Can losing weight be dangerous? That seems to be the conclusion of a study by American and Australian researchers published on April 10. After studying more than 19,000 people aged 65 and over in the US and 70 and over in Australia, they reported that weight loss appears to be associated with higher mortality. rates in both men and women.
That really surprised me. We know that obesity is a factor in many conditions, including disability, hypertension, high cholesterol, diabetes and sleep apnea, not to mention arthritis, cancer and cognitive function. Excess weight can limit mobility and make it more difficult to maintain independence due to strain on the lower extremities.
And now we are told that weight loss between 5 and 10 percent can also be dangerous? It’s ironic that this comes at a time when weight-loss drugs like Ozempic are all the rage. As young people like to say, “Mind. Blown.”
All of the people in the study were considered “healthy older adults” with no known conditions that could lead to premature death, such as cardiovascular disease, cancer or dementia. And yet, weight loss over a four-year period was associated with a 33 percent higher risk of death for men and 26 percent for women.
Weight gain was not associated with an increased risk of death.
“It is important for older adults to be aware that even a small 5 percent weight loss, especially in the absence of obvious disease, can significantly increase the risk of mortality,” said the study’s lead author, Sultana Monira Hussain, a senior research fellow at the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia.
So what could be going on here? I see a few possibilities.
First, correlation is not causation. Weight loss was associated with mortality, which means it’s correlated — but that doesn’t mean the weight loss caused a person’s death.
Another factor is unintentional weight loss. It’s not uncommon for older people to lose weight as they lose muscle mass, and because of that lack of muscle, it’s harder for them to gain weight back. Being underweight and frail increases the risk of bone fractures and can weaken the immune system.
Unintentional weight loss can also be a sign of an underlying physical condition, so it’s important to see your doctor if that’s the case.
There is also the fact that obesity is different in young people than in older people. That loss of fat-free mass, mainly muscle, makes way for an increase in fat mass. This condition is called sarcopenia and even someone with a “healthy” body mass index (BMI) can be considered obese because they are carrying too much fat, not necessarily too much weight.
Some of the risks of obesity also vary by age group. For example, a higher BMI is associated with less risk of hypertension in older adults compared to younger adults.
The question becomes: what do we do with this information? Should we all run out and gain 10 or 20 pounds? No. Rather, it is important to practice three healthy aging habits to help us maintain and gain lean muscle and reduce fat:
Diet: Protein, protein, protein. As we age, our bodies become less efficient at using protein, so we should eat more lean protein. Research supports increasing the recommended intake of protein for older adults by up to 50 percent, 0.45 to 0.55 grams per pound of body weight. That’s about 68 to 83 grams per day for someone who weighs 150 pounds.
High protein foods such as chicken, salmon, Greek yogurt, low-fat milk, and beans are some of the best foods to gain lean muscle.
Exercise: Resistance training, whether that’s free weights, machines, resistance bands, or using your own body weight, will help your body maintain and build muscle mass. Shoot three times a week.
Adequate Sleep: An elderly person needs a minimum of seven hours but no more than nine hours of sleep to allow muscles to rest and rebuild.
As I noted earlier, BMI may not be the best measure of obesity in seniors. On the contrary, studies have suggested that waist circumference or waist-to-hip ratio might be more useful. The American Heart Association recommends that women keep no more than 14 inches around the center and men 16 inches.
We’ll see if the findings of this new study hold up over time. Whether they do or not, we can all take steps toward healthier aging.
• Teri Dreher is a board-certified patient advocate. She has been an ICU nurse for over 30 years and founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is now available on Amazon. She offers Daily Herald readers a free telephone consultation; call her at (847) 612-6684.