Rising Obesity Rate Among Older Adults Complicates Health Issues

It seems as if no age group, from young children to older adults, has escaped the clutch of obesity. The most recent data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006 found that 68.6 percent of adults aged 60 and over are overweight or obese (body mass index over 25), up from 60.1 percent in NHANES 1988-1994. (There was no significant change in obesity rate between 2003?2004 and 2005?2006.) The weight concerns of older adults pose unique challenges, according to a review performed by researchers from the Sticht Center on Aging at Wake Forest University School of Medicine in North Carolina published in the Journal of the American Dietetic Association in November 2009.

Unique concerns. The over 65 group is expected to increase to about 20 percent of the U.S. population by 2030, up from 12 percent in 2000. The rising obesity problem in a growing population is alarming, since both age and obesity are independent risk factors for chronic health conditions such as arthritis, hypertension, heart disease, stroke, cancer and diabetes. Additionally, overweight and obesity are linked with an increased risk of physical and cognitive disability?major risk factors for dependency, institutionalization, greater health care costs and use of health care services, poor health outcomes, and mortality. The social, medical and economic implications of this scenario are compelling. Yet obesity has barely been addressed in this age group. Instead, public health programs have focused on issues of malnutrition. What’s urgently needed are approaches that will foster a healthier lifestyle within a growing number of overweight older adults living independently.

Developing a weight loss fix. Part of the problem is that experts haven’t fully dealt with how to handle weight loss in older adults, because in older adults, weight loss is linked with loss of muscle mass and bone mineral density, and unintentional weight loss that accompanies diseases of aging is associated with increased mortality. Thus, weight loss is not widely recommended by health care professionals because of concerns that the risks might offset the benefits. To date, there is little research available on potential health benefits of weight loss in older people.

But age alone should not discourage people from seeking treatment from obesity, according to the National Heart, Lung and Blood Institute. Older, overweight and obese adults should be evaluated on an individual basis, weighing the benefits versus the risks. If weight loss is targeted, it should be done without sacrificing bone or muscle health. A lifestyle intervention should include a low-calorie diet, physical activity and behavioral and social support such as stress management and learning better eating habits. Both the American Society for Nutrition and the Obesity Society recommend a modest reduction of 500-750 calories per day to result in weight loss of one to one-and-a-half pounds per week. Older adults should get adequate levels of vital nutrients including protein, vitamin D, vitamin B 12, fiber and fluid. Regular moderate-intensity aerobic exercise for a minimum of 30 minutes, five days a week is suggested for those with no physical limitations. The bottom line: It’s never too late to reap the rewards of a healthier lifestyle.

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