Vitality As You Age Has Little To Do With Your Body Fat.

What connects us traverses the perceived divide that separates us far more than our mega-rich media-driven world “allows” you to see. Each right or wrong you believe, good or bad barrier you define carries you along the path of separateness and maya (illusion).

Do you have judgements about obesity? Its goodness or badness? Do you hold perceptions about a person’s strength or weakness, intelligence, or lack thereof? Where did all these judgements come from? Are they based on science or cultural conditioning? Do you further notice that we could put any media “trigger” topic in the place of the word obesity (gender rights, abortion rights, gun rights, religious status, etc.) and ask the same questions?

Dividing people is how the mega-rich authoritarians turn the influenceable into their playthings, the single-issue voter that will vote for self-annihilation in order to be “right” about one subject they hold to be most important. The gaming of society into winners and losers applies when it comes to a very simple subject: weight.

Apparently, Martha Stewart and Sports Illustrated have brought this conversation to the forefront of our collective awareness. Amazing how being thin and white helps you overcome convictions on conspiracy, obstruction of justice and lying charges. I am sure Lizzo would get the same latitude? While all Lizzo does is make music, stand for equality and inclusivity for all, certainly a SI spread is coming any time now? (to the credit of the SI Swimsuit team, Lizzo did appear in a great video about body conversations, available on Instagram)

I love people of all shapes and sizes. My job as a doctor, a healer, abides in wellness. First, freedom from disease, then freedom from imbalance, then to true vibrancy/freedom. I order the same tests on everyone, thin or fat. They define the objective reality behind any weight, delineating cardiometabolic health parameters which distinguish healthy from unhealthy.

Societal conformity trumps science when it comes to perception; science speaks differently, and clearly about weight. We will discuss body fat percentage as the gold-standard and not the BMI (Body Mass Index) as BMI misrepresents too many people. The following image gives us a very accurate look at how body fat changes with age and sex.

Please get a KoreScale or similar scale that tracks both body fat and lean body mass; mine uses the FeelFit App on my Smartphone. As you will see, the loss of lean body mass, sarcopenia (with associated loss of strength and function), becomes our primary driver of wellness.

The measures of sarcopenia provoke debate in the field, but measures of function appear to lead the research. Within the journal Frontiers in Physiology (Front. Physiol., 21 January 2021, Prevalence of Sarcopenic Obesity Using Different Definitions and the Relationship With Strength and Physical Performance in the Canadian Longitudinal Study of Aging), the following definitions are used; bold and italics added for clarity:

Handgrip strength was measured using a digital grip dynamometer (Tracker Freedom JTECH Medical; Midvale, Utah, United States). Participants sat in a straight-backed chair with feet on the floor and upper arms close to the body with the elbow of the dominant hand at 90 degrees flexion. After a practice maximal squeeze of the dynamometer, participants completed three maximal squeezes with 15 s between each trial. The highest measure from the dominant hand was used in this analysis. Low handgrip strength was defined as < 16 kg in females and < 27 kg in males, in line with the updated recommendations proposed by the European Working Group on Sarcopenia in Older People (Cruz-Jentoft et al., 2019). 

Participants completed a 4-meter gait speed test to assess physical performance. A practice trial was completed before each test. Participants were instructed to walk as fast as possible through a straight 4-meter path marked on the floor and asked to stop a few steps after the finish line. The time taken to complete the course was recorded using a stopwatch. Speed was calculated as the 4-meter length of the path divided by the time to complete the test (m/s). Slow gait speed was defined as < 0.8 m/s (Cruz-Jentoft et al., 2019).

To be clear, I don’t routinely measure grip strength or gait speed in my practice, although I should! These would be for detecting the highest risk individuals, and we would need a graph like the body fat graph above to determine optimal ranges. Grip strength remains the most reliable test, but one would assume we must substitute gait speed for those with arthritis or other conditions that might impact hand strength.

In “Sarcopenic obesity, weight loss, and mortality: the English Longitudinal Study of Ageing” (Am J Clin Nutr. 2017 Jul;106(1):125-129 doi:10.3945/ajcn.117.152488. Epub 2017 May 24.), we see a conclusion found throughout clinical research: sarcopenia alone correlates with outcomes, and the only additional risk factor for mortality was weight loss itself!

So, these proclamations and judgements about obesity and health don’t fit the data. Interestingly, with my body fat sitting at 17%, I routinely get admonished that I should lose weight. I don’t fit their idea of a Paleo Doctor. Projections across the sea of cultural conditioning.

Live gently. Live peacefully. You do not know the history, the conditions, the trials of why that individual across from you has obesity, or smokes, or nearly anything about them until they enter your inner circle. As their friend, focus on their happiness, their wellness, and not their dress size.

Your Journey to Health and Healing,

Gary E Foresman MD