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.

Every Saturday, we post a piece from the CHG archives. This one comes from June 2009.

Though it might seem intuitive, determining a recipe’s cost and nutritional value can get pretty complicated, pretty quickly. Ingredient prices can add up before you know it, and a combination of fats, meats, and cheeses will take a toll on your calorie count without even registering on your radar. And sometimes, even the most harmless-looking dishes, like All Recipes’ Greek Pasta Salad with Shrimp, Tomatoes, Zucchini, Peppers, and Feta, can run you $2 and 42 grams of fat per serving.

So, how can you tell if a dish is good for you, just by looking at it? How can you avoid the pitfalls of secretly fatty and financially unsound food? How can you err on the side of caution when it comes to cooking?

Look no further, sweet readers. We’ve got you covered. If your recipe source doesn’t give a nutritional breakdown and you’re unsure of the potential cost, these tips will help you decide whether the money/waistline expenditures are worth the trouble. If you have any suggestions, be sure to include them in the comment section.

DO choose your source wisely. Man, I love Paula Deen. Her food looks stupendous and she’s endlessly entertaining – like Yo Gabba Gabba if it was a charmingly cackley southern woman. That said, her concoctions might not be the best choice for those concerned about weight. If you know you’re looking for healthier recipes, sources like Everyday Food, Cooking Light, and Eating Well will generally be more helpful than the Neelys or the Two Fat Ladies. Likewise, reproducing a dish from Grant Achatz’s Alinea cookbook will probably run you a pretty penny compared to the average Cook’s Illustrated meal. Starting your search with a website, cookbook, or blog aimed at your requirements is half the battle.

DO check the number of servings. Once you have a recipe in mind, before you do anything else, check how many people it’s supposed to sate. Fourteen ounces of flank steak does little damage split among eight eaters, but can destroy diets if it’s meant only for two.

DO read the ingredient list caully. After the serving size, the ingredients are the most important determinant of the cost and nutritional value of a recipe. Scan the rundown, look for a few keywords (many of which are listed below), and be extra aware of extravagant or difficult-to-find foods for your area, which will drive up the price.

DO consider recipes with one or two out-of-the-box ingredients. In small doses, odds are it/they won’t break the bank, and you can incorporate new flavors into your repertoire. Lemongrass? Meyer lemons? Lemon basil? Sure, why not?

DON’T dismiss a long list of ingredients outright. Lighter foods like Bon Appetit’s Turkey Chili with Beans frequently require multiple, inexpensive spices and flavorings to make up for the absence of fat. While their sheer number can seem pretty intimidating, don’t fret. Oftentimes, these foods can be found right in your pantry for minimal cost.

DO count the number of ingredients already in-house. Speaking about that pantry, recipes based on dry goods will usually be cheaper than ones requiring a trip to the supermarket. Look for meals that use rice, beans, pasta, and other staples as jump off points, and go from there.

DO opt for whole food ingredients. If it can be found in the outer aisles of your supermarket, it’s probably a good start to a meal. Fresh fruits, veggies, and lean meats give recipes more bang for the buck, and almost guarantee a healthier overall experience. Fewer preservatives and extra-excellent flavor are just bonuses.

DON’T choose recipes made from processed food. The less ingredients are handled by humans, the better. Why? Well, in general, heavily processed and pre-cut edibles are more expensive and worse for you than the aforementioned whole foods. Semi Homemade-style meals may be convenient, but when you’re sacrificing money, nutrition, and taste, is it worth it?

DO watch out for lots of meat and cheese. In moderation, neither of these is anything to fear. But prices and calories rise when a meal centers on multiple cups of frommage or large cuts of beef or pork. Instead, search for recipes where meat and cheese are add-ons instead of the main event. You’ll save all around.

DO calculate about 12 or 13 grams of fat per tablespoon of butter or oil. When doing a cursory scan of any recipe, I take extra care to check the total cooking fat. If there’s a lot, but it can be easily reduced (like in sautés), I keep going. If there’s a lot, but the amount is set in stone (as in some baking), I move along to the next dish.

DON’T rule out all fatty ingredients. Nuts, olives, avocados and certain oils aren’t low-fat foods, but they’re healthy ones because of the vitamins and minerals they offer. Relatively inexpensive and often pivotal to a dish’s overall flavor, they should be incorporated into any diet in moderation.

DO look for words like: baked, roasted, steamed, grilled, or sautéed. These cooking techniques tend to use less fat than others while still producing flavorful foods. Steaming and boiling are good keywords as well.

DON’T choose recipes with the words: fried, au gratin, cream sauce, bisque, bacon-wrapped, or lard. Each of these terms implies one thing: fat. If you’re serious about watching your weight, there are lighter recipes for certain dishes (Spaghetti Carbonara, etc.), but straight-up lobster bisque will do a number on your numbers.

Confusing? Maybe. Do-able? Definitely. With some practice, these rules will get easier to use. And in the end, you’ll have no problem telling the difference between the recipe you really want and the recipe you thought you wanted.

Readers, fire away in the comment section.

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