What to know about body roundness index, an alternative to BMI
(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.”
(NEW YORK) — The spread of a newer strain of mpox in Africa led the World Health Organization (WHO) to declare the disease a public health emergency of international concern (PHEIC) on Wednesday.
This newer strain is believed to be behind an outbreak in the Democratic Republic of the Congo (DRC) with more than 14,000 cases — mostly among children — and more than 500 deaths, and has been detected in neighboring countries that had never reported countries of mpox before.
On Thursday, Sweden became the first nation outside of the African continent to report a case of the newer strain of mpox, according to the country’s public health agency.
Cases of other strains, or clades, of mpox have popped up in other countries. In the U.S., there are more than 1,600 cases reported this year so far, more than twice the number seen at this time last year but not as many as seen during the outbreak in 2022-23.
“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus during a media briefing on Wednesday.
Experts told ABC News that by declaring a PHEIC, the WHO can help more countries collaborate by sharing data, allocating resources and helping make vaccines more readily available.
What is a PHEIC?
A PHEIC is defined as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response,” by the International Health Regulations.
To be considered a PHEIC, the condition is considered, serious, sudden, unusual or unexpected; has implications for public health beyond where the place it originates; and has the potential to require immediate international action, according to the WHO.
“This is really [the WHO’s] highest level of alert,” Thomas Duszynski, director of epidemiology education at Indiana University’s Fairbanks School of Public Health, told ABC News.
“This means that this particular virus, or the mpox virus, and the illnesses that it causes, has reached a level that is now at a much higher rate than it should be, than when we see like in a normal year, as well as it’s starting to spill outside of the country of the Democratic Republic of Congo, which means that we have to get our arms around it and try and contain it,” he said.
A PHEIC was last declared for mpox during the outbreak in 2022-23, but this current outbreak is different because it involves a clade called clade Ib that seems to spread more quickly and has a higher mortality rate, Duszynski said.
What becomes available when a PHEIC is declared?
Emily Smith, an associate professor in the Department of Global Health at George Washington University’s Milken Institute School of Public Health, said declaring a PHEIC can help galvanize collaboration and mobilize resources.
“Collaboration can be really important in terms of sharing data from different surveillance systems or even things like genomic sequences, so we can understand how different cases are related to each other,” she told ABC News.
On the mobilizing resources front, Tedros said during the media briefing on Wednesday that WHO had released $1.5 million in contingency funds and planned to release more soon. The WHO’s regional response plan — including support surveillance and preparedness and response activities — will cost $15 million.
Additionally, last week, the WHO triggered the process to begin allowing mpox vaccines to go through the process for emergency use listing, similar to what was seen with the COVID-19 vaccine during the pandemic.
The PHEIC will also allow vaccines to be sent to other affected countries more quickly than they might have been without an emergency declaration, Duszynski said.
“In the Democratic Republic of Congo, their access to the impact vaccine is limited,” he said. “So, for example, the U.S. has dedicated 50,000 doses of that vaccine for the Democratic Republic of Congo, so that that’s part of that cooperation of not only sending, knowledge and science and research, but also aid, in the sense of vaccines.”
“We could also send personnel, such as epidemiologists, to help with the investigation and to help identify those who are ill and put some isolation and quarantine around those individuals to keep this virus from spreading,” Duszynski added.
What should the public do?
The experts said the best thing to do is to get vaccinated if you are a high-risk individual.
Currently, the JYNNEOS vaccine, a two-dose vaccine approved by the Food and Drug Administration to prevent smallpox and mpox, is the only vaccine being used in the United States to prevent mpox. Data from Africa has shown two doses of JYNNEOS are at least 85% effective in preventing mpox infection.
High-risk individuals include those who are immunocompromised, suffer from chronic diseases, or have a history of eczema, which causes breaks in the skin and can lead to mpox transmission.
Smith said other high-risk individuals include gay, bisexual or men who have sex with men — a group that was most affected during the 2022-23 outbreak — should get vaccinated.
She said that anyone who has only received their first dose should be sure to get their second dose.
“Just be aware if you or anyone you know, or your family, experiences lesions, skin lesions or genital lesions,” Smith added. “[You] definitely want to contact your doctor. We do have treatment options available in the U.S.”
Both Smith and Duszynski reiterated the Centers for Disease Control and Prevention’s warning that the general public is at low risk from the type of mpox circulating in the DRC.
(NEW YORK) — A New Hampshire resident died after being infected with a rare mosquito-borne disease, health officials said Tuesday.
The resident, an adult from Hempstead — near the southeastern border with Massachusetts — had tested positive for Eastern Equine Encephalitis virus (EEEV). The patient was hospitalized due to severe central nervous system disease and died of their illness, according to an update from the state’s Department of Health & Human Services (DHHS).
This is the first reported human case of EEEV in New Hampshire in a decade after three people contracted the disease in 2014, two of whom died, DHHS said.
It’s unclear when the resident, who recently passed away, first became infected with EEEV. No other details were available including name, age or sex.
In addition to the person infected with EEEV, the virus has also been found in one horse and seven mosquito batches in New Hampshire so far this summer, according to the health department.
Neighboring states have been experiencing similar threats. In Massachusetts, 10 communities were designated as being under high or critical risk of the virus, according to the state’s Department of Public Health. Many of the areas began implementing targeted mosquito spraying to protect residents.
“In New Hampshire, mosquitos transmit infections including Eastern Equine Encephalitis Virus, West Nile Virus, and Jamestown Canyon Virus,” Dr. Benjamin Chan, New Hampshire’s state epidemiologist, said in a statement.
“We believe there is an elevated risk for EEEV infections this year in New England given the positive mosquito samples identified. The risk will continue into the fall until there is a hard frost that kills the mosquitos. Everybody should take steps to prevent mosquito bites when they are outdoors,” the statement continued.
EEEV is a rare but serious disease that spreads by bites from infected mosquitoes. It does not spread via touching or droplets from coughing or sneezing, according to the Centers for Disease Control and Prevention (CDC).
Most people who are infected either show mild symptoms or no symptoms at all. However, severe cases usually begin with fever, headache, chills and vomiting before progressing to encephalitis, which is swelling of the brain, or meningitis, which is swelling of the membranes that surround the brain and spinal cord.
Many survivors have ongoing neurologic problems including convulsions, paralysis and intellectual disability, and about 30% of encephalitis cases from this virus result in death.
There are no human vaccines and no treatments specifically for EEEV. The CDC says rest, fluids and over-the-counter pain medications may help relieve some symptoms.
As of Tuesday, four cases have been reported aside from the New Hampshire case — with one case each in Massachusetts, New Jersey, Vermont and Wisconsin, according to the CDC.
The New Hampshire DHHS said residents can protect themselves by using effective mosquito repellents, wearing long-sleeve shirts and long pants when outside and avoiding outdoor activities when mosquitoes are the most active, including early in the morning and during evening hours.
Additionally, residents are advised to remove standing water from around their homes, which attracts mosquitoes, and to make sure doors and windows have tight-fitting screens.
(NEW YORK) — The U.S. Food and Drug Administration has delayed consideration of a long-anticipated proposal to ban formaldehyde (FA) in hair-relaxing products, which some studies have linked to certain types of cancers.
It is not clear when the agency plans to consider the proposed rule, which was first entered in the Unified Agenda, a government registry of actions that administrative agencies plan to issue, last October.
If enacted, the rule would “ban formaldehyde and other FA-releasing chemicals as an ingredient in hair smoothing or hair straightening products marketed in the United States,” according to the language entered in the Unified Agenda.
Frequent use of hair-straightening products that include chemicals like formaldehyde has been found in studies to put women at a higher risk for uterine cancer, a type of cancer that starts in the uterus and is a risk factor for anyone with a uterus but the risk increases with age, especially during and after menopause, according to the Centers for Disease Control and Prevention.
A 2022 study found an association that women who self-reported frequent use of hair straightening products were more than twice as likely to later develop uterine cancer than women who did not use the products.
The study found that Black women may be more affected by the increased risk of uterine cancer not because of their race, but due to the fact that they use chemical hair straightening products at a higher rate. Frequent use of the products was defined as more than four times in the previous year, according to the study, which included more than 33,000 women between the ages of 35 to 74.
Scientists caution that it’s not clear yet if these products cause cancer. For now, research only hints at a probable link.
Formaldehyde is described by the Environmental Protection Agency as a “colorless, flammable gas” that can cause “adverse health effects” with exposure. When used in hair smoothing products, the formaldehyde is released into the air as a gas when the products are heated.
The Department of Health and Human Services lists formaldehyde as a “known carcinogen.”
The FDA has previously issued a warning stating that the use of hair smoothing products in an area that is not properly ventilated could lead to a risk of a person inhaling formaldehyde. In the warning, the agency acknowledged it began receiving “inquiries from consumers and salon professionals” about the safety of formaldehyde in products as far back as 20 years ago.
Safety tips for women in the absence of a ban
Dr. Angela Lamb, a New York City-based dermatologist, told ABC News’ Good Morning America Tuesday that women should read labels on their own and ask their salon provider about the ingredients in the products they’re using prior to undergoing treatments like hair straightening.
The three key ingredients to look for are formaldehyde, methylene glycol, and formalin, according to Lamb.
“You want to make sure, if you’re at a salon and you’re using something, if you have any reactions, let your salon provider know,” she said.
According to the FDA, possible reactions that have been reported range from eye problems to headaches, dizziness, nausea, chest pain, vomiting, coughing, wheezing and throat soreness.
Consumers can report bad reactions to the FDA by phone and online.
Lamb said if women want to avoid formaldehyde-containing products completely, they can opt for heat-styling options like roller sets and presses.
With those options, no chemicals are involved at all, according to Lamb.