WHETHER YOU are a super-fit athlete training for the marathon or a journalist draining a glass in Mulligan's, the chances are you will cross your fingers when you are called to hear the results of your health screening, writes Martin Noonan
I had taken my tests some weeks ago, and when my day of destiny finally arrived, I had a second set of fingers crossed. My plan on entering the surgery was to examine the demeanour of the doctor. Could I detect any solemn tone in his voice or maybe a conspicuous lack of eye-contact.
The initial impressions were encouraging. The doc was smiling. And it soon got better. "Congratulations," he said. "It looks like you ticked all the right boxes." I uncrossed my fingers, quietly let out a sigh of relief and tried to look as if I was expecting nothing less.
We then went through my results item by item. He looked impressed. I certainly was. My ECG was normal; blood pressure normal; urine, again normal - that was a surprise; my biochemistry, including the ever-important cholesterol, all very good; and my haematology, including my red and white cell count, again very good.
I thought I was the perfect specimen. Not quite. There was one blot on the landscape, which he kept until last.
The reading for my Body Mass Index was 29.556. This is a statistical measurement that compares a person's weight and height and is a useful tool to estimate a healthy body weight, based on how tall you are. And according to the BMI table, I was borderline obese. That took the smug smile off my face.
Everybody has a self-image as far as their weight is concerned. Mine was that I could lose a few pounds. My very health-conscious wife would suggest a few more. But borderline obese? Not even she would go that far. On my weighing scales there's very skinny, skinny, perfect, a little overweight (me), overweight, very overweight, fat, very fat and after that borderline obese.
BMI was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet, during the course of developing "social physics". It is a mechanism used by actuaries in the insurance industry when assessing insurance premium. It is now accepted that even excess body weight - in people who are not considered obese - substantially increases the risk of cardiovascular disease, diabetes and many other serious conditions.
My father died of a heart attack. And had I been told that my cholesterol levels were too high I would certainly act on the information. It was time to listen.
The shortcomings of BMI, because it depends solely upon weight and height, have been acknowledged by some in the medical profession. It is not considered appropriate to use it as a final indication for diagnosing individuals. Waist measurement and waist-hip ratio can be a better guide.
A waist circumference greater than 80cm for women and 94cm for men indicates increased risk and above 85cm for women and 102cm for men is particularly worrying.
Waist-hip radio is an even better measurement of risk. You measure the circumference of your waist at its smallest point. Then measure the circumference of your hips at their widest point. Divide your waist measurement by your hip measurement. A ratio of greater than 0.9 for men and 0.85 for women indicates an increased health risk.
Unfortunately, I'm an apple, not a pear. That is, I carry my weight around my waist, unlike a pear, which carries it further south. An old saying - if you can pinch an inch, you're fat - comes to mind. People who are a pear shape, or more diffusely plump, are less likely to develop heart disease and diabetes.
I feel a new year's resolution coming on.