For Optimum Health in the Elderly; Maintain Muscle Mass

"The trajectory is that most people will get heavier with age until they reach their 60s, and then they begin to lose weight. [But the] ideal weight depends on the individual.There are going to be larger people who are metabolically fit and skinny people with diabetes."

"[When you lose or gain weight the number of fat cells in your body remain stable; think of them] like balloons -- the fat cells expand or shrink and everyone's fat cells expand to differing degrees, meaning people store different amounts of fat safely."

"Tracking BMI [Body Mass Index] across a population is useful on average, the higher your BMI, the more fat you carry, and the more unhealthy you're likely to be. But on an individual basis, it's not the best measure; if you're a doctor looking at the human being in front of you, you need to look at how healthy the individual is. Are they young, muscular, older, have they just had a baby?"

"People in middle age tend to be less active because we're sitting on our backsides doing our jobs, plus the fact that we have more money on average, and so eat richer foods."

"Your metabolism stays stable for a surprisingly long time -- until 60 or so -- before it begins to fall. When people get older, we're not as physically active and you begin to lose muscle. Muscle has the highest metabolic rate in your body, so you could be the same weight, but carrying more fat than muscle, and then the metabolic rate will be lower."

Giles Yeo, professor of molecular neuroendocrinology, University of Cambridge

Scientists from Australia's Monash University conducted a study of over 16,000 healthy pensioners, and discovered that elderly men who lost over ten percent of their body weight were almost three times more at risk of dying in the following few years than those who maintained their weight. That same mid-April study led to the discovery that a ten percent body mass loss more than doubled the risk of death for women. The subjects in the study had no existing chronic illnesses at the study start after which they were assessed over four and a half years.

 

Body Mass Index representing weight in kilograms divided by the square of height in metres -- was thought to represent the most accurate health measurement. "The major problem with BMI is that it doesn't take into account the amount of fat or muscle you have", explained Professor Yeo. Experts more recently emphasized a healthy waist-to-height ratio determined by dividing waist size by height; men and women should maintain waist circumference at no more than half their height.

 

An increase in overall weight is not as dangerous as extra inches around the middle since visceral fat accumulates around internal organs and is linked to an increase in risk of cardiovascular disease and cancer. The risk of health conditions such as stroke, heart disease, Type 2 diabetes and some types of cancer rises with obesity (BMI of 30 or over). In later life, however, underweight (BMI of under 18.5) is also linked to health outcomes such as nutritional deficiencies, bone fractures and osteoporosis and weakened immune systems. 

Physical activity in middle age helps to counteract that infamous 'middle-age-spread'. Moderate daily exercise of 30 minutes daily helps -- inclusive of brisk walking, hiking or riding a bicycle. Maintaining muscle mass and keeping weight-to-height ratio makes for one's BMI remaining within the healthy range; preferable to focusing on weight itself. A slowing metabolism is also aided by keeping weight within a healthy range. A diet rich in protein, low in processed foods and refined carbohydrates such as white bread, pasta, pastries and pies helps immeasurably.

Published in the Journal of Epidemiology and Community Health, a study found all-cause mortality was lowest among people aged 65 and over, among those who had a BMI of 25-29.9 for men and 25-32.4 for women. "In your 60s, it's probably not too late to lose weight, as it enhances your ability to live healthier for longer", comments Professor Yeo. Moderate aerobic exercise like brisk walking works when built to the point the recommended 150 minutes per week is reached.

Older patients with a higher BMI had a significantly reduced mortality risk following surgery, according to another recent study from the Archives of Orthopaedic and Trauma Surgery. "As you go into your 70s and 80s, in particular, obesity is no longer a major problem because you lose weight quite rapidly", through loss of muscle mass or appetite, notes Dr. Yeo. "I think people underestimate how much that matters [muscle helps to maintain cardiovascular health and bone density with moderate strength training] and it really, really matters when you get older."