The first step in maintaining a healthy weight in older adults – a scientific assessment
It is predicted that around 2035, the elderly population aged 60 and above will exceed 400 million, accounting for more than 30% of the total population, entering the stage of severe aging. Chronic noncommunicable diseases, disability and falls are all important health problems faced by older people, and obesity is a common risk factor for these health problems. On the other hand, underweight is often accompanied by malnutrition, low immunity, reduced muscle mass, and a significant increase in the risk of death. Therefore, maintaining a healthy weight is very important for the elderly.
The first step to maintaining a healthy weight is to learn how to evaluate it scientifically.
1. Conduct a scientific assessment of your own weight
Body mass index (BMI) is commonly used to determine whether an adult is of healthy weight, and the criteria for determining are: BMI< 18.5 kg/m2 is underweight, 18.5 ≤ BMI< 24 kg/m2 is normal, and 24≤BMI<28 kg/m2 is considered overweight, and BMI ≥28.0 kg/m2 is obese. The "Dietary Guidelines for Chinese Residents" proposes that the appropriate range of BMI for the elderly is 20.0-26.9Kg/m2, and the "Guidelines for the Appropriate Range of Body Mass Index and Weight Management for the Elderly in China" issued by the Chinese Nutrition Society recommends that the appropriate range of BMI for the elderly aged 80 and above is 22.0 to 26.9Kg/m2.
There are certain limitations in the application of BMI, such as BMI is difficult to distinguish the weight of adipose tissue from the weight of non-adipose tissue such as muscle and bone, and it is impossible to identify fat distribution. Therefore, in the process of weight assessment, another indicator often used is waist circumference, which is used to determine whether it is abdominal obesity, also known as visceral obesity, central obesity, and centripetal obesity. According to the Guidelines for the Prevention and Control of Overweight and Obesity in Chinese Adults (2021), a waist circumference of ≥ 90cm for men and 85cm for women ≥ 85cm can be judged as abdominal obesity.
Therefore, although BMI and waist circumference can be used independently as criteria for determining obesity, the two perspectives are different, and in fact, BMI is judged to be normal weight, and abdominal obesity may also be determined. The determination of healthy weight needs to be combined with the condition of the elderly themselves, and a comprehensive assessment of BMI and waist circumference.
2. Factors that affect one's own weight
Conduct a scientific assessment
Maintaining a healthy weight requires a thorough assessment of the possible factors that affect your weight.
1. For the obese elderly, it is necessary to assess whether there are eating habits of "high calories, lack of fruits and vegetables, and more sweet snacks", and whether there is insufficient activity. In addition, sleep disorders, psychological problems, and taking certain medications can also lead to weight gain and need to be taken seriously.
2. For the elderly who are underweight, it is necessary to assess whether there are oral health problems, reduced swallowing function, weakened digestive function, dulled sensory response such as vision, smell, taste, cognitive function decline, etc., whether there is low food accessibility and variety, and reduced appetite. These changes can significantly affect the food intake, digestion and absorption ability of the elderly, resulting in the decomposition and consumption of lean tissues such as muscles and weight loss in the elderly.
Contributed by Yin Zhaoxue, Office of Misflow Disease, Chinese Center for Disease Control and Prevention