DEAR DR. GOTT: I am a lady in her 90th year and hope you can answer a pertinent question. Until my 70s, I was a respectable 5’ 6”. Now I am 1 ½” shorter. When checking height charts for healthy weight, which height do I use? At 150 pounds I am below the BMI of 25 if the higher height is used. I am just above the 25 mark if the lower height is used. I know that life is not fair, but should one be considered overweight at 90 when I was okay at 70? Just asking!
DEAR READER: At 90, you needn’t be worried about your weight or body mass index. Your weight and BMI are essentially normal and should not be a concern to either you or your physician. As we age, most of us shrink and gain some weight. This is usually normal. I would only be concerned if your loss of height were coupled with back pain or increased fractures (signs of osteoporosis) or if your weight drastically changed (loss could signify cancer or malnutrition, gain may mean edema or heart failure).
Body Mass Index (BMI) is calculated from a person’s height and weight. It is considered a reliable indicator of body fatness, yet does not measure it directly. BMI is one of several tools used to identify possible weight problems for adults. It cannot be used as a diagnostic tool however. For example, well muscled and highly trained athletes may have a high BMI but low body fat. This is because the test does not distinguish between fat and muscle, only weight to height ratios.
There are four categories, underweight (BMI under 18.5), normal (18.5-24.9), overweight (25.0-29.9) and obese (30.0 and up). To put this in perspective, an individual who is 5’ 9” can have a weight range of 125 pounds to 168 pounds with BMIs ranging from 18.5-24.9. With respect to amount of body fat, it varies by age and gender. Men and women with the same BMI often have different amounts of body fat because women tend to have more fat than do men. This is also true for older people who generally have increased amounts of fat over that of younger individuals.
It is important to remember that body mass index alone is not enough to assess health risks. It must be used in conjunction with other tools, such as waist circumference. Other risk factors must also come into play such as smoking, inactivity, hypertension or high cholesterol.
Many individuals over the age of 80 can safely ignore most of the “rules” of good health. Mildly elevated cholesterol levels and blood pressures are common and generally inconsequential. In those younger however, preventive medicine is always the best medicine. Take care of your health while young so you can enjoy it when you’re old.
To give you related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott