Retrospective #420: Damn the epidemiologists!

BMI’s for the “elderly”? Note, I put “elderly” is in quotes because I am riled. This post will be a rant. But I do not intend to dissect the epidemiological studies that guide the medical establishment with respect to the optimal BMI for the elderly (≥65). I will only reference them and instead write about n = 1: me.

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 1980s. Our NIH and CDC adopted it 1998. Now virtually everyone (the “elderly” anyway) is measured for height and weight and assigned a BMI virtually 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 at every office visit. Put simply: Non-compliance means their reimbursement for services rendered 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 type 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 will less certainly be noted on your medical chart. To provide guidance, epidemiologists have laboriously 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. Regular readers here know it is the Very Low Carb Way of Eating, just OMAD (one meal a day), with occasional full-day fasting. Now, for the first time since I was a teenager, I have a chance to be “normal” weight (BMI≤25). And now I’m reading that I’M TOO OLD to be normal weight!  My goal, having some time ago become “not half the man I once was,” was to continue losing and then maintain my weight between 172 (BMI=24.7) and 175 pounds (BMI=25.1), and thus maintain a 200 pound loss.

However, lumping me in with all the other “elderly” in these studies, the WHO/NIH/CDC now tells 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.  They’re telling me I should be FATTER than I was at my lowest weight! 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 “elderly” population taken as a whole. 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 at home independently, some of whom indubitably are in declining health. And that’s not me! I’m thriving!

Clearly, the epidemiologists need to rethink giving public health guidance to the “elderly” as anyone over the age of 65. Most in this population are also not eating a nutritious low-carb diet of real food with healthy saturated fats to allow uptake of the fat-soluble vitamins A, D, E and K. And, importantly, they are NOT avoiding “wheat, excessive fructose and excessive linoleic acid” (Omega 6s from oxidized, processed “vegetable” oils like soybean and corn oil).

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 78 and I’m going strong, trying to lose weight and reach my goal weight between 172 and 175 pounds. And according to that same BMI table, the middle “normal” weight for a person of my height is just 150 pounds. So, there will still be plenty of fat on my body to carry me through a long illness and to cushion my fat butt at the ballpark.