2023-07-08 08:57:45
Dubai, United Arab Emirates, (CNN) — A new study finds that being overweight as measured by BMI is not associated with increased mortality, when viewed separately from other health problems.
The BMI for adults is calculated by dividing weight by the square root of a person’s height, and people have different degrees of body fat.
According to the US Centers for Disease Control and Control (CDC), an adult is considered overweight if his BMI ranges between 25 and 29.9, and his weight is considered normal or healthy if the index ranges between 18.5 and 24.9, and if it exceeds 30, he is considered to be overweight. He suffers from obesity.
The study’s first author, Dr. Ayush Visaria, MD, a resident physician specializing in internal medicine at Rutgers Robert Wood Johnson Medical College in New Brunswick, New Jersey, said the real message from this study is that weight gain is defined by BMI as a poor predictor of mortality risk, and that weight gain is a poor predictor of mortality risk. Body mass index in general is poor in terms of determining health risks, and it must be supplemented with information represented by waist circumference, other measures of fat, and weight trajectory.
According to experts not involved in the study, research limitations make it difficult to determine if the results are due to BMI or other factors.
Dr. Baptiste Laurent, Lecturer in Medical Statistics at University College London, explained, “The use of the word ‘overweight’ is misleading here, because it excludes everyone whose BMI is over 30. He said in a statement that the word ‘overweight’ is usually interpreted to include Anyone whose weight is above the “normal” index, including those who are obese.
“This paper found a clear association between BMI and mortality, both before and following adjusting for risk factors,” added Laurent, who was not involved in the study.
Dr. Robert H. Schmerling, senior faculty editor at Harvard Health Publishing, affiliated with Harvard Medical School in Boston, said that observational studies only show association, not causation.
“They looked at mortality rates, but there were other important outcomes they didn’t look at, such as quality of life, or the development of new comorbidities such as new cases of diabetes or heart disease,” Schmerling, who was not involved in the study, said.
Death versus disease
In the new study, published in the journal PLOS ONE Wednesday, researchers analyzed data from more than 554,000 non-pregnant Americans over the age of 20 collected from the 1999-2018 National Health Interview Survey and the 2019 US National Mortality Index.
Visaria and co-author Dr. Soko Setoguchi, professor of medicine and epidemiology at Rutgers Robert Wood Johnson School of Medicine and Rutgers School of Public Health, compared BMI levels with recorded deaths over the next 20 years.
Visaria noted that the risk of death increased from 18 to 108% for most people with BMI levels above 27.5, and the risk increased with overweight following a U-shaped curve.
There was one exception: adults over the age of 65. They had no significant increase in mortality among an elderly person with a BMI between 22.5 and 34.9, which is a range that includes those who are of normal weight, overweight, and obese.
In the view of Naveed Sattar, professor of cardiovascular health and metabolism at the University of Glasgow in Scotland, who was not involved in the study, “this paper does not add anything new.”
“We know that BMI often presents a U-shaped curve with mortality, but that’s because many people (particularly older people) at the lower end of the BMI range experience unintentional weight loss,” Starr said in a statement. Due to illness”.
Weight loss is often associated with the development of dementia and cancer and the accompanying loss of appetite in older patients. Previous research has found that losing at least 5% of body mass increases the risk of premature death among those 65 and older, particularly among men.
The most important finding of the study, Visaria said, is that adults ages 20 to 65 with a body mass index of 24.5 to 27.5, the lower end of the measure of overweight, did not have a significant increase in risk of death.
However, Tom Sanders, emeritus professor of nutrition and dietetics at King’s College London, who was not involved in the study, said future risk of disease was “probably the most important health measure of all causes”.
“The main risk of being overweight (BMI 25-29.9) and moderately obese (BMI 30-35) is a three times higher risk of developing diabetes, which contributes to cardiovascular disease, kidney failure, and blindness,” he said in a statement.
Visaria told CNN that while the study controlled for smoking and a variety of other diseases associated with premature death, this information was only collected once for each person who participated in the survey. Therefore, the study might not follow this person to see if he later developed conditions such as high blood pressure or diabetes that might contribute to death, which is one of the limitations of the study.
“They didn’t look at the cause of death, maybe it was a car accident or something unhealthy,” said Shmerling, former clinical chief of rheumatology at Beth Israel Deaconess Medical Center in Boston.
“To that, if you look at the big picture results, they found an increase in mortality due to obesity, so it’s not like they disprove the usefulness of BMI for all purposes.”
Shmerling added that those in the overweight category may change their lifestyle, such as increasing exercise, eating a healthy diet, and obtaining medical care so that they do not develop diabetes, heart disease or other comorbidities.
Waist circumference is a key metric
To BMI, Visaria noted that the study also looked at data that measures waist circumference, or the thickest part of the stomach. The results showed that using waist circumference “significantly alters the association between BMI and all-cause mortality,” he said.
“People with a large waist circumference are at greater risk of death than those with a normal waist circumference within the same BMI groups,” he added. “In the overweight BMI range (25-29.9), the risk of death was 17 to 27% higher among people with an increased waist circumference compared to a low waist circumference,” he added.
This type of deep fat that surrounds body organs, often called abdominal or visceral fat, has been linked to a 39% increased risk of dementia in older women, and heart disease, frailty, and early death in both sexes.
A waist circumference measurement should be accompanied by standing on a scale as part of any health assessment, according to guidelines published by the American Heart Association in April 2021.
And the American Medical Association recently adopted new guidelines calling on doctors to use more than BMI when assessing an individual’s health.
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