BMI and all-cause mortality in older adults: a meta-analysis

Winter, Jane; MacInnis, Robert J.; Wattanapenpaiboon, Naiyana; Nowson, Caryl

doi:10.3945/ajcn.113.068122

Cited by 618 publications

(498 citation statements)

References 60 publications

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“…Our findings showed that men who were overweight and obese had lower mortality rates, consistent with research on the protective effect of high BMI with ageing (Janssen et al 2005) with the view that extra body weight, including lean tissue mass and fat mass, may provide protection against nutritional and energy deficiencies, metabolic stresses, the development of wasting and frailty and loss of muscle and bone density caused by chronic diseases (Janssen 2007). Our findings are in contrast to a recent meta-analysis that showed increased risk of mortality for older adults with a BMI above 33 kg/m 2 (Winter et al 2014). These differences could possibly due to the inclusion of both men and women in the meta-analysis, and due to inclusion of a younger population aged 65 and over, whereas our sample include men with mean age of 77 years.…”

Section: Discussioncontrasting

confidence: 62%

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Hirani

Naganathan

Blyth

et al. 2014

AGE

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This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005)(2006)(2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of mortality included in the final model (p<0.05) were older age, body mass index<20 kg m 2 , high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong nondrinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it AGE (2014) was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.

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Section: Discussioncontrasting

confidence: 62%

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Hirani

Naganathan

Blyth

et al. 2014

AGE

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“…However, the average length of stay was one day shorter in the BMOS cohort, and the majority of the paper menu service cohort (59%) were admitted for orthopaedic surgery compared to 51% of the BMOS cohort admitted for general medical or gynaecological surgery (Table 1). Overall the study participants (paper menu and BMOS combined) had an average age of 65.1 years, with an average length of stay 9.1 days, an average body mass index (BMI) of 28.5 in the acceptable weight range adjusted for age ≥65 years (25-29.9) (16) , self-reported normal appetite and good health, and reflected a similar mix of "prescribed" diets and diagnoses. The longer length of stay of study participants compared to the hospital population was most likely a result of the study requirement for participants to be in hospital greater than 24 hours to be eligible (in order to comment on the meals and meal ordering process), and then a futher 48 hours to be able to complete all of the data collection.…”

Section: Resultsmentioning

confidence: 99%

Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients

Maunder

Lazarus

Walton

et al. 2015

Clinical Nutrition ESPEN

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(2015). Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients. Clinical Nutrition ESPEN, 10 (4), e134-e139.Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients AbstractBackground and aims Electronic bedside spoken meal ordering systems (BMOS) have the potential to improve patient dietary intakes, but there are few published evaluation studies. The aim of this study was to determine changes in the dietary intake and satisfaction of hospital patients, as well as the role of the Nutrition Assistant (NA), associated with the implementation of an electronic BMOS compared to a paper menu. Methods This study evaluated the effect of a BMOS compared to a paper menu at a 210-bed tertiary private hospital in Sydney during 2011-2012. Patient dietary intake, patient satisfaction and changes in NA role were the key outcomes measured. Dietary intake was estimated from observational recordings and photographs of meal trays (before and after patient intake) over two 48 h periods. Patient satisfaction was measured through written surveys, and the NA role was compared through a review of work schedules, observation, time recordings of patient contact, written surveys and structured interviews. Results Baseline data were collected across five wards from 54 patients (75% response rate) whilst using the paper menu service, and after BMOS was introduced across the same five wards, from 65 patients (95% response rate). Paper menu and BMOS cohorts' demographics, self-reported health, appetite, weight, body mass index, dietary requirements, and overall foodservice satisfaction remained consistent. However, 80% of patients preferred the BMOS, and importantly mean daily energy and protein intakes increased significantly (paper menu versus BMOS): 6273 kJ versus 8273 kJ and 66 g versus 83 g protein; both p < 0.05. No additional time was required for the NA role, however direct patient interaction increased significantly (p < 0.05), and patient awareness of the NA and their role increased with the BMOS. Conclusions The utilisation of a BMOS improved patient energy and protein intake. These results are most likely due to an enhancement of existing NA work processes, enabling more NA time with patients, facilitating an increase in patient participation and satisfaction with the service.

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“…A role for catabolic tissue loss in increased mortality risk during old age is suggested by epidemiological studies concluding that, in the elderly, moderately elevated BMI tends to be associated with improved survival (Janssen 2007;Auyeung et al 2010;Winter et al 2014). Yet analyses of the Adventist Health Study and Adventist Mortality Study, in which BMI was monitored serially, indicated that, among non-smoking men who maintain a relatively stable BMI during their mature years, mortality risk increases directly with BMIas one might expect from the health consequences of excess abdominal adiposity (Singh et al 1999;Singh et al 2011).…”

Section: Dietary Leucine Promotes Anabolism By Stimulating Mtorc1 Actmentioning

confidence: 99%

An increased need for dietary cysteine in support of glutathione synthesis may underlie the increased risk for mortality associated with low protein intake in the elderly

McCarty

DiNicolantonio

2015

AGE

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Restricted dietary intakes of protein or essential amino acids tend to slow aging and boost lifespan in rodents, presumably because they downregulate IGF-I/ Akt/mTORC1 signaling that acts as a pacesetter for aging and promotes cancer induction. A recent analysis of the National Health and Nutrition Examination Survey (NHANES) III cohort has revealed that relatively low protein intakes in mid-life (under 10 % of calories) are indeed associated with decreased subsequent risk for mortality. However, in those over 65 at baseline, such low protein intakes were associated with increased risk for mortality. This finding accords well with other epidemiology correlating relatively high protein intakes with lower risk for loss of lean mass and bone density in the elderly.

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BMI and all-cause mortality in older adults: a meta-analysis

Cited by 618 publications

References 60 publications

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients

An increased need for dietary cysteine in support of glutathione synthesis may underlie the increased risk for mortality associated with low protein intake in the elderly

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