don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

Earlier this year, former Surgeon General C. Everett Koop said, "the measurement of body fat will become the new standard for assessing disease risk in adults." As such, it is of vital public health significance. It may also serve to replace the American obsession with body weight with a more appropriate measure of good health.

Just so, Dr. Koop! It is time to replace the normal focus on how much you weigh with one centered on how much of you is fat versus other stuff, such as water, bone and so on. In a little more scientific vein, the idea is to know how much of you is fat mass (adipose tissue) and how much fat-free mass (all bodily tissue other than fat.) A ratio statistic expressive of the relative balance between the two is what Dr. Koop was talking about.

Some claim that "What gets measured gets managed." Managing body fat, not just weight, should be the goal of anyone concerned with excess fat. In America, that's nearly everybody!

If you know your body composition or fat mass (henceforth FM), you can make a number of assumptions that are a lot more accurate than any based simply on how much you weigh in total, which is all you learn from a standard scale. Body composition should not be confused with BMI or “body mass index.” This is somewhat more useful than total weight because it takes account of how tall you are. This is really not a great improvement, however. BMI is calculated by dividing your weight in kilograms by the square of your height in meters. If you are mathematically inclined, be advised that the algebraic expression for BMI is BMI = Kg / (m)2 — if you are not so inclined, ignore this equation. Either way, forget about BMI—it’s a waste of time. It fails to take account of or measure lean body mass. A healthy, muscular individual with very low body fat could, using the BMI formula, be classified as overweight, which is ridiculous.

With a FM reading, a high ratio indicating excessive fat mass will confirm that you are at increased risk of coronary artery disease (CAD), hypertension, diabetes mellitus, osteoporosis, impaired functional capacity and certain types of cancer. Of course, people who weigh 300 pounds or so and obviously look obese generally know they are at risk for these conditions. The difference is that more accurate risk assessments can be made with FM measures and, more important, you can better track improvements in your bodily fitness level once you start on a vigorous wellness program using FM data.

How is FM assessed? Can anyone do it? Well, with a bit of training, most can do it. As for assessments, body composition can be measured in the laboratory or in the field. There are many techniques, a few of which the layperson can quickly master with minimal instruments or gadgetry. In decreasing level of complexity, these include hydrostatic weighing, radiography, hydrometry (for measuring total body water), photon absorptiometry, dual-energy X-ray absorptiometry (DEXA), bioelectrical impedance, infrared interactance and skinfold measurement. Not surprisingly, the former laboratory techniques are the most complicated, costly and, alas, accurate. Yet, the others are close enough to be valuable -- and a huge improvement over the standard weighing method to determine gross weight. Skinfold measures, for instance, provide a direct measurement of subcutaneous fat and its distribution in key bodily areas.

One of the biggest obstacles to the widespread replacement of weight scales with FM assessments is that even the simplest assessment tools, such as skinfold measurement devices, require a bit of operator training. I am currently working as a faculty advisor to a doctoral student seeking to develop a standardized way for individuals to properly learn and maintain the skills to do FM assessments. He is trying to develop, test and perfect a computer-based tutorial that will be effective in helping ordinary folks learn to do skinfold FM measurements. I hope he can do it. Besides becoming very rich, he will render to the obese parts of the world, like America, a major service. He could end up with a Nobel Peace Prize or something! (A pity some of the glory does not go to the doctoral dissertation advisers!)

Let's hope for the best while continuing to look on the bright side of life.

PS. If you want to know more about this study, feel free to contact the doctoral candidate to whom I referred, namely, William L. Elliott. His address is 1289 Mount Estes Drive, Colorado Springs, CO 80921. His phone is (719) 487-0937. You can send him an email and check out his website.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of appearance and aging. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

 Send e-mail to Don Ardell