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  • Wednesday, August 6, 2008

    There Are Old People and Fat People, But Few Old Fat People

    Look around you at the bodies of the extremely old - when was the last time you recall seeing an obese centenarian? Excess fat held over the years is a killer, and the oldest people are very rarely overweight. I noticed a paper today that works backwards from medical and mortality data to further support the same conclusion:

    There has been ongoing debate about the health risks associated with increased body weight among the elderly population. One issue has not been investigated thoroughly is that body weight changes over time, as both the reasons and results of, the development of chronic diseases and functional disabilities.

    Structural models have the ability to unravel the complicated simultaneous relationship between body weight, disability, and mortality along the aging process. Using longitudinal data from the Medicare Current Beneficiary Survey from 1992 to 2001, we constructed a structural model to estimate the longitudinal dynamic relationship between weight, chronic diseases, functional status, and mortality among the aging population.

    A simulation of an age cohort from 65 to 100 was conducted to show the changes in weight and health outcomes among the cohorts with different baseline weight based on the parameters estimated by the model. The elderly with normal weight at age 65 experience higher life expectancy and lower disability rates than the same age cohorts in other weight categories. The interesting prediction of our model is that the average body size of an elderly cohort will converge to the normal weight range through a process of survival, senescence, and behavioral adjustment.

    Become fat and stay fat, in other words, and you'll remove yourself from the picture much sooner than would otherwise be the case. In addition, your health in the years ahead will be much the worse for it. Do as you will with your life, but don't say you weren't warned.

    Posted by Reason

     
    Share |

    Posted by: AntiCitizenOne at August 11, 2008 6:42 AM

    It's not all bad... Be fat and qualify for an impaired-life annuity, and you can live more comfortably on your larger pension.

    [Posted by: AntiCitizenOne at August 11, 2008 6:42 AM]

    Posted by: h at August 11, 2008 6:53 AM

    Couldn't it be that people who are fat in mid-life lose weight in old age?

    [Posted by: h at August 11, 2008 6:53 AM]

    Posted by: Edouard Coneho at August 11, 2008 7:21 AM

    Every female relative on both sides of my family passed away between 95 and 100. They were each as big as barrels. The men were each rail thin, wiry, tough. They died in their 60s, or early 70s.

    While this article seems legitimate, personal experience is contrary to the conclusion.

    [Posted by: Edouard Coneho at August 11, 2008 7:21 AM]

    Posted by: Bruce at August 11, 2008 8:07 AM

    These "models" have the same relevance as climate "models" that predict the weather with such accuracy .... ha ha ha ha.

    [Posted by: Bruce at August 11, 2008 8:07 AM]

    Posted by: Shannon Love at August 11, 2008 8:07 AM

    The interesting prediction of our model is that the average body size of an elderly cohort will converge to the normal weight range through a process of survival, senescence, and behavioral adjustment.

    This is caused by the inability of the elderly to keep on weight in their later years. In other words, live long enough and you won't be fat. People see all the skinny people in nursing homes and assume that the people were skinny all their lives. In fact, they may have been quite hefty until just a couple of years before.

    I would also point out that the "normal" weight gauged optimal by the simulation would be considered slightly fat by most people. Being a rail with low body fat will reduce you lifespan as much as being slightly obese.

    [Posted by: Shannon Love at August 11, 2008 8:07 AM]

    Posted by: Josh at August 11, 2008 8:40 AM

    Edouard:

    Do you know why husbands tend to pre-decease their wives?

    Because they want to.

    [Posted by: Josh at August 11, 2008 8:40 AM]

    Posted by: Deoxy at August 11, 2008 9:12 AM

    I would also point out that the "normal" weight gauged optimal by the simulation would be considered slightly fat by most people.

    Including our moronic, nannying government. The healthy weight used in this study is officially "overweight". Yes, the people who changed that designation (such that many sports starts are officially "obese") are complete idiots.

    [Posted by: Deoxy at August 11, 2008 9:12 AM]

    Posted by: David Preiser at August 11, 2008 10:04 AM

    I spent some time working in nursing homes in my youth, and my experience was that there were no big guys. The few men who were clearly overweight were certainly not obese, yet without exception they had either suffered a stroke, developed diabetes, got earlier dementia than thin men, experienced congestive heart failure earlier, or were otherwise much more severely impaired than average size (even with a bit of a "gut") or thin men.

    Anecdotes about fat relatives living to a ripe old age always seem to be about women, who are biologically tuned to carry fat better than men.

    None of this takes into consideration other causes of death in males which are completely unrelated to being severely overweight.

    [Posted by: David Preiser at August 11, 2008 10:04 AM]

    Posted by: teqjack at August 11, 2008 11:30 AM

    So, the "normal" weight used is at least "over" weight according to current government "guidelines" - which then brings it into alignment with the majority of studies, which show that government's "normal" weight people are actually more prone, once having any illness that hospitalizes them for more than one day, to early mortality.

    The Federal guidelines changed a while back to those recommended by WHO: a study in Japan recently showed the WHO guide for Japanese put their healthiest populace over the WHO-recommended "norm."

    Here in the US -
    In 1985 a consensus conference convened by the National Institutes of Health (NIH) recommended that men and women be considered “overweight” at BMIs of 27.8 and 27.3, respectively. In 1996 an NIH-sponsored review of the literature found that “increased mortality typically was not evident until well beyond a BMI level of 30.” Yet two years later [1998], the NIH yielded to a World Health Organization recommendation that “overweight” be defined downward to a BMI of 25, with 30 or more qualifying as “obese.”

    [Posted by: teqjack at August 11, 2008 11:30 AM]

    Posted by: Ana S at August 11, 2008 11:30 AM

    Most people that get to their seventies and eighties lose weight until they are at normal weight, so the study won't predict as much. I had older relatives that died in their eighties and nineties. Based on their weight when they were old they were normal, however they were fat most of their lives.

    [Posted by: Ana S at August 11, 2008 11:30 AM]

    Posted by: SwampWoman at August 11, 2008 1:45 PM

    Thin in old age and heavier at middle age is just the natural pattern of aging.

    The demands of yearly childbearing and lactation were such that women (who rarely survived to menopause in 1900) needed to store up energy (expended in childbearing and lactation) to regain lost nutrition and provide a safety margin against illness in old age. Osteoporosis and bone fracture (hip/pelvis) greatly increases an older person's mortality risk, and this danger would have been much greater for an underweight woman that had borne multiple children. The greatest risk for osteoporosis is being thin, female, Caucasian or Asian.

    Women no longer have to worry about a yearly pregnancy, but our bodies are still genetically programmed to store as much energy as possible after puberty to provide for the next generation, and again at menopause to protect against osteoporosis and poor nutrition in old age.

    It was only after WWII that the majority of humans (in the west) have not had to worry as much about going hungry/starving in the winter after bad weather/harvest in the summer, although the 1960s and 1970s still saw a significant percentage of underweight and undersized malnourished children. Indeed, the people of advanced age in the nursing homes today lived through times of calorie restriction in the great depression and WWII.

    All in all, I'd rather take my chances with an abundance of food and lots of nice labor-saving devices.


    [Posted by: SwampWoman at August 11, 2008 1:45 PM]

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