Persons with overweight and obesity or other lifestyle disorders are advised to reduce body weight to delay or prevent complications. However, all weight loss may not be beneficial as shown in a new study published online April 10, 2023 in JAMA Network Open. According to this study, a weight loss of 5% or more in healthy older adults was associated with increased risk of all-cause mortality.¹

A post hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial involving 16,703 Australians aged ≥70 years and 2411 participants from the US aged ≥65 years was conducted to examine if a change in body weight and waist circumference was associated with heightened mortality risk in healthy older adults.

Data for both body weight and waist circumference, at baseline and at 2 years, was available for 16,523 participants; of these, more than half were women (55.6%; 9193) and the remaining 7330 (44.4%) were men. None of the study subjects had any cardiovascular disease (CVD), dementia, physical disability or any other incurable chronic illness at baseline. The body weight and waist circumference were measured at the start of the study and then after 2 years. A total of 1256 deaths occurred over a mean of 4.4 years. A variation in body weight and waist circumference within 5% was described as stable. The other four categories were: weight loss 5-10%, weight loss >10%, increase in weight by 5-10% and increase by >10%. Participants with stable weight acted as controls.

Results showed that the majority of the study participants (74.9%; n= 12,370) had stable weight, while 1953 (11.8%) recorded a weight loss of 5-10% and 587 (3.6%) had a weight loss of >10%. Weight loss occurred mainly in women, prefrail or frail individuals. Almost 8% (n=1299) had an increase in weight by 5-10% and 314 (1.9%) had an increase of more than 10%.

Men who had a weight loss of 5-10% were at a 33% higher risk of all-cause mortality when compared to men with stable weight with hazard ratio (HR) of 1.33, while men with weight loss of >10% had a 289% higher risk of all-cause mortality (HR 3.89). A similar trend was observed among female participants of the study. Compared with those with stable weight, women with a 5-10% weight loss had a 26% higher risk of all-cause mortality with HR of 1.26. Women who lost >10% of their body weight were at a 114% higher risk (HR 2.14).

In men with >10% weight loss, the HR for cancer-specific mortality was 3.49; it was 3.14 for CVD-specific mortality and 4.98 for noncancer non-CVD-specific mortality. Women with >10% weight loss were also at higher risk of all-cause mortality, cancer-specific mortality and CVD-specific mortality with HRs of 2.14, 2.78 and 1.92, respectively compared with those with stable weight. Women with weight loss ranging between 5% and 10% were also at a greater risk of all-cause mortality (HR 1.26) and cancer-specific mortality (HR 1.44).

A reduction of >10% in the waist circumference was also associated with all-cause mortality in both men (HR 2.14) and women (HR 1.34).

This study has shown that a weight loss as small as 5%, increased the odds for mortality due to any cause (such as cancer, CVD, trauma, Parkinson disease, dementia, etc.) among healthy older adults, more so in men. This association was evident regardless of the baseline weight. It is therefore prudent to measure body weight often to detect any change for timely identification of risks and investigate the cause of weight loss as it may be a red flag for any underlying disease, especially if it is unintended. Nonetheless, older adults should be encouraged to lead a healthy lifestyle, including a healthy balanced diet and regular physical activity, for overall health and well-being.

Reference

1. Hussain SM, et al. Associations of change in body size with all-cause and cause-specific mortality among healthy older adults. JAMA Netw Open. 2023;6(4):e237482. doi:10.1001/jamanetworkopen.2023.7482.