Abstract
Objectives
To assess BMI range with the lowest mortality for those aged <65 years and those >65 years, utilising cohort studies that spanned the entire adult age range.
Design
A two-stage random effects meta-analysis of studies that reported mortality in cohorts both ≥65 years and <65 years.
Setting / Participants
Community living adults aged ≥65 and <65 years.
Results
Eight studies were included with a total of 370 416 subjects (306 340 aged <65 years; 64 076 ≥65 years). In the older age group, mortality risk increased at BMIs lower than 22 (BMI range 21.0-21.9: hazard ratio (HR) (95% confidence interval (CI)): 1.05 (1.03, 1.07)), which was not seen in younger adults. In the younger group, mortality increased from BMI range 28.0-28.9 (HR (95% CI): 1.13 (1.00, 1.29)), but mortality did not tend to increase significantly in the older group at BMIs above 23.
Conclusion
The recommended healthy weight range is appropriate for younger and middle aged adults but a higher BMI range should be recommended for older adults based on mortality.
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References
United Nations. World Population Ageing 2013. In: Department of Economic and Social Affairs PD, editor.2013.
World Health Organisation. Global Health Observatory Data. Overweight and obesity. http://www.who.int/gho/ncd/risk_factors/overweight_text/en/ (accessed 1 December 2015)
Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012;307(5):491–7
Health and Social Care Information Centre. Health Survey for England: Trend tables -2014. https://www.gov.uk/government/statistics/health-survey-for-england-trendtables-2014 (accessed 1 June 2016)
Australian Bureau of Statistics. Profiles of Health, Australia, 2011-2013. Overweight and obesity. http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001 (accessed 1 June 2016)
de Hollander E, Van Zutphen M, Bogers R, Bemelmans W, de Groot L. The impact of body mass index in old age on cause-specific mortality. J Nutr, Health Aging 2012;16:100–6.
Winter JE, Mac Innis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 2014;99(4):875–90.
Stessman J, Jacobs JM, Ein-Mor E, Bursztyn M. Normal body mass index rather than obesity predicts greater mortality in elderly people: the Jerusalem Longitudinal Study. J Am Geriatr Soc. 2009;57(12):2232–8.
Sorkin JD. BMI, age, and mortality: the slaying of a beautiful hypothesis by an ugly fact. Am J Clin Nutr 2014;99(4):759–60.
Harrell FE, Lee KL, Pollock BG. Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst 1988;80(15):1198–202.
Orsini N, Li R, Wolk A, Khudyakov P, Spiegelman D. Meta-analysis for linear and nonlinear dose-response relations: examples, an evaluation of approximations, and software. Am J Epidemiol 2012;175(1):66–73.
Jackson D, White IR, Thompson SG. Extending DerSimonian and Laird’s methodology to perform multivariate random effects meta-analyses. Stat Med 2010;29(12):1282–97.
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Medicine 2002;21(11):1539–58.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629–34.
Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. The New Engl J Med 2010;363(23):2211–9.
Freedman DM, Sigurdson AJ, Rajaraman P, Doody MM, Linet MS, Ron E. The mortality risk of smoking and obesity combined. Am J Prev Med 2006;31(5):355–62.
Gulsvik AK, Thelle DS, Mowe M, Wyller TB. Increased mortality in the slim elderly: A 42 years follow-up study in a general population. Eur J Epidemiol 2009;24(11):683–90.
Janssen I, Bacon E. Effect of current and midlife obesity status on mortality risk in the elderly. Obesity (Silver Spring) 2008;16(11):2504–9.
McTigue K, Larson JC, Valoski A, Burke G, Kotchen J, Lewis CE et al. Mortality and cardiac and vascular outcomes in extremely obese women. JAMA 2006;296(1):79–86.
Reis JP, Macera CA, Araneta MR, Lindsay SP, Marshall SJ, Wingard DL. Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring) 2009;17(6):1232–9.
Tayback M, Kumanyika S, Chee E. Body weight as a risk factor in the elderly. Arch Int Med 1990;150(5):1065–72.
Visscher TLS, Rissanen A, Seidell JC, Heliövaara M, Knekt P, Reunanen A et al. Obesity and unhealthy life-years in adult Finns: an empirical approach. Arch Int Med 2004;164(13):1413–20.
Holme I, Tonstad S. Survival in elderly men in relation to midlife and current BMI. Age Ageing 2015;44(3):434–9.
Peter RS, Mayer B, Concin H, Nagel G. The effect of age on the shape of the BMImortality relation and BMI associated with minimum all-cause mortality in a large Austrian cohort. Int J Obes 2015;39(3):530–4.
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Winter, J.E., MacInnis, R.J. & Nowson, C.A. The influence of age on the BMI and all-cause mortality association: A meta-analysis. J Nutr Health Aging 21, 1254–1258 (2017). https://doi.org/10.1007/s12603-016-0837-4
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DOI: https://doi.org/10.1007/s12603-016-0837-4