Once you have made the choice:
- To take responsibility for your own health
- To age as well as you can
- To change your approach to food
you are ready to find out "where you are." But, before we review the tests and evaluations which are available, let me address activity and safety.
Activity
If you are not active ( women getting 27 aerobic points a week and men getting 32 ) then all the other measures which we will discuss will be to no avail. In order for you to gauge whether you are achieving that result consider the following. If you walk two mile in thirty minutes, you are earning five aerobic points each period of exercise. If you walk three miles in forty five minutes you are earning eight aerobic points. If that pace is too fast for you at first, you can get five aerobic points for walking three miles in sixty minutes. You can see the frequency you would need to walk each week to reach the goals of 27 or 32 points per week.
Soon, you will be able to go to SETMA's website, www.jameslhollymd.com, to calculate your aerobic points whether you are golfing, playing tennis, swimming, rowing, jogging, running or walking. By the way, you may be surprised to discover that playing 18 holes of golf ( carrying your own bag and walking the course ) earns you 1.8 aerobic points. Golf may be good for you mentally, socially and professionally, but it isn't helping your heart.
Aerobic activity strengthens your heart and preserves your muscle mass. The former is important for "aging well" and the latter increases your "basal metabolism rate," which helps you control your weight.
Safety
Additionally, if you are practicing high-risk behaviors ( you do not wear your sit belt, you do not wear a helmet when bicycling, you ride a motorcycle at all, etc. ) your attempt to improve your rate of aging and quality of life while aging is probably not going to help. The potential of your dying prematurely from these and other high risk behaviors are so great that it very well may negate your efforts to maintain your health. Living healthily means avoiding these high risk behaviors because even if you are only injured in an accident, that injury will have a negative impact upon your longevity.
Not Covered by Insurance
It is important to realize that the majority of tests and treatments associated with "aging well" are not presently covered by insurance. In the future, insurance companies may discover that they save money by keeping people healthier, but at present none of these tests or therapies is paid for by insurance.
Perhaps the most dysfunctional illustration of this is in the case of Medicare which only pays for testing "if you already have a problem." Unfortunately, paying for care after a problem develops is expensive and often unsuccessful, whereas paying for preventive treatment would be less expensive and more often successful. This will gradually change as it becomes more and more apparent to public policy makers that health is more cost effective than the lack of it.
Finding Where You Are
If you understand that health is a continuum which goes from "perfect health with no problems" through a gradual deterioration of your health to a point of poor health and multiple problems, you will understand why it is important to know where you are.
There is an old adage which says, "What you don't know can't hurt you." The reality is that in regard to your health, the only thing which will absolutely hurt you is "what you don't know." Many people approach their health with the Ostrich mentality. I'll just ignore it and it'll go away. Unfortunately, that isn't true in any area of life and particularly in regard to your health.
In his book, If Aristotle Ran General Motors, former Notre Dame philosophy professor, Dr. Tom Morris, related Aristotle's four cardinal virtues, "truth," "goodness," "beauty" and "unity" to modern business life. Morris said, "Aristotle wrote about truth, in contrast to falsehood (and he said) "To say of what is that it is not, or of what is not that it is so, is false; while to say of what is so that it is so, and of what is not so that it is not so, is true.'" Morris continued, "knowledge is the possession of a map (by which to navigate well through life) and truth is what that map gives us, linking us to reality."
Apply this lesson to your health and you will tell yourself the truth. This is the fundamental principle behind self-realization when someone desperate to change finally stands up and says, "Hi, my name is ____ and I am an alcoholic." They don't say, "I am a victim." They don't say, "My mother or father mistreated me." They don't say, "My wife and children don't understand me." They declare, honestly, truthfully and unequivocally, "I am an alcoholic."
In the same way, facing any health problem begins by telling yourself the truth. "Hi, my name is ______ and I am fat." You don't say, "I'm over weight.'" You don't say, "I have a 'mature' figure'" (There is nothing mature about being fat except a lot of people who are older are fatter.) You finally, once and for all, look yourself in the mirror and say, "Hi, my name is _____ and I am fat."
Furthermore, "telling yourself the truth," means not trying to displace the blame. Regardless of what the legal issues are, MacDonald's and the Do-Nut store did not make you fat. Your decision to eat the wrong foods made you fat. The Oreo Cookies didn't make you fat eating them made you fat.
The very first step to aging well, whether you are eighteen or eighty, is to determine where you are and determine to tell yourself the truth.
But, What If I Find Out That There is Nothing I Can Do?
Fear keeps many people from asking questions about their health. The major fear is that they find out that they have some dread disease for which there is no cure. First, while this is a possibility; it is statistically improbable. This doesn't help the person who has a terminal, incurable illness, but it is the reality that that is by very far the exception rather than the rule. And, frankly, even in these situations, it is better to know than not to know. Even if you can't be cured, you can be comforted and you can make spiritual preparations for your journey.
Second, almost every condition known to man can be helped by appropriate interventions. And, every condition which is related to aging can be helped by knowing where you are and by making the decision to do something about your health.
Beginning
There is no better place to start than with your body composition. Remember, if you are a female and your body fat percent is 25 or below, or if you are a male and your body fat percent is 20 or below, you have eliminated weight and body fat as a health risk for any presently known disease. That makes achieving your ideal body fat percent a valuable goal, not because you will "look better," but because you will "be better" in regard to your health.
Here are some definitions, which will help our discussion:
- Overweight - A person is overweight if their Body Mass Index (BMI) is higher than 25 but lower than 30. (Soon, it will be possible to go to SETMA's website, www.jameslhollymd.com, and calculate your own BMI or you can have your SETMA provider calculate it during any office visit.)
- Obesity (Overfat) - Over 30 specific diseases have been linked to obesity. Obesity is defined as a BMI over 30 and severe obesity is a BMI over 40.
- Percentage Body Fat - is the percentage of total body weight that is fat. This is a much more accurate measurement of obesity than the BMI. This is not determined by calculations based on height and weight but by measures by one of several methods of the actual fat in your body. This requires special equipment. SETMA has this equipment.
- Body Fat - functions as insulation, protection and energy reserve. When the percentage is too high, fat increases a person's risk of high blood pressure, elevated cholesterol, diabetes, heart disease, and some forms of cancer. It can also interfere with the immune system, prevent heat loss, stress the musculoskeletal system, cause sleep problems, and may affect self-esteem.
- Basal Metabolic Rate (BMR) - is the rate at which the body burns calories to maintain normal body functions while at rest. It is affected by the amount of muscle you have. Body weight remains constant when you burn up the same number of calories you eat. A 3,500 calorie difference between dietary intake and energy expenditure is necessary to gain or lose one pound of fat. Weight loss by diet alone may result in a loss of muscle, and this will slow the metabolic rate, making it more difficult to keep the weight off. Exercise, however, increases your metabolic rate for hours even after exercise, and can increase the amount of muscle you have. SETMA can calculate your BMR for you.
Determining Obesity
Height-Weight Tables - were originally developed by insurance companies to establish recommended weight ranges for men and women. The "desirable" weights were those associated with the lowest mortality among large population studies of insured people. Unfortunately, these studies do not accurately represent a cross-section of the entire American population.
Body Mass Index (BMI) - is a simple calculation that determines height to weight ratio. This index correlates a person's physical stature with mortality ratios based on actuarial studies. According to the National Institutes of Health and World Health Organization, overweight is defined as a BMI or 25-29.9, and obesity as a BMI equal to or greater than 30. A person with a BMI of 30 is about 30 pounds overweight/overfat. A BMI or 18 or lower indicates that a person is underweight/underfat.
While BMI is widely accepted, it can be misleading. Current guidelines do not differentiate for gender, ethnicity or age, and do not distinguish obesity or leanness for individuals who are extremely muscular. It is, however, more precise than height/weight tables and allows comparisons of population groups. Studies have confirmed that obesity-related health risks start in the BMI range of 25-30.
Waist Measurement - Waist size is an additional, independent risk factor and can be used in conjunction with any other method. It reflects growing evidence that excess visceral fat - surrounding the abdominal organs - on its own increases the chance of heart disease or diabetes.
Research indicates that visceral fat (waist size) is more important in the disease process than subcutaneous fat which is just under the skin. ("love handles", "pinchable inches"). Abdominal fat cells appear to produce certain compounds that may influence cholesterol and glucose metabolism. A waist size of 35 inches or more is deemed a risk for people who have a BMI over 25.
The first step in "aging well," is to know your:
- Height
- Weight
- Basal Metabolic Rate
- Body Mass Index
- Body Fat Percent
Then to determine to get those last three numbers into the "normal range." Remember, it is your life and it is your health.
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