Central adiposity and the overweight risk paradox in aging: follow-up of 130,473 UK Biobank participants.
Am J Clin Nutr
; 106(1): 130-135, 2017 Jul.
Article
en En
| MEDLINE
| ID: mdl-28566307
ABSTRACT
Background:
For older groups, being overweight [body mass index (BMI; in kg/m2) 25 to <30] is reportedly associated with a lower or similar risk of mortality than being normal weight (BMI 18.5 to <25). However, this "risk paradox" is partly explained by smoking and disease-associated weight loss. This paradox may also arise from BMI failing to measure fat redistribution to a centralized position in later life.Objective:
This study aimed to estimate associations between combined measurements of BMI and waist-to-hip ratio (WHR) with mortality and incident coronary artery disease (CAD).Design:
This study followed 130,473 UK Biobank participants aged 60-69 y (baseline 2006-2010) for ≤8.3 y (n = 2974 deaths). Current smokers and individuals with recent or disease-associated (e.g., from dementia, heart failure, or cancer) weight loss were excluded, yielding a "healthier agers" group. Survival models were adjusted for age, sex, alcohol intake, smoking history, and educational attainment. Population and sex-specific lower and higher WHR tertiles were <0.91 and ≥0.96 for men and <0.79 and ≥0.85 for women, respectively.Results:
Ignoring WHR, the risk of mortality for overweight subjects was similar to that for normal-weight subjects (HR 1.09; 95% CI 0.99, 1.19; P = 0.066). However, among normal-weight subjects, mortality increased for those with a higher WHR (HR 1.33; 95% CI 1.08, 1.65) compared with a lower WHR. Being overweight with a higher WHR was associated with substantial excess mortality (HR 1.41; 95% CI 1.25, 1.61) and greatly increased CAD incidence (sub-HR 1.64; 95% CI 1.39, 1.93) compared with being normal weight with a lower WHR. There was no interaction between physical activity and BMI plus WHR groups with respect to mortality.Conclusions:
For healthier agers (i.e., nonsmokers without disease-associated weight loss), having central adiposity and a BMI corresponding to normal weight or overweight is associated with substantial excess mortality. The claimed BMI-defined overweight risk paradox may result in part from failing to account for central adiposity, rather than reflecting a protective physiologic effect of higher body-fat content in later life.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Envejecimiento
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Índice de Masa Corporal
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Tejido Adiposo
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Relación Cintura-Cadera
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Adiposidad
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Obesidad Abdominal
Tipo de estudio:
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Am J Clin Nutr
Año:
2017
Tipo del documento:
Article