Obesity without metabolic syndrome still associated with increased mortality

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1. Women with an unhealthy BMI (<18.5 or >25) or waist circumference (>88cm) were associated with increased odds of mortality by 85 years old. 

2. Overweight and obese women (BMI>25 or waist circumference >88cm) surviving to 85 years old were more likely to develop disease or mobility disability relative to patients with normal BMI. 

Evidence Rating Level: 2 (Good)           

Study Rundown: Obesity is a known risk factor for developing many chronic diseases and contributes to significant disability, especially among older adults. Previous research has shown that men with a healthy weight were more likely to live longer without disease and disability. This study examined the effect of obesity on female survival to 85 years old without major disease or disability.  The authors found that having an unhealthy BMI and waist circumference was significantly associated with increased odds of mortality as well as mobility disability and developing chronic disease by 85 years. Conversely, women with a healthy BMI or waist circumference were more likely to live until 85 years without a major disease or mobility disability. This study included data from a large and ethically diverse sample of women who were followed for almost 19 years. Overall, these findings provide support for interventions to promote healthy weight among elderly women.

Click to read the study in JAMA Internal Medicine

Relevant Reading:  The effect of obesity on disability vs mortality in older Americans

In-Depth: This longitudinal study analyzed 36,611 women from the Women’s Health Initiative.  Women classified as overweight (BMI = 25-30) were more likely to die by 85 years old (Odds Ratio: 1.09, CI: 1.01-1.18) and live to 85 years with mobility disability (OR: 1.64, CI: 1.50-1.79), after adjusting for baseline age, hormone therapy use, race/ethnicity, baseline smoking status and alcohol use, among other variables. Similar to previous studies, women with a BMI less than 18.5 were at increased odds of death by 85 (OR 2.09, CI: 1:54-12.85). Waist circumference above 88cm was also significantly associated with increased odds of mortality (OR=1.83, CI: 1.66-2.03) and living to 85 years with mobility disability (OR=1.65, CI: 1.49-1.84).

By Jonathan Lichkus and Rif Rahman

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