Is there an obesity paradox in the Japanese elderly population? A community-based cohort study of 13280 men and women

Kenji Yamazaki, Etsuji Suzuki, Takashi Yorifuji, Toshihide Tsuda, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

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13 Citations (Scopus)

Abstract

Aim: Despite increased interest in an obesity paradox (i.e. a survival advantage of being obese), evidence remains sparse in Japanese populations. We aimed to verify this phenomenon among community-dwelling older adults in Japan. Methods: Older adults aged 65-84years randomly chosen from all 74 municipalities in Shizuoka Prefecture completed questionnaires including body mass index information. Participants were followed from 1999 to 2009. Following World Health Organization guidelines, participants were classified using an appropriate body mass index for Asian populations as follows: <18.5kg/m2 (underweight), 18.5-23.0kg/m2 (normal weight), 23.0-27.5kg/m2 (overweight) and ≥27.5kg/m2 (obesity). We estimated hazard ratios and their 95% confidence intervals for all-cause mortality, controlling for sex, age, smoking status, alcohol consumption, physical activity, hypertension and diabetes mellitus. Results: Compared with normal-weight participants, overweight/obese participants tended to have lower hazard ratios; the multivariate hazard ratios (95% confidence interval) were 0.86 (0.62-1.19) for obesity, 0.83 (0.73-0.94) for overweight and 1.60 (1.40-1.82) for underweight. In subgroup analyses by sex and age, the hazard ratios tended to be lower among obese men, albeit not significantly; hazard ratios (95% confidence interval) were 0.56 (0.25-1.27) in men aged 65-74years, and 0.78 (0.41-1.45) in men aged 75-84years. Conclusions: The present study provides evidence of a conservative obesity paradox among older Japanese people, using the appropriate body mass index cut-off points for Asian populations. In particular, obese older men tend to have a lower risk of all-cause mortality. Geriatr Gerontol Int ••; ••: ••-••.

Original languageEnglish
JournalGeriatrics and Gerontology International
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Cohort Studies
Obesity
Body Mass Index
Thinness
confidence
Confidence Intervals
Population
community
mortality
Independent Living
Weights and Measures
cause
Mortality
hypertension
alcohol consumption
WHO
Alcohol Drinking
chronic illness
evidence
municipality

Keywords

  • Body mass index
  • Elderly
  • Japanese
  • Mortality
  • Obesity

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Cite this

@article{38e97c6fb2e348e2b38001ce33f663a3,
title = "Is there an obesity paradox in the Japanese elderly population? A community-based cohort study of 13280 men and women",
abstract = "Aim: Despite increased interest in an obesity paradox (i.e. a survival advantage of being obese), evidence remains sparse in Japanese populations. We aimed to verify this phenomenon among community-dwelling older adults in Japan. Methods: Older adults aged 65-84years randomly chosen from all 74 municipalities in Shizuoka Prefecture completed questionnaires including body mass index information. Participants were followed from 1999 to 2009. Following World Health Organization guidelines, participants were classified using an appropriate body mass index for Asian populations as follows: <18.5kg/m2 (underweight), 18.5-23.0kg/m2 (normal weight), 23.0-27.5kg/m2 (overweight) and ≥27.5kg/m2 (obesity). We estimated hazard ratios and their 95{\%} confidence intervals for all-cause mortality, controlling for sex, age, smoking status, alcohol consumption, physical activity, hypertension and diabetes mellitus. Results: Compared with normal-weight participants, overweight/obese participants tended to have lower hazard ratios; the multivariate hazard ratios (95{\%} confidence interval) were 0.86 (0.62-1.19) for obesity, 0.83 (0.73-0.94) for overweight and 1.60 (1.40-1.82) for underweight. In subgroup analyses by sex and age, the hazard ratios tended to be lower among obese men, albeit not significantly; hazard ratios (95{\%} confidence interval) were 0.56 (0.25-1.27) in men aged 65-74years, and 0.78 (0.41-1.45) in men aged 75-84years. Conclusions: The present study provides evidence of a conservative obesity paradox among older Japanese people, using the appropriate body mass index cut-off points for Asian populations. In particular, obese older men tend to have a lower risk of all-cause mortality. Geriatr Gerontol Int ••; ••: ••-••.",
keywords = "Body mass index, Elderly, Japanese, Mortality, Obesity",
author = "Kenji Yamazaki and Etsuji Suzuki and Takashi Yorifuji and Toshihide Tsuda and Toshiki Ohta and Kazuko Ishikawa-Takata and Hiroyuki Doi",
year = "2016",
doi = "10.1111/ggi.12851",
language = "English",
journal = "Geriatrics and Gerontology International",
issn = "1447-0594",
publisher = "Japan Geriatrics Society",

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TY - JOUR

T1 - Is there an obesity paradox in the Japanese elderly population? A community-based cohort study of 13280 men and women

AU - Yamazaki, Kenji

AU - Suzuki, Etsuji

AU - Yorifuji, Takashi

AU - Tsuda, Toshihide

AU - Ohta, Toshiki

AU - Ishikawa-Takata, Kazuko

AU - Doi, Hiroyuki

PY - 2016

Y1 - 2016

N2 - Aim: Despite increased interest in an obesity paradox (i.e. a survival advantage of being obese), evidence remains sparse in Japanese populations. We aimed to verify this phenomenon among community-dwelling older adults in Japan. Methods: Older adults aged 65-84years randomly chosen from all 74 municipalities in Shizuoka Prefecture completed questionnaires including body mass index information. Participants were followed from 1999 to 2009. Following World Health Organization guidelines, participants were classified using an appropriate body mass index for Asian populations as follows: <18.5kg/m2 (underweight), 18.5-23.0kg/m2 (normal weight), 23.0-27.5kg/m2 (overweight) and ≥27.5kg/m2 (obesity). We estimated hazard ratios and their 95% confidence intervals for all-cause mortality, controlling for sex, age, smoking status, alcohol consumption, physical activity, hypertension and diabetes mellitus. Results: Compared with normal-weight participants, overweight/obese participants tended to have lower hazard ratios; the multivariate hazard ratios (95% confidence interval) were 0.86 (0.62-1.19) for obesity, 0.83 (0.73-0.94) for overweight and 1.60 (1.40-1.82) for underweight. In subgroup analyses by sex and age, the hazard ratios tended to be lower among obese men, albeit not significantly; hazard ratios (95% confidence interval) were 0.56 (0.25-1.27) in men aged 65-74years, and 0.78 (0.41-1.45) in men aged 75-84years. Conclusions: The present study provides evidence of a conservative obesity paradox among older Japanese people, using the appropriate body mass index cut-off points for Asian populations. In particular, obese older men tend to have a lower risk of all-cause mortality. Geriatr Gerontol Int ••; ••: ••-••.

AB - Aim: Despite increased interest in an obesity paradox (i.e. a survival advantage of being obese), evidence remains sparse in Japanese populations. We aimed to verify this phenomenon among community-dwelling older adults in Japan. Methods: Older adults aged 65-84years randomly chosen from all 74 municipalities in Shizuoka Prefecture completed questionnaires including body mass index information. Participants were followed from 1999 to 2009. Following World Health Organization guidelines, participants were classified using an appropriate body mass index for Asian populations as follows: <18.5kg/m2 (underweight), 18.5-23.0kg/m2 (normal weight), 23.0-27.5kg/m2 (overweight) and ≥27.5kg/m2 (obesity). We estimated hazard ratios and their 95% confidence intervals for all-cause mortality, controlling for sex, age, smoking status, alcohol consumption, physical activity, hypertension and diabetes mellitus. Results: Compared with normal-weight participants, overweight/obese participants tended to have lower hazard ratios; the multivariate hazard ratios (95% confidence interval) were 0.86 (0.62-1.19) for obesity, 0.83 (0.73-0.94) for overweight and 1.60 (1.40-1.82) for underweight. In subgroup analyses by sex and age, the hazard ratios tended to be lower among obese men, albeit not significantly; hazard ratios (95% confidence interval) were 0.56 (0.25-1.27) in men aged 65-74years, and 0.78 (0.41-1.45) in men aged 75-84years. Conclusions: The present study provides evidence of a conservative obesity paradox among older Japanese people, using the appropriate body mass index cut-off points for Asian populations. In particular, obese older men tend to have a lower risk of all-cause mortality. Geriatr Gerontol Int ••; ••: ••-••.

KW - Body mass index

KW - Elderly

KW - Japanese

KW - Mortality

KW - Obesity

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