Wednesday, May 2, 2012

Longevity and Weight: What's the connection?

For the past year, I have been meeting with, treating, and lecturing to over a thousand seniors. Although this is not a scientific conclusion, I notice that people in their late 80s and above are never markedly overweight and those who are markedly overweight often look older than they are. This is consistent with a study of Jews of Eastern European descent that are believed to have a longevity gene that confers the potential to live into their 90s and above. The study showed that despite sometimes living unhealthy lifestyles, none of those living into their 90s were overweight.

A study reported today further supports this conclusion.

First, let's review what is the Body Mass Index (BMI).  BMI is a measurement of weight classification calculated by factoring in your weight and height. It is an imperfect measurement because it doesn't differentiate between high body fat and muscle content. BMI has been used by the World Health Organization as the standard for recording obesity statistics since the early 1980s. (The formula is pasted at the end of the blog.) Here in the U.S., it is also the most commonly used measurement to determine underweight, normal weight, overweight, and obesity.

Generally a BMI below 18.5 is considered underweight, 18.5-25 is considered normal, above 25 to 30 is overweight, 30 to 35 moderately obese, 35 to 40 severely obese, and above 40 very severely or morbidly obese.  (It is used differently for children but I won't discuss that here. Write me for more information.)

In a new study,  Nicholas J. Timpson, PhD, of the University of Bristol, in England, and colleagues found that for every .8 (point eight)  increase in BMI, ischemic heart disease risk rose 52%.

 "These data add evidence to support a causal link between increased BMI and ischemic heart disease risk, though the mechanism may ultimately be through intermediate factors like hypertension, dyslipidemia, and type 2 diabetes," the group wrote in the May issue of PLoS Medicine."

Furthermore, they explained that "Observational studies, both prospective and retrospective, consistently link higher BMI to heart risks across different populations, but haven't convincingly demonstrated causality because of the possibility of confounding, reverse causation, and bias."

Everyone knows that being overweight is often associated with developing chronic diseases like heart disease, diabetes, stroke, cancer and dementia. However, this study is a big deal because it shows a direct correlation between weight and heart disease risks.

So it turns out that what I have been noting empirically, is in fact, scientifically grounded. The heavier you are over a BMI of 25 the more likely you are to die prematurely from ischemic heart disease, and I suspect, from other diseases as well.

At a health fair on Monday, I greeted passersbys with "How would you like to add more healthy years to your life?"  I thought this question will receive a resounding yes every time asked and it would allow me to engage the person in a meaningful conversation regarding the benefits of taking advantage of Medicare's smorgasbord of wellness and preventive services. I was wrong.

At least a quarter of the people said they were not interested. Perhaps it was my delivery or they were wary of what I was offering as too good to be true.  I really don't know the reason, but it amazed me anyway that anyone could answer that question negatively. I shouldn't be surprised.  Since the introduction of new wellness and preventive benefits in January 2011, less than 94% of eligible seniors nationwide have taken advantage of over $1,000 worth of these life-enhancing benefits. These services were implemented by Medicare to help seniors avoid chronic disease, prevent heart attacks, lose weight, and allow for early disease detection. Yet, few doctors are providing the service and few seniors are receiving them. What gives? Do they not know of the benefits or are they simply not interested?

I can't profess to know exactly what goes through seniors minds (even though in my past work experience I led an organization that cared for 5 million seniors), as I am a generation younger, but it still breaks my heart that they are not all willing to do whatever they can to live longer, healthier lives.

I can only imagine the fears they have of doing so-fears of developing dementia, fears of running out of money, fears of being institutionalized, or being left alone with the passage of friends and family. These can be legitimate fears as they can and do happen, but early planning can make a difference and I know plenty of seniors who continue to enjoy life into their 90s and beyond. I recently presented to three centenarians, the oldest 103. They all peppered me with questions.

Many seniors don't realize that the longer they live, the more good years they have enjoyed. A researcher at Albert Einstein College of Medicine also concluded that the longer you live, the less you spend on medical care. That may not make sense at first pass, but when you think about it, it begins to resonate. Living longer typically means you have less sick days and that means less visits to doctors, etc. Medical costs are a huge drain as we age and avoiding such expenses preserves our capital.

The bottom line is whether you do it for yourself, for some member of your family, or for any reason that motivates you, take care of your health (and weight) so that you can enjoy a long, healthy life.

BMI formula:

= \frac{\mbox{mass}(\mathrm{lb})}{\left(\mbox{height}(\mathrm{in})\right)^2}\times 703

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