Welcome to the next installment of our Normalize This Series. This month, we’re addressing why fitness is important as we age. THIS IS NOT A FEATURE ON WEIGHT LOSS. As you might expect, we want to talk about fitness in a way that is inclusive and holistic. Fitness, especially as we age, is about prioritizing your health and wellbeing. Here to help us expand and reframe how we look at fitness is Dr. Barbara Frank, Harvard-affiliated OBGYN and Attn: Grace Medical Advisor.
Q. Barbara, I think we need to start by knocking BMI off its high horse, am I right?
Yes. Did you know the Body Mass Index (BMI) was introduced in the early 19th century by a Belgian named Lambert Adolphe Jacques Quetelet? He was a mathematician, not a physician. He produced the formula to give a quick and easy way to measure the degree of obesity of the general population to assist the government in allocating resources.
Said in another way, the BMI was developed as a short-hand tool/calculation to discuss populations not individuals. Not to mention, those populations were composed of only white Anglo-Saxon bodies in an entirely European population. Because of this, it is not always an accurate depiction of health for other demographics and races. For example, researchers found the BMI obesity cut-off for Asian populations actually falls lower than the standard BMI chart. In 2004, the World Health Organization found Asian people with a high risk for type 2 diabetes and cardiovascular disease had lower BMIs.
The bottom line is, BMI gives an incredibly incomplete measure of a person’s health and wellness. Medical definitions are more complex than this simple (and somewhat flawed) calculation.
Q. Glad we’ve gotten that out of the way. Can you help us reframe “fitness”?
Honestly I'm not sure what defines "healthy" or "physically fit". We know of signs and symptoms of bad health — high cholesterol, high blood pressure, diabetes/insulin resistance. We also know that genetic predisposition plays a huge role as well.
Fitness also does not have one precise definition. Cardiologists typically ask, can you walk up a flight of stairs without getting winded, how about 2? What is your resting heart rate? The answer to these questions is part of your fitness but remains incomplete.
Fitness includes everything from when you wake up to when you fall asleep, including when you’re actually sleeping! This is all part of your overall health.
When reframing health and fitness, we need to think holistically. It is easy to focus on weight and clothing size, but we must consider the whole body and the mind too.
Q. Shattering the traditional definition of fitness feels freeing, but also a bit daunting. Can you help us assemble a more holistic / inclusive rubric for us to keep in mind?
I like to divide the larger concept of “health” into the following categories, because ultimately being “fit” means taking care of every single system in your body. Below are each of your bodies systems, and some diseases/ailments that would negatively affect your overall health.
- Endocrine-metobolic: diabetes, and metabolic syndrome
- Cardiovascular: coronary artery disease, high blood pressure, other blood vessel diseases
- Musculoskeletal: sarcopenia (loss of muscle mass as you age), arthritis, back pain, osteoporosis (loss of bone as you age or with chronic disease)
- Gastrointestinal: bowel/gut health, fatty liver disease
- Pulmonary: COPD
- Renal: chronic kidney disease, urinary incontinence
- Rheumatology-Immunology: decreased immune cell function
- Neurological: stroke
- Psychological: anxiety, depression, mental illness, or emotional disturbances
If I had to choose one word to define health I would talk soley about INFLAMMATION (we also call it oxidative stress on the cells). Your goal is to have low systemic inflammation.
Q. What are some tips for avoiding or reducing systemic inflammation?
By taking care of our overall health, like healthy eating habits, exercise, and decreasing stress and cortisol levels we will, in turn, decrease our overall inflammation.
- Healthy Eating Habits:
Making good choices in our diet to include fresh vegetables and fruits as well as reducing refined sugar intake can make a big difference.
- Make Time to Exercise:
Regular exercise is an excellent way to prevent inflammation, not to mention, it’s good for heart health, managing weight, and reducing stress as well.
- Manage Your Stress:
Chronic stress or high levels of cortisol contributes to inflammation of the body. We may not be able to change many of the stressful situations we encounter in life, but we can change our response and perception by learning to manage stress better. Sleep, exercise, meditation, and therapy can all help.
Less inflammation means your cells are more able to do their job in keeping your body running as it should. Inflammation in the body causes increased stress on a cellular level, and over time can cause disease processes in each of the body's systems.
Q. When it comes to certain life stages, do you have any advice?
Milestones like pregnancy/postpartum or perimenopause are junctures in life that tend to make us re-examine our "health" and "fitness". Many times when women are trying to conceive, they want the best environment for their growing baby. The same goes with perimenopause, only the focus is finally on YOU! Many women are triggered to jump back into their fitness and larger wellness routines as they start to experience signs and symptoms of menopause or perimenopause. It’s great. Not only are you taking stock of your health, which is always important, you’re doing it at a time when your body is really evolving, often quite dramatically, on so many levels. Exercise, meditation, mindfulness -- just to name a few -- can all make such an enormous difference in how you feel day-to-day.
Want more on wellness?
More from our Normalize This Series