[acb-diabetics] a few extra pounds may not hurt older people

[Patricia LaFrance-Wolf]

Issue 543

 

A Few Extra Pounds May Benefit Older People

 

A little excess weight after age 70 could do the body some good, according
to results of a study involving 9,000 older patients. Overweight study
participants

had a 13% lower risk of death compared with normal-weight participants.... 

 

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1089869/4-Lantus_Oad_0_300x250_Gif_0  

 

Leon Flicker, PhD, of the Western Australian Center for Health and Aging in
Perth, and colleagues found that, overweight participants in the cohort
study

had the lowest 10-year mortality. Normal-weight and obese participants ages
70 to 75 had a similar and slightly higher risk of death.

 

The findings add to evidence suggesting that being overweight in older age
is not such a bad thing and might even be beneficial.

 

The researchers concluded that, "These results lend further credence to
claims that the body mass index [BMI] thresholds for overweight and obese
are overly

restrictive for older people." The authors also found that a sedentary
lifestyle doubled the mortality risk for older women but did not affect
survival

of older men.

 

The World Health Organization has established four BMI thresholds to
characterize body weight: 

 

list of 4 items

 <18.5 kg/m2, underweight 

 18.5 to 24.9 kg/m2, normal weight 

 25 to 29.9 kg/m2, overweight 

 ?30 kg/m2, obese 

list end

 

The authors noted that the thresholds were derived primarily from studies of
younger and middle-age adults. Whether the cut points for overweight and
obese

are appropriate for older individuals has remained unclear.

 

Two systematic reviews and a meta-analysis showed no increased mortality
risk associated with a BMI in the overweight range for older people (Arch
Intern

Med 2001; 161: 1194-1203, Obesity Rev 2007; 8: 41-59). However, methodologic
differences complicated the comparison of different studies.

 

So they sought to address some of the uncertainty by analyzing data from two
large Australian cohort studies involving more than 9,000 individuals ages

70 to 75 (4,677 men, 4,563 women).

 

The principal objectives were to determine the BMI threshold associated with
the lowest mortality in older people and to determine whether the
relationship

between BMI and mortality differed between men and women.

 

Data for the analysis came from self-reported measures of height and weight,
which the authors used to calculate BMI for the study participants.
Participants

also provided demographic, lifestyle, and health information.

 

Using the WHO criteria for BMI, the authors found that 1.3% of men and 3.1%
of women were underweight; 43.5% of men and 50.3% of women were normal
weight;

44.3% of men and 33.5% of women were overweight; and 11% of men and 13.1% of
women were obese.

 

During 10 years of follow-up, overweight study participants had a 13% lower
risk of death compared with normal-weight participants (HR 0.87, 95% CI 0.78

to 0.94). Obese participants had a mortality risk similar to that of
normal-weight participants (HR 0.98, 95% CI 0.85 to 1.11).

 

Self-reported sedentary lifestyle doubled the mortality risk for women
across all BMI categories (HR 2.08, 95% CI 1.79 to 2.41). In contrast,
sedentary

lifestyle increased the mortality risk for men by 28% (HR 1.28, 95% CI 1.14
to 1.44).

 

Separate analyses involving common causes of death, such as cardiovascular
disease and cancer, showed similar relationships between BMI and mortality
risk.

 

"Even after removing the effects of early mortality, those who were
overweight were still at lowest risk, a finding consistent with the
observation that

weight loss in older age groups is associated with greater mortality," the
authors wrote.

 

"Overweight older people are not at greater mortality risk, and there is
little evidence that dieting in this age group confers any benefit," they
added.

 

Practice Pearls:

list of 2 items

 Explain to patients that this study suggests that overweight older people
do not have an increased mortality risk. 

 Note that the association between BMI and mortality in older people is
controversial.

 

list end

 

Flicker L, et al "Body mass index and survival in men and women aged 70 to
75" J Am Soc Geriatr Soc 2010; DOI: 10.1111/j.1532-5415.2009.02677.x. 

 

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