Todd Allen Posted June 4, 2018 Report Share Posted June 4, 2018 Al Pater posted this in his citations thread. I thought it deserved discussion as on first glance it looks pretty damning for CR, at least for continuing the practice in advanced age. Associations of Body Mass Index and Waist Circumference with 3-Year All-Cause Mortality Among the Oldest Old: Evidence from a Chinese Community-Based Prospective Cohort Study. Lv YB, Liu S, Yin ZX, Gao X, Kraus VB, Mao C, Yuan JQ, Zhang J, Luo JS, Chen HS, Zeng Y, Shi XM. J Am Med Dir Assoc. 2018 May 25. pii: S1525-8610(18)30152-X. doi: 10.1016/j.jamda.2018.03.015. [Epub ahead of print] PMID: 29807748 Abstract OBJECTIVE: Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate the relation of BMI and WC with 3-year all-cause mortality among the oldest old. DESIGN, SETTING, AND PARTICIPANTS: A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study. MEASUREMENTS: BMI and WC were measured at baseline in 2011 and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association. RESULTS: Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0) and was lower in participants with abdominal obesity. Compared to the upper tertile, those in the middle and lower tertile of BMI had a higher risk of mortality for men [hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [hr: 1.21 (1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle and lower tertile of WC for men [hr: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for women [hr: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses or when using propensity score matching, in subgroup analyses, or in octogenarians, nonagenarians, and centenarians. CONCLUSIONS: In Chinese oldest old, both higher BMI and higher WC predict better survival in both genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the current recommendations for the oldest old may need to be revisited. KEYWORDS: Body mass index; mortality; oldest old; waist circumference Here's a link for the full paper https://sci-hub.tw/10.1016/j.jamda.2018.03.015 The graphics on page 3 look to me like they indicate the opposite of the text, ie lower BMI & waste circumference = better survival. The graphics on the next page appear to support the text lower BMI & waste circumference = higher hazard ratio. One thing that may be relevant is that their threshholds for over weight and obesity are lower than ours and by western standards the cohort was relatively lean. BMI were categorized into four categories: underweight (BMI < 18.5), normal weight (18.5 BMI < 24.0), overweight (24.0 BMI < 28.0), and obese (28.0).7 Given that only 139 (3.2%) participants’ BMI were higher than 28, this group was merged with the overweight group. Central obesity was defined as WC 85 cm in men or WC 80 cm in women.7 Gender-specific tertiles of BMI and WC were created; the lower, middle, and upper tertiles were, respectively, <19.1, 19.1-22.0, and 22.0 for BMI in men; <18.2, 18.2-21.4, and 21.4 for BMI in women; <78, 78-86, and 86 cm for WC in men; and <73, 73-83, and 83 cm for WC in women. Link to comment Share on other sites More sharing options...
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