What to know about body roundness index, an alternative to BMI
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(NEW YORK) — While body mass index (BMI) has long been a go-to measure of a person’s health, used by doctors and health insurers alike, a new approach is taking hold.
Body roundness index, or BRI, is gaining prominence as a way of predicting one’s health risk by taking into account more than just a person’s height and weight, which are the sole factors used to determine BMI, according to the National Institutes of Health.
Here are five questions answered about BRI and why it’s being used with increasing frequency.
1. What is body roundness index?
Body roundness index takes into account a person’s height and waist circumference to determine whether they are in a healthy or unhealthy sphere, according to Maya Feller, a registered dietitian and nutritionist.
A study published in June in JAMA Network Open described BRI as an evidence-backed tool for more accurately determining a person’s mortality risk.
2. How do I calculate my own BRI?
BRI is calculated using a mathematical formula: 364.2 − 365.5 × √(1 − [waist circumference in centimeters / 2π]2 / [0.5 × height in centimeters]2, according to the study.
There are online calculators where you can enter your height and waist and hip measurements to determine your BRI.
Once your measurements are entered, you will see a number and whether that puts you in or out of the “healthy zone.”
3. What are the criticisms of BRI?
According to Feller, one criticism of BRI is that it favors a certain body type.
“The challenge with the BRI is that it really favors more slender bodies, and it says that, okay, rounder bodies are not as ‘healthy,'” Feller said.
4. What is wrong with using BMI?
BMI is still a go-to determinant of health used by medical providers.
Some critics, though, argue that BMI does not take into account a person’s body composition because it only measures weight and height, according to Feller.
With BMI, a person is categorized as either underweight, normal weight, overweight or obese.
Last year, the American Medical Association said in a policy announcement that BMI does not account for racial, sex, age ethnic and gender diversity.
“It doesn’t take body composition into consideration,” Feller said. “So someone who’s very muscular might wrongly be put in the overweight or obese category, and that’s just not okay.”
5. What are other ways to check my health status?
Feller noted that while BRI and BMI can be useful, she recommends relying on tests that measure a person’s internal health rather than their weight or measurements.
“I always like to check the insides,” Feller said. “You can look as wonderful as you want on the outside, but what’s happening with your lipids? What’s happening with your blood pressure, your blood sugars? Those are the things that I want to see.”
(DURHAM, N.C.) — As hospitals and health care facilities work to get back up and running after Hurricane Helene slammed into Florida’s Big Bend, affecting several states, the medical supply chain could be at risk.
Baxter International, a health care and medical technology company, announced this week that it must close its largest plant in North Carolina due to flooding and destruction caused by the hurricane.
The plant, located in North Cove, 60 miles northeast of Asheville, primarily manufactures IV fluids and peritoneal dialysis solutions, according to Baxter. It is the largest manufacturer of such solutions in the U.S., employing more than 2,500 people, the company said.
“Our hearts and thoughts are with all those affected by Hurricane Helene,” José Almeida, chair, president and CEO of Baxter, said in a statement. “The safety of our employees, their families, and the communities in which we operate remains our utmost concern, and we are committed to helping ensure a reliable supply of products to patients.”
“Remediation efforts are already underway, and we will spare no resource – human or financial – to resume production and help ensure patients and providers have the products they need,” the statement continued.
Baxter said it implemented a hurricane preparedness plan ahead of Helene, which included evacuation plans for staff and moving products to higher ground or to secure storage. However, heavy rainfall and storm surge “triggered a levee breach,” which led to flooding in the facility.
Among those impacted by the Baxter plant closing is Duke University Health System (DUHS), in Durham, North Carolina, according to William Trophi, DUHS interim president vice president of supply chain.
“[Baxter has] published their action items, and they have announced to us that they’re putting a hold on all distribution for 48 hours to understand what they have in their supply line, and then they’re going to be setting up pretty strict allocations based on prior usage to make sure that everyone is getting their fair share based on their volume and their needs,” he told ABC News.
Trophi said DUHS and Duke University have not seen major disruption to their supply chain following Helene’s landfall, but notes there may be delays in the future if the Baxter plant closure lasts for several weeks, if more plants close, and depending on how long the dockworkers’ strike on the East Coast and the Gulf Coast lasts.
“What we’re doing internally is we’re looking at conservation models, so similar with our IV solutions, we’re going to look at what can we be doing differently to treat our patients in a safe, effective manner to conserve IV solutions,” he said. “And we’ll start to look at other high, critical, sensitive items that could be impacted by this, and look at what can we be doing differently to conserve the way in which we treat our patients in a safe, effective manner.”
Paul Biddinger, chief preparedness and continuity officer for the Boston-based Mass General Brigham health care system, told ABC News that facilities typically begin stockpiling and taking inventory of supplies prior to a natural disaster. After the event has happened, health care centers will work to identify what products are affected by supply chain issues and which patients are using the products.
In the case of the Baxter plant, the products are primarily used by kidney patients, cardiac patients and urologic patients, Biddinger said, adding that hospitals and other health care facilities will typically try to conserve as much of the affected product as possible, and will also investigate any alternatives or substitutions for the product.
“If the shortage is so severe that we just can’t continue with normal usage, even with conservation, then we have to start a process of allocating across our clinical services, of course, prioritizing lifesaving care and emergency care, and then going down our list for more scheduled or more elective kinds of procedures,” Biddinger said.
Samantha Penta, an associate professor of emergency management and homeland security at the University at Albany in New York, said one really important factor to consider when understanding the implications of Hurricane Helene is just how large the affected area is.
“We’re not just talking about a couple of counties. We’re not even just talking about one state. This has affected multiple states very significantly,” she told ABC News. “One of the things that organizations, in general, including hospitals, long-term care facilities and like – really, anything in the health care sector – does, is you can rely on neighboring facilities.”
Penta said if health care facilities need to send patients to a neighboring facility because they’re running low on supplies or space, or if their facility is damaged, they typically can do so. The same holds true if one facility is running low on supplies; another facility might send them some of their reserves as part of a mutual aid agreement.
But in the case of Helene, “effectively, the people who need help, their neighbors are also being affected. So, any given hospital, the closest hospitals to them, are likely dealing with the same issues,” Penta said. “That further complicates it, because things have to come from even farther away, whether that’s working within a network or ordering from different vendors.”
Over the weekend, North Carolina became the latest state to have a public health emergency declared by the U.S. Department of Health & Human Services (HHS) in response to Hurricane Helene.
The HHS’s Administration for Strategic Preparedness and Response deployed about 200 personnel to the state, including Health Care Situational Assessment teams to evaluate the storm’s impact on health care facilities such as hospitals, nursing homes and dialysis centers, and Disaster Medical Assistance teams to help state and local health workers provide care.
(NEW YORK) — A new study suggests that GLP-1 agonist medications like Ozempic, which are used for diabetes management and weight loss, may help reduce the risk of overdose and alcohol intoxication in people with substance use disorders.
“It helps to underline another significant benefit of this class of medication,” Dr. Angela Fitch, the co-founder, and chief medical officer of knownwell, a company that provides weight-inclusive health care, told ABC News.
The large study, published in the journal, Addiction, analyzed the health records of 1.3 million people from 136 U.S. hospitals for nearly nine years. That included the records of 500,000 people with opioid use and more than 800,000 with alcohol use disorder.
Those who took Ozempic or a similar drug had a 40% lower chance of overdosing on opioids and a 50% lower chance of getting drunk compared to those who didn’t take the medication, the study found.
“The existing medications for treating substance use disorder are underutilized and stigmatized,” said Fares Qeadan, associate professor of biostatistics at Loyola University in Chicago. “These medications intended for diabetes and weight loss can help addiction without the associated stigma, which will be a new window for how to deal with addiction.”
The protective effects were consistent and even applied to people with Type 2 diabetes, obesity, or both conditions.
Fitch expressed optimism about the study’s results.
“As clinicians, recognizing that people can get double benefits from something is always helpful and as more obesity medications enter the market, this can help personalize treatments,” she said.
GLP-1 drugs, such as Ozempic and the combination drug tirzepatide also included in the study, mimic a natural hormone known as glucagon-like peptide-1 to help regulate blood sugar and insulin levels. For managing obesity and diabetes, these medications work by slowing digestion, reducing appetite, and enhancing insulin release in response to meals.
Scientists don’t fully understand how these drugs work yet. Some studies indicate that they activate specific “reward” receptors in the brain that make high-calorie foods less gratifying, so users eat less.
This could also be the reason these drugs may reduce cravings for alcohol and opioids. For example, a previous study found that adding the GLP-1, exenatide, was effective at helping some people with obesity and alcohol use disorder drink less.
The Addiction study does not prove that GLP-1 medications directly lower the risks of opioid overdose and alcohol intoxication, only that people taking them seemed to be helped. And it only included hospitalizations so it’s not clear if they will work as well in less serious cases.
Prescribing the drugs to treat substance use, at least for now, isn’t possible because they aren’t approved by the U.S. Food and Drug Administration for that purpose, Fitch pointed out.
“One of the challenges that we have as clinicians is we know that some of these benefits help patients. And not being able to get them access is very challenging,” she said.
People with substance use disorder keep using drugs or alcohol even though it causes problems in their life. According to the CDC, there are 178,000 annual deaths linked to excessive drinking. Over 75% of drug overdose deaths in 2022 involved opioids.
If you or someone you know is living with substance use disorder, free, confidential help is available 24 hours a day, seven days a week, by calling or texting the national lifeline at 988.
Dr. Faizah Shareef is an Internal Medicine Resident Physician and a member of the ABC News Medical Unit.
While the United States has made considerable progress fighting the HIV/AIDS crisis since its peak in the 1980s, headway has not been equal among racial/ethnic groups.
Overall, HIV rates have declined in the U.S. and the number of new infections over the last five years has dropped among Black Americans and white Americans. However, Hispanic and Latino Americans have not seen the same gains.
Between 2018 and 2022, estimated HIV infections among gay and bisexual men fell 16% for Black Americans and 20% for white Americans, according to data from the Centers for Disease Control and Prevention. Meanwhile, Hispanic Americans saw rates held steady, the CDC said.
There may be several reasons for the lack of decline, including Hispanic Americans facing health care discrimination, experts told ABC News. Some may also face the stigma that prevents patients from accessing services or makes them feel ashamed to do so. There is also a lack of material that is available in their native language or is culturally congruent, experts said.
“Where we are in the HIV epidemic is that we have better tools than ever for both treatment and for prevention, and we have seen a modest slowing in the rate of new infections, but we have seen a relative increase in the rate of new infections among Latino individuals, particularly Latino men who have sex with men,” Dr. Kenneth Mayer, a professor of medicine at Harvard Medical School and medical research director at Fenway Health in Boston, told ABC News.
“So, the trends are subtle, but they’re concerning because it does speak to increased health disparities in that population,” he continued.
Hispanic Americans make up more cases and more deaths
Although Hispanic and Latino Americans make up 18% of the U.S. population, they accounted for 33% of estimated new HIV infections in 2022, according to HIV.gov, a website run by the U.S. Department of Health and Human Services. This is in comparison with white Americans, who make up 61% of the U.S. population but just 23% of HIV infections.
Hispanic and Latino gay men currently represent the highest number of new HIV cases in the U.S.
What’s more, Hispanic males were four times likely to have HIV or AIDS compared to white males in 2022 and Hispanic females were about three times more likely than white females to have HIV over the same period, according to the federal Office of Minority Health (OMH).
Additionally, Hispanics males were nearly twice as likely to die of HIV Infection as white males and Hispanic females to die of HIV Infection in 2022, the OMH said.
Erick Suarez, a nurse practitioner and chief medical officer of Pineapple Healthcare, a primary care and HIV/AIDS specialist located in Orlando, Florida, told ABC News that watching the lack of progress made in the HIV/AIDS crisis for the Hispanic and Latino population is like “traveling back in time.”
“When I say traveling back in time for the Hispanic/Latino population with HIV, I mean [it’s like] they are living before 2000,” he said, “Their understanding of treatment and how to access it is in that pre-2000 world. … The state of HIV and AIDS in the Hispanic/Latino population in the United States right now is a few steps back from the general American population.”
He said many Hispanic/Latino HIV patients come to the United States unaware of their HIV status. If they are aware of their status, they come from countries where prevention and pre-exposure prophylaxis (PrEP) is hard to find or doesn’t exist.
When they get to the United States, they be afraid or unsure of where or how to access health care. Even Hispanic/Latino Americans whose families have been here for generations, have trouble accessing health care due to racial and ethnic disparities, Suarez said.
Previous research has shown Hispanic/Latino Americans with HIV reported experiencing health care discrimination, which could be a barrier to accessing care.
Facing discrimination, stigma
Hispanic and Latino patients with HIV report facing discrimination in health care, experts told ABC News. A CDC report published in 2022 found between 2018 and 2020, nearly 1 in 4 Hispanic patients with HIV said they experienced health care discrimination.
Hispanic men were more likely to face discrimination than Hispanic women and Black or African American Hispanic patients were more likely than white Hispanic patients to face discrimination, according to the report.
There may also be stigma — both within the general population and within their own communities — associated with HIV infection that could prevent patients from accessing services, according to the experts.
Suarez said one of his most recent patients, who is Cuban, traveled two hours to a clinic outside of their city to make sure no one in their familial and social circles would know their status.
“The interesting part is that even though I speak with them like, ‘You understand that everything that happens within these walls is federally protected, that it is private information. No one will ever know your information, and our goal is for you to get access healthcare. You can do this in your own city,'” Suarez said.
“Now, because of the stigma, they will travel long distances to avoid contact with anyone and make sure that no one knows their status. So, stigma is a huge factor,” he continued.
Rodriguez said this stigma and mistrust has led to many Hispanic and Latino Americans to not seek medical care unless something is seriously wrong, which may result in missed HIV diagnoses or a missed opportunity to receive post-exposure prophylaxis, which can reduce the risk of HIV when taken within 72 hours after a possible HIV exposure.
Making resources ‘available, attainable and achievable’ Experts said one way to lower rates is to make information on how to reduce risk as well as how to get tested and treated available in other languages, such as Spanish, and making sure it is culturally congruent.
However, Rodriguez says translating documents is not enough. In the early 2010s, when the CDC was disseminating its national strategy to reduce HIV infection, the agency began to circulate materials on how to reduce HIV incidence, reducing stigma and increasing use of condoms for sex, Rodriguez said.
He said that of a compendium of 30 interventions, maybe one was in Spanish. When he took the materials back to his native Puerto Rico, many were having trouble understanding the materials because it has been translated by someone who is of Mexican heritage.
Secondly, rather than the materials being written in Spanish, they had been translated from English to Spanish, which doesn’t always translate well, Rodriguez said.
“When we talk about Hispanics, we have to talk about, first of all, the culture. Our culture is very complex. Not one Spanish language can speak to all of the Hispanic communities,” he said. “And then we also have to look at the generations of Hispanics. Are you first generation, second generation, third generation? “
He added that the key is making resources “available, attainable and achievable.”
This month, the White House convened a summit to discuss raising awareness of HIV among Hispanic and Latino Americans and to discuss strengthening efforts to address HIV in Hispanic and Latino communities.
Mayer said it’s also important to make sure information is disseminated on social media that is culturally tailored for Hispanic and Latino experiences.
“It’s important for social media to seem culturally relevant, to make sure that they understand that HIV is not just a disease of old white guys, and that they may have a substantial risk,” he said. “Make sure that they’re educated by what they can do to protect themselves since we have highly effective pre-exposure prophylaxis, and we have ways to decrease STIs with a doxycycline post-exposure prophylaxis.
The experts added that having more Hispanics and Latinos represented in medicine, research and public health may encourage more Hispanic and Latino Americans with HIV or at risk of HIV to seek care or treatment.
“Seeing and being able to recognize that your healthcare provider looks like you, sounds like you, in some way it represents you, is a key aspect of getting people on treatment and access,’ Suarez said. “And not only that, but keeping them in treatment and having them come back and stay and keep that going, that’s a key issue.”
