Higher BMI Associated With Reduced Costs, Better Health For Diabetics

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This article is courtesy of PRWeb, please share your thoughts below…..

diabeteswordIt’s a paradox: Diabetics with above-normal weight use health care less and report overall better physical health than their diabetic counterparts with normal weight, according to two new studies from UC Davis Health System. The authors suggest that the extra weight isn’t protecting diabetics as commonly assumed, but that normal-weight people with diabetes are afflicted with a more severe form of the disease.

Prior studies found that diabetics with normal BMIs have a higher mortality risk than those who are overweight or obese.

“The mortality paradox led to the ‘protection explanation’ that seems unlikely to be true because we didn’t see any beneficial effects of excess weight in people who did not have diabetes,” said Anthony Jerant, professor of family and community medicine at UC Davis and lead author of the studies. “The possibility that there is more than one form of type 2 diabetes is supported by basic science studies showing physiological differences in leaner people with diabetes.”

For their research, Jerant and his colleagues evaluated data on about 120,000 patients in the 2000-2011 Medical Expenditures Panel Surveys (MEPS), an annual assessment from the U.S. Department of Health and Human Services on health status, medical services and health care costs among a representative sample of U.S. civilians.

Characterized by unstable blood sugar levels, diabetes is currently diagnosed as type 1, an unpreventable form typically diagnosed in children or young adults, or type 2, which mostly affects adults and is linked with unhealthy lifestyles. Because the vast majority — about 90 percent — of the nearly 30 million diabetics in the U.S. have type 2, the study results are most applicable to type 2 diabetes.

In a study published online March 20 in the journal Medical Care, the UC Davis team compared health care expenditures, hospitalizations and emergency department visits for those with and without diabetes and in relation to their BMIs (normal, overweight or obese), a standard measure of weight adjusted for height. For all three study criteria, health care utilization was significantly higher in normal weight than in heavier diabetic persons, differences that were not observed in those who did not have diabetes.

In another study published online April 27 in the journal Nutrition & Diabetes, the researchers evaluated results of self-reported physical and mental health status for patients with and without diabetes. Overall, those with diabetes had worse physical and mental health status than non-diabetic persons. Among just those with diabetes, physical health status was better for those who were either overweight or obese as compared to those who had normal weight, and most optimal for those who were overweight.

Jerant believes the new findings provide evidence that it’s time to quit thinking that leaner type 2 diabetics are at lower risk for bad outcomes from the disease than their heavier counterparts.

“Researchers should be looking at genetic and metabolic factors that define type 2 diabetes for those with different weights,” said Jerant. “Teasing out those factors could eventually enable us to develop and test diabetes management plans that address those differences.”

Jerant’s co-authors were Peter Franks and Klea Bertakis, professors of family and community medicine at UC Davis. They received no external funding for their research.

“Body Mass Index and Health Care Utilization in Diabetic and Nondiabetic Individuals” is available at http://journals.lww.com/lww-medicalcare/Abstract/publishahead/Body_Mass_Index_and_Health_Care_Utilization_in.99062.aspx.

“Body Mass Index and Health Status in Diabetic and Nondiabetic Individuals” is available at http://www.nature.com/nutd/journal/v5/n4/full/nutd20152a.html

For more information about UC Davis Health System and its Department of Family and Community Medicine, visit http://healthsystem.ucdavis.edu.

Public Schools Screen Students For Childhood Obesity Using BMI

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obeseboyvectorbellyFrom Your Health Journal…..”A very interesting article from a local ABC/FOX channel entitled Public Schools Screen Students for Childhood Obesity using BMI out of Massachusetts. The Massachusetts Department of Public Health requires public schools to screen each student for their BMI in 1st, 4th, 7th and 10th grade. Then all parents are sent a letter with the results. Last year in West Springfield over 33% of students in any of these grades was considered overweight or obese. Of course, this has been a sensitive issue in many parts of the United States, where parents do not want the schools to test their children due to the embarrassment of the situation or lack of sensitivity to the children. Once it has become a routine in many areas, the controversy has lessened to a point where students are not feeling uncomfortable with it, and testing is completed in a non-embarrassing manner. BMI, or Body Mass Index estimates the ideal weight of a person based on its size and weight. The Body mass index is valid for an adult man or woman (18 to 65 years). A high BMI is associated with increased risk of death. The risk of death increases with a high overweight for both men and women (cancer or other diseases) . The factor increases if the person smokes. What is your opinion on this issue? Use the comments section below to share your thoughts, and please visit the ABC/FOX web site (listed below) to read the complete article.”

Want to know your BMI?

From the article…..

Childhood obesity rates have more than tripled in the last 30 years. That’s according to the Centers for Disease Control and Prevention. Body Mass Index or BMI, is used to determine obesity rates in public schools across the state.

It’s a regulation that has been in place for 5 years. The Massachusetts Department of Public Health requires public schools to screen each student for their BMI in 1st, 4th, 7th and 10th grade. Then all parents are sent a letter with the results. Last year in West Springfield over 33% of students in any of these grades was considered overweight or obese. But according to West Springfield Superintendent Russell Johnston, the regulation does help.

“It helps to just communicate to parents two important things. Here are the results and if you have any concerns about this we encourage you to speak with your pediatrician or your child’s nurse to follow up because this is just one indication of your child’s weight,” Johnston said.

To read the complete article…..Click here

Making Health Easier – Video

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CDC Video

The video highlights the efforts of one educational organization, Los Angeles Universal Preschool (LAUP), to keep kids healthy at an early age. Childhood obesity now affects approximately one in six kids and disproportionately affects low-income and minority populations. LAUP teaches kids healthy habits and is incorporating small, healthy changes that can be made in any classroom—like teaching fun dances and providing nutritious snacks.

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– Thank you to the CDC for granting permission to use this video

Is Your BMI A Lie?

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From Your Health Journal…..”A great article today from the New York Daily News by Tracy Miller called, “Is your BMI a lie? Formula that calculates healthy weight is flawed, says Oxford professor.” Body mass index, or BMI, has long been used as the quickest measure of whether a person’s weight falls within the normal range for their height. It is a chart that lets you know if your weight falls within a healthy range. You look up your height and weight, and where they meet on the chart corresponds to a certain number. For example, below 18 may be considered underweight, 18-25 may be considered normal, 25-30 may be considered overweight, and over 30 may be considered obese. At times, the BMI has received criticism because many experts felt it did not take into account lean body mass and water weight. Now, a mathematics professor says the formula is flawed. According to the professor, the good news: if you’re tall, you might lose a point or two, which could mean the difference between being obese and merely overweight, or overweight and normal. The bad news is for shorter people, who may gain a couple points. Please visit the Daily News site (link provided below) to read the complete article.”

From the article…..

The current body mass index formula is weighted against tall people, says mathematician Nick Trefethen, making them think they’re fatter than they really are. He proposes a new formula to straighten it out, and short people may not be happy.

The current BMI calculation gives tall people the short end of the stick, an Oxford mathematician says.

Body mass index, or BMI, has long been used as the quickest measure of whether a person’s weight falls within the normal range for their height. It’s calculated by your weight in kilograms divided by your height in meters squared. (Use a BMI calculator here.) A BMI in the range of of 18.5-24.9 is considered normal; 25-29.9 is overweight; and 30 and above indicate obesity.

But the current BMI formula is flawed, according to mathematics professor Nick Trefethen — which means there’s good news and bad news.

The good news: if you’re tall, you might lose a point or two, which could mean the difference between being obese and merely overweight, or overweight and normal.

The bad news is for shorter people, who may gain a couple points.

Trefethen, of Oxford University, says this is because the current calculation fails to account for something fairly obvious: tall people can take up more space without being fat.

“We live in a three-dimensional world, yet the BMI is defined as weight divided by height squared,” Trefethen wrote in a letter to the Economist, published January 5. “It was invented in the 1840s, before calculators, when a formula had to be very simple to be usable. As a consequence of this ill-founded definition, millions of short people think they are thinner than they are, and millions of tall people think they are fatter.”

He later clarified on his website, “I don’t believe that 2 should simply be replaced by 3. People don’t scale in a perfectly linear fashion as they grow. I believe a better approximation to the actual sizes and shapes of our bodies would be given by an exponent of 2.5.”

To read the full article…..Click here

How Useful Is Body Mass Index In Predicting Long-Term Health?

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From Your Health Journal…..”I just love Forbes.com, and recommend it to all of you. So many people think of it just as a business site, but they run many great health articles like the one being reviewed today. Forbes is reporting about the controversy of the BMI or Body Mass Index – which is an indicator if someone’s weight falls within a healthy range. It is a chart that takes height and weight measurements – which correspond to a number. For example, if someone’s BMI is below 18, they may be considered underweight. Around 18-25 is considered normal, 25-30 overweight, and above 30 is considered obese. The BMI has stirred controversy over the years, as some experts like it, others not. However, like IQ, the single number for BMI does not tell us all we need to know. This is because BMI does not distinguish between fat mass and lean mass (muscle, water, bone, etc). Someone who is physically fit can have a high BMI due to having greater than average muscle mass. While misclassifying some people as obese (BMI of 30 or greater) who are not obese, using this criterion actually misses more than half of people with excess body fat. Please visit the Forbes.com web site (link provided below) to read the full story.”

From the article…..

We all want simple and clear answers telling us how to improve our health, but no one number – in this case, body mass index – and no one study can provide the final word.

Last week’s paper in JAMA on body mass index and mortality may have set a record for creating confusion in the public at large and generating a bewildering range of responses among experts – some of them startling in their uncritical acceptance, others in their hostility.

At one extreme, Walter Willett, professor of nutrition and epidemiology at Harvard, denounced the paper, calling it a “pile of rubbish” and saying that “no one should waste their time reading it.” He emphasized that, “We have a huge amount of other literature showing that people who gain weight or are overweight have increased risk of diabetes, heart disease, stroke, many cancers and many other conditions.”

At the other extreme, Paul Campos, a professor of law and author of “The Obesity Myth,” in a New York Times op-ed, leveled attacked the public health establishment for classifying two-thirds of the adult U.S. population as being in need of weight reduction.

How could a dry, scholarly paper have opened up such a Pandora’s box, and how could interpretations of it differ so drastically?

Part of the problem is that the latest paper tends to get highlighted in the public sphere in a way that makes it seem like the final word, as if it supercedes all prior knowledge and delivers revealed truth. Few papers can live up to this kind of billing. This “microscope effect” focuses attention on one study to the exclusion of other considerations. Let’s look at what the study actually entails.

The paper by Katherine Flegal and colleagues presents the results of a meta-analysis – that is, an arithmetic averaging — of the results of studies worldwide that examined the association of body mass index (BMI) with subsequent death from any cause. The sample included 97 studies, nearly 3 million people, and 270,000 deaths. The authors used standard categories of BMI: 18.5-<25 (normal weight), 25-<30 (overweight), and >=30 (obese). The last category was further subdivided into 30-<35 (class 1), 35-<40 (class 2), and >=40 (class 3).

What they found is that, compared to normal weight individuals, those in the overweight category had a lower risk of dying of any cause, and those in the obese category had an elevated risk. However, more than half of those in the obese category were in class 1, and these individuals had no increased risk of dying compared to normal weight individuals. Class 2 and 3 individuals did have a significantly elevated risk of death.

Thus, this analysis correlating BMI with risk of dying found that being overweight actually appeared beneficial and that the ill effects of obesity were limited to the very obese.

To read the full article…..Click here