How healthy are you?

Can you look down and see your toes? If you cannot, it is time to take stock of your health. RUTH N. DAVIDAR gives tips on how to go about it.

START with this simple and practical test. Stand upright and look down. You should be able to see your toes without turning your head or bending forward. Not a few will be surprised that they cannot pass this seemingly straightforward measure that can effectively determine how healthy they really are.

Height and weight are generally considered good indicators of health status. However, height and weight charts for Indian adults are still not available. What gymnasiums and diet clinics base their programmes upon are standards for good health relevant in the United States or the United Kingdom where an important consideration is build - small, medium, large. In India, only scant guidelines exist for those over 18 years of age.

So, while the Indian Council of Medical Research (ICMR) is in the process of formulating a set of recommendations for us to follow, we can, in the meantime, resort to two universally recognised parameters to determine how healthy we are for a given height and weight.

The first of these two standards is called the Body Mass Index (BMI) or Quetlet's Index. The BMI is a measure of health for both men and women. To determine your BMI, divide your weight in kg by the square of your height in metres. The formula may be written as follows:

BMI = Weight in kgs/Height in metres x Height in metres

Example = 58/1.68x1.68 = 58/2.8 = 20.5

You are healthiest if your BMI is between 18.5 and 25. A BMI between 25 and 30 would indicate that you are overweight, while over 30 would mean that you are obese. Below 18.5 would suggest undernutrition.

The likelihood of being a victim of heart disease or adult-onset diabetes increases if you have a BMI between 25 and 30. Anyone in this category will have to pay close attention to both diet and exercise.

However, even with a BMI in the acceptable range, you cannot sit back and lead a relatively healthy life. Where fat is stored in your body matters as well. In fact, it could be crucial in establishing one's health status. Body shape, therefore, is the key to keeping healthy. If you are apple-shaped, (fat stored around your waist and chest) then heart disease and other complications like diabetes and arteriosclerosis (thickening and hardening of the walls of the arteries) are more likely. People who accumulate fat around their thighs and hips are described as pear-shaped, and generally enjoy better health. To decide whether you are apple or pear-shaped, you will have to ascertain your Waist-Hip Ratio. This is done by dividing your waist measurement in centimetres by your hip measurement in centimetres.

Waist-Hip Ratio = Waist Measurement in cms/Hip Measurement in cms. For Example = 69/97 = 0.7

A waist-hip ratio of less than 0.9 is healthiest for men. For women, the value should not exceed 0.8.

To get your waist and hip measurements, stand upright and first measure around the navel with a measuring tape after a normal exhalation. Then measure around the broadest part of your hips.

A true picture of your health can only be determined when both these standards are applied. Ignoring one or the other would be unrealistic, because it is now known that you could get a heart attack or stroke even with a normal BMI. And all those damsels out there, it is worth remembering that, down the ages, men have - either consciously or unconsciously - picked women with a Waist-Hip Ratio within the acceptable limit, since it has always been taken as a reliable indictor of good health.

While on this subject, it is important for young girls to know that being extremely skinny and anorexic is unhealthy. In the process of evolving into a woman, female hormones give girls the curves that suggest their readiness for childbearing in the future. So, a degree of plumpness is desirable, and any attempt to alter it unnaturally could be very harmful indeed. Provided, of course, the limits specified by both the BMI and Waist-Hip Ratio are not exceeded.

In this process of staying slim, calories have received undue and irrelevant attention. Counting calories cannot help you lose weight, i.e., no energy is burned in the process. Since calories have to be expended to promote weight loss, it is important to understand what they actually are. Calories are units of heat that give us energy for action which could be voluntary (work and exercise), and involuntary (heartbeat, digestion, excretion and so on).

Calories come from four sources: proteins, carbohydrates, fats and alcohol. For a long time, it was believed that a calorie was a calorie was a calorie. That is, once calories were produced after food had been digested and assimilated, it was assumed it did not matter where they came from. They would be used to drive the many systems in the body or be burnt through deliberate effort, and any excess would be stored as fat.

Today, it is known that the source of the calorie is an important criterion as to how it will be utilised. Accordingly, calories from carbohydrates and proteins (four calories per gram) are most likely to be used for activity. The body takes a slightly lazier attitude to calories from fats (nine calories per gram), tending to store rather than burn them. Lastly, calories from alcohol (seven calories per gram) can be expected to end up around your middle, giving credence to the term "beer belly". Therefore, a low-fat, high-carbohydrate diet with adequate protein is the way to get the calories that are right for you, not by counting them.

And, finally, while counting calories are unlikely to keep you in trim, regular exercise can. Short bursts of intense activity are less beneficial than keeping active all the time. Walk the dog, water plants, handwash clothes. Anything to bring a little more activity into your daily routine that involves more than exercising your index finger to channel-surf. It will not be long before you notice how much happier and healthier you are. Get started today.

The author is a nutritionist and food writer.

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