Body weight and weight change and their health implications for the elderly
Abstract
After the age of 60 y, body weight on average tends to decrease. The contribution of fat mass to this weight loss is relatively small, but fat tends to be redistributed with advancing age toward more abdominal (particularly visceral) fat. Anthropometric data are relatively poor indicators of these aging processes. This may be one of the explanations why the relationship between high body mass index and mortality is less pronounced in older than in younger people. Reduced lipolysis in the visceral fat depot with aging is among potential explanations why increased visceral fat seems to be less harmful in elderly subjects compared to young adults. Even though the relative contribution of increased fat mass to mortality may be less pronounced in elderly people, the impact on disability and functional limitations is found to be important from both a clinical and a public health point of view. At the other end of the scale studies have shown that low body mass index and weight loss in the elderly are both strong predictors of subsequent mortality. This cannot be explained by effects of smoking and early mortality after baseline. There are only few systematic studies comparing the predictive validity of different anthropometric data for mortality. One recent prospective study showed that a high waist circumference (in nonsmoking men) may be a better predictor of all-cause mortality than high body mass index and waist/hip ratio. Low BMI was a better predictor of mortality than low waist circumference. In conclusion changes in body composition and fat distribution with aging are poorly captured by standard anthropometric data. Low lean body mass is probably better reflected by low BMI, whereas increased (abdominal) fatness is better reflected by increased waist circumference.
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Unintentional weight loss, more likely driven by comorbid disease, excessively impacts metabolically active tissue over fat mass.
“Unintentional weight loss, more likely driven by comorbid disease, excessively impacts metabolically active tissue over fat mass [45].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [45]
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BackgroundObesity in the Elderly Diabetic Patient
Kyrou, I., & Tsigos, C. (2009) · Diabetes Care · doi:10.2337/dc09-s348 · Cited by 53 · see citing works
“Therefore, it seems that in the elderly, underweight and low lean body mass is better evaluated by measurements of BMI (low BMI more accurately reflects the associated risk of underweight), whereas obesity and adiposity is better evaluated by measurements of waist circumference (increased waist circumference more accu…”
BackgroundRoskam, A.-J. R., & Kunst, A. E. (2008) · Public Health Nutrition · doi:10.1017/s1368980008002747 · Cited by 51 · see citing works
“Also, the validity of BMI as a measure for fat mass may be hampered in the elderly, as muscle mass may decrease above the age of 60 years((14)).”
BackgroundDiet and Lifestyle in Prostate Cancer
Wilson, K. M., & Mucci, L. A. (2019) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-32656-2_1 · Cited by 52 · see citing works
Weight Change and Lower Body Disability in Older Mexican Americans
Snih, S. A., Raji, M. A., Markides, K. S., Ottenbacher, K. J., & Goodwin, J. S. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53522.x · Cited by 51 · see citing works
The Relationship Between the Trajectory of Body Mass Index and Health Trajectory Among Older Adults
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Obesity pharmacotherapy in older adults: a narrative review of evidence
Henney, A. E., Wilding, J. P. H., Alam, U., & Cuthbertson, D. J. (2025) · International Journal of Obesity · doi:10.1038/s41366-024-01529-z · Cited by 51 · see citing works
“Unintentional weight loss, more likely driven by comorbid disease, excessively impacts metabolically active tissue over fat mass [45].”
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“Over the last 10–15 years societies as geographically and culturally distant as Barbados, Russia, Kuwait, and Japan have all experienced rapid increases in relative weight, affecting both children and adults [51-55].”
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The Effect of Visceral Fat Mass on Pancreatic Fistula after Pancreaticoduodenectomy
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“does not always accurately reflect the amount of visceral fat because the distribution of fat tissue greatly varies among individuals [18, 19].”
BackgroundNilsen, C., Andel, R., Fors, S., Meinow, B., Darin‐Mattsson, A., & Kåreholt, I. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-878 · Cited by 47 · see citing works
Metabolic Syndrome and Weight Gain in Adulthood
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“This study is a joint project of the Epidemiology & Research Unit of the Medical and Public Health Service of Curaçao, the Northern Centre for Health Care Research of the University of Groningen in the Netherlands, the Foundation European Journal of Clinical Nutrition for Promotion of Research and International Coope…”
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Association between C-Reactive Protein and Metabolic Syndrome in Korean Adults
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“…risk effect, we propose the following clinical and methodological insights for future research reference: (1) Non-static nature of IR and obesity: It is well-established that IR and obesity are not static conditions but exhibit adaptive dynamic fluctuations in response to metabolic changes [63–67].”
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Nutritional status and health outcomes for older people with dementia living in institutions
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Therapeutic approaches to non-alcoholic fatty liver disease: past achievements and future challenges
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The ability of waist-to-height ratio to identify health risk
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- Authors
- Seidell, J., & Visscher, T.
- Affiliations
- National Institute for Public Health and the Environment (NL)
- Venue
- European Journal of Clinical Nutrition
- Published
- 2000-06-01
- Volume
- 54
- Issue
- S3
- Pages
- S33-S39
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2027647230
- Cited by
- 324
- References
- 0
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 12 · 2023: 10 · 2022: 13 · 2021: 18 · 2020: 16 · 2019: 11 · 2018: 7 · 2017: 8 · 2016: 9 · 2015: 16 · 2014: 15 · 2013: 12 · 2012: 12
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- body weight, weight loss, aging, older adults, visceral fat, abdominal fat distribution, body mass index, waist circumference, anthropometric indicators, mortality prediction, low body mass index, lean body mass, body composition, functional disability, lipolysis
- MeSH terms
- Adipose Tissue, Aged, Aging, Anthropometry, Body Composition, Body Constitution, Body Weight, Cross-Sectional Studies, Health Status, Humans, Mortality, Viscera, Body Mass Index
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