mcmanigle
Line Up and Wait
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John McManigle
So there's a lot of talk around two variations on the same theme:
1. "The BMI is only relevant for those who fit precisely under a narrow mid-point +/-standard deviation from the distribution of body types."
2. "It's well known that BMI is not a realistic measure for someone who has a lot of muscle mass."
Number 1 is fairly wrong. The population for whom BMI is generally meaningful is huge. Just because you exercise a few times a week or are "big boned" or pretty strong or whatnot doesn't mean that BMI doesn't apply to you. Number 2 has some more truth to it, as far as "obesity" goes. If you really are muscle-bound, ie you look in the mirror and see abdominal muscle rather than abdominal fat, you're probably not obese. And clearly there's a bit of a range between #1 and #2. But we can go back and forth all day about what we want to call "obese". That's not the issue. The issue is sleep apnea risk.
So let's look at a population that might give us some insight to people who have a lot of muscle, with or without fat. The study attached looked at 129 retired NFL players. It found:
BMI is NOT a good measure of body fat obesity in this population of retired NFL players, but
BMI IS a risk factor for sleep apnea in this population, regardless of body fat obesity
My conclusion: even if you're one of those people for whom BMI is calling you obese when really a lot of your weight is muscle rather than fat, that high BMI is still putting you at higher risk of OSA.
By all means continue the debate as to whether the FAA should have this kind of index of suspicion, but the argument that "so many people are getting to 40 / 35 / 30 because of all of their muscle; they're not a risk" is moot both because there really aren't that many people in that category, and even those who are present a heightened risk.
1. "The BMI is only relevant for those who fit precisely under a narrow mid-point +/-standard deviation from the distribution of body types."
2. "It's well known that BMI is not a realistic measure for someone who has a lot of muscle mass."
Number 1 is fairly wrong. The population for whom BMI is generally meaningful is huge. Just because you exercise a few times a week or are "big boned" or pretty strong or whatnot doesn't mean that BMI doesn't apply to you. Number 2 has some more truth to it, as far as "obesity" goes. If you really are muscle-bound, ie you look in the mirror and see abdominal muscle rather than abdominal fat, you're probably not obese. And clearly there's a bit of a range between #1 and #2. But we can go back and forth all day about what we want to call "obese". That's not the issue. The issue is sleep apnea risk.
So let's look at a population that might give us some insight to people who have a lot of muscle, with or without fat. The study attached looked at 129 retired NFL players. It found:
BMI is NOT a good measure of body fat obesity in this population of retired NFL players, but
BMI IS a risk factor for sleep apnea in this population, regardless of body fat obesity
My conclusion: even if you're one of those people for whom BMI is calling you obese when really a lot of your weight is muscle rather than fat, that high BMI is still putting you at higher risk of OSA.
By all means continue the debate as to whether the FAA should have this kind of index of suspicion, but the argument that "so many people are getting to 40 / 35 / 30 because of all of their muscle; they're not a risk" is moot both because there really aren't that many people in that category, and even those who are present a heightened risk.