1. ¹Department of Primary Care and Population Science, Royal Free and University College Medical School, London, UK
2. ²Department of Public Health Sciences, St George's Medical School Hospital, London, UK

Correspondence: Dr S Goya Wannamethee, Department of Primary Care and Population Science, Royal Free and University College Medical School, London NW3 2PF, UK. E-mail: goya@pcps.ucl.ac.uk

Contributors: SGW and AGS developed the study aim and design. SGW carried out the statistical analyses and wrote the initial draft with AGS. PHW designed the study and contributed to the writing of the report. MW was study coordinator and responsible for the follow-up questionnaire data collection.

Received 2 June 2003; Revised 5 September 2003; Accepted 4 November 2003; Published online 31 August 2004.

Abstract

OBJECTIVE: To examine the prevalence of disease burden and disability associated with overweight and obesity in men aged 60–79 y and to assess whether the current WHO weight guidelines are appropriate in the elderly.

DESIGN: Cross-sectional survey 20 y after enrolment.

SETTING: General practices in 24 British towns.

PARTICIPANTS: In total, 4232 men aged 60–79 y (77% of survivors) with measured weight and height.

MAIN OUTCOME MEASURES: Cardiovascular (CV) risk factors, prevalence of diabetes, cardiovascular disease, cancer, disability and regular medication.

RESULTS: In total, 17% of the men were obese (body mass index (BMI) 30 kg/m²) and a further 52% were overweight (BMI 25–29.9 kg/m²). Prevalence of hypertension, low HDL-cholesterol, high triglycerides and insulin resistance and the prevalence of most disease outcomes increased with increasing degrees of overweight/obesity. Men in the normal weight range (18.5–24.9 kg/m²) had the lowest prevalence of ill health. Compared with normal weight men, obese men showed a two-fold risk of major CVD (odds ratio (OR)=1.96, 95% CI 1.44–2.67) and locomotor disability (OR=2.26, 95% CI 1.66, 3.09) and were nearly three times as likely to have diabetes, CV interventions or to be on CV medication. Over 60% of the prevalence of high insulin resistance was attributable to overweight and obesity as was over a third of diabetes and hypertension, a quarter of locomotor disability and a fifth of major CVD.

CONCLUSION: In elderly men, overweight and obesity are associated with a significantly increased burden of disease, in particular CV-related disorders and disability. The current guidelines for overweight and obesity appear to be appropriate in elderly men.