice Wang is pleased that, after many years of research into flavour and sensory perception, the team can now present biological evidence of how the senses interact.
“We now have a new way of influencing flavor perception, creating a better meal experience and potentially a better overall experience, without necessarily changing the food itself,” she says.
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