Tag Archives: aging

Fat people live longer, show less dementia

Life expectancy is hardly affected by weight in the normal - overweight- obese range. BMI 30-34.9 = obese.

Life expectancy is hardly affected by weight in the normal – overweight – obese range. BMI 30-34.9 = obese.

Lets imagine you are a 5’10” man and you weigh 140 lbs. In that case, you have a BMI of 20, and you probably think you’re pretty healthy, or perhaps you think you’re a bit overweight. Our institutes of health will say that you are an “average-wight” or “normal-weight” American, and then claim that the average-weight American is overweight. What they don’t tell you, is that low weight, and so-called average weight people in the US live shorter lives. Other things being equal, the morbidity (chance of death) for a thin American, BMI 18.5 is nearly triple that of someone who’s obese, BMI 32. The morbidity of the normal-weight American is better, but is still nearly double that of the obese fellow whose BMI is 32.

Our NIH has created a crisis of overweight Americans, that is not based on health. They work hard to solve this obesity crisis by telling people to jog to work, and by creating ever-more complicated food pyramids. Those who listen live shorter lives. A prime example is Jim Fixx, author of several running books including “The complete Book of Running.” He was 52 when he died of a heart attack while running. Similar to this is the diet-expert, Adelle Davis, author of “Let’s eat right to keep fit”. She died at 70 of cancer — somewhat younger than the average American woman. She attributed her cancer to having eaten junk food as a youth. I would attribute it to being thin. Not only do thin people live shorter lives, but their chances of recovering from cancer, or living with it, seem to improve if you start with some fat.

The same patter exists where age-related dementia is concerned. If you divide the population into quartiles of weight, the heaviest has the least likelihood of dementia, the second heaviest has the second-least, the third has the third-least, and the lightest Americans have the highest likelihood of dementia. Here are two studies to that effect, “Association between late-life body mass index and dementia”, The Kame Project, Neurology. 2009 May 19; 72(20): 1741–1746. And “BMI and risk of dementia in two million people over two decades: a retrospective cohort study” The Lancet, Volume 3, No. 6, p431–436, June 2015.

Morbidity and weight, uncorrected data, and corrected by removing the demented.

Morbidity and weight, uncorrected data, and corrected by removing the demented. The likelihood of dementia decreases with weight.

Now you may think that there is a confounding, cause and effect here: that crazy old people don’t live as long. You’d be right there, crazy people don’t live as long. Still, if you correct the BMI-mortality data to remove those with dementia, you still find that in terms of life-span, for men and women, it pays to be overweight or obese but not morbidly so. The study concludes as follows: “Weight loss was related to a higher mortality risk (HR = 1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded.” As advice to those who are planning a weight loss program, you might go crazy and reduce your life-span a lot, but if you don’t go crazy, you’re only reducing your life-span a little.

In terms of health food, I’ve noticed that many non-health foods, like alcohol and chocolate are associated with longevity and mental health. And while low-impact exercise helps increase life-span, that exercise is only minimally associated with weight loss. Mostly weight loss involves changing the amount you eat and changing your clothes choices to maximize radiant heat loss.

Dr. Robert E. Buxbaum, October 26, 2017. A joke: Last week I was mugged by a vegan. You may ask how I know it was a vegan. He told be before running off with my wallet.

Seniors are not bad drivers.

Seniors cause accidents, but need to get places too

Seniors are often made fun of for confusion and speeding, but it’s not clear they speed, and it is clear they need to get places. Would reduced speed limits help them arrive alive?

Seniors have more accidents per-mile traveled than middle age drivers. As shown on the chart below, older Canadians, 75+, get into seven times more fatal accidents per mile than 35 to 55 year olds. At first glance, this would suggest they are bad drivers who should be kept from the road, or at least made to drive slower. But I’m not so sure they are bad drivers, and am pretty certain that lower speed limits should not be generally imposed. I suspect that a lot of the problem comes from the a per-mile basis comparison with folks who drive long distances on the same superhighways instead of longer, leisurely drives on country roads. I suspect that, on a per-hour basis, the seniors would look a lot safer, and on a per highway-mile basis they might look identical to younger drivers.

Canadian Vehicle Survey, 2001, Statistics Canada, includes drivers of light duty vehicles.

Deaths per billion km. Canadian Vehicle Survey, 2001, Statistics Canada, includes light duty vehicles.

Another source of misunderstanding, I find, is that comparisons tend to overlook how very low the accident rates are. The fatal accent rate for 75+ year old drivers sounds high when you report it as 20 deaths per billion km. But that’s 50,000,000 km between fatalities, or roughly one fatality for each 1300 drives around the earth. In absolute terms it’s nothing to worry about. Old folks driving provides far fewer deaths per km than 12-29 year olds walking, and fewer deaths per km than for 16-19 year olds driving.

When starting to research this essay, I thought I’d find that the high death rates were the result of bad reaction times for the elderly. I half expected to find that reduced speed limits for them helped. I’ve not found any data directly related to reduced speeds, but now think that lowered speed limits would not help them any more than anyone else. I note that seniors drive for pleasure more than younger folks and do a lot more short errand drives too — to the stores, for example. These are places where accidents are more common. By contrast, 40 to 70 year olds drive more miles on roads that are relatively safe.

Don't walk, especially if you're old.

Don’t walk, especially if you’re old. Netherlands data, 2001-2005 fatalities per billion km.

The Netherlands data above suggest that any proposed solution should not involve getting seniors out of their cars. Not only do seniors find walking difficult, statistics suggest walking is 8 to 10 times more dangerous than driving, and bicycling is little better. A far better solution, I suspect, is reduced speeds for everyone on rural roads. If you’re zipping along a one-lane road at the posted 40, 55, or 60 mph and someone backs out of a driveway, you’re toast. The high posted speeds on these roads pose a particular danger to bicyclists and motorcyclists of all ages – and these are folks who I suspect drive a lot on the rural roads. I suspect that a 5 mph reduction would do quite a lot.

For automobiles on super-highways, it may be worthwhile to increase the speed limits. As things are now, the accident fatality rates are near zero, and the main problem may be the time wasted behind the wheel – driving from place to place. I suspect that an automobile speed limit raise to 80 mph would make sense on most US and Canadian superhighways; it’s already higher on the Autobahn in Germany.

Robert Buxbaum, November 24, 2014. Expect an essay about death on tax-day, coming soon. I’ve also written about marijuana, and about ADHD.