Hey, where's the black BMI?

Posted: March 06, 2014

WE'RE ALL the same on the inside, right? Well, sort of. As human beings, we certainly have more in common than not, but when it comes to genetics and our bodies there's a wide range of differences.

For years, I have debated with readers, friends and family members about the onerous body mass index, and specifically as it relates to African-Americans.

When it comes to blacks, is the BMI accurate? After all, the established standards for the BMI are based on whites, and this bias, more often than not, places many African-Americans in the overweight or obese category (even when we're not).

Now that you're uncomfortable, let me make you more uncomfortable.

The fact of the matter is, studies have delivered irrefutable biological differences between blacks and whites. Generally speaking, studies have shown what black folks already knew: that blacks have a higher bone density, denser muscles, different fat-storage patterns and different proportions.

Those differences alone should justify having a BMI for blacks, you think? Have you ever wondered why the Centers for Disease Control and Prevention and the medical establishment haven't created a more accurate BMI for people of African descent?

Well, I can answer that. First of all, the CDC never created the BMI, they just conveniently usurped it back in 1984. Now, here's the short story on the creation of the BMI:

The body mass index was developed approximately 175 years ago, not by a group of doctors, but by Belgian mathematician Adolphe Quetelet. He created the formula as a quick and dirty way for the government to determine the degree of overweight/obese people in the general population. Quetelet defined the BMI as the individual's body weight divided by the square of their height.

Fast-forward: It is interesting to note that prior to the BMI the medical community used the Metropolitan Life Insurance Co. height and weight charts to determine the so-called ideal weight/height ratio for people. The insurance company created its recommendation by looking at who had the lowest mortality rates based on frame size, height and weight. So, again, no doctors or anyone from the medical community was consulted when coming up with this chart.

As Americans continued to get larger, the Metropolitan Life Insurance charts were ditched and, in 1984, the Centers for Disease Control ushered in the good old BMI. From then on, the BMI was considered the gold standard for height and weight.

I remember this because I was always considered fat according to the Metropolitan Life Insurance chart, which said that for my height (5'3") and frame size (small), I should weigh a meager 110 pounds. Honey, that was never going to happen.

Also interesting to note is that, by today's standards, the Metropolitan Life Insurance Co.'s measure would make nearly everyone overweight or obese.

On the other hand, did you know that there's a BMI for Asians? That's right. When it comes to Asians there seems to be no debating that they are typically shorter, smaller framed and leaner than both whites and blacks. Therefore, it is only natural that they would have a BMI that reflects their body types. For example, the Asian BMI of 27 is the cutoff for obesity, while 30 is the U.S. cutoff. The Asian BMI for overweight is 21, while the U.S. standard is 25.

A community of Asian researchers realized that the standard Western BMI did not apply to the Asian community at all, because they were getting weight-related illnesses at a much lower weight than whites.

According to Dr. Pan Wen-Harn, "Chinese, Japanese, Koreans and Indians experienced metabolic risks such as hypertension and diabetes at a much lower threshold. You don't have to wait until you get a BMI of over 24 - even at 23 or 24 a substantial number of people have those diseases," she told the International Congress on Obesity in Sydney, Australia, back in 2006.

Personally, I've never been a fan of the BMI, which I think has a lot of problems, regardless of race. First of all, the BMI can easily misclassify a muscular person as overweight or obese when they're not. On the flip side, the BMI can classify a person with elevated body fat (which could increase their risk for disease) as healthy simply because their BMI is in the so-called healthy range of 18.5to 24.9.

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