Over the weekend I read an interesting article in the Telegraph. If you wish to read it you can go to the Telegraph's health section or type in the title "Why you need to gain 'buffer' weight over 65 and how to do it healthily".It explains about the concept of "geriatric BMI" ie that a healthy BMI for older people is higher than that of younger people. Two consultant geriatricians are quoted one of whom Professor Jugdeep Dhesi from Guy's and St Thomas' NHS Trust is President of the British Geriatrics Society. She explains that a healthy BMI for older people is between 23 and 30 rather than the 18-25 range used for younger people. The other geriatrician interviewed, Professor Roy Soiza of Aberdeen Royal Infirmary, says that most geriatricians and those who work with older people know this but it is not as widely recognised by the wider public. This is because of the so called "longevity paradox " that overweight older people especially women live longer than their slimmer peers.
A paper linked to in the article and published in the Annals of Geriatric Medicine and Research gives 25 as the lowest healthy BMI for the seniors it studied who were mainly women and in their 70s. At the other end of the range BMIs over 35 were shown to be negative . The researchers concluded that for this demographic a BMI of 31-32 was optimum . For men it was 27-28.
Reading this article jogged my memory about a book I read over 25 years ago that was mainly a critique of the slimming industry. Back then, the study of actuarial tables told the same story. That overweight and even mildly obese women lived longer than skinny lizzies who became frail.
The article stresses that good nutrition and exercise are important for maintaining health in old age but for all those of us that do eat healthily and remain active but are still overweight / mildly obese according to the BMI ranges meant for the young and middle aged - stop worrying, stop beating yourselves up and enjoy your food!
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Auriculaire
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I read in a Heart Failure Family Doctor publication some years back that it better for heart failure patients to have higher bmi than normal.
More recently advised by my physio to ignore the scales, concentrate on strength exercises and leave as long a gap as reasonable between last meal of day and first meal of next. I found this last piece of advice really helps.
Personally I find it almost pathetic to see old people getting obsessed with ' dieting'. Obviously eat sensibly , particularly if diabetic. There is so much around in the way of fresh , nutritious foods that one can allow oneself an indulgence for a dopamine hit!
I also find it annoying when people here ( probably who have never had a life time struggle with weight) lecture those who do struggle with it about the necessity of reducing their BMI to 25 or under on the basis of one study in Australia (that only had 355 subjects ) in order to reduce their afib burden. The actual study makes it clear that it is not just a question of reducing but keeping off the weight. Well it's swings and roundabouts. You may reduce your afib burden at the risk of incurring other health problems.
My bmi is 21 and there is no way I could get it up to the figures quoted in the article, I’ve always been a “skinny lizzie” unable to put weight on so seems no hope for living to ripe old age 🥴
I'm in the same boat as you ! I'm 82 and would like to gain weight, but console myself with the fact that my maternal grandmother, mother and her 8 siblings, all skinny, lived until they were 95 !
I disagree. I have a dear friend who is 92 this year and she has been skinny all her life. I think we all have an allotted time, despite our trying to live forever via different methods. We have control over many things, but not that. We are exactly the way we are meant to be. Have a good day.xxx
I know what you mean! But I refuse to starve myself. At 73 I am trying to ignore what my body looks like and concentrate on how it feels and what I can do.
I agree with the article, but after my total knee replacement, my orthopedic surgeon told me that for every extra pound of body weight, it's equivalent to 4-6 pounds of stress on the joints. However, if I get a bad bout of the flu and can't eat, I suppose I would appreciate the extra weight. It's a Catch-22 -- "dang it I do and dang if I don't."
I think the message from the article was that after a certain age trying to lose weight to fit in with the standard BMI ranges is counterproductive unless one is morbidly obese. I am obese by the standard BMI ranges and have been " overweight " for most of my adult life. I have had both hips replaced but apart from occasional knee pain when I was dancing my knees don't bother me even though I garden a lot and spend a lot of time on them. My GP has never suggested I lose weight and says that at my age -73- weight stability is important. I have occasional fasting glucose tests that stray into the lower part of the prediabetic range but every so often I have a "stabathon" where I test my fasting and post prandial levels intensively for a few days and my post prandials are always good. My blood pressure is fine. My cholesterol is high with a very slightly raised LDL and a high HDL. Triglycerides are always within range. The only health pest is really the afib but even that is not very symptomatic. But I am still vain / brainwashed enough to want to be a lot slimmer having grown up in the age of Twiggy , Jean Shrimptom and other beanpole coat hangers who were pushed as the epitome of female beauty. But I don't want it enough to starve myself and actually become less healthy!
It's great that you're focusing on stability. I read recently that the use of BMI has been medically challenged due to its limitations in accurately measuring a person's overall health along with their weight.
I also grew up in the age of Twiggy and as a teen I thought I was "overweight" when actually I was normal weight. Thankfully those days are long gone. Losing too much weight when older can cause loss of bone density and most importantly, muscle mass, which is crucial for mobility and balance -- not as easy to fall and fracture. It's heartbreaking to see a senior in hospital because of a fall.
Ditto . I went on my first diet when I was 16 and reduced in 6 weeks on an Atkins like diet from a healthy 8 stone (I was just under 5ft) to a skinny 6st 9lbs. I ate most of it back on in 2 weeks when my mother took us to Spain where I ate lots of paella! I had other yo yos when I was at uni which probably set me up for a lifetime of struggle. 7 years of undiagnosed hypothyroidism did not help.
Jean Shrimpton is still alive and kicking in her 80s as indeed is Twiggy at 75 yrs old so who knows and I agree with Cavalierrubie when your times up its up.
thank you for sharing this. Society is quite obsessed with weight and I do feel conscious of being just in the range considered obese. I must say no Dr has made a thing of it but I have felt a degree of shame sometimes. I am quite a lot fitter than many my age so I console myself with that. It’s so refreshing to hear a more balanced and positive take on this arbitrary measurement.
If you nose breath, eat nutritious and whole food, do a moderate amount of exercise every week, limit sugar and alcohol and laugh, love and smile - you will be ok.
Agreed! At nearly 81 I've shrunk from 5ft. 6 and three quarter inches to five ft three and a half. Weight 7 stone 10 lbs. I've been worrying as bmi just under healthy but I eat nutritious meals, lift weights and walk regularly. But I do need to laugh and live a bit more!
I now (finally!) look back to my childhood and see the simple common sense. My parents did not rely on what medics said or BMIs, they gave us quality food, not allowed seconds, told when you get up from the table you should be able to eat the same again and no snacks in between meals. We always had plenty of exercise and access to Nature as we lived on a farm and of course no computer or phone screens then. Job done!
It's good to be aware of our ignorance around "fat shaming" issues, and I'd like to mention a similar concern around "exercise shaming" on behalf of the many (like me) whose mobility is limited, and even "a moderate amount of exercise (of the running and walking variety) every week" impossible due to age, genetics, accident, or disease.
Good point ozziebob. I am in the same category with osteoporosis. I do leg and various excercises while l am sitting to retain muscle mass. It is more difficult as you age. I am thankfully still mobile, but at a much slower pace.
My grandparents both lived to a good ripe old age and both became immobile. I think one can get obsessed with what the media say we should be doing. Stress needs to be avoided!!
Excellent point. I have problems with my tendons due to exposure to FQ antibiotics which attack chondrocytes - the cells that make up healthy cartilage. Walking for more than 15 /20mins gives me pain in the Achilles tendons. I have pulled tendons behind my knees on several occasions just climbing onto our motorbike. So I have to be careful. Also I have band of metal round my left femur due to complications with my left hip replacement which gives me a lot of pain if I lift my leg too high. I think exercise has become an obsession but maybe it's due to more sedentary lifestyles.
You can be slim but not frail if you retain your muscle mass and overweight but frail if you lose your muscles. You can be the same weight even, but the muscular one would be less frail. It depends how the weight is made up. Resistance training is supremely important as we age stuff like modified press-ups, squats or sit to stands. Add some balance work and a brisk walk and you will massively improve your Quality of Life.FREE advice from a Personal Trainer specialising in older people and people with medical conditions 🤣🤣🤣🤣🤣🤣
Unfortunately, with polio, you do "lose your muscles" in the acute phase, and then the remaining motor neurons (--> muscles) get exhausted by overuse during "life", leading sooner or later to all muscle strength and endurance exercises being contraindicated.🤔 That's where I have landed.
"In the period of 2024-2025, polio has primarily been reported in Afghanistan and Pakistan. These countries are the only two where wild poliovirus transmission is still classified as endemic. While there have been outbreaks and detections in other countries, the most significant and persistent transmission continues to be in these two nations. Additional outbreaks have been detected in Guinea and French Guiana, as well as in Gaza." - Google Gemini answer.
I also read USA has had a case recently as well. I contracted mine in Sydney in early 1950's. Dirty boy!🤔😀
This is the problem for some of us isn’t it? Illnesses that we have had in the past often rear their consequences when we become older, when they become added to the delights of other old age ailments. It then becomes difficult to navigate. Although not as severe as yourself, l have my own cross to bear in that respect.
Well, when you can walk on rice paper let me know and l might follow in your footsteps (pun intended)
Yes, l have a great admiration for Taoist monks, indeed all monks for their knowledge, attitude and approach to life. A unique tribe of people who refuse to conform to this world which is always switched on to “fast forward”. We have to strive for peace, they accept nothing else.
The article does talk about the importance of retaining muscle mass and also of the danger of losing muscle mass by dieting without taking steps to retain it.
It is important Auriculaire to retain muscle mass as we age. I see folks go by, riding mobility scooters and wonder if this is adding to the problem. They are, of course, a necessity for some, especially those living alone, but l think only to be used when absolutely necessary and not all the time. I witnessed the deterioration of an elderly neighbour who, after a while, kept having falls.
My friend got cryptogenis organising pneumonia I feel because she was underweight taking antibiotics for flu.
Its been over a year and she is still taking 1/2 tablet. She has put on some weight. Great.
We had a Dr arrive in our Clinic who outrageously told me that I shouldn't be eating cheese or meat.
I sat down with him and said BMI is out. Do get yourself a measure tape. Its kinder for folks and we have a big percenatage of Maori who are massive.
I read that the 35" waist for woman and 40" for men is a better gage of obesity because heavy bones are included in the better guide.
Yes more weight gives better protection in immunity. The fighting side of our bodies.
Dealing with a measure tape is a much more helpful aid.
I'm about 3" over the 35". I was always 10 stone at 50 but with age I have crept up. We had to learn the change from stone to kgs! Help.
I feel after you believe you could lose some weight do and a little at a time deserves a 'pat on the back'.
The chocolate days are over so put those Lindt Dark Chocolate away! I was hunting for discounted rabbits but the answer was no dark chocolate rabbits left or we never had them. Good I said! Small with brown bows and bell.
It’s not that the article doesn’t touch on it, but the idea that higher BMI is better in older adults can be misleading.
Body composition matters most with also studies to back it up. Muscle mass protects, while visceral fat increases risk, even at a normal BMI. Many low-BMI seniors may have lost muscle, not just weight.
In any event, this shouldn’t be a greenlight to become obese—excess weight still raises the risk of diabetes, heart disease, joint problems, and mobility issues. The goal isn’t a higher BMI—it’s a stronger, healthier body.
I don't think that most people reading the article would see it as a greenlight to become obese! But the geriatricians were very clear about a higher BMI being beneficial. I think it is more that the concept of obesity in older people needs to be reassessed and that it is not a good idea for older people with higher BMIs to be going on diets to reduce them to the BMI ranges used for younger people as they risk losing muscle mass as well. BMI is a very poor measure of obesity anyway and does not take into account body composition. When my husband was still working a private health firm came and did health assessments at his office. He and the office marathon runner were classed as obese by BMI. This was ludicrous. He played squash 3 times a week and was quite slim but very well muscled. It is also not always possible for older people to use weights for developing muscle if they have soft tissue issues like chronic tendinitis. I have to-be very careful as my tendons damage easily due to FQ exposure.
But the geriatricians were very clear about a higher BMI being beneficial.
Some good points are made but I think it's a lot more nuanced than "higher BMI being beneficial" so proceed with caution before opening that pack of oreos
Presume this Jugdeep is old and fat himself:). Or has just made his Doctorate diploma thesis on this topic.What an absurd. Metabolism is naturally slows down with age and body healthy decides what it needs. Even if you stuff your face with potatoes and bread max you can achieve a huge blotted belly.
Another way is taking proteins and going to lift weights. Which sounds a bit weird for over 75s. Bones also changed with age, ligaments etc. lifting weights is a recipe for traumas:).
So how Jugdeep advises to put weight on? And how he decided it would be good to be overweight? How many people he assessed in his research?
Chunky oldies. And BMI doesn't take in account person's measurements. You definitely do not need to have more than 1 metre waist line😄
You obviously did not read the article carefully. Prof Dhesi is a she. She isn't old or fat. For donkey's years actuarial tables have shown that heavier people especially women lived longer . If you had bothered to read the study linked to in the article you would see that the number of participants was 1051, 73% of whom were female with a mean age of 77.2 years. This was not a study conducted by either of the geriatricians quoted in the article.
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If you are fit and healthy -- how dangerous is AF? Maybe not as much as we've been led to believe...
The diet that is working (for my husband that is!)
Extreme Exercise For Seniors
The AF journey continues...now ablation
BMI to high for Ablation 
