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Millions of people carry 10 to 15 extra pounds of weight after having children, developing joint problems, becoming less active, and making diet a major part of their social lives. is reaching his later years.
Should we lose this modest excess weight in order to optimize our health? This question has been brought to the fore by the new category of diabetes and weight loss drugs that give people hope that they can shed the extra pounds. .
For years, experts have debated what to advise older people in this situation. On the one hand, weight gain is associated with fat accumulation. And it can have serious negative health effects, causing heart disease, diabetes, arthritis, and many other medical conditions.
On the other hand, many studies suggest that carrying extra weight may have life-saving benefits later in life. For people who have fallen, fat can act as padding and prevent fractures. And for people with serious illnesses such as cancer or advanced kidney disease, the stuffing provides energy and helps them withstand the harsh treatment.
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To maintain muscle mass, the US Centers for Disease Control and Prevention recommends strength training at least twice a week.
Of course, it depends on the weight of the first person. People who are already obese (BMI above her 30) and have excess weight are at higher risk than those who are underweight. And rapid weight gain in later life is always a cause for concern.
Understanding scientific evidence and expert opinion on weight problems in older adults is not easy. Here’s what I learned after reviewing dozens of studies and talking to nearly 20 obesity doctors and researchers.
Our bodies change as we age. As we age, our body composition changes. We lose muscle mass and this process begins in his 30s and accelerates after his 60s. and gain more fat. This is true even if the weight is constant.
In addition, less fat accumulates under the skin, and more fat is distributed in the central part of the body. This belly fat is associated with increased risk of conditions such as inflammation and insulin resistance, cardiovascular disease, diabetes and stroke.
“Fat distribution plays an important role in determining how much weight gain in the form of fat is harmful,” said Mitchell Lazar, director of the Diabetes, Obesity and Metabolism Institute at the University of Pennsylvania Perelman School of Medicine. Stated. “It’s visceral [abdominal] It’s the fat around the waist that we’re really concerned about, not the fat around it (hips and buttocks). ”
Activity levels decline with age. Also, as people age, they tend to become less active. When older people maintain the same eating habits (energy intake) but reduce activity (energy expenditure), they gain weight.
According to the US Centers for Disease Control and Prevention, 27% of 65- to 74-year-olds are not physically active outside of work. It rises to 35% in those over 75 years of age. Health organizations recommend that older adults do at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, and strength-building activities, such as weightlifting, at least twice per week. According to various studies, only 27% to 44% of her older people meet these guidelines.
I’m worried about my muscle mass. Experts are more concerned about inactivity in older people who are overweight or mildly obese (BMI in their early 30s), rather than weight loss. Minimal or no activity “increases the risk of developing a disability or impairment,” which can lead to loss of muscle mass and strength and can interfere with independence, says an obesity researcher and associate professor at North University School of Medicine. said Jon Battsis. Carolina Medical College in Chapel Hill.
Weight loss leads to a lack of muscle mass, to the extent that muscle is lost along with fat. On average, for every weight you lose, 25% comes from muscle and 75% comes from fat.
Older people naturally have less muscle, so “if you want to lose weight, you need to actively increase your physical activity at the same time,” says Ann Newman, director of the Center for Aging and Population Health at the University of America. Pittsburgh School of Public Health.
Your ideal weight may be higher. According to epidemiological studies, the ideal body mass index (BMI) It may be higher in older people than in younger people. (BMI is a person’s weight in kilograms or pounds divided by his height in meters or feet squared.)
In one large and well-regarded study, older adults at the extremes of the BMI spectrum—those with low BMI (<22) and those with high BMI (>33)—had a higher rate of early age than those with BMI in that range. found to be at increased risk of dying in Mid-range (22 to 32.9).
Older people at the lowest risk of early death had a BMI between 27 and 27.9.according to World Health Organization standards, which falls in the “overweight” range (25 out of 29.9) and exceeds the BMI “healthy weight” range (18.5 to 24.9). Also, many older people found to be at highest risk of death in this study (those with a BMI of less than 22) would be classified by WHO as being of “healthy weight.”
The conclusion of the study is that the WHO healthy weight range may not be suitable for older people. Rather, being overweight can be beneficial for older people, but being significantly underweight can cause problems and increase the likelihood of frailty.
In fact, the optimal BMI for older people may range from 24 to 29, Carl Lavi, a prominent obesity researcher, suggested in another study examining the evidence for obesity in older people. . Raby is the Medical Director of Cardiac Rehabilitation and Prevention at Ochsner Health, a large health care system based in New Orleans, and author of the book Obesity Paradox, which explores weight problems in older adults.
Expert recommendations. Obesity doctors and researchers provided some key recommendations during our conversation.
- For overweight older adults (those with a BMI between 25 and 29.9), maintaining fitness and muscle mass is more important than losing weight. “Will losing a few more pounds dramatically improve health? I don’t think the evidence shows that,” said LaVie.
- Unintended weight loss is associated with several serious illnesses and is a red flag that should always be monitored. “If you’re trying to lose weight without trying, see your doctor,” said Newman of the University of Pittsburgh. She is a co-author of a new paper, “Unexpected weight loss is associated with increased risk of death, even in obese adults.”
- Ensuring food quality is essential. “Older people are at risk of vitamin deficiencies and other nutritional deficiencies, and not getting enough protein can be a problem,” said Bhattsis of the University of North Carolina. “I tell all my elderly patients to take multivitamins,” said Dinesh Edem, director of the Medical Weight Management Program at the Arkansas School of Medicine.
- Losing weight is more important for older people with more fat in the middle (apple-shaped) than for those with a heavier lower body (pear-shaped). “For patients with high waist circumferences, we are aggressively working to reduce calories or increase exercise,” said Dennis Kerrigan, director of weight management at Henry Ford Health in Michigan.
- Maintaining weight stability is a good goal for healthy older adults who have excess weight but are not moderately or severely obese (BMI > 35). By definition, “health” is defined as serious metabolic problems (too high cholesterol, blood sugar, blood pressure, triglycerides), obesity-related disorders (often problems with exercise capacity), or severe conditions such as diabetes. This means no serious obesity-related illnesses. Or heart disease. “No big gains, no big losses. That’s what I recommend,” says Katie Dodd, a geriatric nutritionist who blogs about nutrition.
KFF Health NewsFormerly known as Kaiser Health News (KHN), it is a national news editorial office that produces in-depth journalism on health issues and is one of its core operating programs on health issues. KFFMore — An independent source for health policy research, polls and journalism.
