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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 [45].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [45]
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“However, some reports have showed that some malnutrition problems might be missed by using this measure.(2,5,9) Other screening tools have been used for malnutrition detection in elderly individuals.”
MethodFactors associated with maximal walking speed among older community-living adults
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“One such health related change may be obesity which has been increasing dramatically in adult populations worldwide [10–12], although the health implications in the elderly are not fully understood [13,14].”
BackgroundKim, T.-H., & Hong, Y.-S. (2020) · Sensors · doi:10.3390/s20123485 · Cited by 12
“After the age of 60 years, body weight on average tends to decrease [4].”
BackgroundHeloterä, H., Siintamo, L., Kivinen, N., Abrahamsson, N., Aaltonen, V., & Kaarniranta, K. (2024) · Acta Ophthalmologica · doi:10.1111/aos.16681 · Cited by 12
“This study shows that there is at least an association between these findings, but confirming causality would require studies that are more detailed and done with a bigger patient population (Seidell & Visscher, 2000).”
Salminen, M. J., Kuoppamäki, M., Vahlberg, T. J., Räihä, I. J., Irjala, K. M. A., & Kivelä, S. (2012) · Diabetes and Vascular Disease Research · doi:10.1177/1479164112442077 · Cited by 12
“Service sector/ administration/teaching 52 (30) 292 (31)”
Changes in body mass index and waist circumference and concurrent mortality among Swedish women
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“Unintentional weight loss and associated general wasting play a larger role among the elderly (20-23) and are of less relevance in a primarily healthy, mid-life adult population as the one in the present cohort.”
BackgroundSaad, M. A. N., Rosa, M. L. G., Lima, G. A. B., & Filho, R. A. D. C. (2017) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00060916 · Cited by 12
The role of BDNF on food intake and overweight: Linking neuroplasticity and obesity
Sequeira‐Cordero, A., Brenes, J. C., & Vindas-Smith, R. (2025) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2025.111457 · Cited by 13
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Association between weight change over a period of 4 years and mortality in Korean older adults
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Luong, R., Ribeiro, R. V., Cunningham, J., Chen, S., & Hirani, V. (2021) · Nutrition Reviews · doi:10.1093/nutrit/nuab032 · Cited by 12
Joh, H., Kwon, H., Son, K. Y., Yun, J. M., Cho, S. H., Han, K., Park, J., & Cho, B. (2024) · The journal of nutrition health & aging · doi:10.1016/j.jnha.2024.100185 · Cited by 10
Obese Patients Report Modest Weight Loss After Surgery for Lumbar Spinal Stenosis
Knutsson, B., Michaëlsson, K., & Sandén, B. (2014) · Spine · doi:10.1097/brs.0000000000000464 · Cited by 10
Kremers, S., de Bruijn, G., Visscher, T. L. S., Deeg, D. J. H., Thomése, G. C. F., Visser, M., van Mechelen, W., & Brug, J. (2012) · Journal of Environmental and Public Health · doi:10.1155/2012/127857 · Cited by 10
“As the association between BMI and adiposity changes with aging [40, 41], subjects older than 70 years of age were excluded from the present analyses.”
Self-citationTotal Energy Expenditure and Functional Status in Older Adults: A Doubly Labelled Water Study
de Pontes, T. L., Pessanha, F. P. A. D. S., Júnior, R. C. F., Pfrimer, K., Alves, N. M. D. C., Fassini, P. G., Almeida, O. L. S., Moriguti, J. C., Lima, N. K. D. C., Santos, J. L. F., et al. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1482-5 · Cited by 10
“This decrease generates changes in body composition and increases the risk for comorbidities, in addition to cognitive and physical impairments (34, 35).”
Health Behaviors and Transitions of Physical Disability Among Community-Dwelling Older Adults
Wu, Y., McCrone, S., & Lai, H. J. (2008) · Research on Aging · doi:10.1177/0164027508319473 · Cited by 10
Closs, V. E., Rosemberg, L. S., Ettrich, B. D. G., Gomes, I., & Schwanke, C. H. A. (2016) · Scientia Medica · doi:10.15448/1980-6108.2015.3.21176 · Cited by 10
“Embora sejam medidas correlacionadas, os efeitos da adiposidade gluteofemoral subcutânea na saúde metabólica são diferentes dos da adiposidade visceral [13,58], havendo possibilidade de CQ aumentada refletir maior massa muscular.”
BackgroundDharmarajan, T. S., & Dharmarajan, T. S. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1623-5_4 · Cited by 12
Uauy, R. D., & Lock, K. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyi266 · Cited by 10
Lee, B., Yoon, Y., Kang, C. M., et al. (2022) · Surgical Endoscopy · doi:10.1007/s00464-022-09633-9 · Cited by 9
Surveying predictors of late-life longitudinal change in daily activity energy expenditure
Valiani, V., Sourdet, S., Schoeller, D. A., Mackey, D. C., Bauer, D. C., Glynn, N. W., Yamada, Y., Harris, T. B., Manini, T. M., & for the Health, A. A. B. C. S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186289 · Cited by 10
“Aging is also associated with changes in body composition and comorbidities that lead to cognitive [10] and physical impairments [11, 12].”
BackgroundAnthropometric Measures and Frailty Prediction in the Elderly: An Easy-to-Use Tool
Closs, V. E., Ziegelmann, P. K., Flores, J. H. F., Gomes, I., & Schwanke, C. H. A. (2017) · Current Gerontology and Geriatrics Research · doi:10.1155/2017/8703503 · Cited by 9
“Anthropometric measures have been studied due to their ability to identify certain health parameters, such as nutritional status, due to their relationship with diseases and with physical function status [5, 26] and all conditions involved in the course of frailty [1].”
BackgroundSegmental Bioimpedance Variables in Association With Mild Cognitive Impairment
Doan, D. N. T., Ku, B. U., Kim, K., Jun, M., Choi, K. Y., Lee, K. H., & Kim, J. U. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.873623 · Cited by 10
Metadata
- 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 (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › 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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