A systematic review of body fat distribution and mortality in older people

Abstract

We conducted a systematic review investigating body fat distribution in older adults and its association with morbidity and mortality. Our search yielded 2,702 citations. Following three levels of screening, 25 studies were selected to evaluate the association between body fat distribution and comorbidity, and 17 studies were used in the mortality analysis. Most of the selected studies in our analyses used anthropometric measures, e.g., body mass index (BMI), waist circumference, and waist-hip ratio; relatively few studies used direct measures, such as body fat/lean mass, and percentage body fat. Studies reported inconsistent findings regarding the strongest predictor(s) of morbidity and mortality. However, the majority of studies suggested that BMI per se was not the most appropriate predictor of morbidity and mortality in the elderly because of its inability to discern or detect age-related body fat redistribution. In addition, studies using BMI found that the optimal BMI range for the lowest mortality in the elderly was overweight (25 kg/m2 ≤ BMI < 30 kg/m2) or mildly obese (30 kg/m2 ≤ BMI < 35 kg/m2). Our findings suggest that the current clinical guidelines, recommending that overweight and obesity are major risk factors for increased morbidity and mortality are not applicable to this population. Therefore, the central message of this review is to admonish the government to establish new guidelines specifically for this population, using a combination of body fat distribution measurements, and to certify that these guidelines will not be applied to inappropriate populations.

Indices of Central and Peripheral Obesity; Anthropometric Measurements and Laboratory Parameters of Metabolic Syndrome and Thyroid Function

“…The sagittal and transverse abdominal diameters (height) were measured using a portable, sliding-beam caliper for the estimation if abdominal adiposity. Skinfold thickness (ST) was measured by the same caliper at standardized skin pinch points to determine the subcutaneous fat layer thickness (3,12). Several methods were used for the measurements of body composition and body fat distribution, such as computed tomography and dual-energy X-ray absorptiometry.…”

“…Central obesity can also be shown in some other parts of the body's upper trunk like the upper chest nape area of the neck, and even the shoulders. Central obese individuals have been known to be more vulnerable to diseases associated with obesity, whereas there is proof that peripheral fat distribution may be protective (3)(4)(5). Obesity is well-defined by using body mass index (BMI), a quantification obtained by dividing a person's weight by the square of the person's height.…”

Indicadores antropométricos como instrumento de triagem para quedas em idosos

“…Body mass index (BMI), for example, has been considered as a survival measure in this population 8 . However, in epidemiological studies, this measure is not a variable associated with risk of falls in this population [9][10][11] . Measures such as total body fat, lean body mass and fat mass are associated and little explored in investigations.…”

“…Specific anthropometric measurements discriminate better the risk of falls than generalized proportional indicators 22 . Previous studies have suggested that BMI may not be the most ideal predictive of diseases in the elderly for being unable to assess the redistribution of age-associated body fat 11,13,20 . Thus, total body mass of muscle mass measurement can be directly related to functional capacity, which differs from results measured via DEXA in the investigation of Clark and Manini 23 .…”

Fitness Assessment as an Anti-Aging Marker: A Narrative Review

“…This fact is a public health problem due to a body mass index >30 kg/m2, which is positively associated with aging related diseases [42]. Body fat mass is strongly associated with a higher risk of suffering different chronic diseases (cardiovascular disease, diabetes, and/or cancer) [43]. Furthermore, it contributes to a reduction of the functional capacity [44,45] and, consequently, to the acceleration of the aging process.…”