Whether your goal is to lose weight (body fat), gain weight (lean muscle), or to just maintain your current weight, knowing your BMR and BMI can help you attain and maintain your goals. The two are closely related – the higher the BMI, the higher the BMR tends to be and you can work both of them out here.

BMR
(Basal Metabolic Rate)

Your BMR is the number of calories your body burns at rest to do basic functions like breathing, digesting, keeping your heart beating and all the other physiological tasks that keep you alive. Your BMR is partly determined by genetics, but other factors, like your body composition and activity level, may also have an effect on your BMR. Your BMR, however, will decrease as you age. As we get older, our metabolisms naturally slow, making it harder for us to eat whatever we want and still be skinny.

There are equations used to determine your BMR, and they differ based on whether you’re a man or a woman. A woman can determine her BMR by plugging her stats into the Harris-Benedict equation: 655 + (4.35 x weight in pounds) + (4.7 x height in inches) – (4.7 x age in years). The equation for a man to calculate his BMR is as follows: 66 + (6.23 x weight in pounds) + (12.7 x height in inches) – (6.8 x age in years).

Several factors affect your basal metabolic rate — and body fat composition is one of them. Those with more muscle mass tend to burn more calories at rest because muscle tissue requires more calories to maintain than fat tissue. Although BMI and BMR are not directly related, if you have a high BMI because of a high body fat percentage, your BMR may be lower. If you have a high BMI because of a large amount of muscle mass, your BMR may be increased. Additionally, if you are overweight, but very active, that doesn’t mean you’ll necessarily have a low BMR.

BMI and BMR are guidelines that allow nutrition and medical professionals to make educated determinations about your body composition and calorie burn, but every person should still be viewed individually. Check with your doctor or a dietitian to if you have questions about your own BMI and BMR. (livestrong.com)

BMI
(Body Mass Index)

Your BMI is an indirect measure of your body composition — or how much body fat you have. Although BMI doesn’t measure body fat directly, it uses your weight and height to determine whether you’re classified as underweight, normal weight, overweight or obese. This measurement correlates moderately well with other measurements of body fat such as skin fold measurements and underwater weighing, according to the Centers for Disease Control and Prevention. Actual BMI will change as you lose or gain weight and muscle.

BMI is measured by dividing your weight in pounds by the square of your height in inches, then multiplying by 703. The equation looks like this: BMI = (weight / height x height) x 703.

If you’re a woman who is 125 pounds and 5 feet 4 inches, your BMI = (125 / 64 x 64) x 703 = 21.4. This BMI puts you in the normal weight range.

A BMI below 18.5 indicates that you’re underweight; a BMI between 18.5 and 24.9 classifies you as a normal weight; a BMI between 25 and 29.9 puts you in the overweight category; a BMI of 30 or above classifies you as obese.

Because it’s not a direct measurement, BMI is only used as a screening tool and is not considered a diagnostic test. There are also some limitations to this measurement. Because BMI uses only height and weight, it doesn’t account for people who may be of below-average height but above-average muscle mass, like bodybuilders. If a man has a lot of muscle, which is denser than fat, his BMI may categorize him as overweight, when her weight is actually healthy.

BMI also doesn’t adjust for age or gender. Women naturally have more body fat than men, and older people tend to have more body fat than younger people. So a sedentary older woman with low muscle mass may be overly fat, even though she has a normal BMI. (livestrong.com)

BMI male BMI female
underweight below 20 under 19
Normal weight 20-25 19-24
overweight 26-30 25-30
obesity 31-40 31-40
strong obesity greater than 40 greater than 40

Cholesterol
is a waxy substance which is made in the body by the liver but is also found in some foods. It plays a vital role in how every cell works and is also needed to make Vitamin D, some hormones and bile for digestion. However, too much cholesterol in the blood can increase your risk of getting heart and circulatory diseases.

Cholesterol is carried in the blood attached to proteins called lipoproteins. There are two main forms, LDL (low density lipoprotein) and HDL (high density lipoprotein). LDL cholesterol is often referred to as “bad cholesterol” because too much is unhealthy. HDL is often referred to as “good cholesterol” because it is protective. Knowing your levels of these can help explain your risk of heart disease. Your doctor should be able to tell you your levels of “good” and “bad” cholesterol.

Raised or unhealthy patterns of blood cholesterol affect many people. Many factors play a part including:

• the genes you inherit from your parents
• your diet and lifestyle
• your weight
• whether you are male or female
• your age
• your ethnicity
• your medical history

Having unhealthy cholesterol levels alongside other risk factors for heart and circulatory disease such as smoking or high blood pressure can put you at very high risk of early heart disease. (heartuk.org.uk)

Cholesterol levels should be measured at least once every five years in everyone over age 20. The screening test that is usually performed is a blood test called a lipid profile. Experts recommend that men ages 35 and older and women ages 45 and older be more frequently screened for lipid disorders. The lipoprotein profile includes:

• Total cholesterol
• LDL (low-density lipoprotein cholesterol, also called “bad”cholesterol)
• HDL (high-density lipoprotein cholesterol, also called “good” cholesterol)

HDL

HDL (High density lipoprotein) cholesterol is usually nicknamed “the good cholesterol” because high blood levels are associated with less risk of heart disease and low levels are associated with increased risk.
In other words; there is an inverse relationship between HDL cholesterol and the risk of heart disease. It is believed that HDL’s act as scavengers, picking up excess cholesterol in the blood and transporting it to the liver where it’s broken down.

High levels of LDL cholesterol are associated with increased risk of heart disease, but high levels of HDL cholesterol are associated with low risk. HDL particles seem to be involved in clearing and removing cholesterol from arteries and atherosclerotic plaques while LDL particles appear directly involved in the atherosclerotic process.

It is important to understand that measurements of HDL cholesterol only provide information about the amount of cholesterol carried by HDL particles. HDL particles differ in size and function, and there are many types, both small and large.

HDL particle number can be measured by NMR (Nuclear Magnetic Resonance). Studies have shown that such measurements are more strongly associated with atherosclerosis than measurements of HDL cholesterol.

Recent studies have shown that simple measurements of HDL cholesterol may not always reflect HDL function. Thus, there is growing evidence that HDL function may sometimes be impaired although measurements of HDL cholesterol are normal. Therefore, measuring HDL cholesterol may not be the best method to assess HDL function.
Although incomplete, HDL cholesterol is still the most widely used measurement to assess HDL.

Other metrics that are currently being tested include HDL particle number, average HDL size, specific HDL subclasses, and HDL functional properties.

An inverse relationship exists between HDL cholesterol and the development of coronary artery disease. In other words, high levels are associated with low risk of heart disease, and low levels are linked to high risk.
Based on data from the Framingham Heart Study the risk of heart attack increases about 25 percent for every 5 mg/dl (0.13 mmol/L) decrement in blood levels of HDL cholesterol. However, whether HDL cholesterol is a causal risk factor or merely a marker of risk is still intensely debated.

The most widely accepted hypothesis regarding the protective properties of HDL when it comes to atherosclerosis is that it promotes the uptake of cholesterol from tissues, including the vascular wall, and returns the cholesterol to the liver from where it is excreted. This process is often termed “reverse cholesterol transport”.

It has also been postulated that HDL’s may promote normal function of the endothelium, the innermost layer of the arteries. Furthermore, HDL’s may reduce inflammation, protect against oxidation of LDL, and positively affect blood clotting (thrombosis).

The table below shows the reference values;

HDL cholesterol (mg/dL)
(U.S. and some other countries)
HDL cholesterol (mmol/L
(Canada and most of Europe)
Below 40 mg/dL (men)
Below 50 mg/dL (women)
Below 1.0 mmol/L (men)
Below 1.3 mmol/L (women)
Too Low
40-49 mg/dL (men)
50-59 mg/dL (women)
1-1.3 mmol/L (men)
1.3-1.5 mmol/L (women)
Acceptable
60 mg/dL and above 1.6 mmol/L and above Very good

Levels above 60 mg/dl (1.6 mmol/L) are associated with low risk of coronary heart disease. This pattern is more likely to occur in women than men.

HDL cholesterol below 40 mg/dL (1.0 mmol/L) is considered too low and appears to be an independent risk factor for coronary artery disease. Furthermore, the definition of metabolic syndrome includes low HDL cholesterol as one of the five criteria for classification. Low HDL cholesterol is one of the most common phenotypes seen in persons with premature heart disease.

HDL cholesterol in the range of 20-40 (0.5-1.0 mmol/L) may appear in isolation, but is often associated with high triglyceride concentration, insulin resistance and increased risk of type 2 diabetes. Furthermore, some drugs, such as beta-blockers may lower HDL cholesterol. Anabolic steroids can markedly reduce HDL cholesterol and should be suspected particularly in healthy young men with unexpectedly low HDL cholesterol levels.

Levels of less than 20 mg/dL (0.5 mmol/L) are uncommon and can sometimes be attributed to very high triglycerides. It may also be due to rare genetic mutations, such as Tangier disease and fish-eye disease.

Individuals with high HDL cholesterol often have large LDL particles. They are also likely to have low LDL particle number (LDL-P). LDL-P is a strong marker of risk for coronary artery disease.

Measuring apolipoprotein B or LDL-P may help to estimate risk among individuals with high levels of both LDL-and HDL cholesterol. Calculating non-HDL cholesterol may also be useful to assess risk under these circumstances. Assessing the triglyceride/HDL cholesterol ratio may provide further information.

HDL cholesterol can be influenced by lifestyle modification.

Smoking reduces HDL cholesterol and smoking cessation is associated with moderately increased levels.

Regular aerobic exercise can modestly increase HDL cholesterol. This increase is related to the frequency and intensity of physical activity, with greatest increases occurring with frequent, low-intensity exercise, such as five 30-minute sessions per week.

Obesity is associated with low HDL cholesterol levels and high triglyceride levels. A negative correlation exists between HDL cholesterol and body-mass index (BMI), meaning that HDL cholesterol tends to be lower with increasing BMI. Weight loss usually raises HDL cholesterol.

Dietary choices affect HDL cholesterol. If the intake of fat is reduced, levels of LDL- and HDL cholesterol both decline. In one study comparing calorically balanced diets, those who consumed a low-fat diet had lower HDL-cholesterol than those who were fed a high-fat diet.

Intake of saturated fats usually increases both LDL- and HDL cholesterol. Substituting monounsaturated fat for saturated fatty acids may improve the ratio between these tow subfractions of cholesterol.

Limiting intake of simple carbohydrates is usually helpful, in particular if triglycerides are elevated. This is often the case in obese people and those with metabolic syndrome.

A diet rich in n–3 polyunsaturated fatty acids (omega-3) – sources include oils (olive, canola, soy, flaxseed), nuts (almonds, peanuts, walnuts, pecans), cold-water fish (salmon, mackerel), and shellfish — with limited carbohydrates, such as those found in ready-to-eat cereals, potatoes, white bread, and snack foods, is often recommended.

Moderate alcohol consumption raises HDL cholesterol but is usually not recommended for that purpose.
Several classes of medications increase HDL cholesterol levels; these include niacin and fibrates, and, to a lesser degree, statins. With the exception of statins, drug therapy that elevates HDL cholesterol has not been shown to improve outcome or reduce the risk of coronary events. (docsopinion.com)

LDL

LDL is called low-density lipoprotein because LDL particles tend to be less dense than other kinds of cholesterol particles.

Elevated levels of LDL-C in the blood are associated with increased risk of atherosclerosis and heart disease.

There are special receptors on cell surfaces that bind LDL-C, these are called LDL-receptors. A lack of LDL-receptors may reduce the uptake of cholesterol by the cells, forcing it to remain in the circulation thereby raising blood levels.

In familial hypercholesterolemia, which is a genetic disorder, the body is unable to remove LDL from the blood. This leads to high levels of LDL-C in the blood, which may severely increase the risk of cardiovascular disease, even at a young age.

Blood tests typically report LDL-C. These numbers are usually based on calculation, using the Friedewald formula that includes total cholesterol, HDL-C, and triglycerides. This formula relies on the assumption that the ratio of triglyceride to cholesterol is constant, which is not always the case.

Here is how LDL Cholesterol is calculated:

If mg/dl is your unit, like in the United States the formula looks like this:

LDL colesterol = [Total cholesterol]– [HDL cholesterol]– [TG]/5

If mmol/l is your unit like in Australia, Canada, and Europe the formula looks like this:

LDL cholesterol = [Total cholesterol]– [HDL cholesterol]– [TG]/2.2

Thus, LDL-C calculations may have limitations when blood triglyceride levels are either high or low. Direct LDL -C measurements are also available, but are less often done due to higher costs.

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood in the US and some other countries. Canada and most European countries measure cholesterol in millimoles (mmol) per liter (L) of blood.

Some studies show that the number of LDL particles (LDL-P) may be a better predictor of risk than LDL-C. LDL particle size may also be important when assessing risk.

It is considered important to keep cholesterol levels, especially LDL-C within certain limits. If you have other risk factors for heart disease, such as high blood pressure, diabetes, or if you smoke, keeping LDL-C low becomes even more important.

Here you can see how LDL-C levels are looked at in terms of risk:

above 190 mg/dL (4.9 mmol/L) is considered very high
160 – 189 mg/dL (4.1 – 4.9 mmol/L) is considered high
130 – 159 mg/dL (3.4 – 4.1 mmol/L) is considered borderline high
100 – 129 mg/dL (2.6 – 3.3 mmol/L) is considered near ideal
below 100 mg/dL (below 2.6 mmol/L) is considered ideal for people at risk of heart disease
below 70 mg/dL (below 1.8 mmol/L) is considered ideal for people at very high risk of heart disease

How Can You Influence Your LDL Cholesterol?

If your LDL-C is high, your doctor will probably suggest lifestyle changes. Quitting smoking will be helpful and so may eating whole grain, oatmeal, olive oil, beans, fruit, and vegetables. Most doctors will recommend eating less fat from meat and dairy products.

Regular exercise is desirable. Losing weight may be helpful.

Some studies show that low-carbohydrate diets may positively affect LDL particle size and number.

If lifestyle changes don’t help, your doctor may suggest medications that lower cholesterol. So-called statins are the most commonly used drugs for lowering cholesterol.

Studies have shown that statins improve prognosis among patients with coronary artery disease. Their role for treatment of raised LDL-C in healthy people (primary prevention) is less clear. The decision to give statins in primary prevention is usually based on other risk factors as well as the LDL-C value itself. (docsopinion.com)

BP

Taking blood pressure (BP) is important part of routine medical checkups because the high blood pressure can be an indication of the health problems of the future, like heart attack (myocardial infarction), stroke, kidney disease, dementia, etc. So, checking blood pressure is important, especially when you have been asked to do so by your physician.

Blood Pressure

is the pressure exerted by circulating blood upon the walls of blood vessels. When used without further specification, “blood pressure” usually refers to the arterial pressure in the systemic circulation. Blood pressure is usually expressed in terms of the systolic (maximum) pressure over diastolic (minimum) pressure and is measured in millimeters of mercury (mm Hg). It is one of the vital signs along with respiratory rate, heart rate, oxygen saturation, and body temperature. Normal resting systolic (diastolic) blood pressure in an adult is approximately 120 mm Hg (80 mm Hg), abbreviated “120/80 mm Hg”.

Blood pressure varies depending on situation, activity, and disease states. It is regulated by the nervous and endocrine systems. Blood pressure that is low due to a disease state is called hypotension, and pressure that is consistently high is hypertension. Both have many causes which can range from mild to severe. Both may be of sudden onset or of long duration. Long term hypertension is a risk factor for many diseases, including heart disease, stroke and kidney failure. Long term hypertension is more common than long term hypotension in Western countries. Long term hypertension often goes undetected because of infrequent monitoring and the absence of symptoms. (Excerpt from Wikipedia)

Keep in mind that certain factors can cause blood pressure to temporarily rise. Blood pressure normally rises as a result of:

• Stress
• Smoking
• Cold temperatures
• Exercise
• Caffeine
• Certain drugs

Avoid any of these factors that you can when taking your blood pressure. Also try measuring blood pressure at about the same time each day.

How the Test is Performed

Sit in a chair with your back supported. Your legs should be uncrossed, and your feet on the floor.

Your arm should be supported so that your upper arm is at heart level. Roll up your sleeve so that your arm is bare.

You or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The lower edge of the cuff should be 1 inch above the bend of your elbow.

• The cuff will be inflated quickly. This is done either by pumping the squeeze bulb or pushing a button. You will feel tightness around your arm.
• Next, the valve of the cuff is opened slightly, allowing the pressure to slowly fall.
• As the pressure falls, the reading when the sound of blood pulsing is first heard is recorded. This is the systolic pressure.
• As the air continues to be let out, the sounds will disappear. The point at which the sound stops is recorded. This is the diastolic pressure.

Inflating the cuff too slowly or not inflating it to a high enough pressure may cause a false reading. If you loosen the valve too much, you will not be able to measure your blood pressure.
The procedure may be done two or more times.

How to Prepare for the Test

Before you measure your blood pressure:

• Rest for at least 5 minutes before blood pressure is taken.
• Do not take your blood pressure when you are under stress, have had caffeine or used a tobacco in the past 30 minutes, or have exercised recently.
Take two or three readings at a sitting. Take the readings 1 minute apart. Remain seated. When checking your blood pressure outside the doctor’s office, note the time of the readings. Your health care provider may suggest that you do your readings at certain times.
• You may want to take your blood pressure in the morning and at night for a week.
• This will give you at least 12 readings and will help your health care provider make decisions about your blood pressure treatment.

How the Test will Feel

You will feel slight discomfort when the blood pressure cuff is inflated to its highest level.

Why the Test is Performed

High blood pressure has no symptoms so you may not know if you have this problem. High blood pressure is often discovered during a visit to the health care provider for another reason.
Finding high blood pressure and treating it early can help prevent heart disease, stroke, eye problems, or chronic kidney disease.

All adults should have their blood pressure checked regularly.
• Get checked every 2 years if your blood pressure was less than 120/80 mm Hg at the most recent reading.
• You should have it checked yearly if your last reading was 120 to 139/80 to 89 mm Hg.
• People with high blood pressure, diabetes, heart disease, kidney problems, or other conditions should have blood pressure checked at least every year.

Normal Results

Blood pressure readings are usually given as two numbers. For example, your heath care provider might tell you that your blood pressure is 120 over 80 (written as 120/80 mm Hg). One or both of these numbers can be too high.
Normal blood pressure is when the top number (systolic blood pressure) is below 120 most of the time, and the bottom number (diastolic blood pressure) is below 80 most of the time (written as 120/80 mm Hg).
If your blood pressure numbers are 120/80 or higher but below 140/90, it is called pre-hypertension. If you have pre-hypertension, you are more likely to develop high blood pressure.

What Abnormal Results Mean

High blood pressure (hypertension) is when the top number (systolic blood pressure) is 140 or more most of the time or the bottom number (diastolic blood pressure) is 90 or more most of the time (written as 140/90 mm Hg).
If you have diabetes, heart disease, or kidney problems, or if you had a stroke, your heath care provider may want your blood pressure to be lower.

The most commonly used blood pressure targets for people with these medical problems are below 130 to 140/80 mmHg.

Most of the time, high blood pressure does not cause symptoms.

Considerations

It is normal for your blood pressure to vary at different times of the day:
• It is usually higher when you are at work.
• It drops slightly when you are at home.
• It is usually lowest when you are sleeping.
• It is normal for your blood pressure to increase suddenly when you wake up. In people with very high blood pressure, this is when they are most at risk of a heart attack and stroke.
Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your doctor’s office.
• Make sure your home blood pressure monitor is accurate.
• Ask your health care provider to compare your home readings with those taken in the office.
Many people get nervous at the health care provider’s office and have higher readings than they have at home. This is called white coat hypertension. Home blood pressure readings can help detect this problem.

Alternative Names

Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure(medlineplus.gov)

Types of test
that help health care providers make a diagnosis of prediabetes and diabetes.

HbA1c

HbA1C (A1C or glycosylated hemoglobin test) The A1C can be used for the diagnosis of both prediabetes and diabetes. The A1C test measures your average blood glucose control for the past 2 to 3 months. This test is more convenient because no fasting is required. An A1C of 5.7% to 6.4% means that you are at high risk for the development of diabetes and you have prediabetes. Diabetes is diagnosed when the A1C is 6.5% or higher.

The HbA1c lets you see how your blood sugars have averaged over the last couple of months. Increasing HbA1c numbers may indicate a need for a change in medication, diet or activity level. Your Primary Care Physician or Specialist will evaluate this with you and come up with an action plan that will help you achieve better control of your blood sugar. (pmgcares.com)

Fasting Glucose

Fasting Blood Sugar (FBS), a Fasting Blood Glucose (FBG) and a Fasting Plasma Glucose (FPG) they are all the same thing in which a test that tells how much “sugar” (glucose) is in your blood stream before you have eaten anything. The normal range for a fasting blood sugar is below 100.

The fasting blood glucose test is the test most commonly used to diagnose diabetes. It measures blood glucose levels after a period of fasting, usually at least eight hours without food or liquid (except water). This test is more definitive than a random test, because there is no chance that it has been influenced by recent food intake.
If your fasting blood glucose level is greater than 125 mg/dL in two separate tests, then the diagnosis of diabetes is made.

The amount of glucose (“sugar”, measured in mg/dL) in your blood changes throughout the day and night. Your levels will change depending upon when, what and how much you have eaten, and whether or not you have exercised.

– A normal fasting (no food for eight hours) blood sugar level is between 70 and 99 mg/dL
– A normal blood sugar level two hours after eating is less than 140 mg/dL

The chart below contains the FPG test’s blood glucose ranges for prediabetes and diabetes and describes what each diagnosis means. (heart.org)

Blood Glucose Range Diagnosis What It Means
100 to 125 mg/dL Prediabetes (also called Impaired Fasting Glucose) Blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. This condition puts you at increased risk for developing type 2 diabetes, heart disease, and stroke.
126 mg/dL or more Diabetes mellitus (type 2 diabetes) Type 2 diabetes develops when your body doesn’t make enough insulin or develops “insulin resistance” and can’t make efficient use of the insulin it makes. It greatly increases your risk of heart disease and stroke.
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