Opinion: The Quetelet-index

POSTED: 01/31/12 12:52 PM

The number of people with big bellies is increasing. A survey by the Dutch national Institute for public health and environment RIVM shows that 60 percent of men and 44 percent of women between the ages of 30 and 70 are overweight. Fifteen years ago the institute did a similar survey; at that time almost half of the men and a third of the women were overweight.
Overweight and obesity also captured the attention of the Netherlands Antilles in the past. In 2009 Pedro Atacho (then president of the Netherlands Antillean parliament) said that 63 percent of the Antillean population was overweight.
Atacho pushed for action in the form of fitness programs and diets rich in fruit and vegetables. Predictably, no action was taken, at least not in St. Maarten. And still, the issue warrants serious attention. Doing nothing, Atacho pointed out already three years ago, will lead to skyrocketing healthcare costs, a lower life expectancy and lower productivity.
The Dutch survey showed that 27 percent of the men had a belly girth of more than 102 centimeters; 39 percent of the women had a belly girth of more than 88 centimeters. Especially among women in the 30-39 age category excessive belly fat has increased. In the mid-nineties 15 percent of women were too fat, now it’s 26 percent.
Furthermore, 13 percent of the men and 14 percent of the women between 30 and 70 years of age are obese.
The Belgian statistician Adolphe Quetelet developed already in the 1800s a formula to determine whether people were too fat. This so-called Quetelet-index is now known as the BMI, or body mass indicator.
The formula is simple: body weight : (body length x body length) = BMI. The weight is expressed in kilos, the length in meters (for instance 1.93).
A body mass index between 18.5 and 24.9 indicates normal weight. Below 18.5 is underweight, between 25 and 29.9 is overweight, and with a BMI from 30 and higher one is considered obese.
There are also plenty of BMI-calculators available on line, so figuring out one’s situation is really a piece of cake.
How bad is the situation in St. Maarten and how does this affect people’s lives, how does it burden the healthcare system and how does it affect productivity and therefore the economy? The answers to these questions are predictable: like in many other fields, there are no data, or not sufficient data, available. That’s okay because the answer is staring us in the face every day. In the streets, in offices, on the Boardwalk, wherever you go there are people carrying a load they don’t need. That there is a need for action is obvious. But who will take the initiative? It is easy to point to our minister of public health, or maybe to our minister of sports.
Sure, they could come up with a plan. Unfortunately, we are very good at making plans, and very weak at executing them. We don’t have to bring in the ring road or the new government administration building to make this point.
It is therefore up to individual citizens to take action. After all, overweight and obesity affect individual lives. It cannot be comfortable to run around all day with a bulky belly. Ask Bobby Velasquez, to name just one example. Indulge less and move more seems to be a sensible approach.
Psychiatrist Bram Bakker attacked the medical profession for its lackluster approach when it comes to overweight and obesity. He suspects that this approach is inspired by huge financial interests of the pharmaceutical industry. It would not surprise us a bit if this were true.
Bakker expressed his amazement in the Volkskrant yesterday about a statement by a pediatrician who claimed that overweight has a lot to do with hereditary predisposition. Bakker says that the increase in overweight and obese people can only be explained from changed circumstances.
Without predisposition one may not become overweight or obese, but without eating too much or not moving enough neither, Bakker reasons. Predisposition means nothing without aggravating circumstances. Many people are predisposed to become addicted to heroin, but as long as they don’t touch the stuff they won’t ever realize this, the psychiatrist wrote.
Bakker points to attention deficit hyperactivity disorder (ADHD) and to attention deficit disorder (ADD). First, Bakker notes, ADHD occurred among children, later it turned out that adults also suffer from it. This development was inspired by the pharmaceutical industry that was looking for new markets for its products.
Bakker wrote that there is a link between ADD and overweight, but that this link has hardly been researched. It’s time for a different approach, he wrote, because the current initiatives don’t work. He introduced a new diagnosis in his opinion piece: ADHypoD – not enough attention, and not enough exercise. There is no pill on the market to cure this.
But the running therapy would work, Bakker smirks, suggesting entering running therapists into the healthcare insurance system. Not surprisingly, Bakker authored a book entitled Exercise for Beginners, together with Koen de Jong. It’s a simple concept that favors exercise over medication, and it calls on people’s individual responsibility for their health.
It’s about time that the health authorities in St. Maarten wake up to this idea and act upon it.

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