Health Profile - theoretical background
The health profile is intended as a tool for both private and professionals. The interface is easy accessible despite the complicated and evidence-based result calculation. This article gives the background principles and references.Health can be described in many different ways. This health profile is based on variables that are related to physical health, seen as the ability to live a long life without disease and with a high degree of physical function throughout life.
Body mass index (BMI) is a recognized factor in relation to assessing risk for a number of lifestyle diseases. BMI is a valid tool when assessing risk at population base, but on an individual basis BMI will often be misleading because of differences in body type and muscle mass. In addition, a moderately increased BMI is only a limited risk factor if fitness and physical activity is high.
Waist circumference is a simple and relatively reliable measure of obesity. Waist circumference is particularly related to the dangerous fat mass surrounding the internal organs (abdominal fat, visceral fat). The disadvantage is that waist circumference does not take body build in to account. For example, it is not completely fair that a very tall person is evaluated under the same criteria as a smaller person. The usual limits used for waist circumference are relatively coarse. However, this health profile uses a newer subdivision with multiple categories (Bray 2004).
The included parameters are chosen as representative indicators for a healthy or unhealthy diet. Vegetables, fruit, fish and fibre-rich carbohydrates are recognized ingredients of a healthy diet, while sugar and industrially processed fast food are components with a negative effect. Questions about fat intake are not emphasized because fat energy ratio in itself is a debatable risk factor, especially if the fat comes from healthy sources, and the person is generally in energy balance.
Smoking is undeniable one of the most harmful thing you can do to your body body. A little smoking is bad and a lot smoking is very bad. Passive smoking has also been documented to have long-term adverse effects.
Alcohol is probably not a significant health risk in small quantities. Studies have even shown that there may be a health benefit from consumption of 1-2 drinks per day. It should be noted though, that this "benefit" only applies to older persons. For young people there are only negative consequences of alcohol consumption. Several countries recommend limits of 14 drinks per week for women and 21 drinks per week for men. Recent studies indicate that even these levels are probably pragmatic and should from a purely health perspective be lower.
Muscle strength in the upper body is not directly related to one's health in the same manner as diet and fitness, but there are studies indicating that good muscle strength early in life predicts low mortality.
Flexibility is probably the least important of the factors employed here, but nevertheless, good mobility is essential to maintain a good all-round function of the body. Though speculative, it is reasonable to assume a correlation between good overall mobility in the body's joints and the ability to maintain a healthy posture at rest and during activity, which affects the occurrence of back problems.
People with hypertension have a markedly increased risk of several serious cardiovascular diseases such as blood clots and heart failure. The general threshold for "hypertension" is a blood pressure of 140/90 mmHg, but we know that even blood pressure below this threshold are associated with increased risk. Generally studies show that the lower the blood pressure is, the less risk.
Not all elements have equal weight in the overall score. For example, it gives a low score to be a smoker, whereas having a low flexibility only gives a small deduction in score. Furthermore, it is not all tests that give a higher overall score even if you improve. For example, it is healthy to have adequate muscle strength, whereas having extremely good muscle strength is not necessarily healthier.
Risk factors and public health in Denmark
Knud Juel, Jan Sørensen og Henrik Brønnum-Hansen
The National Institute of Public Health, Denmark, June 2006
YMCA Fitness Testing and Assessment Manual
4th Edition. 2000. YMCA of the USA
Lawrence A. Golding, Phd
ACSM's guidelines for exercise testing and prescription. 7th edition
American College of Sports Medicine. Lippincott Williams & Wilkins, 2005
Physical activity – handbook on prevention and treatment
The National Board of Health, Denmark 2003
Measurement and Evaluation in Human Performance, Third Edition
James R. Morrow, Jr., Allen W. Jackson, James G. Disch, Dale P. Mood
Human Kinetics 2005
Advanced Fitness Assessment and Exercise Prescription. 5th Edition
Vivian H. Heyward
Human Kinetics 2006
Norms for Fitness, Performance, and Health
Human Kinetics 2006
New approaches to predict VO2max and endurance from running performance.
Tokmakidis SP, Léger L, Mercier D, Péronnet F, Thibault G.
Journal of Sports Medicine, 27:402, 1987.
Cureton TK Jr. Flexibility as an aspect of physical fitness. Research Quarterly Supplement 12 388-390. 1941
Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample.
Han TS, van Leer EM, Seidell JC, Lean ME.
BMJ. 1995 Nov 25;311(7017):1401-5.
Waist circumference as a screening tool for cardiovascular risk factors: evaluation of receiver operating characteristics (ROC).
Han TS, van Leer EM, Seidell JC, Lean ME.
Obes Res. 1996 Nov;4(6):533-47.
A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys.
Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G.
Int J Obes Relat Metab Disord. 2001 May;25(5):652-61.
Waist circumference and not body mass index explains obesity-related health risk
Ian Janssen, Peter T Katzmarzyk and Robert Ross
American Journal of Clinical Nutrition, Vol. 79, No. 3, 379-384, March 2004
Don't throw the baby out with the bath water.
George A Bray
American Journal of Clinical Nutrition, Vol. 79, No. 3, 347-349, March 2004