Thursday, May 15, 2014

Alert ladies: BMI and the accidental workout effect

Spongy bones are breakable bones. So to keep them dense and strong, obviously you need to have calcium on board and the vitamin D necessary to help you body absorb that calcium. Got it. We know that already. 

But what else do you need to consider? 
This new study shows that your weight itself can determine whether your bone mineral density is high or low. Researchers at Brigham Young University assessed 262 women, across 20 cities in Utah and Wyoming, for hip bone density and BMI. They controlled for how much calcium/vitamin D the ladies consumed, their menopause status, age, height, bone drug use, and physical activity. 

Basically, they just wanted to find out whether any of these factors were associated with good bones vs bad bones. 

What did they find? 
Pretty straightforward. Higher BMI = higher bone strength. Lower BMI = lower bone strength. 

Could this be related to any of the other lifestyle factors they measured (listed above)? Maybe they found this effect because some just happened to be eating more calcium/vitamin D, or are in menopause. The answer is ... a big nope! None of these factors were related to the bone changes. None at all. 

Calcium/vitamin D consumed, menopause status, age, height, bone drug use, and physical activity were not responsible for this effect. 

What does this mean?Of all the health advice that waffles to and fro, seeming to reverse itself year by year, this one is pretty rock solid. Weight-bearing exercises can increase bone density. And, one of the very cool things about this effect is that it's just as true for young people as it is for us ancient folk. 

In essence then, individuals in this study who had higher BMI were basically doing those weight bearing exercises with each step they took throughout the normal course of a normal day. And because of that continual added weight, their bones respond by increasing the bone density with each step taken. 

What is the take home message? 
If a person is at a lower weight level, should they put on weight for bone health? Of course not. But what this result does tell us is that these individuals should focus on adding weight-bearing exercises to their workout plan. Again, this turns out to be true for everyone from adolescents to old people. All bones benefit. 

But it also makes me wonder about this study. What if they looked at the bone mineral density of the non-load bearing bones -- instead of the hip bones, look at the arm bones? That would tell you if BMI by itself impacts, positively or negatively, bone health in the absence of this accidental workout effect. I'd like to see that follow up research done on these same ladies. 
For more information: Click here to visit Will Clower's website.

Wednesday, May 14, 2014

Treating the problem, not the symptom, of an unhealthy lifestyle

Just got my copy of the Am J of Health Promotion, in which there is a great article on "The association between employee obesity and employer costs: Evidence from a panel of US employers."  

The results are exactly as bad as you might imagine. 

Normal weight employees cost ~$3830/yr (medical, sick day, short-term disability, and workers' comp claims). Obese employees cost > 2X that amount, ~$8067. These numbers are stark and, for self-insured companies who are paying all their own bills, this is a heavy burden to bear. This is why wellness has moved from a "feel good" item to a "strategic imperative" to build a strong workplace culture of health.

But what to do about it? 
It's important to distinguish between symptoms and problems. Overweight/obesity (the symptoms) are physiological expressions of an unhealthy lifestyle (which is the problem that creates the symptoms you see). Sure, companies can DO some manner of "biggest loser" weight loss challenge ... and that's fine. But these initiatives must also accompany lifestyle coaching or the problem will just recur.
As any clinician will tell you, it's indeed important to treat the symptoms that present themselves to you. However, as any dieter who has "yo-yoed" up and down will tell you, short term improvements won't stick unless the root of the issue is addressed. 

When thinking about driving solutions, we must educate on healthy lifestyle behaviors that ultimately lead to low weight, healthy hearts, and longer lives. 

For more information: Click here to visit Will Clower's website.

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