They are middle-aged adults under the age of 65; BMI 23-25, part of the “normal” range, was associated with the lowest risk of death from cardiovascular disease. However, the optimal BMI for people over 65 is between 26 and 28, which corresponds to the “overweight” range.

“Our findings suggest that differences exist in optimal cutoff points for BMI and cardiovascular mortality risk between older and non-elderly people with diabetes. “We have identified a relatively reasonable BMI range that determines the lowest incidence of cardiovascular death in elderly and non-elderly diabetic patients, which is essential in this aging society.” said Xiaoyong Xu, MD, lead author of the study. A member of the endocrinology department at Xiangyang Central Hospital, Hubei University of Arts and Sciences, told Healthline.

In terms of practical implications, this study suggests that there is no “one size fits all” approach to cardiovascular risk assessment in patients with diabetes. Rather, a personalized approach is more likely to provide health benefits.

To investigate the association between BMI and cardiovascular disease outcomes in people with type 2 diabetes, researchers used UK Biobank, a medical database containing genetic, lifestyle and health information for approximately 500,000 people across the UK. data was used. .

The study involved approximately 23,000 people with baseline type 2 diabetes. The majority of participants were Caucasian, with an average age of 59 years. About two-thirds of them were women. Individuals were enrolled between 2006 and 2010, with a mean follow-up period of 12.5 years. During this period, 891 people died from cardiovascular disease. The researchers used data on BMI and age to examine how those factors affected mortality rates.

They compared two groups based on age: older adults (65 years and older) and middle-aged adults (65 years and younger). Middle-aged adults with a BMI in the “overweight” range had a 13% increased risk of dying from cardiovascular disease. The opposite effect was seen in the older group, with those who were “overweight” having a 28% reduced risk compared to older participants with a “normal” BMI range.

The study also identified an optimal BMI cutoff point at which the risk of death from cardiovascular disease begins to increase. The cut-off for the middle-aged group was 24, while the cut-off for the elderly group was 27.

“We think this adds valuable data because we need to consider more than BMI when making weight loss recommendations. This study shows that age matters and that weight loss goals are It highlights the need to individualize,” Ivania Rizzo, MD, assistant professor of endocrinology and director of obesity medicine at Boston Medical Center, told Healthline. She was not involved in the study.

Other experts were more cautious about drawing conclusions from the study.

“There are still questions,” Sang Kim, MD, PhD, associate professor of endocrinology at Stanford University, told Healthline. She had no connection to her research.

He said that while the study investigated the association between baseline BMI and cardiovascular disease, it was also important to document how participants’ BMI changed during the follow-up period.

Kim is skeptical about whether a higher BMI is actually better for older people. “Does that mean normal-weight older adults should also gain weight? Again, I think we need to look at the limitations of this study here,” she said. Kim points out that the American Diabetes Association’s current guidelines indicate it’s important for her to lose weight.

But she still agrees with the overarching message about the importance of personalized care.

“Some older overweight people may benefit from weight loss even if they have uncontrolled type 2 diabetes or other comorbidities with excess fat (but not excess BMI). Yes, overweight people with well-controlled cardiovascular risk factors may benefit more from focusing on exercise and maintaining lean body mass, which decreases with age. Yes,” she said.

The science behind BMI, obesity, and related health effects is often controversial. BMI itself has been criticized for being inaccurate because it does not distinguish between fat and lean muscle mass. It also does not take race or ethnicity into account and is based primarily on data from white men.

This is an all-too-common, yet simple and easy-to-implement method for assessing an individual’s weight. Measuring body fat directly is more difficult, takes more time, and requires specialized equipment. Basically, it is not something that can be easily done through a health check.

“BMI is a surrogate measure of body fat. Measuring body fat in a clinical setting is not practical (at this time), but it would be great to be able to do it to give patients a meaningful goal,” says Kim. he said.

However, there are also many more controversies in this area. Scientists have documented that among some older adults, those with obesity along with other chronic conditions, such as heart disease, may actually have a lower risk of death than those with a healthy BMI. I am. This supposedly “protective” effect of obesity is known as the “obesity survival paradox.”

“The obesity paradox remains controversial. We are also exploring other markers of function, frailty, and waist-to-height and waist circumference to better understand the risk of cardiovascular death, especially for people over 65. “We also emphasize the need to assess the risks that obesity poses to a person’s health,” Rizzo said.

Other ways to measure obesity include: waist to height ratio and Waist circumference perhaps It’s better than BMI, but it’s not perfect either.

Using multiple measurements in combination, rather than relying on them individually, will undoubtedly reveal clearer information about not just a person’s weight, but their health in general.

“This study highlights the importance of looking at not only BMI but also other anthropomorphic markers…such as waist circumference and waist-to-height ratio, in all age groups, but especially in people over 65. “It’s important to look at other factors as well, because elevated trends in both of these markers were positively associated with cardiovascular events and mortality,” Rizzo said.

Researchers found that the ideal BMI to reduce the risk of death from cardiovascular disease varies by age.

Older adults with type 2 diabetes had better health outcomes when their weight was within the “overweight” BMI range compared to when their weight was within the “normal” range.

Experts say the findings highlight the importance of personalized care rather than a “one-size-fits-all” approach to cardiovascular risk assessment.

Some of the science surrounding BMI, obesity, and its effects on health remains controversial.