Department of Medicine, University of Verona, Verona, Italy.
SIAN AULSS 8, Vicenza, Veneto, Italy.
Eat Weight Disord. 2021 Feb;26(1):27-35. doi: 10.1007/s40519-019-00815-4. Epub 2019 Dec 21.
In association with the rapid lengthening of life expectancy and the ever-rising prevalence of obesity, many studies explored in the elderly the phenomenon usually defined as the obesity paradox.
This article is a narrative overview of seventy-two papers (1999-2019) that investigated the obesity paradox during the aging process. Twenty-nine documents are examined more in detail.
The majority of studies suggesting the existence of an obesity paradox have evaluated just BMI as an index of obesity. Some aspects are often not assessed or are underestimated, in particular body composition and visceral adiposity, sarcopenic obesity, and cardio fitness. Many studies support that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages.
Inaccurate assessments may lead to a systematic underestimation of the impact of obesity on morbidity and premature mortality and, consequently, to clinical behaviors that are not respectful of the health of elderly patients. Knowledge of the changes in body composition and fat distribution will help to better understand the relationship between obesity, morbidity, and mortality in the elderly.
Level V, narrative overview.
随着预期寿命的迅速延长和肥胖症的患病率不断上升，许多研究在老年人中探索了通常被定义为肥胖悖论的现象。
本文对 72 篇（1999-2019 年）研究衰老过程中肥胖悖论的文献进行了叙述性综述。详细检查了 29 篇文献。
大多数表明肥胖悖论存在的研究仅将 BMI 作为肥胖的指标进行评估。一些方面经常未被评估或被低估，特别是身体成分和内脏脂肪、肌肉减少性肥胖和心脏健康。许多研究支持，在确定肥胖与老年人健康风险相关的因素中，中心性肥胖和脂肪无组织量的相对损失可能比 BMI 更重要。
不准确的评估可能导致对肥胖对发病率和过早死亡率的影响的系统低估，从而导致不尊重老年患者健康的临床行为。了解身体成分和脂肪分布的变化将有助于更好地理解肥胖、发病率和死亡率之间在老年人中的关系。
V 级，叙述性综述。
