Sunday, February 18, 2018

Type 2 Nutrition #420: BMIs for the “elderly”

BMI’s for the “elderly”? Note: “elderly” is in quotes here deliberately. If I sound a little riled, it’s because I am riled. This post will be a rant. But I am NOT going to dissect all the epidemiological studies that give guidance to the medical establishment with respect to the optimal BMI for the elderly (≥65). I will reference them only and instead deal with n = 1, the specific individual, in other words, “me,” and maybe “you” too. Read on!
First of all, we (in the U. S. anyway) know what a ridiculous chart the BMI table is anyway. It was created by the infamous Ancel Keys in 1972 and adopted by the World Health Organization (WHO) in the 80s. Our NIH and CDC bought into it 1998. Now virtually everyone (the “elderly” anyway) is measured for height and weight and assigned a BMI practically every time they visit the doctor. Medicare and now the entire U. S. health care establishment follows the WHO public health guidelines and will sanction your doctor if (s)he doesn’t record these statistics every time you visit. Put simply: Their reimbursement by the government will be reduced!
The BMI chart is ridiculous for many reasons, among them: it only measures your height and weight. You are assigned a BMI on that basis regardless of your gender, age, frame or body composition (muscle vs. fat). That number is then used as “guidance” to tell them whether you are “normal,” “overweight,” or “obese.”
The flaws of such an arbitrary chart are myriad and manifest. So, even though your BMI number is indelibly inscribed in your permanent medical record, your doctor presumably has the discretion to provide you with individualized guidance, albeit that guidance less certainly noted on your medical chart. To provide guidance, epidemiologists have studiously pored over millions of medical records for the “elderly” and have concluded that the elderly shouldn’t be normal weight (as the young should). The elderly SHOULD be overweight!
This is interesting to me because, in my dotage, I have finally found, if not the Fountain of Youth, the secret to losing weight and improving my general and diabetic health through a lifestyle change (the Very Low Carb Way of Eating with full-day fasting). Now, for the first time since I was a teenager, I have a chance to be “normal” weight, or at least be on the cusp (BMI≤25). And now I’m reading that I’m too old to be normal weight!  My goal, having a while back becomenot half the man I once was,” is soon to maintain my weight between 172 (BMI=24.7) and 175 pounds (BMI=25.1), and thus maintain an altogether 200 pound weight loss.
However, lumping me in with all the other “elderly” in these studies, the WHO/NIH/CDC  tell me that my BMI should be no less than 27.5 (192 pounds), smack dab in the middle of the “overweight” range for my height. I just worked damn hard to lose that last 20 pounds, and they’re telling me I should be 20 pounds FATTER! The reason, they say, is that epidemiologically speaking, my risk of death (“all cause mortality”) is much higher in the “normal” (BMI<25) weight range. They say that for me a BMI of 27.5 is “ideal,” epidemiologically speaking.
My take: This epidemiological data only looks at the death statistics of the entire “elderly” population. It does not take into account wellness vs. frailty, smoking status, activity level, or even “advanced” age. It includes everyone at or over the age of 65, including nursing home populations and many elderly who are still living independently, some of whom indubitably are in declining health. And that’s not me! I’m actually thriving!
Most in this population are also not eating a nutritious low-carb diet of real food and healthy saturated and monounsaturated fats. And they are NOT avoiding “wheat, excessive fructose and excessive linoleic acid” (n6s).
To all this I say, damn the epidemiologists and anyone else who relies on this crapola to provide guidance to the healthy “elderly.” I’m 76 and I’m going for a BMI between 24 and 25, to maintain my weight between 172 and 175 pounds. My new wardrobe cost too much to just hang in the closet. And trust me, there’s still plenty of fat on my body to carry me through a long illness and to make a cushion for my fat butt at the ballpark.

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