Imagine looking through a door viewer to find out what the weather outside is like: if we spot a bit of sunlight, can we tell how hot the day is going to get? Or if we see a drizzle, does it mean the monsoon has arrived? Just as a glimpse does not help us foretell the weather, a single test of BMI does not give us a true picture of our health. So, what else do we need to know?

BMI, or Body Mass Index, is a simple metric that tells you if you are at a healthy weight, based on your height. The global standard suggests that a BMI of 18.5 to 24.9 is a normal range, while 25 is considered overweight and 30, obese.

There’s no doubt that this index is a useful starting point to assess certain risks, like the likelihood of weight-related heart health conditions, especially at a population-level. But as far as understanding the health risks of individuals is concerned, this number has its limitations, and must be supported by other crucial health data, with standards adjusted for specific populations.

Where does BMI fall short?

The most significant drawback of BMI is that it does not distinguish between fat, muscle and bone. This inability to consider fat percentage and distribution could lead to errors in highlighting risks — athletes, who may weigh more due to greater muscle mass, could be categorized as obese as per their BMI, while elderly people, who face age-related muscle loss (sarcopenia) and have a higher amount of fat, may be inaccurately placed within a normal, healthy range. 

It’s clear, therefore, that BMI cannot be used as the sole marker for fitness or wellbeing. It needs to be looked at along with other parameters for a deeper insight into overall health.

Weight to Height Ratio: What Waist Measurements Mean for your Metabolism

If you are on a workout plan or train with a fitness expert, you may be familiar with the waist-to-height ratio — a measurement of your waist circumference, relative to your height, to estimate the amount of fat around your belly. Visceral fat, stored around the organs in the abdominal region, is associated with higher cholesterol, hypertension (high blood pressure) and type 2 diabetes. Thus, the waist-to-height ratio is a more relevant gauge of health risks, than BMI.  

Screening Blood for Lipids

Most of us have come across ‘lipid profile’ as part of a regular health check-up: a test that measures the amount of fat molecules called lipids, including cholesterol and triglycerides, in the blood. Excess lipids in the blood could cause unhealthy fatty build up in the arteries, narrowing them. This is a key indicator of cardiovascular health risks.

But how do we know when we need to get tested?

While the frequency of lipid testing is generally suggested as per some basic guidelines, doctors may recommend more regular screening for those with an elevated health risk, due to age, hereditary factors or other chronic health conditions, like hypertension. Medical experts report that South Asians have a unique lipid profile which makes them more susceptible to coronary artery disease at an earlier age. This genetic predisposition, too, could call for a more frequent lipid profile analysis to keep cardiovascular health in check.

Of Muscle, Fat and Bone Mineral Density

While waist circumference is an indication of fat distribution, techniques like a DEXA (dual-energy X-ray absorptiometry) scan, provide a more detailed analysis of body composition: besides accurately measuring visceral fat, this non-invasive test also assesses lean muscle mass — a crucial indicator of metabolic health — and evaluates bone density, which can highlight bone loss and the risk of osteoporosis. These results give healthcare providers a much clearer picture of a person’s metabolic health, as compared to BMI.

Viewing Health Through a Wider Lens

The limitations of a single health marker can be addressed by studying it alongside other indicators of wellbeing. Thus, a combination of relevant tests is more effective for a broader, more nuanced understanding of our health. Further, these tests must be evaluated in the context of specific populations, as health risks could vary by ethnicity. For example, an HDL (High density lipoprotein or ‘good’ cholesterol) of 40 mg/dL or less is considered a risk factor for heart disease. However, according to the Indian Heart Association, the target HDL for South Asians should be 50-60 mg/dL, due to an elevated risk. Acknowledging these differences will help to ensure that diagnostic tools and healthcare systems are more inclusive, and able to accommodate the needs of diverse groups of people.

A well-rounded perspective of health can help us take charge of our wellbeing. As healthcare research evolves to deepen our understanding of our bodies, comprehensive diagnostic measures can open doors to a more holistic view of wellness, enabling us to make health decisions with greater discretion, confidence and ease.

Disclaimer: The information mentioned in this document is only suggestive /for patient education and shall not be considered as a substitute for doctor’s advice or recommendations from Abbott. Please consult your doctor for more information.