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Anthropometric measurements and survival in older Americans: Results from the third national health and nutrition examination survey

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

The impact of adiposity on mortality in older adults remains controversial. Some reports suggest that measures of general adiposity such as body mass index (BMI) predict better survival. We assessed the relationship between measures of adiposity and mortality in older adults.

Design

Cross-sectional analysis of a population-based sample.

Setting

Non-institutionalized persons in the United States participating in the National Health and Nutrition Examination Surveys III and its linked mortality dataset.

Participants

A subsample of 4,489 non-institutionalized survey participants aged >60 years with measures of body composition using bioimpedance. To account for possible residual confounding, smokers, subjects with heart failure, respiratory disease, kidney disease and cancer were excluded (n=2,920). Data from 1569 subjects were analysed.

Measurements

BMI, waist circumference (WC), waist-hip ratio (WHR), lean mass (LM) and % Body Fat (BF) were classified by tertiles (lowest=referent). Proportional-hazard models evaluated the association of anthropometric indices with overall and cardiovascular mortality.

Results

Mean age was 69.4years, and 265(16.9%) were >80 years. There were 717(47.6%) women and 792 deaths of which 284 [35.9%] were cardiovascular related. Elevated BMI was associated with reduced cardiovascular mortality (HR 0.53 [0.30–0.84]), and remained significant after adjusting for LM (HR 0.54 [0.31–0.93]). Elevated %BF was associated with reduced mortality from cardiovascular causes (HR 0.52 [0.29–0.91]). Low BMI was associated with higher risk of cardiovascular (HR 3.66 [1.25–10.69]) and overall death (HR 2.44 [1.22–4.90]).

Conclusion

Measures of adiposity in older participants are associated with lower mortality from cardiovascular causes that cannot be explained by major known confounders between obesity and mortality. Further studies need to elucidate a possible protective role and interplay between adiposity and skeletal muscle in older adults.

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Abbreviations

BF:

body fat

BMI:

body mass index

CHF:

congestive heart failure

CV:

Cardiovascular

HDL:

high density lipoprotein

LDL:

low density lipoprotein

LM:

lean mass

NHANES:

National Health and Nutrition Examination Survey

WC:

waist circumference

WHR:

waist-hip ratio

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Authors and Affiliations

  1. Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA

    John A. Batsis

  2. Division of Cardiovascular Diseases, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, Alabama, 35294-0006, USA

    S. Singh

  3. Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    F. Lopez-Jimenez

Authors
  1. John A. Batsis
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  2. S. Singh
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  3. F. Lopez-Jimenez
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Correspondence to John A. Batsis.

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Batsis, J.A., Singh, S. & Lopez-Jimenez, F. Anthropometric measurements and survival in older Americans: Results from the third national health and nutrition examination survey. J Nutr Health Aging 18, 123–130 (2014). https://doi.org/10.1007/s12603-013-0366-3

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  • DOI: https://doi.org/10.1007/s12603-013-0366-3

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