After a certain age, staying slightly overweight can be healthier than losing weight. This is clear from the new dietary guide for people over 65 years of age prepared by the British Dietetic Association, which has the support of the British Geriatrics Society and whose criteria are shared by nutrition specialists from the Spanish Society of Geriatrics and Gerontology (SEGG). consulted.
Geriatricians maintain that there are several reasons why slightly overweight older people may not see their health improve, and may even worsen, if they lose weight. They argue, first, that weight loss tends to cause both fat and muscle loss, and the latter increases the risk of falls and health problems.
They also point out that fat acts as an energy reserve that the body can draw on when people get sick and lose their appetite. Additionally, they say, people who go on a diet may become tired and less likely to stay physically active, which may further contribute to that loss of muscle mass.
“There are clinical trials that support that people with a very low body mass index (BMI) and people with moderate or severe obesity have increased mortality rates, while BMIs that in the general population are considered overweight or obese are grade 1, in older people they are associated with a healthy life and lower mortality,” explains Naiara Fernández Gutiérrez, coordinator of the SEEG Nutrition group and IMQ Igurco care director.
And it details that, if in the younger adult population a person with a BMI above 25 is considered overweight and beyond 27 is classified as obese, in older people up to a BMI of 30 is assumed to be normal weight.
For this reason, Fernández explains, if people who are somewhat overweight restrict their diet to reach the weight according to the tables of a young adult, “that can cause them to lose muscle mass and have worse health than if they maintain that overweight which guarantees that they do not reduce muscle. ”.
Because, explains the geriatrician, as you age, when you lose weight, instead of losing perivisceral fat, you mainly lose muscle, “and in older people, what causes worse health, greater dependency and greater mortality is sarcopenic obesity. , that is, having a high fat mass and little muscle."
For this reason, he argues that it is not advisable for older people to follow a restrictive diet to lose a few extra pounds because "it will cause the muscle to lose quality, and if the muscle loses quality, life loses quality."
And added to this, according to Fernández, is the impact that following a diet can have on the mood, activity and sociability of older people. “Socially we enjoy the act of eating, so limiting it affects our mood; Furthermore, if the person follows a restrictive diet, they do not meet friends to eat, they do not go out for a snack... and that has a great impact on the health of the elderly; It has been proven that having a social life increases the longevity and quality of life of the elderly,” she points out.
In this sense, the guide from British dietitians emphasizes that, as you age, nutrients, vitamin D or hydration are important, but it is also very important to "enjoy what you eat and eat in the way that best suits you." everyone likes it.
Ana de Hollanda, coordinator of the Obesity Area of the Spanish Society of Endocrinology and Nutrition (SEEN), explains that “it would be unwise to say that older people should not lose weight, because as they get older they gain kilos and that has consequences for the health”, but highlights that when one is overweight the key is not to look at the kilos but rather whether the person has complications derived from that weight.
“If there is no comorbidity and the BMI does not reach 30, it does not make sense to emphasize losing kilos but rather on improving your lifestyle, avoiding abusing pastries and eating enough protein to avoid muscle loss,” he says. .
And he emphasizes that rather than looking at BMI, the ideal thing to improve people's diet would be to do a study of their body composition, the percentage of fat and muscle they have.
