User talk:Abseraj

Mohammed Formula

For Calculating Ideal Body Weight (IBW)

Obesity is considered as the number one public health problem in the USA. Although it started in the developed industrial countries, it is currently spreading like wild-fire all across the world. That is why many people have started to call it Globesity instead of Obesity. About 1/3rd of American population is obese and 2/3rd is either obese or over weight.

Obesity and over weight is not just a body-image, fitness or agility problem, rather it is associated with a host of common chronic co-morbidities like Diabetes, Hypertension, Heart Disease, Osteoarthritis, Gallstone and Cholecystitis, Steato-Hepatitis, Sleep Apnea, and certain Cancers.

The key cause of rapid rise of the problem can be incriminated to, lack of knowledge of what it is (definition), why it is (cause), and how it can be prevented or controlled (intervention). The problem is humongous but tools and research are scanty. Most general people do not know what should be the deal/normal/ healthy body weight. Ironically, even the professionals who have been working on this field have no updated universally acceptable working definition of ideal body weight(IBW) and categorization of over weight and obesity. Ideal body weight percentage (IBW)% like body mass index (BMI) is used to categorize nutritional status of people either malnutrition or overweight-obesity. But there is no good easy tool to calculate Ideal or Desirable Body Weight.

By the way, one very anatomically interesting concomitant happening but overlooked by most of us, is the secular trend in increasing heights of humans paralleling the rise in prevalence of over weight or obesity. Across the globe average heights of people are increasing but this unique phenomenon failed to create appropriate cues to the researchers. Why the weight and height of people are increasing and is there a common cause or link for this phenomenally important biological physical evolution in humans, deserves research attention.

Human biological scientists used to hold it as the natural fact that the height of a kid is average of its parents heights. In recent times, that rule is no more tenable. In all ethnic groups, now the heights of mature kids exceed the average of parents heights.

Although obesity is a giant public health problem, I believe, it is somewhat exaggerated as we do not take into account the current trend of height increase of humans. We are using BMI for categorization of obesity but it must be faulty because it is based on about half a century anthropometric survey data. The normal BMI (Body Mass Index) should be lower for shorter individuals compared to the taller ones.

BMI in fact, doesn't truly measure body fatness, rather it is the measure of weight per unit body surface (per unit square heights). BMI can be analogized with foundation or frame of a structure. The taller the building or structure we need bigger foundation or rod size of the frame. So is the BMI. For taller people normal BMI should be higher than for shorter or medium height individuals. So, unless we do update the current BMI classification of weight status we will inflate the problem of obesity and assign unfair and misleading classifications for significant part of our shorter or taller population.

Dietitians/Nutritionists do this job using a decades-old Rule of Thumb or Hamwi formula or few other rarely used formulas. And those formulas, I do believe like many other dietitian-nutritionists, do not work good for many people, especially for individuals with lower and upper ends of height spectrum.

Hamwi Formula employs two different calculations for male and female. For adult women IBW in pounds = 100 pounds for first 60 inches height plus pounds for each inches above 60 inches ( 5 feet). For example, a 64 inches woman, her Ideal Body Weight [IBW] would be 120 pounds [ 100 pounds plus 4 x 5 pounds]. For men, 106 pounds for first 60 inches plus 6 pounds for every inch above 60 inches or Five feet. So, for example, the IBW in pound for 70 inches man would be 166 pounds [ 106 pounds plus 6 x 10 pounds]. These calculations would gives mean IBW but to get range of IBW, 10% of IBW would be subtracted or added with mean ideal body calculated from the formula. This widely used formula is cumbersome, somewhat inaccurate for heights of both extreme ends of height spectrum [very short or tall]. Moreover, with this formula we can not calculate IBW for people below 60 inches height [five feet].

Though mean IBW represents a single number of weight, normal/healthy/desirable/ideal body weight can not and should not be a single number, rather it is a range of weight. To get the range the propounders of the currently used formulas suggest adding or subtracting 10% of mean IBW ( in fact an arbitrary number rule). IBW actually a good anthropometric parameter to have a gross idea of weight or nutritional status making people weight conscious. But BMI is the better tool to assess the nutritional status and universally used by clinicians and researchers. The normal ideal body weight range we can calculate from Hamwi and other formulas in many a cases conflict with BMI classification of nutritional status, especially with the population extremely short and tall heights.

Keeping the aforesaid problems of existing tools of weight classification in mind I started trying something innovative for a better tool of calculating Ideal/Desirable Body Weight (IBW/DBW). More importantly, unless we can provide people with easy tool to know about their normal or desirable weight we can not make them weight conscious and curb the core problem of obesity.

And with my closer observation of patients and people, and modest personal level research effort and playing with the numbers on heights and weights I had come up with an easy formula to calculate Ideal Body Weight. Calculating BMI by general population will not be feasible. But calculating desirable/ideal/normal body weight would be pretty easy for common people and make them weight conscious.

Moreover, my formula will also obviate present problems the dietitian-nutritionists face everyday in their current practice and it should be remembered by every one to make people weight and health conscious.

Here is my formula and I call it as the MOHAMMED FORMULA for calculating Ideal Body Weight. This formula will be a good tool for all adult individuals short and tall but not for children. The formula will give mean ideal body weight in pounds or kilograms and to get range for normal/ideal/desirable body weight we have to subtract or add 10% of obtained mean Ideal Body Weight (IBW)

My formula has four parts: all to calculating IDEAL BODY WEIGHT [IBW] using the height unit either in Inches [British System] used in the USA or Meter, height unit in Metric System, used universally across the globe.

MOHAMMED FORMULA FOR IBW

1) IBW (pound) = Height in Inches x Height in Inches x 0.032. 2) IBW (kilogram) =Height in Inches x Height in Inches x 0.0145 3) IBW (pound) = Height in Centimeter x Height in Centimeter x0.005 4) IBW ( kilogram) = Height in Centimeter x Height in Centimeter x0.00225.

One can use any of the above formula to calculate IBW depending on what unit one would like to use. This formula ignores little virtual gender difference in body fat composition men and women. To get the range as Ideal or normal body weight can't or should not be a single number we should actually figure out the range. And to obtain we can add or subtract 10% of IBW calculated from the above formulas. Weight of any individual below the range may be considered as under weight and above that range, over weight.

Example of calculation, IBW of an individual with 65 inches or 165 Centimeter would be 135.2 lbs or 61.5 kg. Plugging the height unit in any system and multiplying the corresponding factor we can easily get the Mean Ideal Body Weight.

1) IBW (pound) = 65 x 65 x 0.032 = 135.2 2) IBW (kilogram) = 65 x 65 x 0.0145 =61.3 3) IBW (pound) = 165 x 165 x 0.005 = 136. 4) IBW (kilogram) = 165 x 165 x 0.00225 = 61.3

Range of IBW for a 65" or 165 centimeter individual would be 122-149 lbs (135.2 x 0.9=122; 135.2 x 1.1=149; or 55.2-67.4 kg (61.3 x 0.9=55.2; 61.3 x 1.1=67.4)

Addendum: Thanks to Pogo, for your good comment on the formula. You demanded detail explanation what the basis of my claim that my formula is better than all existing formula. I have already mentioned them before. But now I would try to explain the reasons with examples. First of all, all the existing formulas are similar and have base weight based on base height [five feet 60 inches. So these formulas are useless for a a big population of shorter stature like the women of Maxican and other ethnecities and many are even as short as around 50 inches. But as clinical dietitians how do we calculate their IBW? When I ask this questions to my fellow dietitians they say, they just put any number based on their own best educated guess-work. Some say we do reverse counting or starting deducting from the base weight. By example, what should be IBW of 54" woman? Using Devine/Hamwi formula if we start reverse calculating as many dietitians do the IBW would 100 minus 5x6 would be 70 lbs. And if we further want the range minimum normal weight by subtracting 10% it would be 63 lbs. And then BMI for that weight becomes 15.1 kg/m2 and this weight for 54" women by BMI-wise falls in the category of severe to moderate malnutrition. So this formula conflicts with BMI classification of nutritional status. Moreover, reverse calculation is more time-consuming. But with my formula mean IBW becomes 95 lbs and BMI for that weight and height is 23 kg/m2; and if we want the lowest normal range and subtract 10% we get 85.5 lbs and BMI for that weight of 54" individual comes 20.6 kg/m2 within normal range BMI.

On the other hand, if look into the exsisting formulas for the taller population, for example 6 feet 6 inches like most basket ball players what we find. By Hamwi/Devine and so on formulas the mean IBW we get is 214 lbs and if want to add 10% IBW for calculating the maximum normal range the weight become 235.4 lbs and the BMI with that weight and height is 27.2 kg/m2 and that conflicts and go beyond the normal range of BMI. With my formula IBW for a 78" man is 195 lbs and BMI for that wt is 22.5 kg/m2, within BMI normality range.

In the recent past, there are couple of more formulas those are not based on base weight for base height. Those newer formulas are better than the older version formulas. Yet, they are not immune of inconvenience of use and defects. My formula tried to rid of most of the pitfalls and is more calculation and user-friendly. But my candid confession, as I understand, is that none of the formulas can solve the problem of calculating the true IBW diminishing the defects to nil considering all the associated variables like body composition, gender, ethnicity, body statures, muscle-building work out etc. But knowing the IBW range using the currently existing formulas is a good way to make people health conscious and one best starting point of preventing chronic diseases.

By Mohammed Giashuddin (MBBS, DTMH, MS, RD, CNSC)

a poem on a fon
Agoshago Bangabandhur Goshona (Declaration) 28 Jun Posted by abuusa28

আঘোসাঘো বংগবনধুর ঘোষনা আ মো সিরাজ

(এক) 25শে মার্চ রাতের প্রথম প্রহর 1টা ঘড়ির কাঁটায় কাঁটায়। হে প্রিয়তমা হাসুর মা, নিবৃত্য কর তোমার অশ্রুজল নির্ঝর ঝর্ণাসম আষাঢ়ের মুষলধারা।

শক্‌ত

হও, সাহসে বাঁধো বুক, জানি, কতো বেদনা-বিধুঁর এ মুহু্র্ত্য, তবু যে যেতে হবে, নিয়তি মোর কারাগারে হাজার মাইল দূরে খুব-সম্‌ভব পশ্‌চিম সীমান্‌তপারে। কাছে এসো একেঁ দিই মোর বিদায়ী চুম্‌বনখানি তব চির-পরিচিত অশ্রুসিক্‌ত কপোলকোলে আর সেইসাথে বাংলা মায়ের চরনতলে।

(দুই) হে প্রিয়তমা, জানিয়ে দিও তুমি আমার পরমপ্রিয় দেশবাসীকে শেখ মুজিব কাপুরুষ নয় আমি আত্‌মসমর্পন করিনি পাকিবাহিনীর হাতে। আমি গ্রেফতার বরন করেছি বীরদর্পে ভ্রুকুটি করে শতভয়, জীবনমায়া জেলখানা, ফাঁসির-রজ্‌জু, ফায়ারিং স্‌কোয়াডের বুলেট। আবারো ব্‌নদী হচ্‌ছি আমি, তোমাদের তরে গ্রহন কর মোর শ্রেষ্‌ঠ উপ-হারখানি "চিরমুক্‌তি"। আজ থেকে তোমরা স্‌বাধীন দেশ তোমাদের আর পাকিস্‌তান নয় সে যে তোমাদেরই জন্মভূমি বাংলাদেশ। আমিই তোমাদের দি্‌বতীয় নবাব সিরাজদৌল্‌লাহ রাষ্‌ট্রপতি শেখ মুজিবর রহমান।

(তিন) হে বিশ্‌ববাসী, আমরা তোমাদের স্‌বীকৃতি চাই তোমরা আমাদের অস্র দাও, রসদ দাও, সাহস দাও লড়িবারে পাশব বর্বরে। পাশে দাঁড়াও, দাঁড়াতে দাও মোদের আপন পায়ে বলিষ্‌ঠ চিত্‌তে, উন্‌নত মস্‌তকে। হে কমরেড সংগী-সাথীরা মোর, নিষ্‌ঠার সাথে চালিয়ে যাও স্‌বাধীন সরকারের সব দায়-দায়ীত্‌ব।

(চার) হে দেশবাসী, মনে রেখো ইন্‌শায়াল্‌লাহ, আবারো আমি আসিবো ফিরে তোমাদের মাঝে, এ বাংলায়। ধানসিঁড়ি নদী, গাঙচিল, দোয়েল, কাকাতুয়া, শালবন আর শালিকের দেশে। দৃঢ়পদে হাঁটিব আমি সদম্‌ভে পদ্‌মা-মেঘনা-যমুনার বুকচিরে, থাকবেনা যখন সেথায় কোনো স্রোতধারা মরণ-বাঁধ ফরাক্‌কার কৃপা-কল্যানে। তবু গাইবো আমি, "আমার সোনার বাংলা" ধলেশ্‌বরী, তুরাগ, করতোয়া, মধুমতির তীরে তীরে। যদিও ধরিতে পাইবোনা সেথায় কোনো মাছ কই, টেংরা, পুঁটি, এমনকি ওকোলটাকি। তবে যে কোনো দুঃখ নেই তাতে, মারিতে পারিবো মোরা, মনের সুখে মজাকরি রাজাকার, আল্‌শাম্‌ছ, আল্‌বদর যুগযুগ ধরি।

(পাঁচ) হে প্রিয়তমা হাসুরমা, আরো যে অনেকছিলো বলার, সময় যে নেই মোর, সিপাহীরা দিচ্‌ছে তাড়া, দাও মোর জেলখানার অনবদ্য-সঙী প্রিয় পাইপখানি। ভারী বুদ্ধিমতি তুমি, গুছিয়ে রেখেছো সবই সুন্‌দর করি তরে তরে, মোর সুইটকেইছখানি। রয়েছে তাতে গামছা-লুঙি, পান্‌জাবী-টুপি টুথ্‌পেষ্‌ট, টুথ্‌ব্রাশ, আর একখানি ছোট্‌টো এল্‌বাম তোমার ও হাসু-রেহানা, কামাল-জামাল-রাসেলের গুচ্‌ছ-ছবি। চমত্‌কার! সেটেছো তাতে সাতই মার্চের জনসভার কাটিং, সমুদ্রসম জনতা, বাঙালী ভাইয়েরা আমার।

(ছয়) বিদায়লগ্‌নে বলি, হে মোর দেশবাসী লও মোর রক্তিম সালাম, শেখ মুজিব কাপুরুষ নয়, আমি তোমাদের হিরো, তোমাদের নেতা বঙবন্‌ধু, তোমাদেরই দেবতা, বাঙলার নয়নমণি, জাতির জনক শেখ মুজিব। ভুলনা আমায়, পারবেনা তোমরা কোনোদিন আমার গর্বিত কন্‌ঠস্‌বর, বাঙালীর মুক্‌তির বাণী

"এবারের সংগ্রাম মুক্‌তির সংগ্রাম, এবারের সংগ্রাম স্‌বাধীনতার সংগ্রাম" জয়-বাংলা, জয়-পাকিস্‌তান।