Revisiting the Value of BMIs in Older Adults

The highest risk was not at the upper end of the scale.

Reprinted from Eating Disorders Review
July/August Volume 25, Number 4
©2014 iaedp

Body mass index (BMI, kg/m2), or Quetelet’s Index, was defined by Lambert Adolph Quetelet in 1835. This widely used method of adjusting height for weight, now so universally applied for estimating overweight and obesity, was little used until the late 1970s. At that time the standard for overweight and obesity was found in ideal weight tables for men and women published by the Metropolitan Life Insurance Company (the Metropolitan Life Desirable Weight Table). Dr. Reubin Andres’ 1970s studies on the connection between height and weight and mortality helped establish the BMI as a standard. In other work, after Dr. Andres argued that higher BMIs produced higher mortality at all ages, the BMI became an important measure of health, overweight, and obesity (Int J Obes.1980; 4:381).

An Australian study questions the value of BMI ranges in older persons

Jane E. Winter and her co-workers at the University of Melbourne and Deakin University, Burwood, Melbourne, Australia, have questioned the validity of current BMI mortality assumptions for older populations (Am J Clin Nutr. 2014;875). In their meta-analytic study of men and women 65 and older, being overweight or obese was not associated with an increased risk of mortality. However, there was increased mortality with a BMI below 23.0.

In an editorial in the same issue, Dr. John D. Sorkin, from the Baltimore VA Center and the University of Maryland’s Division of Gerontology and Geriatric Medicine, notes that the study did not address the question whether mortality at low BMI is higher in older adults. He suggests that a more direct approach to this question would have been to include adults of all ages and to compare the nadir of the U-shaped curve in younger and older adults.

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