Pittsburgh IBW Center

                           Pittsburgh IBW Center

                        Ideal Body Weight by Anthropometry
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                                                      Dr. Ode

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1- Introduction

2- Theoretical Principle of the Method
3- The Method
4- Essential Definitions
5- Frequent Questions Asked (FQA)
6- How to Measure the fixed Landmarks on the Skeleton
7- Instruments used for the Measurements
8- Warnings
9- Data to be Submitted for the Anthropometric Evaluation
10- Agreement to be signed for the Anthropemetric Evaluation
11- Examples of the Anthropometric Evaluation

 

I-Introduction :

The concept of Ideal Body Weight has never been formulated nor defined. In 1871, the French surgeon Dr. P.P. Broca advanced this formula for calculating the ideal body weight of a man or woman :

   Weight (kg) =  Height (cm) – 100 +/- 15 % for women and 10 % for men

An unknown person translated the Broca’s formula  into pounds and inches :

   Weight = 100 lbs for first 5 feet and 5 lbs for each additional inch for women

   Weight =  110 lbs for first 5 feet and 5 lbs for each additional inch for men

In 1941 and 1942, the Metropolitan Insurance Company published two Height and Weight Tables of people with the longest longevity among the five million men and women insured with the company by using the terms “Ideal Body Weight” without definition of the terms. The heavy criticisms made the company change the name to “Desirable” then to simply “Height and Weight Tables”.

In 1987, Dr. De Nguyen and James J. Reilly, Jr. at the University of Pittsburgh, Pennsylvania offered a definition of the terms “Ideal Body Weight” and conceptually formulated the Anthropometric Method for calculating an individual ideal body weight.

II-Thereotical Principle of The Method :

The function of a man and a car is similar in many physical aspects. An engineer who builds a car, has to determine the total weight it can carry, so he can build an engine which is powerful enough to move the car safely and to last long. The engineer uses good material to build the car body which can support the total weight and assure its quality. In human being, the skeleton represents the car body. It can support the total body weight The heart is comparable to the engine which supplies blood nutrients for the metabolic requirements of all the tissues in the body in all circumstances in the life of a man. The Creator is the perfect engineer who has inscribed genes in every man and woman at the conception to assure their good health. These genes check the balance between the skeletal size (or body weight) and the heart function. Any excess of body weight by the violation of the human being will end up in diseases such as heart failure, arthritis and diabetes mellitus. Dr. De Nguyen and Dr. James J. Reilly, Jr. at the University of Pittsburgh, Pennsylvania have deciphered the health secrets of the Creator who has inscribed these genes in the people. They designed a mathematical method based on the fixed landmarks of the human skeleton to calculate the ideal body weight which would maintain the balance between the heart function and the body weight  to ensure the good health of the individual.

III- The Method :

Dr. De Nguyen and Dr. James J. Reilly, Jr. assimilate the whole human body and its arm to two cylinders of diameter D and d. They came up with the formula to calculate an individual ideal body weight :

                                                                        C

                                                    IBW   =  k.--- . H            (1).

                                                                        L

 IBW  =  Ideal Body Weight of the individual; H  =  Hight of the individual; L  =  Length of the arm; C  =  Ideal Mid-Arm Circumference; D = Distance between two lateral ends of the clavicles (not seen in the formula).   k  =  System of coefficient of proportionality between the cylinder of whole body and that of the arm (Fig.1 and Fig.2).   

            Figure 1: Human body and Arm assimilated to two cylinders of diameter D and d.

                           Figure 2 : Mathematical representation of the human body and arm.

IV- Some Essential Definitions :

The concept of the theoretical principle of the method was based on our definition of the Ideal Body Weight which could maintain the good health of men and women during their life span in all daily circumstances and/or emergency activities.

 1- Ideal Body Weight (IBW) :

They define Ideal Body Weight as the best body weight of a man or woman which could prevent any significant physical and/or emotional damages to his or her health in all daily circumstances and/or emergency activities during his or her life span. You can call it simply the Healthy Weight

 2- Actual Body Fat (BF) :

It is the fat content in our whole body. It is increased in old age because of elderly inactivity. The body fat is only an estimate.

 3- Ideal Body Fat (iBF) :

Ideal Body Fat is the healthiest  amount of body fat which each man or woman could have at different age and sex.

 4- Lean Body Mass (LBM) :

It is the weight of muscles mass and bones in our body without fat. It is also an estimate. It permits to differentiate the Overweight from the Obesity.

 5- Ideal Lean Body Mass (iLBM) :

It is the healthiest amount of weight of bones and muscle mass which each man or woman could have to avoid serious damages to human body and mind.

6- Frame Size (FS) :

It is the width of our body  measured by the distance D between two lateral ends of the clavicles (collar bones). It is mathematically proven that the greater D is, the heavier the body weight. Our research study found that the majority of women have more small and medium frame sizes than men. Much less women have a large frame size.

7- Ideal Mid-Arm Muscle Circumference :

The Ideal Mid-Arm Muscle Circumference (C) is established based on the mathematical relationship among the measured Height (H) of the individual, Length (L) of the Arm , and the distance (D) between the lateral ends of both clavicles (collar bones). It permits to calculate the ideal body weight by the formula (1).

8- Mid-Arm Muscle Circumference :

The Mid-Arm Muscle Circumference is the measured Mid-Arm Muscle Circumference at the mid-section of the arm when the arm forms a 90 degree with the forearm in a relaxed position. It permits to calculate the Lean Body Mass of the whole body (without fat) by replacing the ideal Mid-Arm Circumference by the measured Mid-Arm Muscle Circumference in the formula (1). The Lean Body Mass is also an estimate.  

V- Frequent Questions Asked (FQA) :

Q1: Was the research study published in any magazine? If yes, please, tell us so.
A1: Their research study was published in the Journal of Parenteral and Oral Nutrition (JPEN, Vol,11, No,3, May/June 1987).

Q2: What the method can do?
A2: The method calculates your individualized ideal body weight, body fat, ideal body fat, lean body mass, age-related healthy weight in the elderly population : The elderly people usually have more body fat and less muscle mass because of their lack of exercises. It is to notice that the Metropolitan Height and Weight Tables which give you a class of average body weights particular to a group of weight at a certain height level associated with an assumed frame size (the frame size is illusively defined). It is not your individualized body weight.

Q3: What the method can do but others can not?
A3: The method is applicable to both normal and sick people (such as patients having  liver cirrhosis with severe malnutrition and abundant ascites). It can tell Obesity from Overweight and Undernutrition from Fluid Retention. Just a few examples. The Height and Weight Tables of the Metropolitan Company is applicable only to normal people. Your height and sex are required . The frame size in the Metropolitan Company Height and Weight Tables is highly subjective and elusive. The range of body weight is statistically determined for a group of people of the same height and assumed frame size.

Q4: How do the method determine the frame size?
A4: Your frame size is determined by the D distance between two lateral ends of the collar bones. If it is less than 34 cm, you have a small frame. If it is more than 38 cm, you have a large frame. The medium size has the values between 34 cm and 38 cm.

Q5: How accurate is the method?
A5: The method is mathematically accurate, scientific, and tested. However, its accuracy is strongly dependable on your measurements - in another term - its accuracy depends on the accuracy of your measurements.

Q6: Can I calculate my ideal body weight by myself?
A6: No. The formula is simple, but the calculation and interpretation are complex. You do not see the distance D in the formula. But the method can not work without the D distance (frame size). You do not know the values of the coefficient system neither. But this coefficient system is one of the main part of the formula obtained by research data. Medical knowledge is needed. It is the greatest difference between our method and all other methods. You need only Height and Sex to determine your desirable weight given by the Height and Weight Tables of the Metropolitan Company. Our method needs more information than those.

Q7: Could the method lead to a diagnosis like pure Overweight or pure Obesity?
A7: YES. It can calculate your body fat and lean body mass separately, so the authors of the method have a program which determines the diagnoses.

Q8: What else the method can accomplish?
A8: The method helps to evaluate your whole nutritional status beside calculating your ideal body weight, body fat, lean body mass, ideal body fat, and frame size.  

Q9: Can the method predict diseases which may be caused by the excess of body weight?
A9: YES. Human being was born with a balance between the body weight and the capacity of the heart which pumps blood to feed all the tissues. The more people put on weight, the more they have blood volume in their vascular system which may exceed the capacity of their heart. By struggling to pump blood to feed tissues, the heart become bigger and bigger (first hypertrophy), finally it dilates and fails. The heart failure ensues.

The excess of body weight may cause the pancreas to fail to secrete enough insulin to control the blood sugar. The diabetes mellitus develops.

The excess of body weight causes a wear-and-tear effect on the articulations. The arthropathy (diseases of the articulations) develops.

VI- How to Measure The Fixed Landmarks on The Skeleton :

1- The Hight (H) of the individual is measured without shoes in centimeters/inches in relaxed standing position.

2- The Body Weight (W) is measured without shoes and in light clothes in the morning before eating or drinking in kilograms/pounds.

3- The Distance (D) between two lateral ends of the two clavicles is measured in centimeters/inches with the Straight Ruler in figure (5) from the lateral end of the right clavicle to the lateral end of the left clavicle. The individual should be in a relaxed standing position. The two prongs of the ruler is to avoid the convexity of the chest.

4- The Length (L) of the arm is measured in centimeters/inches from the upper end of the Humerus to its lower end with the Straight Ruler  when the arm forms a right angle (90 degree) with the ipsilateral (same side) Radius of the forearm in a relaxed standing position (Fig. 3).

      Figure 3 : The Humerus forms an angle 90 degree with the Radius of the forearm.

5- The Mid-Arm Muscle Circumsference is measured in centimeters/inches by a Flexible Ruler which tightens the mid-portion of the arm  while we pinch the Skin Fold just below the triceps at that site a Skinfold Caliper (ENRICH) is applied to measure the Skin fold thickness . We then add the circumsference around the mid-portion of the arm to the skin fold thickness which is the value of the Mid-Arm Muscle Circumsference (Fig.4).

                       

Figure 5 : Mid-Arm Muscle Circumference.

5- To calculate the age- and sex-related body fat, ideal body fat, and ideal lean body mass, we need your age and gender for our equations.

 6- We need also know whether you actually have edema of your extremities or face and ascites (free fluids in your peritoneal cavity).

VII- Instruments Used for Measurements :

Here are the necessary instruments for accurate measurements : scale, straight ruler for the Height (H) and Distance (D) between the two ends of the clavicles and the Length (L) of the Arm, and  flexible ruler for measurement of the Mid-Arm Muscle Circumsference, Adipometer (Skinfold Caliper ENRICH), and  pencils.

           Figure 5 : Straight Ruler for measuring the Distance D and Length of the Arm.

          

                        Figure 6 : Adipometer (Skinfold Caliper ENRICH) + Flexible Ruler.

VIII- WARNINGS :

 1-At the time being, there is no method which could measure or calculate the living human body fat or lean body mass accurately, so our method can calculate an estimate of body fat and lean body mass only.

 2-As mentioned above, the method is mathematically accurate. But its accuracy strongly depends on your own measurements of the fixed landmarks on the human body, so you have to follow the instructions strictly. We can say “Its accuracy is your own accuracy”

3-We calculate your ideal body weight, body fat, lean body mass, and frame size, which are based on your submitted measurements. The results of this anthropometric evaluation are for your information only. Consult your doctor if this method is good for you. We do not manage your body weight.    

5-The medical sciences teach us that all foods (carbohydrates, proteins and fat) have different caloric values : one gram of carbohydrate (bread, rice..) have 4 calories. Each gram of protein (meats, eggs…) has 4 calories. Each gram of fat has 9 calories. All carbohydrates, proteins, and fat enter our body, go through the Krebs cycle, and are transformed all into glucose and energy under the form ATP (Adenosine TriPhosphate).  

IX- Data to Be Submitted for Anthropometric Evaluation :

 We need the following data to calculate your ideal body weight, actual body fat (aBF), actual lean muscle mass (aLBM), ideal body fat (iBF), ideal lean body mass (iLBM), and frame size :

   1- Date of measurement : ………………

   2- Age = ____
   3- Sex =  Male = _______ ;  Female = _______
   4- Edema : Yes ____ , No ____ . Ascites: Yes ___ , No ___ .
   5- Height (H) = _____________ cm/inches.
   6- Actual body weight (W) = _______________ kg/pounds.
   7- Length of the arm (L) = _____________  cm/inches.    
   8- Distance between two ends of the clavicles (D) = ___________ cm/inches. 

Note : You are offered two (2) first free Anthropometric Evaluations which take place one now and another in three or six months. It will take 2-3 weeks to have the results of the anthropometric evaluations.

X-EXAMPLES OF ANTHRPOMETRIC EVALUATION :

1- Case 1 :

A 18 years old female student has an actual Body Weight = 60,5 kg, Height = 150,5 cm, Distance between the shoulders D = 31,8 cm, Length of her arm L = 30,1 cm, Mid-Arm muscle circumference C = 25,8 cm. She does not have edema nor ascites.

Results :

Her Ideal Body Weight is :  IBW =  51,6 kg or 113,6 lbs.
Her actual Body Fat is : aBF =  23 %.
Her actual Lean Body Mass is : aLBM = 46,6 kg or 105,5 lbs.
Her ideal Body Fat is :  iBF =  18,9 %.
Her ideal Lean Body Mass is :  iLBM   =  45,4 kg or 99,9 lbs.
Her Frame Size : SMALL ( D is less than 34 cm).
Her Nutrition Index is : 17,2 %
The nutritional diagnosis :  NORMAL WEIGHT .

2- Case 2 :


A 35 y/o Woman  has her actual Body Weight W =  60,9 kg, Height =  162 cm, Distance between the shoulders D =  31,5 cm, Length of the arm  L =  33,1 cm and Mid-Arm muscle circumference C =  25 cm. She does not have edema nor ascites.    

Results :

Her Ideal Body Weight is : IBW =  59,6 kg or 131,1 lbs.
Her actual Body Fat is : aBF =  21,2 %.
Her actual Lean Body Mass is : aLBM =  48 kg or 105,6 lbs.
Her ideal Body Fat is : iBF =  24 %.
Her ideal Lean Body Mass is : iLBM =  46,5 kg or 102,2 lbs.
Her Frame Size is : SMALL (D is less than 34 cm).
Her Nutritional Index is : NI =  2,2 %.
The nutritional diagnosis is : NORMAL WEIGHT
3- Case 3 :

A 34 y/o Woman has her actual weight W =  49,3 kg, Height = 163 cm, Distance between the shoulders D =  30,8, Arm Length L =  32,3 cm. and Mid-Arm muscle circumference C =  20 cm. She does not have edema nor ascites.

Results :

Her Ideal Body Weight is : IBW =  58,2 kg or 127,7 lbs.
Her actual Body Fat is : aBF =  21,7 %.
Her actual Lean Body Mass is : aLBM =  38,6 kg or 84,9 lbs.
Her ideal Body Fat is 23,7 %.
Her ideal Lean Body Mass is : iLBM =  45,7 kg or 100,4 lbs.
Her Frame Size is : SMALL (D is less than 34 cm).
Her Nutritional Index is : NI =  -15,2 %.
The nutritional diagnosis is UNDERWEIGHT with decreased LBM.

Note : The ideal Body Fat in the cases 2 and 3 is higher than that of the case 1 : This fact shows that the human body fat increases with age (aging process and/or inactivities in the elderly population).

4- Case 4 :

A 20 y/o male has his actual weight W =  69,2 kg,  Height =  176 cm, Distance between the shoulders D =  37,5 cm, Arm Length L =  35,2 cm and Mid-Arm muscle circumference C =  35 cm. He does not have edema nor ascites.

Results :

His Ideal Body Weight is : IBW =  64 kg or 151,8 lbs.
His actual Body Fat is : aBF =  - 4,2 %.
His actual Lean Body Mass is : aLBM =  72,1 kg or 158,6 lbs.
His ideal Body Fat is : iBF =  18 %.
His ideal Lean Body Mass is : iLBM =  58,2 kg or 128 lbs.
His Frame Size is : MEDIUM (D greater than 34 cm, but less than 38 cm).
His Nutritional Index is : 0,28 %.

We noted two abnormal numbers (negative actual BF and actual LBM which is greater than his actual weight), we remeasured every thing. We found that the mid-arm muscle circumference in the completely relaxed position was 33 cm instead of 35 cm. The calculation showed :

The IBW, ideal BF, ideal Lean Body Mass were unchanged. But the actual Body Fat aBF =  1,8 % and actual Lean Body Mass =  68 kg or 149,6 lbs which is smaller than actual weight.

The error was probably due to the fact that the young man contracted his arm muscle to show how much muscle he had. It is clear that patients can not fool the mathematics.

The nutritional diagnosis is then NORMAL WEIGHT with decreased Body Fat. The decreased Body Fat is probably due to weight exercises (Body Build men).

 

5- Case 5 :

A 21y/o Male has an actual weight W = 121 kg, Height =  189 cm, Distance between the shoulders D =  45,1 cm, Arm Length L =  37,5 cm and Mid-Arm muscle circumference C =  42 cm. He does not have edema nor ascites.

Results :

His Ideal Body Weight is : IBW =  79,4 kg or 174,8 lbs.

His actual Body Fat is : aBF =  24 %.

His actual Lean Body Mass is : aLBM =  92 kg or 202,4 lbs.

His ideal Body Fat is : iBF =  18,2 %.

His ideal Lean Body Mass is : iLBM =  66,6 kg or 146 lbs.

His Frame Size is : LARGE (D greater than 38 cm).

His Nutritional Index is : NI =  52,3 %.

The nutritional diagnosis is NORMAL WEIGHT.