Problems and Risks Arise When Defining The Terms Of A Healthy Body Size

Problems and Risks Arise When Defining The Terms Of A Healthy Body Size

The ideal body weight, IBW, is the optimal weight based on gender and height.  The ideal weight for a woman my height, 5’ 3”, is 104 to 140 pounds.  Unfortunately, ideal body weight is an incomplete measurement and does not necessarily reflect the health of a person.  Height and gender are the primary factors determining ideal body weight, and some calculators take age into consideration. However, build, muscular development, and body fat percentage are not taken into account.  Because of this, many athletes and fit individuals may be considered overweight based on the ideal body weight, while so-called skinny fat people may be well within their ideal body weight numbers. 

The Ideal Healthy Body Has Little To Do With The Pounds Displayed On The Scale

When working with clients, I encourage them to ditch the scale and measurements like IBW and to focus instead on body composition, inches lost instead of pounds lost, and, if they really want to explore body composition and have some money to spend, I recommend utilizing tools like Dexa body composition scan and whole body phethysmography. 

Excess body weight and body fat have a negative impact on health, and they come with numerous health risks, from type 2 diabetes to sleep apnea.  One of the systems that is negatively impacted by obesity and being overweight is the cardiovascular system.   Excess body fat is a major contributor to hypertension, which is the number-one cause of stroke.  It is also harmful to the kidneys.  People who are overweight or obese are also at higher risk for chronic inflammation and diseases of infertility like polycystic ovarian syndrome.  

Being overweight or obese is also linked to at least 13 different types of cancers (including breast, thyroid, uterus and ovaries, as well as colon and rectum cancer).  While the exact mechanisms aren’t clear, some possible ways in which excess body fat contributes to cancer concern DNA damage resulting from chronic inflammation.   The estrogenic effect of fat tissue most likely increases risk of endometrial, breast, ovarian and uterine cancer.  Obesity is also linked to high blood levels of insulin and IGF-1, which promote tumor development by inhibiting programmed cell death.  Fat cells also produce the hormones adipokines, which have the ability to stimulate or hinder cell growth.  It goes without saying that maintaining a healthy body weight is foundational for cancer prevention. 

The Mediterranean Diet And Healthy Body Size

The Mediterranean diet is touted as one of the healthiest of the planet.  There is not one Mediterranean diet but several variations, depend on the region.  While different Mediterranean countries eat different foods, there are staples consumed throughout the Mediterranean, from Italy to Greece to Spain: fresh seasonal vegetables, fish, lamb, nuts, legumes, herbs and spices, some nuts and seeds, and our stars: olives and olive oil.  The Mediterranean diets avoid added sugars, highly processed foods, trans-fats, and refined vegetable oils.  Water is the beverage of choice; coffee and teas are widely consumed, and wine is also included in moderation.  

The Mediterranean diet is rich in fiber and healthy fats, and it is the diet of choice for heart health.  Studies show that it improves lipid profiles, decreases lipid oxidation and reduces risk of thrombosis. 

The Paleolithic Diet And Reaching Ideal Body Composition

The Paleolithic diet focuses on the foods eaten by our ancestors during the Paleolithic era, when humans were hunter-gatherers.  While there are several variants of the diet, the Paleolithic diet (or “paleo”) removes sugar, processed foods, vegetable oils, trans-fats, legumes and grains.  It includes meat, poultry, fish, vegetables and fruit, nuts and seeds. Some variations incorporate dairy.  Potatoes were initially excluded, but in recent years they have been added to the list of allowed foods.  The paleo diet therefore removes many inflammatory foods (processed foods, trans-fats), as well as foods that trigger food sensitivities (gluten and dairy).  A 2009 study showed that the Paleolithic diet was superior to the diabetes diet in managing cardiovascular risk factor in patients with type 2 diabetes.  Other studies show improvement in serum biomarkers for cardiovascular disease.

Paleolithic Diet Versus Mediterranean Diet

While both diets are beneficial for cardiovascular disease, my preference would be to start a client on the Paleo diet.  I like using the paleo diet as an elimination diet.  Usually, after an initial phase (lasting 1 to 2 months depending on the client), I carefully and slowly reintroduce foods allowed in the Mediterranean diet.  This allows added variety which can help stave off boredom which is extremely important for compliance.  Ultimately, the choice will be the client’s.  It would be unwise to recommend a Paleo diet to a client who is not likely to comply with such restrictive way of eating.  In my practice, clients are active participants in setting goals and how to reach them.

References:

Ortega‐Loubon, C., Fernández‐Molina, M., Singh, G., & Correa, R. (2019). Obesity and its cardiovascular effects. Diabetes/metabolism research and reviews35(4), e3135.

Peterson, C. M., Thomas, D. M., Blackburn, G. L., & Heymsfield, S. B. (2016). The universal equation for estimating ideal body weight and body weight at any BMI. The American journal of clinical nutrition103(5), 1197-1203.

Obesity and Cancer Fact Sheet – National Cancer Institute [Internet]. 2017 [cited 2020 Nov 2]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet

Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015;16(2):111–7.

Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., … & Djousse, L. (2020). Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation, E139-E596.

Mediterranean diet for heart health [Internet]. Mayo Clinic. [cited 2020 Nov 2]. Available from: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

Jönsson T, Granfeldt Y, Ahrén B, Branell U-C, Pålsson G, Hansson A, et al. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009 Jul 16;8:35.

Sharman MJ, Kraemer WJ, Love DM, Avery NG, Gómez AL, Scheett TP, et al. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr. 2002 Jul;132(7):1879–85.

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