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The Numbers That Matter

A person’s waistline can reveal future health risk

Published

By EDUARDO GONZALES, MD

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I get confused when I receive and go over the results of the laboratory, xray, and other medical tests that form part of our annual medical. Which of these numbers really matter?—eterna_londy@ gmail.com

There are indeed numerous parameters that are available to measure
a person’s health and many of these form part of the annual medical exam packages for employees of many corporations. But the truth of the matter is that most of these tests say very little about a person’s overall health. There are only a handful of metrics that you need to maintain within normal limits to significantly increase your odds of living a long, healthful, and productive life. The more important ones are discussed below.

BMI and waist circumference
Overweight, especially obesity, is arguably the biggest risk factor for chronic diseases such as diabetes, cardiovascular disease, and cancers that cause premature death. If you are overweight or obese you have two- to three fold higher risk for coronary artery disease and hypertension, and more than tenfold increase in the risk for diabetes type two compared to lean individuals. You also have increased chances of dying from cancers of the colon, breast, kidney, endometrium, and other organs.

There is no universally accepted measure for overweight and obesity
but the reliable ones are Body Mass Index (BMI) and waistline. BMI
is currently the yardstick preferred by most physicians and researchers in determining obesity. You can compute for your BMI by dividing your weight (in kilograms) by the square of your height (in meters). You have a healthy body weight if your BMI is 18.5 to 22.9.

As far as waistline is concerned, studies show that the circumference of a person’s waist—which indirectly measures the amount of excess fat in and around the belly—is really a more sensitive determinant of the metabolic and cardiovascular complications of obesity than BMI. When you measure your waistline, start at the top of your hip bone then bring the tape measure all the way around your body, level with your belly button. As per WHO Asia-Pacific Guidelines, Filipino women should have a waist circumference of no more than 80 cm (31.5 inches) while Filipino men should have no more than 90 cm (35.5 inches).

Blood Pressure (BP)
High blood pressure or hypertension increases your risk of heart attack, heart failure, kidney disease, stroke, blindness, and dementia.

Blood pressure values are written blood sugar in the form of a fraction where the systolic blood pressure is the numerator and the diastolic, the denominator. The normal resting systolic blood pressure is below 120 mmHg while the normal resting diastolic blood pressure is below 80mmHg. Thus, a normal blood pressure is below 120/80 mmHg. You are hypertensive if your resting BP is 140 mmHg or higher and/or your diastolic blood pressure is 90 mmHg or higher.

Blood Sugar
Diabetes, which is characterized by a persistently high blood sugar level, kills more than 1.5 million worldwide every year. In the Philippines, where 5.8 percent of adults (5.5 percent of males and 6.1 percent of females) have diabetes, the condition accounts for six percent of all deaths.

Diabetes damages blood vessels and many vital organs, very gradually, but progressively, hence, during the first few years of the disease, the injured organs still function adequately, the person does
not have any symptom and he/she senses nothing wrong with his/her body.

If untreated, diabetes invariably results in serious complications that
include poor healing of wounds in the extremities, stroke, heart failure and heart attack, kidney failure, blindness, susceptibility to infection, and nerve damage that results in muscle weakness and reduced sensation.

To detect diabetes mellitus at the earliest possible time, adults age 45 and older should have their fasting (FBS) taken every three years, but for adults with a high risk for diabetes it should be done annually beginning at age 30.

FBS of less than 100 mg/dL (5.6 mmol/L) is normal, 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes, and 126 mg/dL (7 mmol/L) or higher means diabetes.

Lipid Profile
Lipid profile is a group of blood tests that helps determine one’s risk of developing cardiovascular disease. It includes total cholesterol, high-density lipoprotein cholesterol (HDL-C or “good cholesterol”), low-density lipoprotein cholesterol (LDL-C or “bad cholesterol”), and triglycerides. Adults need to take a lipid profile test every five years; youths, once between the ages of nine and 11 and again between ages 17 and 21. People who are at risk for cardiovascular disease need more frequent screening. You need not
memorize the desirable and undesirable values of blood lipids. They are indicated in the laboratory reports when you take the blood exam.

(Note: Email inquiries on health matters to: medical_notes2@yahoo.com)

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