How Much Is Too Much: Is the President Too Chunky?

ByFELICIA D. STOLER, ABC News Medical Unit

Aug. 7, 2006 — -- Last week President Bush underwent his annual physical. It revealed he was in pretty good health, except for one thing. According to his body mass index, he's overweight.

His BMI was 26, putting him in the lower range of the overweight category. He weighs 196 pounds, meaning he has gained 5 pounds since last year and his percentage of body fat has increased to 16.8 percent, which is, overall, pretty good for a man who just turned 60. (To calculate your BMI, go here).

Still, the appropriate body weight range is 157 to 192 pounds for a 5-foot, 11-inch man. Is there cause for alarm? Should the president go on a diet?

Possibly, dietitians say.

"When you're 60 and your BMI is 26, it's a risk," says dietitian Cathy Nonas, a spokeswoman for the American Dietetic Association. "As you get older, you are more prone to other ailments -- diabetes, arthritis and cardiovascular disease. It is helpful to not add another BMI point each year."

The notion that everyone gains weight as they age is not an excuse, say health care professionals.

"I don't know if I would say he's overweight, but if you look at the trend, increasing body weight is not a good pattern," says Leslie Bonci, director of Sports Nutrition at the University of Pittsburgh Medical Center. "This weight gain trend is important as we get older."

While some experts have voiced concern over the president's weight, others say he has nothing to worry about. And one leading nutrition researcher believes BMI alone does not provide enough information to make a decision.

"In men, BMI is particularly misleading because of muscle mass. I would like to know the president's waist circumference. It appears the president is pretty healthy. However, if he's beginning a trend of gaining 5 pounds a year, that is not a good thing," says Barbara Rolls, head of nutritional sciences at Penn State University.

And J. Larry Durstine, president of the American College of Sports Medicine, says he believes the president should be recognized as a leader in maintaining good health.

"If 60 percent of Americans had a BMI of 26 or less, we would have a healthier population," he says.

So why is Bush technically overweight?

Body mass index is the ratio of a person's weight to height and is meant to indicate how likely someone will develop an illness, such as heart disease, because of his or her weight. A BMI of less than 25 has a low risk. A BMI between 26 and 29.99 is considered overweight and anything higher than 30 is obese and poses a high risk. An individual with a BMI under 19 may be at risk for osteoporosis and, potentially, malnutrition.

However, there is controversy with using this formula, as it may overestimate risk or inaccurately put someone in an overweight or obese category, especially men.

Although there are more precise ways of determining a person's percentage of body fat, BMI is perhaps the easiest and quickest measurement for the general population. Still, a BMI should always be taken into account with other measurements and tests, experts say.

"BMI cutoffs are not absolute about health risks," says Kelly D. Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University.

In addition, "BMI is one thing in a constellation of risk factors that should be considered for cardiovascular disease, diabetes and metabolic syndrome," says Barry A. Franklin, director of Cardiac Rehabilitation and Exercise Laboratories at William Beaumont Hospital. "I would not be upset by a BMI of 26 and would consider other factors to gauge global health, including fitness, blood pressure, lipids. In this case, the president's values are all stellar."

Bush is not the only one to have a BMI that seems incorrect or perhaps a bit unfair. In his prime, as Mr. Universe, Arnold Schwarzenneger's BMI was 33. Jack LaLanne, the fitness guru, had a BMI of 26.1 when he turned 90.

The experts agree that because of muscle mass, BMIs can put some men in the obese category. However, some larger athletes are not only made up of extra muscle mass -- some, such as football linebackers, have higher body fat levels as well.

One of the world's most famous athletes, Shaquille O'Neal, has struggled to keep his BMI low. At one point, the 7-foot-one Miami Heat teammate held the NBA's highest BMI at 31.6, according to an AP analysis. While he has lost some weight recently, Miami Heat officials refused to comment on his current status.

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