Numbers in Context!
Many of my past posts and content center on the patient taking an active role in his or her health. This responsibility begins with the types of food on the fork, daily activity levels, and steps taken to reduce exposures to our increasingly toxic environment. This responsibility should not stop with regard to evaluating our health and wellness when we are subjected or elect to receive blood tests.
Getting an annual check-up or investigative bloodwork can be an extremely intrusive and anxiety-driven situation for many individuals. In our current medical environment, these labs are usually ordered in times of illness or trying to resolve ongoing symptoms so increased anxiety levels are understandable and many will try and avoid stomaching the outcomes. The reality is that once you can understand and educate yourself on what these metrics and results may truly represent, interpreting the results can be a freeing and educational experience. Over many years of reading, listening, and learning about these metrics, I have come to believe that we have placed too much reliance on our medical professionals for guiding our actions after receiving these results. My issue is that many of these professionals may have very narrow views and interpretations of certain metrics that drive their diagnosis path a bit off course. What we need, as patients, is to be given a full picture of our health and be able to link tangible lifestyle factors to the actual results of our blood tests. I have written that functional medicine has this approach but wanted to take a deeper dive into some specific examples to offer guidance on making more educated interpretations of your own results. So here we go!
Weight and BMI
I contend that the invention of the bathroom scale and our obsessive relationship with the number it provides has caused immensely more harm than good with respect to our relationships with our bodies, perception of health, and has drastically impacted the way we view food. Somehow, we have been convinced that this one number, in isolation, represents a healthy or unhealthy individual such that if person A is being pulled down to the center of the Earth at a stronger rate than person B (i.e. person A weighs more than person B) person B must be healthier. Without any other metrics or context, you can see how silly this conclusion is. Okay, so that one is simple to ignore; however, our medical system has somehow placed reliance on Body Mass Index ("BMI") in order to provide context to weight and determine one's health status. BMI is derived from a simple math formula. It was devised in the 1830s by Lambert Adolphe Jacques Quetelet, a Belgian astronomer, mathematician, statistician, and sociologist. It aims to estimate whether a person has a healthy weight by dividing their weight in kilograms (kg) by their height in meters squared. So now we have added a variable, height, which is out of our control, in order to attempt to provide context to weight. Given the calculation and interpretation of paramaters, one can become "healthier" by simply getting taller or losing weight. Thus, using BMI to guide someone towards a healthier life, we could advise people with a high BMI to either get leg extension surgery or simply remove one of their legs. Either would result in a lower BMI and thus be given a clean bill of health. Again, a ridiculous conclusion and an incredibly useless metric. Further, BMI will unjustly classify individuals with increased muscle mass, such as myself, as obese or tall and thin individuals as underweight which may cause false interpretations of their own health and the snowball effect of the issues I expressed above with respect to body image and food relationships. As such, I conclude that viewing weight and even BMI in isolation is extremely misleading and can misguide users of these metrics to truly harmful outcomes. Thus I propose a modified view of these metrics.
In order to provide useful context to weight or BMI, we must add in another component, body composition. Body composition is used to evaluate the percentages of fat, bone, water, and muscle in human bodies. If we know the components that make up the mass or weight of our bodies, we can then evaluate whether or not we may be carrying around excess, harmful weight. With these metrics, we can assess leanness or adipose accumulation and be able to identify if we truly need to lose mass in order to become healthier. It is generally accepted that improved body composition defined by low body fat (subcutaneous and visceral) and a higher proportion of muscle mass represents a healthier individual. Applying this to the example given above, if person A weighs more than person B, yet has 20% less body fat, this paints a very different picture and lends much more useful insight. With this said, toss the bathroom scale and ignore the number. It does not mean a thing without more context.
Other common biomarkers and recommended contextual numbers follow:
Every metric in the chart above could and does have its own medical library on all the nuances and variables that should be considered in understanding what they mean. I tried to capture very basic levels in order to begin the conversation with your medical professionals. Further, you'll see a recurring theme in the dogmatic approach for the treatment of these single variables and how this approach may lead us and our loved ones to become subjects of our over-medicated populous. I hope that these insights lead to productive discussions between yourself and the individual(s) that you place faith in with respect to your health and wellness. If nothing else, these insights may lead you to a new approach to medicine. A significant red flag should be raised if these concepts are new or foreign to your practitioners.
Many say that age is just a number and this article serves to show you that these metrics are just numbers as well. Only when we look at them with context can we truly evaluate their meanings and paint the full picture of our health. I encourage you to look back on your bloodwork, identify issues, and see if you can prescribe yourself a solution that most of the time will be free and won't require a pharmacy!
Thanks for reading!