TY - JOUR
T1 - The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China
T2 - a 20-year prospective cohort study
AU - Lv, Yuebin
AU - Mao, Chen
AU - Gao, Xiang
AU - Ji, John S.
AU - Kraus, Virginia Byers
AU - Yin, Zhaoxue
AU - Yuan, Jinqiu
AU - Chen, Huashuai
AU - Luo, Jiesi
AU - Zhou, Jinhui
AU - Li, Zhihao
AU - Duan, Jun
AU - Zhu, Qingyang
AU - Zeng, Yi
AU - Wang, Wentao
AU - Wang, Jiaonan
AU - Shi, Xiaoming
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2022/5
Y1 - 2022/5
N2 - National and international recommendations of healthy body mass index (BMI) are primarily based on evidence in young and middle-aged populations, with an insufficient representation of the oldest old (aged ≥80 years). Here, we report associations between BMI and mortality risk in 27,026 community-dwelling oldest old (mean age, 92.7 ± 7.5 years) in China from 1998 to 2018. Nonlinear curves showed reverse J-shaped associations of BMI with cardiovascular disease (CVD), non-CVD and all-cause mortality, with a monotonic decreased risk up to BMIs in the overweight and mild obesity range and flat hazard ratios thereafter. Compared to normal weight, overweight and obesity were significantly associated with decreased non-CVD and all-cause mortality, but not with CVD mortality. Similar associations were found for waist circumference. Our results lend support to the notion that optimal BMI in the oldest old may be around the overweight or mild obesity range and challenge the application of international and national guidelines on optimal BMI in this age group.
AB - National and international recommendations of healthy body mass index (BMI) are primarily based on evidence in young and middle-aged populations, with an insufficient representation of the oldest old (aged ≥80 years). Here, we report associations between BMI and mortality risk in 27,026 community-dwelling oldest old (mean age, 92.7 ± 7.5 years) in China from 1998 to 2018. Nonlinear curves showed reverse J-shaped associations of BMI with cardiovascular disease (CVD), non-CVD and all-cause mortality, with a monotonic decreased risk up to BMIs in the overweight and mild obesity range and flat hazard ratios thereafter. Compared to normal weight, overweight and obesity were significantly associated with decreased non-CVD and all-cause mortality, but not with CVD mortality. Similar associations were found for waist circumference. Our results lend support to the notion that optimal BMI in the oldest old may be around the overweight or mild obesity range and challenge the application of international and national guidelines on optimal BMI in this age group.
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U2 - 10.1038/s43587-022-00201-3
DO - 10.1038/s43587-022-00201-3
M3 - Article
C2 - 37118064
AN - SCOPUS:85128740901
SN - 2662-8465
VL - 2
SP - 389
EP - 396
JO - Nature Aging
JF - Nature Aging
IS - 5
ER -