Metabolic Health Status and the Obesity Paradox in Older Adults

• Published in: Journal of nutrition in gerontology and geriatrics 2016-07, Vol.35 (3), p.161-176
• Main Authors: Cheng, Feon W., Gao, Xiang, Mitchell, Diane C., Wood, Craig, Rolston, David D. K., Still, Christopher D., Jensen, Gordon L.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Body Mass Index; Cohort Studies; elderly; Female; Health Services for the Aged; Health Status; Humans; Male; metabolic health; mortality; Nursing; obesity; Obesity - metabolism; Obesity - mortality; Pennsylvania; Prospective cohort study; Risk Factors
• ISSN: 2155-1197; 2155-1200
• DOI: 10.1080/21551197.2016.1199004

The explanation for reduced mortality among older persons with overweight or class I obesity compared to those of desirable weight remains unclear. Our objective was to investigate the joint effects of body mass index (BMI) and metabolic health status on all-cause mortality in a cohort of advanced age. Adults aged 74 ± 4.7 (mean ± SD) years at baseline (n = 4551) were categorized according to BMI (18.5-24.9, 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m 2 ) and the presence or absence of a metabolically healthy phenotype (i.e., 0 or 1 risk factors based on a modified Adult Treatment Panel III). Metabolically unhealthy was ≥2 risk factors. There were 2294 deaths over a mean 10.9 years of follow up. Relative to metabolically healthy desirable weight, metabolically healthy overweight or class I obesity was not associated with a greater mortality risk (HR 0.90; 95 CI% 0.73-1.13 and HR 0.58; 95 CI% 0.42-0.80, respectively) (P-interaction