Upending conventional wisdom, a new study has found that there is no one-size-fits-all healthy body mass index (BMI) range for people with Type 2 diabetes.
Surprising Finding
Upcoming research to be unveiled at the European Obesity Congress in Venice during May 12–15 sheds new light on the ideal body weight range for adults with Type 2 diabetes to reduce their risk of dying from cardiovascular disease.The study, based on health data from the UK Biobank, a biomedical database available to the public that contains genetic, health, and behavioral information on about 500,000 people, followed 22,874 participants with the condition for nearly 13 years, tracking their cardiovascular health.
The researchers examined the data by dividing participants into two age cohorts—those older than 65 (the elderly) and those aged 65 or younger (the middle-aged). They then assessed how factors including BMI, waist circumference, and waist-to-height ratio correlated with the risk of cardiovascular death in each age group.
The findings suggest that people 65 and younger who were overweight showed a 13 percent increased risk of cardiovascular mortality compared with those who maintained a normal BMI, which is between 18.5 and 24.9.
However, the trend reversed for those older than 65. In this older group, people who were moderately overweight had the lowest risk, experiencing an 18 percent lower risk of cardiovascular death than their normal-weight peers.
Experts Weigh In
“Importantly, we demonstrate that optimal BMI for people with type 2 diabetes varies by age, independent of traditional cardiometabolic risk factors,” Dr. Shaoyong Xu from Xiangyang Central Hospital, lead author of the study, said in a statement. “Our findings suggest that for older individuals who are moderately overweight but not obese, maintaining rather than losing weight may be a more practical way of reducing their risk of dying from cardiovascular disease.”The results are “very difficult to interpret and draw conclusions from,” as it is an observational study and no causes could be identified, Dr. Theodore Strange, chair of medicine at Staten Island University Hospital in New York, told The Epoch Times.
The researchers could not determine why being overweight was protective for older diabetics. The findings may not apply to people from non-white ethnic backgrounds, as the UK Biobank cohort was predominantly white, they noted.
A small amount of excess weight in the elderly could indicate better nutritional status and prevent frailty, Dr. Strange said. “But this has never been shown in an evidenced-based study.”
The ‘Obesity Paradox’
The phenomenon described in the study falls under what is commonly known as the “obesity paradox,” Dr. Shiara Ortiz-Pujols, an obesity medicine specialist at Staten Island University Hospital in New York, told The Epoch Times.The obesity paradox refers to counterintuitive findings suggesting that while people who are overweight or obese are at higher risk of developing heart problems, those with existing heart conditions who are overweight or obese tend to have better outcomes and lower mortality rates than their normal-weight counterparts.
The science behind BMI remains contentious. The American Medical Association has acknowledged the metric’s significant limitations and has encouraged doctors to not rely on BMI alone when diagnosing obesity.
BMI, the primary factor used to assess risk in this study, fails to account for important factors such as body composition, gender differences, fat distribution, and muscle mass, Dr. Ortiz-Pujols said.
- Greater fat accumulation
- Loss in lean muscle mass
- Increased frailty and reduced exercise capacity
- Higher risk of malnutrition
- Greater risk of cachexia, an unintentional weight and muscle loss associated with chronic diseases, including heart failure
