These two articles align with my thoughts on Body Mass Index--which is to say that BMI is not a useful measure of health. BMI's only advantage is that it uses the data that's easiest to obtain - everbody knows their height and weight. Unfortunately, it doesn't take weight distribution into account. BMI numbers will tell you that your 92 year-old bottom-heavy, tiny-waisted great-grandmother (with an HDL cholesterol of 117 and a triglyceride reading of 93) is just as obese as your 56 year-old skinny-legged and pot-bellied aunt (HDL 33, TG 237) and that simply isn't the case.
What really matters is not arbitrarily defined obesity but waist size corrected for frame size in men, and waist size and waist to hip ratio corrected for frame size in women. Simply put, it's good to have a small waist for men, and a small waist and bigger hips for women.
So, I've come up with my own way of measuring risk of dying, the WARM for men (Waist to Arm Ratio Measurement) and WHARM for women (Waist to Hip to Arm Ratio Measurement.) I'll use myself as an example.
My waist today is 33 1/4 inches. I measure it at its widest point around the belly button. I take my arm measurement which is the width at the bony part of the elbow with my arm bent at a 90 degree angle. (This is called the epicondyles.) I use body fat calipers to make the measurement. So that makes my WARM 33.25/2.7 = 12.3.
For women it's more complicated. Your Italian great-grandmother's WHARM with a waist of 32 inches, hips of 48 inches and an arm measurement of 2.5 inches would be the waist to arm ratio multiplied by the waist to hip ratio, or (32/2.5) X (32/48) = 8.5. Your aunt's WHARM with waist 40, hips 38, and arm 2.3 would be (40/2.3) X (40/38) = 18.3.
If you are actively trying to improve your health, whatever fitness and nutrition program you start out on, if the number drops lower as you go, you are decreasing obesity related health risks. If it stays the same or goes higher, then your health risks are increasing. It is important to note that a drop in the scale won't necessarily translate into a drop in your WARM/WHARM index.
This Japanese study shows a higher risk of mortality in the lowest quartile of BMI the underweight people, with no higher risk for "obese" BMIs. This is probably a malnutrition/cancer/chronic disease effect. I know, I'm citing a BMI study after I've been trashing BMI as a measure. I will have to come up with an adjustment factor for the risk of being underweight.
Let's say we're all 5 ft 7 in tall and we all weigh 162 lbs. That means we all have a BMI of 25. Are we all equally at risk? Who's gonna live the longest? What's the ideal WARM or WHARM? I don't know yet, but lower is probably better (up to a point.) I'll start keeping data on patients, looking at HDL, TG, LDL, cardiac CRP, and what actual diseases such as diabetes, HTN, CAD, cancer, BPH, and other diseases effected by inflammation.