Doctor’s Advice: Finally February

By James McGuinness, M.D.

February is American Heart Month, and we are all encouraged to focus on our cardiovascular health. Heart disease is the leading cause of death in the United States. People with poor cardiovascular health are at increased risk for severe illnesses. Being physically active, getting enough sleep, not smoking, reducing stress and eating healthier foods can help prevent heart disease.

The Body Mass Index or BMI has been used for a very long time to assess our health. It is based only on a person’s height and weight. Studies have shown that the BMI may under or overestimate body fat in certain people. Using only height and weight to estimate body fat percentage leaves out important variables such as muscle mass, bone density, age, sex and body fat location. Visceral fat is a type of body fat that accumulates around the internal organs, such as the liver, heart, and intestines. Unlike subcutaneous fat, which is visible and located just beneath the skin, visceral fat is hidden and contributes to chronic and systemic inflammation. It is associated with insulin resistance, diabetes, and cardiovascular complications. The many health risks associated with visceral fat, as well as the significance of body fat distribution, have led to an ‘update’ to the BMI. Known as the Body Roundness Index, or BRI, it shifts the focus to visceral fat. Instead of a ratio of someone’s height and weight, the BRI calculation uses their height and their waist circumference. Although an improvement over the BMI, the BRI is also just an estimate. It should be used in conjunction with other diagnostic tests. The American Medical Association (AMA) has said that it is important for doctors to understand the benefits and limitations of using BMI in clinical settings to determine the best care for their patients.

Besides knowing our BMI or BRI, we must be cognizant of the winter respiratory illnesses like the flu, COVID, and RSV which have been rising in recent months, according to the Centers for Disease Control and Prevention (CDC). The best way to protect yourself from the flu and COVID is to get vaccinated which can reduce your chances of getting sick. Both seasonal flu and COVID vaccines are recommended for nearly everyone over the age of six months. The norovirus, which causes diarrhea and vomiting has also been more common this season. The spread of these viral infections has some people calling it a “Quad-demic” as the number of cases for all four of these viral infections continue to rise. Instead of coughing or sneezing, the Norovirus results in sudden and violent vomiting and diarrhea. Norovirus is very contagious and is spread through contaminated surfaces and food. Since there is no vaccine to protect against norovirus, your best bet is to wash your hands and clean surfaces to help minimize the risk of catching or spreading disease. The number of Norovirus cases this season has doubled from last season.

To help get through the new year, keep a positive attitude on life. Try to remember that the glass is half full, not, half empty. Surround yourself with positive people and keep negative feelings confined. Little wins can be just as important as big wins. When appropriate, wear masks, wash hands and keep social distancing.  Stay warm, healthy and happy these winter months.

The natural healing force within each one of us is the greatest force in getting well. -Hippocrates

James McGuinness, M.D., is a Family Physician in Middletown, and is the Medical Director Emeritus of the Parker Family Health Center in Red Bank