Excess weight is protective in the elderly? New research says no

Obesity is a known health risk. The number of epidemiological studies that have linked excess weight to cardiovascular disease, cancer, diabetes, other chronic conditions, and increased risk of death is staggering.1,2 In fact, the cutoff points for BMI into overweight and obese were created to reflect increased risk of disease and death due to excess fat.3

Photo of obese man

Then there is the “obesity paradox.” This is the term used to describe the opposite of the usual finding - there are certain groups of people, usually those with severe chronic diseases such as heart failure and kidney disease, in which a higher BMI seems to be associated with a decreased mortality risk.4,5

Elderly persons are another group in which an obesity paradox has been observed in some studies.6 However, this observation is not consistent – other studies have reported an increased risk with higher BMI in adults over age 70 or 75, similar to younger age groups, and others have shown no association at all.7-11 Overall, the relationship between BMI and mortality in the elderly has been unclear.

Several explanations have been proposed to explain the paradox – these are a few examples:

  • BMI is not a true indicator of body fat – older persons tend to have more body fat at the same BMI as younger adults.3 One study found that greater waist circumference in the elderly was associated with increased mortality risk, but greater BMI was associated with decreased risk. In these individuals, greater BMI may reflect greater fat-free mass, rather than greater body fat. Waist circumference and fat-free mass may be more important indicators than BMI for obesity-associated health risks in the elderly.12,13
  • Unintentional weight loss may be involved – many older persons in these studies who are at a low or normal BMI may be there because of disease-related weight loss. Weight loss in elderly has been shown to be associated with negative health outcomes, presumably for this reason.14 So a study of elderly persons that only takes one weight measurement and does not measure weight change over time is inherently flawed.
  • Another issue with the length of studies is that weight gain late in life is probably less dangerous than weight gained earlier in life and then maintained for many years – being obese for 50 years results in more cumulative damage than being obese for 15 years. The earlier you become obese, the greater the risk of death.15,16 Therefore, long-term data (decades, not years) is needed to get an accurate picture of health risks in the elderly due to obesity.

Newer research attempted to reconcile the contradictions in previous studies by using long-term data. Although the researchers used BMI rather than waist circumference, they used two weight measurements 17 years apart, and followed subjects for a total of 29 years – importantly, they only included subjects who maintained a similar weight over the first 17 years – this helped to remove any potential effects from late life weight gain or disease-related weight loss.

Men (age 75-99) who maintained a BMI greater than 22.3 had a shorter life expectancy by 3.7 years, and an 88% increased risk of death during the study period compared to men with a lower BMI. Men who maintained a BMI greater than 27.3 had double the risk of death compared to those with a BMI less than 22.3. Women in the same age group who maintained a BMI greater than 27.4 shortened their life expectancy by 2.1 years, and had a 41% increase in risk of death compared to women with a lower BMI.17,18

This study leads us to conclude: no matter what your age, carrying excess weight for a significant length of time is dangerous – in fact, it can be deadly.

 

References: 

1. Guh DP, Zhang W, Bansback N, et al: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health 2009;9:88.
2. McGee DL: Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Ann Epidemiol 2005;15:87-97.
3. U.S. Centers for Disease Control and Prevention: About BMI for Adults. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. Accessed
4. Oreopoulos A, Padwal R, Kalantar-Zadeh K, et al: Body mass index and mortality in heart failure: a meta-analysis. Am Heart J 2008;156:13-22.
5. Schmidt D, Salahudeen A: The obesity-survival paradox in hemodialysis patients: why do overweight hemodialysis patients live longer? Nutr Clin Pract 2007;22:11-15.
6. Oreopoulos A, Kalantar-Zadeh K, Sharma AM, et al: The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med 2009;25:643-659, viii.
7. Calle EE, Thun MJ, Petrelli JM, et al: Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999;341:1097-1105.
8. Janssen I, Mark AE: Elevated body mass index and mortality risk in the elderly. Obes Rev 2007;8:41-59.
9. Grabowski DC, Ellis JE: High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging. J Am Geriatr Soc 2001;49:968-979.
10. Kuk JL, Ardern CI: Influence of age on the association between various measures of obesity and all-cause mortality. J Am Geriatr Soc 2009;57:2077-2084.
11. Stevens J, Cai J, Pamuk ER, et al: The effect of age on the association between body-mass index and mortality. N Engl J Med 1998;338:1-7.
12. Janssen I, Katzmarzyk PT, Ross R: Body mass index is inversely related to mortality in older people after adjustment for waist circumference. J Am Geriatr Soc 2005;53:2112-2118.
13. Zamboni M, Mazzali G, Zoico E, et al: Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 2005;29:1011-1029.
14. Woo J, Ho SC, Sham A: Longitudinal changes in body mass index and body composition over 3 years and relationship to health outcomes in Hong Kong Chinese age 70 and older. J Am Geriatr Soc 2001;49:737-746.
15. Adams KF, Schatzkin A, Harris TB, et al: Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 2006;355:763-778.
16. Sun Q, Townsend MK, Okereke OI, et al: Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study. BMJ 2009;339:b3796.
17. Singh PN, Haddad E, Tonstad S, et al: Does excess body fat maintained after the seventh decade decrease life expectancy? J Am Geriatr Soc 2011;59:1003-1011.
18. Contrary to Earlier Findings, Excess Body Fat in Elderly Decreases Life Expectancy. 2011. ScienceDaily. http://www.sciencedaily.com/releases/2011/08/110811151325.htm. Accessed September 29, 2011.

 

Omega-3 fatty acids slow cellular aging

In coronary heart disease (CHD) patients, higher levels of the omega-3 fatty acids EPA and DHA in the blood are associated with survival.1,2 Since patients with higher circulating omega-3s seemed to live longer, scientists wondered whether these patients were actually aging more slowly. 

They were able to indirectly measure rate of aging by measuring the telomere shortening rate in the patients’ white blood cells. Telomeres are regions of DNA at the ends of linear chromosomes – since telomeres are shortened during each cell division as DNA is replicated, telomere shortening is an indicator of aging at the DNA level. Faster telomere shortening means faster aging.

Blood levels of EPA and DHA and white blood cell telomere length were measured in CHD patients at baseline and again after 5 years.  The patients who had the lowest omega-3 levels had the fastest rates of telomere shortening, and those with the highest omega-3 levels had the slowest rates of telomere shortening. 

Omega-3s may in fact slow aging at the DNA level.

Omega-3 fatty acids, have several health benefits , and more benefits continue to be uncovered. In addition to slowing the aging process, in the past year alone the omega-3 fatty acid DHA has been suggested to promote cognitive development, prevent atherosclerotic plaque development, curb inflammation, and protect against cancer. 

Read more about the newly found health benefits of DHA, and why it may be both safer and more environmentally sound to use an algae-based DHA supplement, like my DHA Purity, instead of fish oil. I also still strongly recommend that certain seeds and nuts rich in the omega-3 ALA, such as flax, chia, hemp, or walnuts are important to be included in the diet as well for other documented health benefits. 

 

References:

1. Chattipakorn N et al. Cardiac mortality is associated with low levels of omega-3 and omega-6 fatty acids in the heart of cadavers with a history of coronary heart disease. Nutr Res. 2009 Oct;29(10):696-704.

2. Farzaneh-Far R et al. Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease. JAMA. 2010 Jan 20;303(3):250-7. 

Excess iron and copper contribute to chronic disease and aging

Both iron and copper serve vital functions, but as we age excess stores of these metals may build and become toxic. A report from the American Chemical Society1 suggests that iron and copper toxicity are unrecognized but significant threats to public health, in particular for adults over the age of 50.

pennyIron is crucial for oxygen transport and the proper function of several enzymes and proteins. Similarly, copper is also a component of enzymes that catalyze important reactions in several of the body’s cells and tissues. The human body evolved to store excess iron and copper to fuel these vital processes in case of extreme conditions like bleeding or famine, but their accumulation over time may be detrimental because both metals are involved in the production of reactive oxygen species (ROS).

It is now generally accepted that oxidative damage, a byproduct of oxygen-dependent energy production, contributes to chronic diseases and aging.

Oxidation of LDL cholesterol is one of the initial steps of atherosclerotic plaque development. Epidemiological associations between body stores of each of these metals and atherosclerosis have been found, and this is thought to be due to ROS production.2 

Oxidative damage and depletion of the brain’s natural antioxidant defenses are implicated in the neurodegeneration associated with Alzheimer’s disease. Because the brain uses more oxygen and produces more energy than any other organ, it is the most vulnerable organ to oxidative damage. The high iron content of the brain, even higher in those with excessive iron stores, makes the brain even more vulnerable to oxidative stress.3

In people at least 65 years of age who consumed diets high in saturated and trans fats, copper intake was associated with accelerated cognitive decline. Copper bound to cholesterol is also commonly found in the β-amyloid plaques characteristic of Alzheimer’s disease.4

Excess quantities of these metals primarily come from meat, followed by multivitamin/multimineral supplements. Copper in supplements and drinking water is even more toxic than copper derived from food sources.1   

The author of this new report has outlined steps that we can take to limit our exposure to copper and iron, including:

  • Avoiding or minimizing red meat consumption

  • Avoiding drinking water from copper pipes

  • Choosing a multivitamin that does not contain copper and iron. 

Dr. Fuhrman designed his Gentle Care Formula multivitamin/multimineral to be free of potentially toxic ingredients like copper and iron.

 

References:

1. American Chemical Society (2010, January 22). Consumers over age 50 should consider cutting copper and iron intake, report suggests. ScienceDaily. Retrieved January 29, 2010, from http://www.sciencedaily.com /releases/2010/01/100120113553.htm 

Brewer GJ. Risks of Copper and Iron Toxicity during Aging in Humans. Chem Res Toxicol. 2009 Dec 7. [Epub ahead of print]

2. Brewer GJ. Iron and Copper Toxicity in Diseases of Aging, Particularly Atherosclerosis and Alzheimer’s Disease. Exp Biol Med 232 (2): 323. 2007

3. Kidd PM. Neurodegeneration from Mitochondrial Insufficiency: Nutrients, Stem Cells, Growth Factors, and Prospects for Brain Rebuilding Using Integrative Management. Alternative Medicine Review 2005;10(4):268-293

4. Morris MC et al. Dietary copper and high saturated and trans fat intakes associated with cognitive decline. Arch Neurol. 2006 Aug;63(8):1085-8.

Exercise keeps your DNA young - and it's never too late to start

 

people exercising

A study on mortality rate in men with varying levels of physical activity, as would be expected, found that the group of men with high levels of physical activity had a 32% reduction in mortality rate compared to those in the sedentary group. 

A subset of these sedentary men began exercising at or around age 50 – after 10 years, these men had the same mortality rate as the men who had been actively exercising all along.1 

In addition to the many well-known benefits of exercise (prevents chronic disease, reduces cancer risk, beneficial for heart health), there is now accumulating evidence that exercise slows aging at the DNA level.

Telomeres are non-coding regions located on the end of linear chromosomes, and they are shortened with each cell division until the cell no longer divides. For this reason, telomere length is an indicator of cellular aging. Telomere length is maintained in actively dividing cells (such as stem cells and immune cells) by an enzyme called telomerase. There is an inverse association between leisure time exercise energy expenditure and telomere length – meaning that those who exercise regularly have “younger” DNA in their immune cells than those who are sedentary.2-3 A study of middle-aged German track and field athletes found not only longer telomeres in immune cells but also increased activity of the telomerase enzyme and decreased expression of cell-cycle inhibitors – molecules that prevent cell division – in these athletes compared to age-matched untrained individuals.4

Collectively, these studies tell us that exercise not only prevents disease, but promotes longevity, even if we get a late start.

 

References:

1. Byberg L et al. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. BMJ 2009;338:b688

2. Ludlow AT et al. Relationship between Physical Activity Level, Telomere Length,

and Telomerase Activity. Med Sci Sports Exerc. 2008 October ; 40(10): 1764–1771

3. Cherkas LF et al. The association between physical activity in leisure time and leukocyte telomere length. Arch Intern Med. 2008 Jan 28;168(2):154-8.

4. Werner C et al. Physical Exercise Prevents Cellular Senescence in Circulating Leukocytes and in the Vessel Wall. Circulation. 2009 Nov 30. [Epub ahead of print]

 

Early Weight Gain Linked to Impaired Mobility Later

A new study in the American Journal of Epidemiology claims carrying around extra bodyweight earlier in life is associated with decreased mobility later on. Researchers examined 2,845 individuals with no reported mobility issues, collecting new information on their mobility limitations every six months for the next seven years. Data revealed women who were overweight or obese during their mid-20s to 70s were three times more likely to develop mobility limitations. Men only had about half that risk; via ScienceDaily.

Not only do extra pounds slow you down, but a recent study revealed obesity can shorten lifespan by 4 to 10 years, similar to cigarette smoking. Good thing healthy foods like grapes help fight abdominal fat and protect against high blood sugar and insulin resistance.

So, if you don’t feel like shuffling around when you get older. Stay active! Start doing weight-bearing exercises, like jumping, to keep your muscles strong and your bones sturdy.

Image credit: hey mr glen

Take it Easy, Stress Will Make You Crazy!

Next time you’re freaked out, calm down. A new study in Neurology claims people who cope with stress are less likely to develop dementia. In outgoing, social people the findings were particularly high. A decreased risk was also observed in less social people that could still handle stress well. Researchers tracked 506 older people for 6 years, during this time 106 became demented. In the beginning, participants filled out questionnaires to determine their personality type and stress level; CNN reports.

I deal with stress by bashing my head against the wall. Kidding! Actually, for me Yoga is a huge stress alleviator. And a previous study reveals mediation and prayer techniques, like those found in Yoga, might change people’s gene activity and help them better react to stress. Shanti, shanti!

And other reports show being social improves memory and reducing stress helps you live longer.

Image credit: bethboya

Women Less Active than Men

Presenting at the UK Society for Behavioral Medicine’s annual conference, researchers claim both young girls and women over 70, aren’t as active as their male counterparts. In children, boys tended to play very physicals games and run around like mad men, but girls spent more time in smaller groups, engaging in conversation, verbal games and socializing. In older folks, exercise levels were down among both genders. However, men did more intensive activities, but rested more. While women engaged in lower intensity activities, like housework, for longer intervals; The BBC News investigates.

Staying active and exercising is important for everyone, especially women. Exercise can help build stronger bones, staving off osteoporosis.

Via That’s Fit.

Walking Fights Age-Related Weight Gain

Walking just a half an hour each day might help keep you from packing on the pounds as you get older. The research, appearing in the American Journal of Clinical Nutrition examined 5,000 men and women, ages 18 to 30, for 15 years, revealing those who walked 30 minutes a day reduced weight gain by 1 pound. The results also found those who exercised more during their middle adult years were more likely to maintain their weight as they got older; WebMD reports.

It can’t get much easier than walking. Heck, it’s what we evolved to do! But a lot of us are too busy with work and don’t have the time to walk around for a half an hour. So try taking the stairs instead, it’s been proven to improve heart health. And simple stretches at your desk can keep the blood following too.

Now, if you can, get running! A previous study showed runners actually live longer.

Via CalorieLab.