Orchard Chiropractic Centre - Jersey

High BMI, Low Lean Body Mass and Childhood Obesity

Wednesday 30 October 2019

At a recent chiropractic seminar it was observed through palpation that the majority of the delegates felt 'a bit flabby' suggesting low muscle mass (low lean body mass). The delegates in question were between the ages of 23 and 35 and therefore should have been at their peak, yet their lack of muscle suggested longstanding low levels of exercise and poor nutrition (or poor absorption which can be due to poor gut flora and/ or poor food choices). This observation is pertinent as it offers an insight into the state of the nation's health and the direction it is headed.

What is BMI?

Most people are familiar with the Body Mass Index (BMI) which uses mass and height to categorise you from under weight to obese. This can be useful, however, scientists investigating the link between BMI and morbidity noticed what they termed the 'obesity paradox'. The paradox is that studies have shown that people at the higher end of the BMI scale and those at the bottom had increased risk of death from all causes.

The paradox exists because the BMI is a measure of body mass in relation to height. BMI does not account for muscle mass, or visceral fat. Therefore a short muscular person can appear as having a high BMI (obese) and a tall thin person with excess visceral fat can register in the normal/ ideal range. Research shows that visceral fat (fat around the organs) is 300% more inflammatory than other body fat. As will be discussed, new evidence shows that lean body mass is a far more accurate predictor of health than BMI.

Lean Body Mass

A US study[1] of more than 38,006 men found that men with low lean body mass (low muscle mass) and those with a high fat mass had an increased the risk of mortality from all causes.  This finding suggests that the “obesity paradox” controversy may be largely explained by low lean body mass, rather than low fat mass, in the lower range of BMI.

According to a study published in 2018[2] fat-to-muscle ratio is highly predictive of metabolic syndrome[3]. Additionally, the authors cited another study that showed that the muscle-to-fat ratio is also clinically useful for evaluating the presence of insulin resistance.

Ideal Muscle to Fat Ratio

Ideal muscle to fat ratio for men is 3:1 compared to 2:1 for females. Muscle mass in the stated ratios is evidence of and promotes hormonal balance, especially insulin and oestrogen. In order to reduce one's fat mass and increase muscle mass oestrogen and insulin levels must be normal as imbalance promotes a whole host of symptoms including fat storage, fatigue and weakness.

The prevalence of insulin resistance, diabetes and other hormonal disorders in the west is intrinsically linked to the high carbohydrate, low fat diet that has been advocated for the past 60 years. A prolonged high carbohydrate diet reduces insulin sensitivity which reduces glucose transport from the blood to the muscles, increases insulin secretion and promotes fat storage. Another side effect of increased carbohydrate consumption is oestrogen dominance compared to progesterone. Side effects of oestrogen dominance include insulin resistance, weakness, fatigue and weakening of the bones (symptoms of menopause). 

How to Increase Lean Body Mass

Exercise and nutrition are key regulators of muscle mass. Resistance training is particularly important for building mass. Big muscles burn more fuel than small muscles, so it is easier to keep the flab off if you have good muscle mass and tone. A study published in 2018[4]  showed that even moderate resistance training reduces the risk of type 2 diabetes by 30%. 

In order to build healthy muscle, your body requires adequate supply of nutrient dense foods containing proteins, fatty acids, vitamins and minerals. The following link will take you to the relevant page of our website containing low carbohydrate and gluten free recipe ideas and anti inflammatory foods https://www.orchard.co.je/info/food-ideas/. An absence of nutrient dense food in conjunction with lack of exercise is driving the obesity epidemic and associated conditions that is crippling state health systems. The following link will take you to the relevant page of our website with suggested exercise routines, videos and exercise information https://www.orchard.co.je/info/exercises/

In addition to treating musculoskeletal pain, at the Orchard Chiropractic Centre, Jersey we recognise that nutrition and exercise are essential for optimal health and regularly try to assist our patients to make lifestyle changes to improve their health and wellbeing. Although as an adult adopting a healthy lifestyle is always beneficial, there is far more to be gained from ensuring that our children enjoy a healthy lifestyle so that they do not become part of the obesity/ diabetes epidemic.   

Childhood Obesity Statistics for Jersey

Childhood obesity is a significant problem in the western world and one that is growing in countries where a western (high carbohydrate, low fat) diet is becoming more popular. Poor nutrition, lack of exercise, inadequate sleep and environmental factors all contribute to cause what is now being termed a public health disaster. The States of Jersey Health Department has been monitoring obesity in Jersey since 1997 and the results do not make good reading for islanders: 20% of 4-5-year-olds in Jersey are overweight or obese, increasing to a third of 10-11-year-olds. There is a significant difference in the proportion of obese 10-11-year-olds residing in rural parishes (10%), compared to around one in five children living in urban (21%) or semi-urban areas (20%). Students in non fee paying schools were more likely to be obese.




Statistics show that obese children tend to grow into obese adults and they have obese children which perpetuates the cycle and associated diseases. If we are to break the cycle we need to provide our children with nutrient rich low carbohydrate food and get them into the habit of regular exercise. In practice this means eating:

  • oily fish
  • animal and dairy fats from grass fed animals
  • nuts and seeds
  • bitter foods such as cabbage
  • fresh leafy vegetables with every meal

If you would like a more complete list of foods to eat and avoid, please ask at reception or speak to one of our chiropractors Charles and Cardin who will be happy to discuss further.

[1] Lee DH, Keum N, Hu FB, et al. Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ. 2018;362:k2575. Published 2018 Jul 3. doi:10.1136/bmj.k2575

[2] Ramírez-Vélez, Robinson et al. “Fat-to-Muscle Ratio: A New Anthropometric Indicator as a Screening Tool for Metabolic Syndrome in Young Colombian People.” Nutrients vol. 10,8 1027. 7 Aug. 2018, doi:10.3390/nu10081027

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