What’s the Ideal BMI?

Winalot asked what I thought was the ideal bodyweight or BMI.  I’m not sure there’s a single ideal – different lifestyles will naturally generate different bodies – but I think we’d all agree that this young lady has a pretty healthy body shape:

You can also see her deadlifting in this video, where they tell us she weighs 98 pounds. If she is 5’0” tall, then her BMI is 19.

One factor to keep in mind is that, as Wikipedia notes, the BMI improperly accounts for height — it scales proportionally to height. So a 6’ person with a BMI of 25 has the same body shape as a 5’ person with a BMI of 21.

I’ve always been slender, but as I’ve improved my diet and nutrition I’ve actually gotten heavier. I now weigh 182 lbs at 6’0”, which translates to a BMI of 24.7.  I used to be 160-165 lbs. I’m still slender and have, if anything, less fat than before, but more muscle and I am convinced my bones are denser. Certainly, my teeth are harder and whiter.

If, as I think, I added 10 pounds or so to my bones through vitamin D, K2, C, and magnesium supplementation, then it’s rather obvious that BMI is not a precise measure of health. A BMI of 25 in a person with little muscle and fragile demineralized bones is overweight; but a BMI of 19, even with a great body shape, might indicate some missing nutritional elements.

If the lady in the video is really only 98 pounds, I would suspect that either she’s shorter than 5’0” or that her bones are not as dense as they should be, and she should supplement D, K2, C and magnesium.

Both Shou-Ching and I are pretty sedentary – we both spend 60 hours per week or more at our computers. We go to the gym twice a week for about 30 minutes, and go for a walk for about 2 hours on weekends, or play tennis. We would love to get outdoors and exercise more, but life is busy for us.

If you eat right and your metabolism is healthy, not a lot of exercise is needed to attain an attractive body shape and move mass from adipose cells into muscle. Even though we’re sedentary, both of us have been getting stronger, and we’ve remained fairly slender.

So: Be sure to eat at least 600 calories per day of carbs+protein, and there should be sufficient protein for muscle synthesis. (At lower carb+protein intakes, more protein may be consumed in gluconeogenesis than is eaten, for a net loss of protein from muscle.) Resistance exercise will help drive muscle development. These steps will allow surplus fat to go into muscles, not belly flab. Then control overall calorie intake, perhaps with intermittent fasting, to keep adipose fat from growing. All this should be natural and easy, if your metabolism has not been damaged in some fashion; and your body should end up with an excellent shape.

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39 Comments.

  1. Maybe a dumb question, but does bone require calories to maintain? Muscle requires more than fat, but where does bone fit in?
    And I should get a bone scan soon. My doctors are scared I’m not getting enough calcium. hah.

  2. Hi Abby,

    Well, in starvation bone cells will lose mass as well as muscle cells. The collagen matrix is probably cannibalized as well. Glucose deprivation on a zero-carb diet is damaging for connective tissue and might hit bone. But the most common cause of bone problems is mineral and nutrient deficiencies.

    I think it wouldn’t hurt to humor them on the calcium, Abby, as long as you’re getting plenty of vitamin K2 to keep the calcium from going into blood vessels and other soft tissues, and magnesium to balance the calcium. 600 mg calcium per day is not dangerous if it’s accompanied by K2 and magnesium, and it would be good to rule out calcium as an issue.

  3. “I think, I added 10 pounds or so to my bones..” haha, good joke.. ;))

  4. Hi qualia, Very possibly that’s an overestimate, but … don’t forget I had scurvy 3 years ago and weighed only 145 pounds at the bottom … also that bone mass is variable and increases with muscle mass.

    The normal human skeletal mass is 25 lb or so for a man of my weight. I’m sure my bones are now heavier than average thanks to nutrition, whereas I was lighter than average before. Perhaps muscle has taken more and bone less of the increase, but I don’t think it’s totally out of the question that I now have 30 lb bone, had 20 or less during the scurvy or even during my earlier 160 lb wheat based lifestyle.

    When I started supplementing bone nutrients specifically, I gained 10 lb in two months, with no change in strength relative to body mass as measured by number of push-ups or pull-ups, and no great change in body shape other than better posture and a more expanded chest. It’s hard for me to see where the weight could have been except in bone. It was totally unexpected, as I’d never been above 175 lb in my life before. And it just shot up, then plateaued at the new higher weight.

  5. hmm, well my bones have gone from the 60th percentile to the 90th percentile since I started eating healthier, so I am not particularly worried. I believe there is some in my multivitamin though.

  6. qualia – My wife also thinks 10 lb of bone is silly and that it must be mostly muscle.

    Hi Abby – 90th percentile sounds pretty good. What exactly is your injury?

  7. Osteochondritis dissecans in my right knee. Blood isn’t getting to the bone, and it forms a lesion, which can fall off. The cause is unclear, but its almost always found in athletes.

  8. Hi Paul,

    Thanks for your reply. I asked the question as my thoughts on bodyweight / bf% are slightly different than typical.

    Often on blogs such as yours the focus is on the obese and overweight, whereas I’ve never been overweight in my life let alone obese.

    Until my 30’s I was never over 125lbs and then through force-feeding and weight training I got up to 150lbs, which at 5’11” for a male is still slim.

    Now in my 40’s I’m 175lbs and it’s a royal pain in the arse to maintain; 4000-5000 calories a day and weight training.

    The overweight exercise in an attempt to lose weight and I exercise to keep it on. Might sound great to some, but I can go on holiday for 2 weeks, not train, eat less than usual and easily lose 20lbs.

    Consuming 3 packs of butter a week is probably healthier for me than the porridge and pasta days were, but in some ways that was easier.

    Born prematurely, weighing less than 4lbs, a pro-bodybuilding career was never on the cards for me, no matter how much I’d like it to be.

    Often I think I’ll be done with it and let my body type be what it wants to be and I’d resemble the tall, skinny, white member of an african tribe.

    But, and hence the BMI question above, the fact is I feel more “human”, “robust” and “grown up” at the higher weight, even if it is hard work!

    WP

  9. Hi winalot –

    That’s very interesting, because we have a lot of parallels.

    I was also born premature (4 lb 8 oz), and was always unusually slender – 120 lb at age 18, 140 lb age 22-25, 160 or so through early 40s, that’s for 6′ tall.

    I had difficulty putting on muscle.

    Now it’s quite different. I’m now 182 lb, put on muscle easily, and don’t lose weight when fasting. I also eat fewer calories than before.

    I’m certainly eating much healthier now, and better nourished. I think that’s most of it. Also, I think I had chronic infections for most of my life, that could be significant too. People with parasitic infections, of course, can have great difficulty maintaining weight.

    Have you ever seen an infectious disease specialist to look into parasites or other infections?

    Best, Paul

  10. Hi Paul,

    Thanks for the reply, I’m sure there’s a fair few of us ectomorphic types around.

    Being the poor englishman I am I’ve never pursued an infectious disease specialist. As I’ve mentioned in prior posts my main focus is resolving some of the mental illness I’ve sufferred most of my life.

    I’ve sufferred depression for quite some time, a few suicide attempts, and looking back I can see it’s been something I’ve had most of my life. The crazy thing is that even being a skinny male I had anorexia in late teens and dropped to less than 84lbs. Not good.

    I often wonder if being that undernourished early in life started or caused the vicious circle of my issues despite food volume (the nutrients vs. calories again!).

    I really am indifferent to food and although I consume a lot of food it is a chore.

    Anyway, thanks for taking the time to respond to my rambles 🙂

    WP

  11. I would take seriously the possibility — likelihood, I think — that a chronic infection is responsible both for your depression and difficulty gaining weight.

    I had chronic fungal infections from birth until recently. Even as a child I had perennial brown scaly patches behind my ears, that looked like ground-in dirt but couldn’t be washed clean. It took me forty years to discover that ordinary pharmacy antifungals would clear them. I wonder if this had something to do with my inability to gain weight.

    I personally don’t believe there are strong genes for ectomorphism or endomorphism. There’s probably significant epigenetic regulation involved, which can be inherited. Nutrition and diet and infections are also important in shaping the body.

  12. I think there are some genetic factors that affect body structure and metabolism, but I agree probably not to the extent that some attribute. By getting the system working well a happy medium can typically be found. But I think you’ll agree there’s no way I’d be able to look like a prime Don Howorth in the muscle stakes? My wrist measures less than 6″ around, just like my mother :-/

    I just find that I’m battling where my body wants me to be and where my brain wants me to be.

    I’m sure you’re right about the infections, I just don’t understand it fully or even know where to start.

    Was it the diet, antibiotics or both which finally resolved your chronic issues?

    BYW, really enjoying the e-book, have some feedback / errata, but will wait for my final hard-copy as I suspect they were ironed out.

  13. I would agree that whether the main influences are genetic, epigenetic, or pathogenetic, they’re not easily changed.

    It was both. The diet was crucial but the antibiotics were needed to fix the cognitive/neuropathic issues.

    It’s certainly not easy to know where to start, since medicine remains backward in regard to chronic disease. Our book is a good place to start, but the next step may require some experimentation and a cooperative doctor.

  14. Paul, as long as you’re on the subject of weight …

    I’ve been following your suggested diet and supplements, including 2 T. coconut oil going on the 6th week and neither my weight nor my abdominal bloat have gone down and the problem with gas although lessened a bit, is still problematic.

    However, inexplicably my clothes size (except for the waist) has gone down at least one size and possibly two. From a 14/16 to a 10/12 — for you gentlemen, that’s quite a cause for celebration. :-}

    Is it too soon to see weight loss results?

  15. Hi erp,

    Well, I think it’s pretty soon. Six weeks is still early for body changes. I’ve been on it several years and I still notice changes.

    Ours isn’t primarily a weight loss diet, though it should make weight loss easy if you choose to pursue that. If you’re not intentionally seeking weight loss, it will probably be a gradual process.

    The final version of the book has a little more weight loss advice.

    The gut bloating may be due to dysbiosis rather than abdominal fat. If so that can take a while to cure. Also, over 50% of the elderly have diverticulitis, which often appears as a bloated gut. I developed this myself during the scurvy phase.

    For weight loss, you do have to restrict calories below what you expend. Introducing fasting can help achieve this. Are you consciously trying to restrict calories?

    Personally I think it might be better to not worry too much about weight at first, try to get the diet right and get well nourished, and then after you’re well adapted to the diet start working on weight loss.

  16. Also, erp, like I said in my post I added muscle and bone density on this diet, so my weight went up, but with positive changes in body shape and appearance. It’s possible you’re losing fat but gaining muscle and bone mass.

    Muscle and bone are more dense then fat, so that would explain a smaller dress size at the same weight.

    That shift in body composition is exactly what we’re looking for. Weight loss diets that shrink lean mass as well as fat mass are not healthy in my view. So it may be that things are going just perfectly for you.

  17. Paul, thanks for replying.

    I would like to lose about 15 pounds in part because I may opt for knee surgery and added weight makes that more difficult.

    I’ve had diverticulitis for decades without any problems, my colonoscopy last month was clear, so I don’t know why the bloating and gas started about six months ago.

    Following your advice, I plan to get into the best health I can, get rid of my gut and reach my optimum weight before making any decisions.

    Is it even possible to add muscle and bone at 76?

  18. What do you think of bone meal as a calcium supplement?

  19. Hi erp,

    All living bodies can add muscle and bone. Everything in the body is dynamic — constantly breaking down and being rebuilt.

    Hi Erik,

    Well, we’re not big on calcium supplements. See http://perfecthealthdiet.com/?p=415. We’re even less attracted to phosphorus which is abundant in bone meal. And Wikipedia says a lot of bone meal has been contaminated by lead and toxic metals. So I wouldn’t recommend it. We like magnesium/D/K2/C for bones.

  20. Sorry if this has already been asked, but what do you eat in a typical day?
    I’m having trouble getting the recommended starch calories. An entire sweet potato only has about 25-30g of carbohydrate, and I can’t really eat more than that a day! I eat other vegetables, but they usually add up to about 50-80g a day. I have been trying to get some coconut oil every day though, for ketones.

  21. Hi Abby,

    That’s right, one sweet potato isn’t nearly enough.

    I usually have a banana for breakfast, then I don’t eat until late afternoon. We usually have some rice around, we’ll always have homemade rice soups in the refrigerator (either chicken with rice or beef bones with rice). We always have sweet potato, potato, or taro with dinner, plus some rice. We have Korean seasoned seaweed with dinner which we cut into squares and eat a little bit with some rice. There’s a few incidental carb calories in rice crackers with cheese, yogurt, ice cream, fruit or berries.

    We don’t count vegetables as carb sources, I don’t think they deliver many glucose calories at all, I think the gut bacteria get most of them.

    As you say, when you come from low-carb habits you have to work a little to get enough carb calories. But it’s not really that hard to eat two sweet potatoes and a banana per day, or a sweet potato, a banana and some rice.

    If you just don’t like to eat plant foods, then you should definitely get a rice cooker. You can make small amounts of rice at a time, and it’s much easier to get your carb calories from rice than from any other source.

  22. I’ve been getting a sweet potato on most days, but that’s it. It’s hard to stay under my calorie limit of about 1500-1800 (I still can’t exercise very much with my knee) while getting these carbohydrates and eating fat as well! But I will try to add in another sweet potato or potato. Definitely a change since I’ve been eating panu style for a while.
    I’ve been reluctant to try rice, since it is just empty calories, but how do you make the rice soup?

  23. I don’t think you need a calorie limit. It’s OK to add a bit of weight if you’re eating healthily.

    Rice soup – We may do a post on that soon, we made some yesterday and Shou-Ching took photos.

    In this case, it was a chicken soup. We like a heavy garlic flavor, so a whole chicken and 20 garlic cloves sliced in half, cooked. Meanwhile put a bowl of uncooked rice aside, with just enough water to cover it. When the chicken has cooked a while, pour off the water from the rice and add it to the pot. If you don’t like chicken bones in your soup, you can remove the chicken at this time, let it cool a bit, shred the meat and skin and return it to the soup. Or you can just let the chicken fall apart on its own. Add in chopped vegetables when it’s done or nearly done, depending on what texture you like, and spices, salt and pepper to taste.

  24. Ok. I will try to make it with some stock, so it gets some nutrition at least.
    Would more starchy vegetables such as turnip or onion count for glucose calories?
    I also may make banana or sweet potato ice cream (with my new ice cream maker). I’ll have to brainstorm some more ways to get it in. I’ve been enjoying eating low carb actually, you get more fat!

  25. If you thought sweet potatoes don’t have many carb calories, wait till you look up turnip or onion. They’re great foods, great soup ingredients, but not great calorie sources. You can put potatoes in soup, I actually like their taste better in soup.

    You can still eat a lot of fat! Just add a little rice in. It’ll do you good.

  26. Ok. I will try upping my starch. I never really feel a difference, except with lots of sugar or refined flour, so I’m not sure if I will be able to gauge how I’m doing with it.
    Would you still recommend rice to someone who was trying to lose weight though?
    And how does nutrition affect height? I’m trying to eke out another inch or two, supposedly my growth plates are still open. And I’m just curious how it might affect growth.

    • Hi Abby,

      For height and growth, I’d definitely recommend rice. You want to be well-nourished and glucose, up to about 500-600 calories per day, is a nutrient. Nutrient starvation can impair growth.

      You could take whey protein powder also, supplement vitamins including B vitamins, and do resistance exercise.

      Also, buy Esther Gokhale’s Eight Steps to a Pain-Free Back and practice her posture exercises: http://www.amazon.com/Steps-Pain-Free-Back-Solutions-Shoulder/dp/0979303605/

      As for weight loss, yes, I would recommend eating 200-600 calories per day glucose to anyone, whether trying to lose weight or not. The point is to be healthy. The keys to weight loss are (a) total calories and (b) avoiding toxicity … we don’t think glucose becomes toxic until it gets above 500-600 calories per day, and it may not be very toxic even above that.

      • Abby,

        Another thought – High dairy consumption is thought to be behind the tallness of the Dutch. Drink a lot of whole milk, it has some growth hormones that promote growth as well as being a nourishing drink.

        Also, since whole milk is almost 40% carbs, that’s another way to get those pesky carb calories. A thousand calories of whole milk a day will help you get that inch. Might give you acne though.

        Finally, sleeping in a fasted state raises growth hormone levels. So if you try to do all your eating around mid-day, then don’t eat after mid-afternoon, you may grow a little faster.

        Also, you might try wearing Vibram Fivefingers shoes. They force you to walk with with better posture; stacking the forces properly promotes bone growth. That might also help your knee a bit, who knows.

      • Paul,

        I can’t have whey because it causes boils to appear on my back 🙁 But I do like a smoothie in the morning for convenience with added protein. Which protein powders are good and which must be avoided?

  27. Well I just found a source for raw milk, so that might be an option. Would yogurt have the same hormones?
    But raw milk isn’t great from a longevity perspective though because of the growth hormones, correct? So I will probably have some, but not go crazy.
    And the sleeping thing is interesting, I will try to do that some days.

  28. Hi Abby, some but not crazy is probably a good strategy. I don’t think a year of dairy would do any lasting harm, but no one can say for sure.

    I don’t know whether or not hormones get digested by yogurt bacteria. I would presume many of them are still there.

    Since you’ve expressed concern about your weight, intermittent fasting, say one day a week, might make you more comfortable with eating more the other days, and the variability could help increase growth hormone.

  29. Also, what exactly do the bcaa’s do? I’ve seen you recommend them for various reasons, but what is it that makes them different than other amino acids?
    And will the book be available on amazon soon? And what is the current eta?

    Thank you for answering all of my questions!

  30. Hi Abby, I’ll do an update on ETAs soon, I have to get some information from my printer.

    When you get into the depths of the biology, every molecule has unique properties, and the amino acids are no exception. The BCAAs have some hormonal/signaling properties. There is a tendency to promote muscle synthesis. They also can be turned into ketones more easily than other amino acids.

    It’s not a big effect, but for competitive athletes it might be worth exploiting.

  31. ok one more question…
    What about BCAA supplements? I’m not a huge fan of protein powder.

  32. Well, BCAA supplements are basically a protein powder in a pill. Similar to whey only more expensive.

    I don’t think either are necessary for a tennis player. If you find you are having difficulty maintaining muscle you might look to them.

  33. I am trying to build muscle and get back in shape, but maybe down the road if I am having trouble. I have a lot of things to experiment with for the time being.

  34. When is actually the best time for exercise? In the mornings before breakfast or in the evenings?

    Thanks a lot!

    JP

    • From a health point of view the ideal would be to fast in the morning, do exercise late morning / midday, then eat lunch. But this doesn’t comport with work.

      I think the practical answer is whatever works best for you. Listen to your body and see what makes you feel best, and what fits in your schedule.

  35. Dr. Curmudgeon Gee

    BMI = W/H^2

    i think a better definition should be

    W/H^3

    naturally, this still does not tell the density tho.

    cheers,

    pam

    (she is probably shorter; she looks good)

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