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Title: Healthy obesity and risk of accelerated functional decline and disability
Authors: Bell, Joshua A.
Sabia, Severine
Singh-Manoux, Archana
Hamer, Mark
Kivimaki, Mika
Keywords: Epidemiology
Metabolic risk factor clustering
Metabolic health
Physical function
Bodily pain
Mobility limitation
Issue Date: 2017
Publisher: © The Authors. Published by the Nature Publishing Group
Citation: BELL, J.A. ...et al., 2017. Healthy obesity and risk of accelerated functional decline and disability. International Journal of Obesity, 41 (6), pp. 866–872.
Abstract: Background/Objectives: Some obese adults have a normal metabolic profile and are considered ‘healthy’, but whether they experience faster ageing than healthy normal-weight adults is unknown. We compared decline in physical function, worsening of bodily pain, and likelihood of future mobility limitation and disability between these groups. Subjects/Methods: This was a population-based observational study using repeated measures over 2 decades (Whitehall II cohort data). Normal-weight (body mass index (BMI) 18.5-24.9kg/m²), overweight (25.0-29.9kg/m²), and obese (≥30.0kg/m29 ) adults were considered metabolically healthy if they had 0 or 1 of 5 risk factors (hypertension, low high density lipoprotein cholesterol, high triacylglycerol, high blood glucose, and insulin resistance) in 1991/94. Decline in physical function and worsening of bodily pain based on change in Short Form Health Survey items using 8 repeated measures over 18.8 years (1991/94-2012/13) was compared between metabolic-BMI groups using linear mixed models. Odds of mobility limitation based on objective walking speed (slowest tertile) and of disability based on limitations in ≥1 of 6 basic activities of daily living, each using 3 repeated measures over 8.3 years (2002/04-2012/13), were compared using logistic mixed models. Results: In multivariable-adjusted mixed models on up to 6635 adults (initial mean age 50 years; 70% male), healthy normal-weight adults experienced a decline in physical function of -3.68 (95% CI=-4.19, -3.16) score units per decade; healthy obese adults showed an additional -3.48 (-4.88, -2.08) units decline. Healthy normal-weight adults experienced a -0.49 (-0.12, 1.11) score unit worsening of bodily pain per decade; healthy obese adults had an additional -2.23 (-0.69, -3.78) units worsening. Healthy obesity versus healthy normal weight conferred 3.39 (2.29, 5.02) times higher odds of mobility limitation and 3.75 (1.94, 7.24) times higher odds of disability. Conclusions: Our results suggest that obesity, even if metabolically healthy, accelerates age-related declines in functional ability and poses a threat to independence in older age.
Description: This is an Open Access Article. It is published by Nature under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/
Sponsor: JAB is supported by CRUK (C18281/A19169)and (MC_UU_12013/2). MK is supported by the Medical Research Council (MR/K013351/1) and NordForsk, the Nordic Programme on Health and Welfare. ASM receives research support from the US National Institutes of Health (R01AG013196; R01AG034454). SS is supported by the National Institute on Aging.
Version: Accepted for publication
DOI: 10.1038/ijo.2017.51
URI: https://dspace.lboro.ac.uk/2134/24323
Publisher Link: http://dx.doi.org/10.1038/ijo.2017.51
ISSN: 1476-5497
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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