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Middle Age Poundage Weighs Heavy on Later Years

Long-term quality of life suffers from problems linked to too much weight

WEDNESDAY, Nov. 19, 2003 (HealthDayNews) -- Keeping the pounds off in middle age not only lowers your risk of disease, it could also help you enjoy a more active and enjoyable old age.

Northwestern University researchers surveyed nearly 7,000 men and women 26 years after an initial study recorded their weights in middle age. They found those who had a healthy body mass index (BMI) when they were younger felt mentally, physically and emotionally better than people who were overweight or obese in their middle years.

Study coauthor Kiang Liu says previous research has shown a relationship between too much weight in middle age and an increased risk for cardiovascular disease and diabetes as people age. But the new study goes beyond disease to find that overall quality of life is affected as well.

"We found that BMI in middle age really influences the quality of life when people age," says Liu, a professor of internal medicine at Northwestern's Feinberg School of Medicine in Chicago.

"When people get older it is important that they can function, like walk up stairs, and do the things they want," Liu says. "But if they are limited in that, they don't have the quality of life they want, and it's problematic."

The findings appear in the current issue of the Archives of Internal Medicine.

Dr. Mary Jo DiMilia is an assistant professor of medicine and pediatrics at Mount Sinai School of Medicine and a medical consultant to Weight Watchers International Inc. "This is something we think is true, but it's nice to see hard evidence of following people for a long period of time to see proof of it," she says of the results.

Another Mount Sinai doctor who deals with overweight patients says the new study is valuable because of the "self-reported" nature of the data.

"This is information that comes from the patient. This is really novel," says Dr. Laurie Edelman, also an assistant professor of medicine at the hospital.

In the study, Liu, lead author Dr. Martha Daviglus and their colleagues studied 6,766 men and women who had enrolled in the Chicago Heart Association Detection Project between 1967 and 1973 and who completed a follow-up questionnaire in 1996, which was, on average, 26 years later.

At the start of the study, the participants were between 36 and 64 years old, and free of heart disease and diabetes.

For the follow-up, participants filled out a four-page questionnaire that included information about current illnesses and medications. But it also included self-reports of health-related quality of life and regular exercise patterns.

Liu says questions included whether one could walk for several blocks, climb stairs and carry groceries. Respondents were also asked to rate their own health compared to others their age. The average age of the respondents was 75.

After weighing other factors, including blood pressure, cholesterol, smoking and educational level, the researchers found a strong association between a healthy BMI in middle age and a better quality of life later in life.

Nearly half the women and more than half the men with healthy weights -- a BMI between 18 and 25 -- at the beginning of the study reported being in excellent or very good health as they aged, 46.8 percent and 53.8 percent, respectively.

Men and women who had been overweight -- defined as a BMI between 25 and 29 -- in middle age were less satisfied with their health as they aged, 37.9 percent of women and 49.1 percent of men.

And those who had been obese -- a BMI above 30 -- in middle age reported a far lower quality of life in old age than their thinner peers. Only 24.3 percent of the women and 36.5 percent of the men in this group reported being in good or excellent health.

It's not clear why the men consistently reported feeling better about their quality of life than the women, Liu says.

"In every calculation the men always seem to be doing better, but whether that's really the truth we don't know because this was self-reported," Liu says. The research group is planning further studies to physically assess the respondents to see how their answers match up with their actual health.

In the meantime, Liu says, it's clear that people in middle age should try to keep their weight down, not only for the known risk factors of cardiovascular disease and diabetes, but to aim for a better life later in life.

"We need to pay more attention to the problems of obesity -- increasing exercise and watching diet," he says. "Don't just think about this moment, but about the future."

More information

A good overview of the risks of too much weight can be found at the National Institute of Diabetes & Digestive & Kidney Diseases. You can calculate your body mass index at the National Heart, Lung, and Blood Institute.

SOURCES: Kiang Liu, Ph.D., professor, preventive medicine, Northwestern University's Feinberg School of Medicine, Chicago; Mary Jo DiMilia, M.D. assistant professor, medicine and pediatrics, Mount Sinai School of Medicine, New York City, and consultant, Weight Watchers International Inc.; Laurie Edelman, M.D., assistant professor, medicine, Mount Sinai School of Medicine, New York City; Nov. 10, 2003, Archives of Internal Medicine
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