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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.

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Photo by Bill Oxford from Unsplash.com

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.”

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What you eat could contribute to your menstrual cramps

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

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Despite the fact that menstrual pain (dysmenorrhea) is the leading cause of school absences for adolescent girls, few girls seek treatment. An analysis of relevant studies suggests that diet may be a key contributor, specifically diets high in meat, oil, sugar, salt, and coffee, which have been shown to cause inflammation.

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

This analysis was designed to study the effect of diet on menstrual pain and identify which foods contribute to it and which can reduce it. Research was conducted through a literature review that found multiple studies that examined dietary patterns that resulted in menstrual pain. In general terms, these studies found that diets high in omega-6 fatty acids promote inflammation and foods high in omega-3 fatty acids reduce it. The muscles in the uterus contract because of prostaglandins, which are active in inflammatory responses. When measuring the Dietary Inflammatory Index, it was found that those on a vegan diet (that excluded animal fat) had the lowest rates of inflammation.

“Researching the effects of diet on menstrual pain started as a search to remedy the pain I personally experienced; I wanted to understand the science behind the association. Learning about different foods that increase and decrease inflammation, which subsequently increase or reduce menstrual pain, revealed that diet is one of the many contributors to health outcomes that is often overlooked. I am hopeful that this research can help those who menstruate reduce the pain they experience and shed light on the importance of holistic treatment options,” says Serah Sannoh, lead author of the poster presentation from Rutgers University.

“Since menstrual pain is a leading cause of school absenteeism for adolescent girls, it’s important to explore options that can minimize the pain. Something like diet modification could be a relatively simple solution that could provide substantial relief for them,” said Dr. Stephanie Faubion, NAMS medical director.

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Cultivating well-being in today’s evolving digital world

Manulife invites Olympic gold medalist Hidilyn Diaz to share lessons amid digitalization at IMMAP DigiCon Valley 2022.

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As Filipinos navigate today’s evolving digital world and adjust to life-changing disruptions brought by the pandemic, Manulife shared key lessons on how to cope with changes and cultivate one’s overall well-being at this year’s DigiCon Valley 2022, the largest gathering of the digital marketing and advertising industry in the country organized by the Internet & Mobile Marketing Association of the Philippines (IMMAP).

Headlining Manulife’s segment were Melissa Henson, Chief Marketing Officer of Manulife Philippines and Hidilyn Diaz, Olympic Gold Medalist and one of Manulife’s brand ambassadors, while actor and stand-up comedian Victor Anastacio served as the host.

At the DigiCon’s special segment, Henson and Diaz shared their insights and personal takeaways based on Manulife’s recently released study, “The Modern Filipino Family: Exploring Family Dynamics in the new normal.” The study aimed to understand how Filipino families adapted to the new normal, as hyper-digitalization has impacted relationships, and has been deeply imbued in everyday decisions at home and in family life.

Make time for self-care and mental wellness

Victor Anastacio started the discussion on the challenges Filipinos faced at the height of the pandemic. “Sobrang daming challenges ang kinaharap natin noong nagsimula ang pandemic – physical, emotional and financial challenges. Lahat ito nakaapekto sa ating pamilya, dahil sa maraming hindi pagkakaintindihan.”

These challenges still impact majority of Filipinos today. While people across generations have said that their well-being has improved compared to during the peak of the pandemic, Generation Zs expressed that they are still grappling with negative pandemic effects. Henson shared: “Our study found that 65% of Gen Zs are dealing with digital fatigue, prompting them to seek more offline interactions with friends and family. They also shared that they are sleep-deprived, developed unhealthy eating habits and have increased occurrence of stress, fatigue, and depression. These younger Filipinos may need further guidance on reacquainting themselves in the real world as they have spent most of their time online in the past two years.”

Younger Filipinos may also look to Generation X and millennials for inspiration and ideas on how to deal with stressors. “Gens X and Y have learned to focus on self-care, mental well-being, and personal development, which helped empower them despite the many changes they’ve had to weather,” Henson added. 

Diaz agreed and emphasized that caring for one’s mental health has a tangible impact on one’s physical well-being too. “When I started training for the Tokyo Olympics, I needed to condition my mind that I could win at hindi ako nag-iisa sa pag-abot ng pangarap na ito. Naging malaking part ng aking preparations ang mental training at eventually, ang ‘”ma-manifest” ko na makakuha ng gold medal.”

Learn to seek help when needed

According to Manulife’s study, more Filipinos have also explored various financial products during the pandemic. In the past 12 months, among those surveyed, 25% of Generation X and 33% of Millennials bought insurance products online, while 41% of Generation Z expressed a desire to purchase insurance in the next 12 months. To guide them in their financial journey and make more informed decisions, Henson emphasized the importance of seeking expert advice to help sift through the overwhelming wealth of information available.

“Seeing how more Filipinos are exploring various financial channels to diversify their portfolios is a good sign that they are actively seeking ways to grow their wealth. However, we will need to double down our efforts to provide them expert financial guidance, so they’ll also understand how to balance risk and reward,” Henson said. “Seeking advice from a financial advisor is one way to help Filipinos get a clearer picture of their financial goals and find ways to achieve them while being conscious of their risk appetites to yield better returns.”

To achieve the historic Olympic gold medal, Diaz also underscored the importance of asking for help, by having people around you whom you can rely on for support. “There is a team behind my success. Hindi ko kakayanin ito ng mag-isa. I needed the support of Team HD, Manulife, at ng aking mga kababayan.

Life has no guarantees, but we can get ahead of uncertainty

The pandemic showed how fast things can change, and Filipinos must be ready to keep up with the pace as it can accelerate further. Such mindset and attitude transcend to Filipinos’ heightened desire for protection and security. “The interest in insurance products and life protection increased during the pandemic because Filipinos became hyper aware of the physical and financial impact of falling ill, and the broader impact of other financial challenges. However, this has been a reactive stance. The power of insurance and financial planning is that it helps us prepare for the unexpected before it happens, so we continue to encourage and empower Filipinos to embrace the value of planning ahead and being financially prepared,” said Henson.

To help Filipinos better prepare for uncertainty, Manulife launched a series of flexible and highly customizable financial solutions that can be tailor-fit depending on needs and budget — HealthFlex, which provides protection coverage for critical illnesses, including heart disease, cancer, and stroke; and FutureBoost, which gives additional rewards on top of insurance protection coverage so Filipinos can grow their wealth simultaneously.

As change is inevitable and developments can be beyond our control, Henson noted that it helps to live by an attitude of lifelong learning. “We are all learning creatures. We always find ways to retool ourselves to better cope with the changes in our environment, which is crucial to making us more resilient.”

Diaz added that just as essential is acquiring knowledge on how to plan ahead. “Having a strong foundation sa kung paano mag-plano para ma-achieve ang financial goals ay crucial para sa kinabukasan natin. Mahalaga na maging mas aware ka sa mga financial options available as early as possible para mas maintindihan ang mga kailangang gawin to achieve your goals. Once you decide to grow your investments, you’ll be more consistent with your decisions to make every day better.”

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Pfizer had no idea if mRNA vaccine would prevent COVID-19 transmission

Pfizer, the pharmaceutical company expected to become a $100 billion giant this year thanks to COVID-19 drug and vaccine, has admitted that it actually had no idea if its mRNA vaccine would prevent transmission of the coronavirus when they released the same.

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Photo by Daniel Schludi from Unsplash.com

Pfizer, the pharmaceutical company expected to become a $100 billion giant this year thanks to COVID-19 drug and vaccine, has admitted that it actually had no idea if its mRNA vaccine would prevent transmission of the coronavirus when they released the same.

One of Pfizer’s top executives, the company’s president of international development markets, Janine Small, stated this when she testified before the COVID committee of the European Parliament. Small was there in place of Pfizer CEO Albert Bourla who tested positive for COVID-19 again.

In the exchange that happened in the committee hearing, a Dutch member of the European Parliament asked Small if there is evidence from Pfizer that showed that the vaccine it developed would prevent transmission prior to its wide release in late 2020.

“Was the Pfizer COVID vaccine tested on stopping the transmission of the virus before it entered the market? If not, please say it clearly. If yes, are you willing to share the data with this committee?” the member of parliament specifically asked.

The executive answered: “Regarding the question around, did we know about stopping immunization before it entered the market? No.”

Small added that “we had to really move at the speed of science to really understand what is taking place in the market. And from that point of view, we had to do everything at risk.”

The Dutch politician said that messaging in the past focused on getting vaccinated to one does not spread COVID-19. “If you don’t get vaccinated, you’re anti-social! This is what the Dutch prime minister and health minister told us. You don’t get vaccinated just for yourself, but also for others — you do it for all of society. That’s what they said. Today, this turns out to be complete nonsense.”

The politician said he found the revelations “shocking, even criminal.”

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