- The Washington Times - Tuesday, June 12, 2001

Americans looking to get in shape have to venture through a labyrinth of fitness advice: "Drink more water," "eat protein, skip carbs," "increase your reps" and so on.

Sometimes it´s difficult to tell whether you are getting into shape, because many recommendations and trends can be ambiguous. Take the BMI — Body Mass Index — for example. It´s supposed to tell whether someone´s underweight, normal weight, overweight or obese by dividing the weight in kilograms by the height in centimeters squared.

When using inches and pounds, the following formula is used: BMI = 705 x body weight (in pounds) / height x height (in inches).

If you are 5 feet, 5 inches tall and weigh 170 pounds, you´re overweight, on the verge of being obese, according to the BMI. The index value for someone with those measurements is about 28.5.

An index of between 18.5 and 25 is considered healthy. Those with a score between 25 and 29 are classed as overweight, and those whose BMI is higher than 30 are considered obese, according to the National Institutes of Health.

Being overweight or obese can lead to chronic diseases such as high blood pressure, diabetes, stroke, cancer and diseases of the gallbladder, heart and lungs.

But someone like 34-year old Allen Tardiff, who has exercised his whole life and weighs 170 pounds at 5-foot-5, is not necessarily unhealthy just because he falls into the high end of the overweight category. He is the area director for the Results Gym, which has facilities at 1612 U St. NW and soon in the Capitol Hill neighborhood.

"I have worked out for 24 years, and I have always been like this," Mr. Tardiff says. He is generally healthy, has a low resting pulse (about 60 beats a minute, considered better than normal) and a body-fat measurement of about 14 percent.

"I guess BMI is a clumsy way of looking at [fitness]," says Mr. Tardiff, who at his strongest bench-pressed 405 pounds.

His colleague, Karen "CeCe" Campbell, 24, a certified personal trainer, is the same height but weighs 115 pounds. She is on the light end of normal, according to the BMI measurement. She has the same resting pulse as his, and her body fat is about 18 percent. In her case, the BMI measurement works.

"I think the BMI measurement is good in dealing with large populations. It´s cheap and easy, but it doesn´t give a complete picture," says Ms. Campbell, who is getting a master´s degree in exercise science at George Washington University. "I use both BMI and the percentage-body-fat measure with my clients."

Body fat is determined by measuring a skin fold in areas such as the triceps and thigh with the help of a caliper.

BMI can be an inaccurate tool not only for athletes, but also for children and adolescents who are still growing, for pregnant women, people with large body frames and petite individuals, according to Nutrition Insights, a publication of the Department of Agriculture´s Center for Nutrition Policy and Promotion.

Doctors often do not limit themselves to measuring general fitness through BMI, but instead conduct a series of tests.

For cardiovascular fitness, Dr. Mark Cinnamon, an internist with a practice in Northwest, says he looks at resting pulse and blood pressure. When needed, he puts a patient on a treadmill to see how the body responds to aerobic exercise. If the pulse shoots up quickly, for example, it can be a sign the patient is in the early stages of hypertension.

"You're using several general measurements to give a full assessment," Dr. Cinnamon says.

Dr. Ace Lipson, an endocrinologist with an office in Northwest, says he doesn´t often need to use BMI because it´s obvious if someone is overweight or obese.

"We also look at a patient´s build. If it´s a woman, they are probably at lower risk of disease if their weight is around their rear and thighs," as opposed to stomach," he says.

Most physicians, Dr. Lipson says, also probably would try to alert and help a patient before the patient reached BMIs of 30 or higher. "I would talk to a patient when they are 10 or 15 pounds overweight. I wouldn´t wait until their BMI is 30," he says.

The BMI measurement might be more useful for patients who want to monitor their weight/height ratio on their own, Dr. Lipson says, rather than for doctors.

Despite BMI´s shortcomings in certain population groups, it is a widely accepted tool for identifying and subsequently treating obesity and few dispute the importance of weight reduction in people with high blood cholesterol, high blood pressure, diabetes and cancer.

Surrounded by the newest exercise equipment and every fitness measurement tool imaginable at their fingertips as well as above-average fitness knowledge, health care professionals Mr. Tardiff and Ms. Campbell use a very old-fashioned, nonscientific way to determine their fitness level.

"I look at how my clothes fit me — that they´re not tight — and how I feel," Mr. Tardiff says. Ms. Campbell nods in agreement.

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