Metropolitan Life Insurance Research Articles

Overweight adults in the United States: the behavioral risk factor surveys

Using data on 19 405 adults from telephone interviews across the US, 1981 –1983, we examined the sociodemographic characteristics, health-risk behaviors, body image, and dieting of overweight adults classified by the 1959 Metropolitan Life Insurance tables for weight and height. By self-report, 23% were overweight vs 29% in 1960–62. This modest decline in overweight remained after age-adjusting the 1981–1983 rate to the 1960 population. In 1981–1983, more blacks and Hispanics than whites were overweight [rate ratio (RR) = 1.43]. After adjustment for age and education, more over- than average-weight adults had uncontrolled hypertension, were binge drinking, and had a sedentary lifestyle. Among overweight men and women, 72% and 52%, respectively, were not dieting. Overweight adults acknowledging they were overweight were dieting more often than those without this perception (RR = 1.53). Results are discussed in light of research documenting weight gain and overweight as independent risk factors for cardiovascular disease incidence and mortality.

Obesity and Body Weight Standards

tables for men and women developed by the Metropolitan Life Insurance Company (12) based on the 1959 Build and Blood Pressure Study (2). Thus, the definition of over­ weight and obesity in adults is based on actuarial analyses that indicate the weight range for each height category tha t is associated with the lowest mortality rate in an insured population. Body weight, by itself, is not a measure of obesity. Therefore, when it is used to define obesity, it must be related to more appropriate measures of body fat. To this end, a number of indices of body weight have been developed on the basis of varying relationships with total body fat. These indices have utilized, for the most part, body weight in some combination with height. In children, this has most commonly been the use of weight-for-heigh t distributions (per­ centiles), while in adults the common index has been based on the quotient, WIHn. Although a number of different values of n have been suggested for use in different popUlation groups, the most commonly used power function has been 2, as in W(kg)IH(m f. Other approaches have defined some measure of weight at a given age (such as median or mean) as the standard and related all other weights to this arbitrarily defined standard. Still others have defined the standard within

Some medical maxims do not age well: Andres

Reubin Andres, MD, might be considered a gerontological iconoclast. As the chief of clinical physiology at the National Institute on Aging's Gerontology Research Center in Baltimore, he is waging an assault on several medical maxims. Andres questions whether the definition of obesity, diabetes mellitus, and even disease itself is age-dependent. This is nowhere more evident than in his reexamination of the "rocking-chair logic [that] tells you it's bad to gain weight as you get older." At the recent National Institutes of Health consensus development conference in Bethesda, Md, on health implications of obesity (<i>JAMA</i>[MEDICAL NEWS] 1985; 254:1878), Andres urged that the time-honored weight/mortality tables be adjusted according to age. These tables, initially published by Metropolitan Life Insurance Company in 1942, and updated in 1959 and 1983, are used to counsel overweight patients, calculate ideal weight for an individual, and assess health risks. The tables take into account sex and

Self-Funded Health Benefit Plans

ON JUNE 3, 1985, the Supreme Court decided that states may require group health insurance plans to cover certain specified types of care for employees.¹At issue in the case was whether the Metropolitan Life Insurance Company could be required by the Commonwealth of Massachusetts to provide 60 days of inpatient treatment in a mental hospital and certain minimum outpatient benefits in its health insurance plans. On the surface, this judgment bolsters the ability of states to enforce mandated benefit laws. Beneath the surface, however, and of greater overall significance, is the victory this case represents for employers who fund their own employee health benefits, who are not covered by this decision. In contrast, the commercial insurance industry and Blue Cross/Blue Shield, who<i>are</i>covered by this decision, are now bound to offer what the various states require as minimum benefits for their residents. The Court's ruling calls attention to

Federalism in Equality Clothing: A Comment on Metropolitan Life Insurance Company v. Ward

Federalism in Equality Clothing: A Comment on Metropolitan Life Insurance Company v. Ward

Do the new Metropolitan Life Insurance weight-height tables correctly assess body frame and body fat relationships?

The 1983 Metropolitan weight-height tables include elbow breadth as a measure of frame size. Such tables assume that frame measures provide an estimate of fat free mass and have little or no associations with body fat. These assumptions were evaluated in 437 Canadian adults for six frame measures by their associations with total body measures of fat and fat free mass. All six frame measures were similarly correlated with fat free mass, even when associations with height were taken into account. Wrist and ankle breadths were not associated with total body fat, while shoulder, elbow, hip, and knee breadths were so associated. Thus wrist and ankle breadths satisfy the assumptions inherent in the frame-weight-height tables better than elbow breadth and the other frame measures investigated.

A Leader in Health Education: Metropolitan Life Insurance Company

Abstract The American genius for organization has produced a myriad of agencies, organizations, associations, and societies devoted to the betterment of health in this country. These groups have long provided stimulus, guidance, and inspiration to progress in the health sciences, and each has recognized the fundamental significance of education in the persistent battle against disease and accident. This article briefly describes the work of one of the many groups that have contributed to the rapid advancement of health through education in the United States—the Metropolitan Life Insurance Company, one of the first business organizations to recognize the importance of an enlightened public in matters pertaining to health.

Shakespeare USA: The BBC Plays and American Education

B ORN IN THE BICENTENNIAL FERVOR OF 1976, it was to be grand AngloAmerican enterprise, cultural equivalent of Normandy landing, Lend-Lease Act, and Marshall Plan all rolled into one. The British Broadcasting Corporation and Time-Life Television would produce all plays in special made-for-television productions tailored to general audiences. Designed to be enduring and easily understood, productions would deliberately adhere to plain style: William Shakespeare wrote his plays to please an audience that was neither very sophisticated nor literary, said Shaun Sutton, head of BBC's television drama group, and we hope to bring back these plays on same plain terms to mass audience that would have astounded Shakespeare. Undoubtedly, project will have wide educational future; but primarily, plays will be presented as they were first conceived-as entertainment.I Underwriters for $13.6 million venture were to be three corporate giants: Exxon Corporation, Morgan Guaranty Trust Company of New York, and Metropolitan Life Insurance Company. The Corporation for Public Broadcasting (CPB) would supply funding for ancillary educational activities, including special programs on National Public Radio. And WNET/Thirteen in New York would coordinate broadcasts and educational outreach in United States. Pointing out that American funding came to only $100,000 play, WNET President John Jay Iselin accurately summed up high hopes with which series began, calling it the great Anglo-American alliance of twentieth century. Iselin predicted that it would bring about a Shakespeare Renaissance and special educational experience for generation of Americans. 2 Such were high spirits that inspired unusual collaboration of television

Average? Ideal? Desirable? A brief overview of height-weight tables in the United States

Insurance companies have dominated the development of height-weight tables. Initially, tables indicated average weights for insurees, revealing weight gains with increasing age. While pneumonia and tuberculosis were leading causes of death, underweight was considered undesirable because it was associated with those conditions. Extra weight was then thought to represent a reserve that could be drawn upon in time of illness. As those diseases were brought under control, the risk factors in overweight received increased attention. Since the 1940s, tables have been developed by the Metropolitan Life Insurance Company for "ideal" and "desirable" weights, defined as weights associated with the lowest mortality rate. Body frame size, although poorly defined, was factored into the tables. The data base and philosophy of the tables have been questioned by some researchers. Recently, Metropolitan issued 1983 height and weight tables based on life insurance statistics. Weights for height are slightly higher than in the previous (1959) tables. Although stated weights are those associated with the lowest mortality, they are not labeled "ideal" or "desirable". A method for determining body frame size through measurements of elbow breadth is presented. Health care providers should be aware of the latest revisions of these widely used tables, their philosophy, and data source to ensure most suitable use.

Weight standards: their clinical significance.

Editorials1 February 1984Weight Standards: Their Clinical SignificanceC. WAYNE CALLAWAY, M.D.C. WAYNE CALLAWAY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-2-296 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe notion of ideal weight has been with us for sometime. Although the term itself seems to have been coined by the Metropolitan Life Insurance Company in 1942 (1, 2), the idea that there are optimal weights for heights goes back at least to the turn of the century (3). Elsewhere in this issue, Simopoulos and Van Itallie (4) summarize the deliberations of a National Institutes of Health (NIH) workshop that attempted to unravel some of the problems associated with the nonstandardized and often indiscriminate use of terms such as "ideal weight," "desirable weight," and "acceptable weight"; the epidemiologic studies...

Indices of relative body weight and ideal weight charts

Established indices of relative body weight are reviewed and critically evaluated in terms of five criteria: (1) high correlation with obesity, (2) a conceptual interpretation, (3) universality, (4) simplicity of computation, and (5) zero correlation with height. Regression procedures are used to create standard weight charts which are distributed similarly to the body weight of 13,645 Americans, provided by the National Health Survey (NHS), and which have an arithmetic mean equal to the mean of the Metropolitan Life Insurance (MLI) table of desirable weights. A similar method is used to create a standard weight table based on body mass index (BMI). Finally, standard body weight charts which are uncorrelated with sex, age, and/or body frame are developed and discussed in terms of their usefulness.

Determination of Ideal Body Weight for Drug Dosage Calculations

Formulas for ideal body weight (IBW) in men and women were derived from the Metropolitan Life Insurance Company height and weight tables. Regression determinations of median weight versus height were performed for men and women. A program for a minicomputer was developed to generate plots for small, medium, and large frame sizes and for subjects of all frame sizes. Equations for ideal body weight were derived from the resulting data. For men of all frame sizes, IBW = 51.65 kg + 1.85 kg/inch of height greater than 5 feet. For women of all frame sizes, IBW = 48.67 kg + 1.65 kg/inch of height greater than 5 feet. More accurate estimates of IBW by frame size can be obtained using equations derived from the plots for men and women of each frame size. Estimates of IBW obtained by the widely used empirical method probably contain only minor errors. However, formulas derived from actual height and weight data should be used in pharmacokinetic determination of dosage regimens for some drugs.

Cigarette Smoking as a Confounder of the Relationship Between Relative Weight and Long-term Mortality

Cigarette smoking is a potential confounder of the relationship between obesity and mortality, and statistical control for this factor requires careful consideration. Framingham Heart Study subjects were weighed, their stature measured, and cigarette smoking histories obtained at the first biennial examination starting in 1949. Of men under desirable weight (Metropolitan relative weight [MRW], less than 100%), more than 80% were smokers, while only about 55% of the extremely overweight men were cigarette smokers. When age-, smoking-, and MRW-specific mortalities for 26 years of follow-up were calculated in these men, it was found that smokers had higher mortality than nonsmokers but that in the smokers and nonsmokers, minimum mortalities occurred for subjects who were initially in the "desirable weight" group (MRW, 100% to 109%). Among cigarette smokers, lean men (MRW, less than 100%) experienced considerably elevated mortality, often higher than that in all but the most overweight cigarette smokers. These findings suggest that elevated mortality in low-weight American men results from the mortality risks associated with cigarette smoking and demonstrates the need for controlling for cigarette smoking when considering the relationship between relative weight and mortality. Furthermore, the concept of "desirable weight" developed by the Metropolitan Life Insurance Co in 1959 and subsequently distributed in tabular form is validated by this long-term study. Thus, even those men who were near the average weight (about 20% above "desirable weight") showed appreciably elevated mortality. This finding is contrary to the widely held view that moderate overweight carries no increased risk.

Reproductive failure in women who practice weight control

Forty-seven women (29 with unexplained infertility and 18 with menstrual dysfunction) practiced weight control by caloric restriction in order to maintain a fashionable body habitus. All of these women were below ideal body weight (IBW) when compared with Metropolitan Life Insurance Company tables for height and weight. When 36 of these women followed a dietary regimen designed to increase their weight to predicted IBW, 19 of 26 infertile women (73%) conceived spontaneously; 9 of 10 women (90%) with secondary amenorrhea resumed menstruation. Eleven women (23%) would not accept their practice of weight control as the cause of reproductive failure and did not participate in the study. Differences in the serum gonadotropin luteinizing hormone:follicle-stimulating hormone (LH:FSH) ratio were found to be significantly related to differences in the percentage of IBW. The practice of weight control may be a cause of unexplained infertility and menstrual disorders in otherwise healthy women.

Plasma Lipid and Lipoprotein Changes in Hypertensive Patients Treated with Propranolol and Prazosin

The effects of propranolol and prazosin on plasma lipoproteins in patients with essential hypertension were evaluated according to a crossover protocol of two 8-week periods with a washout of 4 to 6 weeks. Eleven patients with moderate hypertension (greater than 90 but less than or equal to 144 mm Hg, diastolic) and slightly overweight (+10% to +/- +30%, according to Metropolitan Life Insurance tables) were selected. No dietary changes were prescribed. Plasma cholesterol, triglycerides (TG), and lipoprotein changes were monitored at the beginning of each sequence and at 2-, 4- and 8-week intervals. Prazosin, when given first, did not essentially modify any of the metabolic parameters, except for a slight elevation in plasma apoprotein AI levels, i.e., the main protein component of high density lipoprotein (HDL); propranolol caused a significant rise in total TG and very low density lipoprotein TG (VLDL-TG) levels (+37.3% and +23.9%, respectively). Somewhat lower total TG (+19.6%) and vLDL (17.8%) TG elevations were noted when propranolol was given first; plasma glucose was also significantly raised (+12.8%). Triglyceride and glucose levels returned to normal upon changing to prazosin. Total plasma- and lipoprotein-associated cholesterol levels were essentially unchanged with either drug; similarly, no significant changes were detected in total plasma apoprotein B (the main protein component of LDL and also VLDL), a component of apoprotein AI levels. Uric acid levels were slightly raised on propranolol. There was an 8.8% reduction in uric acid levels when the medication changed from propranolol to prazosin.

Health promotion in business: caveats for success.

Director, Center for Health Help, Metropolitan Life Insurance Company, One Madison Ave., New York, NY 10010

Too Many Physicians: Sound Alarm!

In late September 1980, the Graduate Medical Education National Advisory Committee (GMENAC), after four years of study, turned in a report to the US Department of Health and Human Services and announced that there will soon be too many physicians. The 21-member committee, appointed to advise, followed the trend so often shown by federally appointed groups and concerned itself with management, thus demonstrating that federal advisory committees haven't changed much during the present decade. 1,2 As reported in American Medical News (Sept 19, 1980), one committee member, Bruce E. Spivey, MD, emphasized the turn of the tide when he said: We started... with the understanding that we were going to try to describe [emphasis added].... Now, for some reason, we feel compelled to make specific recommendations. Another member, Mr Carl Barrera, assistant general counsel for Metropolitan Life Insurance Co, sounded like the well-known economist, Milton Friedman, when the assistant general counsel

Health Promotion at the worksite.

Journal of School HealthVolume 51, Issue 1 p. 65-66 Health Promotion at the Worksite Andrew J. J. Brennan, Andrew J. J. Brennan Andrew J. J. Brennan, PhD, Director, Center for Health Help, Metropolitan Life Insurance Company, One Madison Avenue, New York, New York 10010.Search for more papers by this author Andrew J. J. Brennan, Andrew J. J. Brennan Andrew J. J. Brennan, PhD, Director, Center for Health Help, Metropolitan Life Insurance Company, One Madison Avenue, New York, New York 10010.Search for more papers by this author First published: January 1981 https://doi.org/10.1111/j.1746-1561.1981.tb02105.xCitations: 3 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume51, Issue1January 1981Pages 65-66 RelatedInformation

"BUT, DOCTOR, YOU SAID..." (30 minutes, color, 16 mm. and videocassette, 1979). Available on free loan to health care professionals from the Health and Safety Education Division, Metropolitan Life Insurance Company, 1 Madison Avenue, New York, New York 10010

<b>"BUT, DOCTOR, YOU SAID..."</b> (30 minutes, color, 16 mm. and videocassette, 1979). Available on free loan to health care professionals from the Health and Safety Education Division, Metropolitan Life Insurance Company, 1 Madison Avenue, New York, New York 10010

Identification of Personality Characteristics of University Women Students Preceding A Weight Control Regimen

This research analyzed the data from 347 subjects who completed a personality assessment and enrolled in a weight control regimen. The subjects were grouped by their deviation from normal body weight as determined by Metropolitan Life Insurance Company Tables (1969). Three groups were identified: (1) underweight, subjects whose weight deviated more than 10 percent below ideal weight; (2) middleweight, subjects deviating within 10 percent of ideal weight; and (3) overweight, subjects deviating more than 10 percent above their ideal weight. On the basis of scores assigned to their responses on the Taylor‐Johnson Temperament Analysis, nearly a fourth of the subjects were categorized as being in the stress syndrome (formerly identified as suicide proneness).Underweight subjects had the highest percentage of scores in the stress syndrome, and overweight subjects had the lowest percentage of scores that identified them as being under stress.A significant relationship was found between the scores of the subjects on the personality trait subjective (emotional, illogical, self‐absorbed) and having fathers whom they perceived to be over weight. Significant relationships were also found between the subjects' scores in the two traits, quiet (socially‐inactive, lethargic, withdrawn) and submissive (passive, compliant, dependent), and the weight of their closest friend, if the weight of the friend was perceived as being either under‐ or overweight rather than normal.