Health for life

Change in Weight More Important Than Where You Start

Some overweight older adults don’t need to lose weight to extend their lives, but they could risk an earlier death if they pack on more pounds.

In fact, the nationwide study found that people who were slightly overweight in their 50s but kept their weight relatively stable were the most likely to survive over the next 16 years.

They had better survival rates than even normal-weight individuals whose weight increased slightly, but stayed within the normal range.

On the other hand, those who started out as very obese in their 50s and whose weight continued to increase were the most likely to die during that period.

Overall, the results suggest that about 7.2 percent of deaths after the age of 51 are due to weight gain among obese people, at least among the generation in this study, said Hui Zheng, lead author of the study and assistant professor of sociology at The Ohio State University.

“You can learn more about older people’s mortality risk by looking at how their weight is changing than you can by just looking at how much they weigh at any one time,” Zheng said.

While some extra weight seemed protective in this study, Zheng cautioned that these results applied only to people over 50. His previous research, published in Social Science & Medicine, suggests that being overweight may not be helpful for younger people.

“Our other research suggests that the negative effect of obesity on health is greater for young people than it is for older people, so young people especially shouldn’t think that being overweight is harmless,” he said.

This new study was published online this month in the American Journal of Epidemiology. Co-authors are Dmitry Tumin, doctoral student, and Zhenchao Qian, professor, both in sociology at Ohio State.

The researchers used data from the Health and Retirement Study, a nationally representative survey of Americans born between 1931 and 1941. This study analyzed 9,538 respondents who were aged 51 to 61 when the survey began in 1992. They were re-interviewed every two years until 2008, and the researchers had information on how their body mass index (BMI) changed at each interview and whether they died at any point before December 2009.

Body mass index measures weight relative to height and is often used to evaluate obesity.

Zheng and his colleagues classified respondents into six groups, depending on their BMI at the beginning of the study and how it changed over the 16-year period they were surveyed.

While slightly overweight people (BMI of 25 to 29.9) whose weight was steady had the highest survival rate, those who moved from overweight to obese (BMI 30 to 34.9) were close behind.

“This suggests that among overweight people at age 51, small weight gains do not significantly lower the probability of survival,” Zheng said.

The third highest survival rate among the six groups was normal weight individuals (BMI of 18.5 to 24.9) whose weight increased slightly, but stayed within normal range.

Next came the Class I obese (BMI of 30 to 34.9) whose weight was moving upward.

“You can learn more about older people’s mortality risk by looking at how their weight is changing than you can by just looking at how much they weigh at any one time.”

Next to last were normal weight individuals who lost weight. Although the study attempted to control for illnesses among those studied, it may be that many of these individuals dropped weight because of illness.

The most obese individuals (BMI of 35 and over) who continued to add weight had the lowest survival rate of the six groups.

There weren’t enough people who started out as overweight and obese and lost weight to include in this analysis, Zheng said.

“We can’t really evaluate the effectiveness of planned weight loss on mortality. Even in the normal-weight people in this study, there was no way to tell whether weight loss was planned,” he said.

Zheng noted that the study took into account a wide variety of demographic and socioeconomic factors that may play a role in both weight and mortality among Americans. The researchers also controlled for whether the respondents smoked, whether they had a variety of chronic illnesses and even how they rated their own health. The results stood even after all of these factors were taken into account.

Why is being slightly overweight protective for older people?

“It is probably because the older population is more likely to get illnesses and disease, especially cancer, that cause dangerous weight loss,” he said. “In that case, a small amount of extra weight 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.”

Younger people are less likely to get many of the diseases that afflict older adults, which is one reason extra weight is not good for them, he said.

But Zheng said the main message for everyone, including older adults, is that packing on the pounds, especially if you’re obese, can be hazardous to your health.

“Continuing to put on weight can lower your life expectancy,” he said.

Hi,

First the good news: I hit 303.25 two days ago as a result of the fasting twice a week. I was really surprised when I saw that number before my very eyes.

I still fluctuate up and down, but today is the beginning of my first fast day for this week so I am just finishing up my first meal of the day and will fast after that. I had just skipped eating earlier today without considering that this is the preparatory fast day. I usually try to eat two meals on this day, but, the day is half over and I cant go back. Dont think I need to really.

I decided to eat a large bowl of steamed Italian green beans, broccoli, and peas plus a pork rib for the protein before I begin the fast. That is out of the way, now, so the next time I eat will be tomorrow at 4:30.

Second the bad news: Ive been dealing with my left knee again. It went out a week ago last Thursday and was very excruciating. I figured I would treat it as I always do which is to wear my knee brace until I can again walk normally. It is Sunday and I am, day by day, seeing some improvement but it still feels "stiffish" right now and I have some small achy pains from time to time depending on the position I put it in.

I went to see Dr. Andy, my chiropractor on Friday and he aligned both the knee and my foot and I did see some improvement the next day. It seems to be improving each day. Ill go to see him again on Tuesday.

The thing I am worried about is collecting all the cookies for the bake sale that I am spear heading for Trinity Childrens center this week. The community sale is being held at the Gwinnett Braves stadium on Saturday and I hope my knee is well enough to allow me to work the booth.

It is the loading and unloading of the cookies when they reach my house that I am kind of worried about. Im thinking of asking my friend John if he will help me with that, but he is often incapacitated and unable to do those kinds of things. The cookies should not be heavy it is just that there will be so many of them. Our goal is 100 dozen and we have about eight people baking them. Im supposed to be making cookies, too.

I am simply putting my trust in the Lord. He will help me to accomplish all that I must do and heal my knee in the process, too.

Now about the fasting....

I feel that Ive done it enough times now that I kind of like the way I feel when Im fasting. I know Ive mentioned that before but it needs to be said again: fasting is really quite easy. As Ive been doing it Ive begun to notice some things that I would never have noticed without having fasted on a schedule.

For one, I think it must actually be more "normal" than I used to think. Having grown up in the US and been fed at least three meals a day for my entire life, fasting used to seem like a dangerous thing. I associated fasting with emaciation, starvation, eating disorders, sickness and disease. It just never seemed possible that there might be a healthy side to it and it might actually be a healthy thing for the overfed to do. Even though I knew Jesus fasted, many of the saints fasted, and it is a natural part of the Old Testament, too, it just seemed beyond extreme to my mind.

You know that idea that when you buy a yellow car, suddenly you see all the other yellow cars on the road? Well fasting seems to be like that for me. Now that I am fasting from time to time, I notice when someone or something points to the fact that our ancestors may have fasted as a matter of course, that I had not realized.

Granted, many of them are just "hints" but they are beginning to be seen by me. Like the idea of having a cup of some hot liquid for breakfast, be it coffee, tea, or broth. That is what I do when Im fasting, I drink lots of water and tea. I never had a liquid meal before I started fasting. Every meal had solid food. And that was part of the problem that I could not see.

Ive even blogged recently about not being able to tell the difference between hunger and thirst. I really do see now that drinking water is a valid response to the feeling of hunger. If you cannot tell the difference then they are the same feeling, arent they? I spent most of my life eating when I may have been thirsty. Ive struggled with keeping my body hydrated for as long as I remember, too. Obesity and dehydration were my two companions, but now that Im fasting, I can see the real value in drinking water and my mind now accepts the concept that I might be thirsty when I get "that" feeling.

It seemed odd to me that when I fasted I also eliminated more water than usual -- like my kidneys were functioning better. When I first noticed it, it was a puzzle to my puny brain. I was surprised that I started peeing more often when I fasted. So much more that it was noticeable to me. But really, if you are drinking more you will be eliminating more, too. Ding. Ding. It all began to make sense. My body was no longer dehydrated because I was not responding to the "feeling" that I call "hunger" with food but with water or tea. My body liked the change. So the solution to the obesity is also the solution to the dehydration. Eat less. Drink more.

I dont resent having been fed, that is not the point. I am relieved that it is OK to not eat some times!! In fact, it is a good idea, for me to drink water and skip the food from time to time. It just seems so natural and so obvious. I wonder why I never saw it before. Dont know why. Just glad I stumbled upon that one. LOL

So this means my inner core ideas about food and eating were based on belief and not fact. My body never did seem to match my beliefs about food. It has been a struggle all my life. The fasting seems to be the best solution to my particular dilemma. It reduces my calorie intake without me having to fight and to measure and to control every morsel that goes into my mouth -- which I was never good at, anyway. It also increases my water intake and helps to make my kidneys function better. So amazing to kill those two birds with that one stone.

I wish I had something more profound to say but that is about it. The fasting is working. The fasting is easy. The fasting makes me feel good and my body function better. Praise the Lord!!

Be back soon,

Marcia

Statins -- the popular class of cholesterol-lowering drugs used widely to prevent recurrent heart disease or stroke as well as risk for having a first cardiac or stroke event -- appear to cause few side effects, according to new research reported in Circulation: Cardiovascular Quality and Outcomes.

Researchers conducted the largest meta-analysis on statin side effects to date, reviewing data from 135 previous drug studies to evaluate the safety of the seven statins on the market. They concluded "as a class, adverse events associated with statin therapy are not common."

Researchers noted that simvastatin and pravastatin, the generic names of the brands Zocor and Pravachol, were found to have the best safety profile in the class. This is particularly true when patients were prescribed low to moderate doses of those statins, said Huseyin Naci, M.H.S., the studys lead author and a doctoral candidate at the London School of Economics and Political Science and research fellow at Harvard Medical Schools Department of Population Medicine.

Researchers also noted a 9 percent increased risk of diabetes among statin users. But according to a previous landmark study, 250 patients need to be treated with a statin for one case of diabetes to be diagnosed.

"I am concerned that patients may misunderstand this small increase in risk and stop adhering to their medications," Naci said. The proven ability of statins to significantly cut the rate of death and hospitalization in patients who have heart disease outweighs the "small increase in diabetes risk," he said.

Researchers reviewed trials published between 1985 and early 2013, which included almost 250,000 patients. On average, the trials lasted a bit longer than a year. Some compared one statin to another, while others compared a statin to an inactive placebo, which is often called a sugar pill or dummy pill.

The study also found that statins were not linked to an increase in cancer risk. However, the drugs were associated with a typically reversible increase in liver enzymes, which Naci said still resulted in a very low rate of actual liver toxicity in statin patients.

"Although the benefits of statins clearly outweigh risks at the population level, individualizing such benefits and risks is more difficult," he said. "This brings into sharp focus the importance of identifying the individuals who stand to benefit the most from statin therapy.

Although the risk of developing diabetes is low, what this risk would amount to over time is simply not known based on the existing evidence," Naci said.