Nutritional status related to poor health outcomes in older people: Which is better, obese or lean?

Abstract

Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health‐related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle‐aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle‐aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older‐old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle‐aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5–13.

The association between nutritional status and functional limitations among centenarians: a cross-sectional study

“…Malnutrition is associated with many adverse events in the aging process of the older [ 7 ], which heavily affect health status and life quality [ 8 ]. Especially in terms of function, it has been proved that malnutrition can lead to functional limitations in the older [ 9 – 11 ]. This is because nutritional status may trigger changes in the structure and function of muscles.…”

Frailty and health risk in older people

“…Frailty and health risk in older people Dear Editor, Kuzuya 1 reviewed the relationship between nutritional status and health outcomes with special reference to life stage. The author mentioned that there was a shift in medical attention in older adults from metabolic syndrome to frailty.…”

“…Changes in total KCL points were 34.5% and 12.1% on 1-year follow-up during the COVID-19 pandemic and non-pandemic period, respectively. In a recent pandemic-related study, including ours, it was indicated that the amount of physical activity was greatly reduced during the COVID-19 pandemic compared with before, [1][2][3][4][5][6] with this inactivity having a huge effect on frailty incidence. In the near future, frail older adults are more likely to need nursing care, 8 and thus more suitable prevention/management strategies for frailty are needed, especially during this pandemic.…”

Author's reply to the letter to the editor from Prof. Kawada T

“…Ikeda et al showed that the numbers of clinics providing home visits and facilities providing visiting nursing services were positively associated with in-home deaths using 1741 municipalities' data. 2 Furthermore, the number of visiting nurses per population could be associated with that of day service care workers per population. The expenditures of long-term care service except for facility service per user were high among prefectures with both high home death rates and a higher number of visiting nurses per population.…”