Cited by 102Nutrition and Health in AgingObesity, Physical Activity, DietBody Composition Measurement Techniques

The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China: A 20-year prospective cohort study

Lv, Yuebin, Mao, Chen, Gao, Xiang, Ji, John S., Kraus, Virginia Byers, Yin, Zhaoxue, Yuan, Jinqiu, Chen, Huashuai +9 more·2022·Nature Aging

Abstract

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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Crossref · 10.1038/s43587-022-00201-3

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Authors
Lv, Y., Mao, C., Gao, X., Ji, J. S., Kraus, V. B., Yin, Z., Yuan, J., Chen, H., Luo, J., Zhou, J., Li, Z., Duan, J., Zhu, Q., Zeng, Y., Wang, W., Wang, J., & Shi, X.
Affiliations
  • Chinese Center For Disease Control and Prevention (CN)
  • Southern Medical University (CN)
  • Fudan University (CN)
  • Duke University (US)
  • Emory University (US)
Corresponding author
Shi, Xiaoming
Venue
Nature Aging
Published
2022-04-25
Volume
2
Issue
5
Pages
389-396
ISSN
2662-8465 (ISSN-L)
OpenAlex
W4224310527
Cited by
102
References
48
Citations by year
2026: 19 · 2025: 23 · 2024: 33 · 2023: 20 · 2022: 7
FWCI
12.83
Type
journal article
Language
en
Open access
closed
Locations
  • Nature Aging (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
obesity paradox, body mass index, oldest old, mortality, cardiovascular mortality, all-cause mortality, waist circumference, overweight, mild obesity, community-dwelling older adults, China
MeSH terms
Obesity Paradox, Aged, 80 and over, Cardiovascular Diseases, China, Humans, Middle Aged, Obesity, Prospective Studies, Risk Factors, Overweight

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