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

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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, Luo, Jiesi, Zhou, Jinhui, Li, Zhihao, Duan, Jun, Zhu, Qingyang, Zeng, Yi, Wang, Wentao, Wang, Jiaonan, Shi, Xiaoming·2022·Nature Aging

DOI 10.1038/s43587-022-00201-3

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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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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
ORCID: Lv, Yuebin
Mao, Chen
Gao, Xiang
Ji, John S.
Kraus, Virginia Byers
Yuan, Jinqiu
Luo, Jiesi
Zhou, Jinhui
Li, Zhihao
Duan, Jun
Zhu, Qingyang
Zeng, Yi
Wang, Wentao
Shi, Xiaoming
Venue: Nature Aging
Publisher: Springer Science and Business Media LLC
Published: 2022-04-25
Volume: 2
Issue: 5
Pages: 389-396
ISSN: 2662-8465 (ISSN-L)
DOI: 10.1038/s43587-022-00201-3
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
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Aging (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Physiology (medical) › 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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The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China: a 20-year prospective cohort study

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