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    Time to Say Goodbye to the B.M.I.?

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    The body mass index has long been criticized as a flawed indicator of health. A replacement has been gaining support: the body roundness index.Move over, body mass index. Make room for roundness — to be precise, the body roundness index.The body mass index, or B.M.I., is a ratio of height to weight that has long been used as a medical screening tool. It is one of the most widely used health metrics but also one of the most reviled, because it is used to label people overweight, obese or extremely obese.The classifications have been questioned by athletes like the American Olympic rugby player Ilona Maher, whose B.M.I. of 30 technically puts her on the cusp of obesity. “But alas,” she said on Instagram, addressing online trolls who tried to shame her about her weight, “I’m going to the Olympics and you’re not.”Advocates for overweight individuals and people of color note that the formula was developed nearly 200 years ago and based exclusively on data from men, most of them white, and that it was never intended for medical screening. Even physicians have weighed in on the shortcomings of B.M.I. The American Medical Association warned last year that B.M.I. is an imperfect metric that doesn’t account for racial, ethnic, age, sex and gender diversity. It can’t differentiate between individuals who carry a lot of muscle and those with fat in all the wrong places.“Based on B.M.I., Arnold Schwarzenegger when he was a bodybuilder would have been categorized as obese and needing to lose weight,” said Dr. Wajahat Mehal, director of the Metabolic Health and Weight Loss Program at Yale University.“But as soon as you measured his waist, you’d see, ‘Oh, it’s 32 inches.’”So welcome a new metric: the body roundness index. B.R.I. is just what it sounds like — a measure of how round or circlelike you are, using a formula that takes into account height and waist, but not weight.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      A Blood Test Accurately Diagnosed Alzheimer’s 90% of the Time, Study Finds

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      It was much more accurate than primary care doctors using cognitive tests and CT scans. The findings could speed the quest for an affordable and accessible way to diagnose patients with memory problems.Scientists have made another major stride toward the long-sought goal of diagnosing Alzheimer’s disease with a simple blood test. On Sunday, a team of researchers reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling the condition.The study, published Sunday in the journal JAMA, found that about 90 percent of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s. Dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73 percent of the time, while primary care doctors using those methods got it right only 61 percent of the time.“Not too long ago measuring pathology in the brain of a living human was considered just impossible,” said Dr. Jason Karlawish, a co-director of the Penn Memory Center at the University of Pennsylvania who was not involved in the research. “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.”The results, presented Sunday at the Alzheimer’s Association International Conference in Philadelphia, are the latest milestone in the search for affordable and accessible ways to diagnose Alzheimer’s, a disease that afflicts nearly seven million Americans and over 32 million people worldwide. Medical experts say the findings bring the field closer to a day when people might receive routine blood tests for cognitive impairment as part of primary care checkups, similar to the way they receive cholesterol tests.“Now, we screen people with mammograms and PSA or prostate exams and other things to look for very early signs of cancer,” said Dr. Adam Boxer, a neurologist at the University of California, San Francisco, who was not involved in the study. “And I think we’re going to be doing the same thing for Alzheimer’s disease and hopefully other forms of neurodegeneration.”In recent years, several blood tests have been developed for Alzheimer’s. They are currently used mostly to screen participants in clinical trials and by some specialists like Dr. Boxer to help pinpoint if a patient’s dementia is caused by Alzheimer’s or another condition.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Aftermath of a U.K. Cyberattack: Blood Shortages and Delayed Operations

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      Several London hospitals, still reeling from a cyberattack last week, have made an urgent plea to medical students to help stem the disruption.Several London hospitals, still under significant strain more than a week after a cyberattack crippled services, have asked medical students to volunteer to help minimize disruption, as thousands of blood samples have had to be discarded and operations postponed.The ransomware attack on Synnovis, a private firm that analyzes blood tests, has crippled services at two major National Health Service hospital trusts, Guy’s and St. Thomas’ and King’s College, which described the situation as “critical.”According to a memo leaked in recent days, several London hospitals asked medical students to volunteer for 10- to 12-hour shifts. “We urgently need volunteers to step forward and support our pathology services,” said the message, which was reported earlier by the BBC. “The ripple effect of this extremely serious incident is felt across various hospital, community and mental health services in our region.”The attack also disrupted blood transfusions, and the N.H.S. appealed to the public this week for blood donors with O-negative blood types, which can be used in transfusions for any blood type, and O-positive blood types, which is the most frequently occurring blood type, saying it could not match patients’ blood at the same frequency as usual.While the N.H.S. has declined to comment on which group was suspected of carrying out the attack, Ciaran Martin, a former head of British cybersecurity, told the BBC last week that a Russian cybercriminal group known as Qilin was most likely the perpetrator. Synnovis said last week in a statement that it was working with the British government’s National Cyber Security Center to understand what had happened.Synnovis, in an email sent Monday to primary health providers, said that thousands of blood test samples would probably have to be destroyed because of the lack of connectivity to electronic health records. In a statement on Wednesday, Synnovis said that the I.T. system had been down for too long for samples taken last week to be processed.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Report Finds ‘Catalog of Failures’ in U.K. Contaminated Blood Scandal

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      A six-year inquiry found that the deaths of about 3,000 people and the infection of tens of thousands of others could have mostly been avoided.A “catalog of failures” by government and medical officials in Britain, most of them avoidable errors, led to blood contaminations that killed about 3,000 people and infected more than 30,000 others over two decades, according to a long-awaited report published on Monday.The report is the product of a six-year inquiry that the British government ordered in 2017 after decades of pressure from victims and their families, and it could pave the way for sizable compensation payments.The independent report puts a harsh spotlight on Britain’s state-run National Health Service, identifying “systemic, collective and individual failures” by British authorities as they dealt with the infections of tens of thousands of people by tainted blood transfusions or contaminated blood products between the 1970s and the 1990s.The authorities at the time refused to acknowledge those failings — including the lack of proper screening and testing of blood — by “hiding the truth,” the report said.“This disaster was no accident,” Brian Langstaff, a former High Court judge who led the inquiry, said at a news conference on Monday. “People put their trust in doctors and the government to keep them safe, and that trust was betrayed.”He added, “The N.H.S. and successive governments compounded the agony by refusing to accept that wrong had been done.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      What to Know About CKM, the Link Between Heart Health, Diabetes and Kidney Disease

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      And they’re increasingly common. Here’s what to know about the shared risk factors for these diseases.Heart disease, diabetes and kidney disease are among the most common chronic illnesses in the United States — and they’re all closely connected.Adults with diabetes are twice as likely to have heart disease or a stroke compared with those who don’t have diabetes. People with diabetes — Type 1 and Type 2 — are also at risk of developing kidney disease. And when the kidneys don’t work well, a person’s heart has to work even harder to pump blood to them, which can then lead to heart disease.The three illnesses overlap so much that last year the American Heart Association coined the term cardiovascular-kidney-metabolic syndrome to describe patients who have two or more of these diseases, or are at risk of developing them. A new study suggests that nearly 90 percent of American adults already show some early signs of these connected conditions.While only 15 percent of Americans meet the criteria for advanced stages of C.K.M. syndrome, meaning they have been diagnosed with diabetes, heart disease or kidney disease or are at high risk of developing them, the numbers are still “astronomically higher than expected” said Dr. Rahul Aggarwal, a cardiology fellow at Brigham and Women’s Hospital in Boston and co-author of the study.The research suggests that people should pay attention to shared risk factors for these diseases early on — including excess body fat, uncontrolled blood sugar, high blood pressure and high cholesterol or triglyceride levels.A Dangerous CycleYour kidneys, heart and metabolic system (which helps process the food you eat into energy and maintains your blood sugar levels) work closely together. If something goes awry with one, it can lead to problems with the others.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More