HealthDay News — In older adults, normal weight obesity is associated with cardiac abnormalities and increased risk for cardiovascular mortality, study findings indicate.

“Current body mass index (BMI) strata likely misrepresent the accuracy of true adiposity in older adults. Subjects with normal BMI with elevated body fat may metabolically have higher cardiovascular and overall mortality than previously suspected,” John A. Batsis, MD, of Dartmouth College in Hanover, N.H., and colleagues wrote in the American Journal of Cardiology.

They examined data from a sample of 1,528 individuals who participated in the National Health and Nutrition Examination Surveys III and had mortality data linked to the National Death Index to assess the association between normal weight obesity and mortality.

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Participants were 60 years of age or older and had a mean age of 70 years. Normal weight obesity was defined as the tertile with the highest percentage of body fat or cutoffs of greater than 25% body fat in men and greater than 35% body fat in women.

Overall, 27.9% and 21.4% of men, and 20.4% and 31.3% of women, had normal weight obesity based on tertiles and cutoffs, respectively. Over a median follow-up of 12.9 years, 902 deaths occurred, 46.5% of which had cardiovascular causes. With increasing tertiles of body fat, lean mass decreased and leptin levels increased.

Short-term cardiovascular mortality (<140 person-months) was higher in women with normal weight obesity, and long-term cardiovascular mortality (>140 person-months) was higher in men with normal weight obesity.

“In a representative cohort of older U.S. adults, subjects with normal weight obesity are at high risk of cardiometabolic dysregulation and mortality,” the researchers wrote, adding that the study findings “highlight the importance of considering body fat in gender-specific risk stratification in older adults with normal weight.”


  1. Bastis JA et al. Am J Cardiol. 2013;112(10):1592-1598.