Research Impact Summary: Can obesity be beneficial in older adults? The answer for this question is still a matter of debate due to a phenomenon known as the obesity paradox. This study discusses the paradoxical relationship between overweight/obesity and mortality in older populations with underlying diseases. Body mass index (BMI) commonly present a U-shaped association with mortality, with lower (BMI<18.5 kg/m2) and higher extremes (BMI>35 kg/m2) showing a detrimental impact, whereas older adults near the nadir (BMI 22-35 kg/m2) may have some protection. Possible mechanisms have been proposed to explain this relationship, such as more aggressive treatment in obese patients, reduction in bone mineral content with ageing, changes in muscle/fat storage, and selection bias. Skeletal muscle mass and muscle function associated with adipose tissue assessment can add valuable information in the risk stratification of older adults.
Fonseca GWPD, von Haehling S. The fatter, the better in old age: the current understanding of a difficult relationship. Curr Opin Clin Nutr Metab Care. 2022 Jan 1;25(1):1-6. doi: 10.1097/MCO.0000000000000802. PMID: 34861670.