General Information

Body Mass Index (BMI)
The term BMI is often used when discussing the obesity epidemic, but what is BMI? BMI stands for Body Mass Index. It is a number that shows body weight adjusted for height. BMI can be calculated with simple math using inches and pounds, or meters and kilograms. For adults aged 20 years or older, BMI falls into one of these categories: underweight, normal, overweight, or obese.

BMI
Weight Status
Below 18.5
Underweight
18.5 - 24.9
Normal
20.5 - 29.9
Overweight
30.0 and Above
Obese

BMI correlates with body fat. The relation between fatness and BMI differs with age and gender. For example, women are more likely to have a higher percent of body fat than men for the same BMI. On average, older people may have more body fat than younger adults with the same BMI.

The BMI ranges are based on the effect body weight has on disease and death. As BMI increases, the risk for some disease increases. Some common conditions related to overweight and obesity include:

Premature death
Cardiovascular disease
High blood pressure
Osteoarthritis
Some cancers
Diabetes

English BMI Formula
Body Mass Index can be calculated using pounds and inches with this equation:

BMI = (
Weight in Pounds
) x 703
(Height in inches) x (Height in inches)

For example, a person who weighs 220 pounds and is 6 feet 3 inches tall has a BMI of 27.5.

BMI = (
220 Pounds
) x 703 = 27.5
(75 inches) x (75 inches)

BMI is not the only indicator of health risk. BMI is just one of many factors related to developing a chronic disease (such as heart disease, cancer, or diabetes). Other factors that may be important to look at when assessing your risk for chronic disease include:

 Diet
Physical Activity
Waist Circumference
Blood Pressure
Blood Sugar Level
Cholesterol Level
Family History of disease

Overweight and Obesity Among Adults
In the United States, obesity has risen at an epidemic rate during the past 20 years. One of the national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15%. Research indicates that the situation is worsening rather than improving.

Recent results of the National Health and Nutrition Examination Survey (NHANES) 1999 indicate that an estimated 61 percent of U.S. adults are either overweight or obese, defined as having a body mass index (BMI) of 25 or more.
Among U.S. adults aged 20-74 years, the prevalence of overweight (defined as BMI 25.0–29.9) has increased an estimated 2 percent since 1980, increasing from 33 percent to the 35 percent of the population in 1999 (based on NHANES II and NHANES 1999 data).
In the same population, obesity (defined as BMI greater than or equal to 30.0) has nearly doubled from approximately 15 percent in 1980 to an estimated 27 percent in 1999.

Overweight refers to increased body weight in relation to height, when compared to some standard of acceptable or desirable weight. Overweight may or may not be due to increases in body fat. It may also be due to an increase in lean muscle. For example, professional athletes may be very lean and muscular, with very little body fat, yet they may weigh more than others of the same height. While they may qualify as "overweight" due to their large muscle mass, they are not necessarily "over fat," regardless of BMI.

Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. The amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits. Body fat distribution can be estimated by skinfold measures, waist-to-hip circumference ratios, or techniques such as ultrasound, computed tomography, or magnetic resonance imaging.

According to the NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, all adults (aged 18 years or older) who have a BMI of 25 or more are considered at risk for premature death and disability as a consequence of overweight and obesity. These health risks increase even more as the severity of an individual's obesity increases.

Waist Circumference
Waist circumference is a common measure used to assess abdominal fat content. The presence of excess body fat in the abdomen, when out of proportion to total body fat, is considered an independent predictor of risk factors and ailments associated with obesity.

Undesirable waist circumferences differ for men and women:
Men are at risk when they have a waist measurement greater than 40 inches (102 cm)
Women are at risk when they have a waist measurement greater than 35 inches (88cm)

If a person has short stature (under 5 feet in height) or has a BMI of 35 or above, waist circumference standards used for the general population may not apply.

Waist-to-Hip Ratio (WHR)
Waist-to-hip ratio (WHR) is the ratio of a person's waist circumference to hip circumference, mathematically calculated as the waist circumference divided by the hip circumference. For most people, carrying extra weight around their middle increases health risks more than carrying extra weight around their hips or thighs. Overall obesity is still more risky than body fat storage locations or waist-to-hip ratio.

For both men and women, a waist-to-hip ratio of 1.0 or higher is considered "at risk" or in the danger zone for undesirable health consequences, such as heart disease and other ailments connected with being overweight. For men, a ratio of .90 or less is considered safe. For women, a ratio of .80 or less is considered safe.

How to measure waist circumference:
With a tape measure, comfortably measure the distance around the smallest area below the rib cage and above the umbilicus (belly button.)

How to measure hip circumference:
With a tape measure, comfortably measure the distance around the largest extension of the buttocks.
(Source: United States Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, July 2003 Update)

Overweight and Obesity: A Vision for the Future
The Surgeon General identifies the following 15 activities as national priorities for immediate action. Individuals, families, communities, schools, worksites, health care, media, industry, organizations, and government must determine their role and take action to prevent and decrease overweight and obesity.

Communication
The Nation must take an informed, sensitive approach to communicate with and educate the American people about health issues related to overweight and obesity. Everyone must work together to:

 Change the perception of overweight and obesity at all ages. The primary concern should be one of health and not appearance.
Educate all expectant parents about the many benefits of breastfeeding. Breastfed infants may be less likely to become overweight as they grow older. Mothers who breastfeed may return to pre-pregnancy weight more quickly.
Educate health care providers and health profession students in the prevention and treatment of overweight and obesity across the lifespan.
Provide culturally appropriate education in schools and communities about healthy eating habits and regular physical activity, based on the Dietary Guidelines for Americans, for people of all ages. Emphasize the consumer's role in making wise food and physical activity choices.

Action
The Nation must take action to assist Americans in balancing healthful eating with regular physical activity. Individuals and groups across all settings must work in concert to:

 Ensure daily, quality physical education in all school grades. Such education can develop the knowledge, attitudes, skills, behaviors, and confidence needed to be physically active for life.
Reduce time spent watching television and in other similar sedentary behaviors.
Build physical activity into regular routines and playtime for children and their families. Ensure that adults get at least 30 minutes of moderate physical activity on most days of the week. Children should aim for at least 60 minutes.
Create more opportunities for physical activity at worksites. Encourage all employers to make facilities and opportunities available for physical activity for all employees.
Make community facilities available and accessible for physical activity for all people, including the elderly.
Promote healthier food choices, including at least 5 servings of fruits and vegetables each day, and reasonable portion sizes at home, in schools, at worksites, and in communities.
Create mechanisms for appropriate reimbursement for the prevention and treatment of overweight and obesity.

Ensure that schools provide healthful foods and beverages on school campuses and at school events by:

Enforcing existing U.S. Department of Agriculture regulations that prohibit serving foods of minimal nutritional value during mealtimes in school food service areas, including in vending machines.
Adopting policies specifying that all foods and beverages available at school contribute toward eating patterns that are consistent with the Dietary Guidelines for Americans.
Providing more food options that are low in fat, calories, and added sugars such as fruits, vegetables, whole grains, and low fat or nonfat dairy foods.
Reducing access to foods high in fat, calories, and added sugars and to excessive portion sizes.

Research and Evaluation
The Nation must invest in research that improves our understanding of the causes, prevention, and treatment of overweight and obesity. A concerted effort should be made to:

 Increase research on behavioral and environmental causes of overweight and obesity.
Increase research and evaluation on prevention and treatment interventions for overweight and obesity and develop and disseminate best practice guidelines.
Increase research on disparities in the prevalence of overweight and obesity among racial and ethnic, gender, socioeconomic, and age groups and use this research to identify effective and culturally appropriate interventions.
(Source: The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, 2002)

New Super CitriMax® Study Reveals Surprising New Results
In the most comprehensive clinical study ever conducted on (–)hydroxycitric acid (HCA), researchers at Georgetown University Medical Center confirmed its effectiveness in the battle against obesity. HCA has been sold as a safe, all-natural diet ingredient for years, however, results have been inconsistent, and thus, unreliable. The new study explored using higher doses of a more bioavailable form of HCA bound to the minerals calcium and potassium called Super CitriMax®, and found that overweight people not only experienced significant weight loss, but increased fat burning, lowered cholesterol, increased beneficial HDL cholesterol and decreased Body Mass Index (BMI), an indicator of obesity health risk. The eight-week randomized, double blind, placebo-controlled human clinical trial also revealed surprising new results: Super CitriMax significantly increased serum serotonin levels (a mechanism of appetite control and eating behavior) and lowered serum leptin levels, a biomarker of the gene that regulates obesity.

The study’s 90 human volunteers received either 1) placebo, 2) Super CitriMax, or 3) a combination of Super CitriMax plus niacin-bound chromium as ChromeMate® and a standardized Gymnema sylvestre extract (patent-pending formula). The supplements were administered daily in three divided doses 30-60 minutes before meals. All three groups were placed on a diet of 2,000 calories per day and participated in a 30-minute supervised walking program, five days a week. Results were as follows:
Study Parameter
Placebo

Super CitriMax®
Full Strength
Super CitriMax® Full Strength Formula
Pounds Lost
3 lbs
(1.6%)
12 lbs
(6.2%)
15 lbs
(7.8%)
Appetite Reduction (percent of food left uneaten daily)
3.3%
15.3%
20.7%
Body Mass Index (obesity health risk) Reduction
-1.7%
-6.3%
-7.9%
Serum Serotonin Levels
+10.9%
+48.5%
+70.4%
Serum Leptin Levels
+1.0%
-40.0%
-42.6%
Urinary Excretion of Malondialdehyde, Formaldehyde, Acetaldehyde and Acetone (fat “burning” metabolites)
No significant changes
+25% to
158%
+46% to
181%
Total Cholesterol
-0.8%
-6.3%
-9.7%
LDL (bad) Cholesterol
-0.8%
-12.3%
-19.0%
Triglycerides
-0.0%
-8.6%
-19%
HDL (good) Cholesterol
-3.3%
+10.7%
+20.7%

Results of the study were presented at the Harvard Medical School Conference on Complementary Alternative and Integrative Medicine Research on April 12, 2002 and the Federation of American Societies for Experimental Biology (FASEB) meeting on April 23.

Dr. Harry G. Preuss, M.D. of Georgetown University, who made the presentations noted, “While we have known for some time that HCA held significant promise in the treatment of obesity, this study, utilizing optimal doses of Super CitriMax®, marks the first time that such a comprehensive, well-monitored clinical study has definitively confirmed its effectiveness in human subjects.  Furthermore, its long-term safety opens the door to the possibility that Super CitriMax may be a valuable tool for long-term weight maintenance, one of the biggest challenges in the fight against obesity.”
(Source: InterHealth Nutraceuticals, Inc., May 2002)