The relationship between body mass index and quality of life in community-living older adults living in the United States

Background

Carrying excess weight is associated with various chronic conditions especially in older adults, and can have a negative influence on the quality of life of this population.

Objective

The objective of this study was to estimate the independent (i.e. adjusted for demographic, socioeconomic and health status differences) impact of Body Mass Index (BMI) on health-related quality of life.

Design

A mail survey was sent to 60,000 older adults living in 10 states. Methods: The survey assessed quality of life using the average physical component scores (PCS) and mental component scores (MCS) obtained from the Veterans Rand 12-item (VR-12) health status tool embedded in the survey. Ordinary least squares (OLS) regression techniques were used to estimate the independent impact of each BMI category on quality of life, compared to the impact of other chronic conditions.

Results

A total of 22,827 (38%) eligible sample members responded to the survey. Of those, 2.2% were underweight, 38.5% had a normal BMI, 37.0% were overweight, 18.5% were obese and 1.9% were morbidly obese. Following OLS regression techniques, respondents’ PCS values were statistically significantly lower for the underweight, overweight, obese and morbidly obese BMI categories, compared to the normal BMI group. Compared with all other chronic conditions, being morbidly obese (?6.0 points) had the largest negative impact on the PCS. Underweight was the only BMI category with a statistically significantly lower MCS value.

Conclusions

The greatest negative impacts of the various BMI categories on quality of life were on physical rather than mental aspects, especially for those in the underweight, obese and morbidly obese categories, more so than many other chronic conditions.     

The association between smoking and body mass index: results from a national sample of Malaysian adults

Aim

To investigate the association between smoking status and body-mass-index (BMI) categories.

Subject and methods

Data are obtained from 2,340 observations from the Malaysia Non-Communicable Disease Surveillance-1. An ordered probability model for BMI categories with ordinal smoking treatment categories is developed and estimated. Marginal and treatment effects are calculated.

Results

Socio-demographic and health-lifestyle factors play significant roles in body weight categories, conditional upon smoking status. Education levels are inversely correlated with BMI categories amongst non-smokers only. Age and income levels are associated with BMI within non-smokers and compulsive smokers. Gender (female), family history of serious illnesses, individual health conditions (hypercholesterolemic, hypertensive), ethnicity (Malays and Indians) and regional locations (metropolitan) are associated with higher BMI levels, irrespective of smoking status. Additionally, BMI categories and levels are closely associated with smoking habits. As individuals switch from non-smoking to casual smoking, the probability of being overweight or obese increases, with an upsurge of 1.89 BMI units. As the casual smoking habit evolves into compulsive smoking, overweight or obese likelihoods are lowered as individuals are more likely to be in the underweight, normal weight or at-risk weight BMI ranges instead, while experiencing a decline of 1.75 BMI units.

Conclusions

There exists close association between BMI categories and levels with smoking habits. As smoking tendencies develop from being a non-smoker to a casual (compulsive) smoker, overweight or obese likelihoods increase (decrease), as individuals realize an upsurge (reduction) in BMI levels.     

Body mass index and health-related quality of life in apparently healthy individuals

Purpose

Obesity is known to be associated with a range of chronic medical comorbidities, but little is known about the impact of overweight and obesity on health-related quality of life (HRQoL) in persons without chronic diseases. The aim of this study was to assess HRQoL, body mass index (BMI) and health behavior patterns in a community sample of subjects who had no long-lasting medical comorbidities

Methods

We assessed HRQoL in 1,187 apparently healthy individuals (mean age 57 ± 7 years), of whom 24 % were classified as normal weight, 49 % as overweight, 20 % as obese and 7 % as very obese. Two different instruments of HRQoL were used: the generic Short-Form Health Survey (SF-36) questionnaire and the preference-based instrument EuroQol (EQ-5D).

Results

All physical components of the SF-36 decreased linearly according to BMI categories in women. In men, only poorer physical functioning scale showed linearity with rising BMI. Scores on the mental components of the SF-36 did not differ by BMI categories in either gender. The EQ-5D index and EuroQol visual analogue scale scores decreased linearly with rising BMI only in women.

Conclusions

In apparently healthy middle-aged subjects, physical HRQoL decreases with increasing level of BMI and more so in women than in men. Mental components of HRQoL do not differ between the categories of BMI in either gender.     

Self-rated health and life satisfaction among Canadian adults: associations of perceived weight status versus BMI

Purpose

Obesity is associated with impaired health-related quality of life (HRQL). As perceived constructs, self-rated health (SRH) and general life satisfaction (LS) might be more strongly related to perceived weight status than actual weight status. The aim was to assess agreement between perceived weight status and self-reported body mass index (BMI), and to investigate their associations with SRH and LS as indicators of HRQL.

Methods

Cross-sectional data included 87,545 adults aged 18–65 years from the 2005 Canadian Community Health Survey. Agreement between perceived weight status and self-reported BMI was assessed. Prevalence of suboptimal SRH and LS was estimated by perceived weight status and BMI, and adjusted logistic regression used to assess the odds of suboptimal outcomes.

Results

Overall agreement between perceived weight status and self-reported BMI was only moderate (females: κ = 0.58; males: κ = 0.42). The lowest prevalences of suboptimal SRH and LS were in those who reported both a healthy weight BMI and “about right” weight perception. Discordance between perceived weight status and BMI status, and congruence (i.e. perceived weight status = BMI) around underweight or overweight/obese were associated with poorer SRH and LS. For weight perceptions of “about right”, BMI status had minimal influence on suboptimal SRH or LS, while perceptions of underweight or overweight were associated with higher odds of suboptimal SRH and LS, independent of BMI.

Conclusions

Adults’ weight status perceptions often do not agree with their actual weight status, even when self-reported. While both perceived and actual weight status influence self-rated health and life satisfaction, perceptions are more strongly associated with these HRQL indicators and should be considered when informing obesity-targeted policies and programmes.     

Body mass index, life-style, and healthy status in free living elderly people in menorca island

Objectives

To assess the BMI, life-style, and healthy status, and explore relationships between these parameters, among Menorca??s free living elderly people.

Methods

A cross-sectional survey carried out in Menorca Island in 2009. A random sample (n=450) of the elderly population (??65 years) was interviewed. Anthropometric measurements and a general questionnaire incorporating questions related to socio-demographic and life-style factors and health status were used.

Results

Approximately five per cent of elders were underweight and 60% overweight or obese. Underweight were positively and overweight and obesity negatively affected by age. The prevalence of central obesity, according to the WC cut-off points, was 66.8% in men and 85.1% in women. Low education, socioeconomic status and physical activity were risk factors for malnutrition and overweight/obesity. A possible cognitive impairment was found among elderly persons with BMI<22 kg/m². A J-shaped association between BMI and hypertension, hypercholesterolemia, heart failure and other CV diseases, a U-shaped relation between BMI and diabetes mellitus, arthritis, and chronic bronchitis, and an inverted J-shape between BMI and gastric ulcer, osteoporosis &; bone fractures, cancer, and prostatitis (in men) were found.

Conclusions

Both low and high BMI are associated with a wide range of prevalent conditions and diseases in Menorca elderly men and women.     

The longitudinal association between weight change and health-related quality of life: the KORA S4/F4 cohort study

Objectives

Despite the increasing importance of patient-centered perspectives, the impact of weight change on the health-related quality of life (HRQL) has remained unclear. This work aims to investigate this longitudinal relationship.

Methods

Data was collected from a population-based cohort study of 3,080 Germans. Anthropometrics and HRQL were assessed at baseline and after a 7-year follow-up period. Using linear regression the average change in HRQL scores was calculated among 5 mutually exclusive weight change groups. Multilevel growth modeling was conducted to differentiate between interpersonal (cross-sectional) and intrapersonal (longitudinal) associations between body mass index (BMI)/BMI change and HRQL.

Results

Heavy weight gain (≥10 % body weight) was associated with impairments in physical health among women (?2.82 points, CI: ?4.29, ?1.34) and obese men (?4.33 points, CI: ?7.62, ?1.04) and with improvements in mental health among women (+3.20 points, CI: +1.37, +5.02). Results from the multilevel models were consistent, showing negative associations between BMI change and physical health, positive associations between BMI change and mental health and a high degree of similarity between interpersonal and intrapersonal associations.

Conclusions

Weight gain leads to clinically relevant impairments in physical health. More research is needed to clarify the antipodal effects of weight change on physical and mental health components.     

Overweight and obesity prevalence and determinants in Italy: an update to 2010

Purpose

To provide updated information on trends and determinants of underweight, overweight, and obesity in Italian adults.

Methods

We considered data from 5 surveys conducted annually between 2006 and 2010, on a total of 14,135 subjects aged 18 years or more (6,834 men and 7,301 women), representative of the Italian adult population, including self-reported information on height and weight.

Results

Overall, 3.1 % of the Italian adult population was underweight (body mass index, BMI, <18.5 kg/m²; 0.8 % men, 5.3 % women), 31.8 % overweight (25≤ BMI <30 kg/m²; 39.8 % men, 24.4 % women), and 8.9 % obese (BMI ≥30 kg/m²; 8.5 % men, 9.4 % women). We observed no specific pattern of overweight/obesity across calendar years in men (multivariate prevalence ratios, PR, for 2010 vs 2006: 0.95; p for trend: 0.980) and a non-significant decreased trend in women (PR: 0.92; p for trend: 0.051). Prevalence of overweight/obesity significantly increased with age (PRs for ≥65 vs 18–24 years: 2.01 in men, 2.65 in women), decreased with education (PRs for high vs low education: 0.79 in men, 0.54 in women), and was less frequent in single than in married adults (PRs: 0.85 in men, 0.78 in women). Overweight/obesity was significantly more frequent in adults from southern versus northern Italy (PRs: 1.13 in men, 1.32 in women) and in former versus never smokers (PRs: 1.23 in men, 1.19 in women).

Conclusions

In Italy, we did not find unfavorable trends in overweight and obesity prevalence across calendar years. However, there are specific subgroups of the population with elevated prevalence of overweight and obesity, mainly adults from southern Italy and less educated ones.     

The relationship between body mass index and 10-year trajectories of physical functioning in middle-aged and older Russians: Prospective results of the Russian HAPIEE study

Objective

To investigate the associations of overweight and obesity with longitudinal decline in physical functioning (PF) among middle-aged and older Russians.

Design

Prospective cohort study.

Setting

Four rounds of data collection in the Russian Health, Alcohol and Psychosocial factors In Eastern Europe study with up to 10 years of follow-up.

Participants

9,222 men and women aged 45-69 years randomly selected from the population of two districts of Novosibirsk, Russia.

Measurements

PF score (range 0-100) was measured by the Physical Functioning Subscale (PF-10) of the 36-item Short Form Health Survey (SF-36) at baseline and three subsequent occasions. Body mass index (BMI), derived from objectively measured body height and weight at baseline, was classified into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obesity class I (BMI 30.0-34.9), and obesity class II+ (BMI≥35.0).

Results

The mean annual decline in the PF score during the follow-up was -1.92 (95% confidence interval -2.17; -1.68) in men and -1.91 (-2.13; -1.68) in women. At baseline, compared with normal weight, obesity classes I and II+ (but not overweight) were associated with significantly lower PF in both sexes. In prospective analyses, the decline in PF was faster in overweight men (difference from normal weight subjects -0.38 [-0.63; -0.14]), class I obese men and women (-0.49 [-0.82; -0.17] and -0.44 [-0.73; -0.15] respectively) and class II+ obese men and women (-1.13 [-1.73; -0.53] and -0.43 [-0.77; -0.09] respectively). Adjustment for physical activity and other covariates did not materially change the results.

Conclusions

PF decreased more rapidly in obese men and women than among those with normal weight. The adverse effect of high BMI on PF trajectories appeared to be more pronounced in men than in women, making more extremely obese Russian men an important target population to prevent/slow down the process of decline in PF.

     

Impaired parent-reported health-related quality of life of underweight and obese children at elementary school entry

Purpose

Examine the health-related quality of life of 5–6-year-old underweight, overweight and obese children.

Methods

Our cross-sectional study included 3,227 parent–child dyads from the “Be active, eat right” study. Parents completed questionnaires regarding child and parental characteristics. Health-related quality of life of the child was measured using the Child Health Questionnaire Parent Form 28. Children were classified normal weight, overweight, obese, severely obese, and underweight according to the international age and gender BMI cutoff points. Bootstrap analyses were performed for general linear models corrected for potential confounding variables.

Results

Severely obese children (β, ?2.60; 95 % CI, ?4.80 to ?0.57, p < 0.01) and underweight children (β, ?1.11; 95 % CI, ?1.85 to ?0.39, p < 0.01) had lower parent-reported scores on the physical summary scale. On the physical functioning profile scale parents of overweight and severely obese children also reported statistically significant lower scores (p < 0.05 and p < 0.01, respectively).There were no significant differences regarding the psychosocial summary scale scores between the different weight categories.

Conclusion

Underweight and overweight children experience impaired health-related quality of life on the physical functioning domain. Physicians, teachers and parents should be aware of the possible negative impact on health-related quality of life in underweight and overweight 5–6-year-old children.     

Impact of body mass index on the relationship between muscle quality and physical function in older women

Objectives

To investigate the impact of body mass index (BMI) (normal weight, overweight, obese) on the relationship between muscle quality (MQ) and physical function in community-dwelling older women.

Design

Cross-sectional study.

Setting

University research laboratory.

Participants

Community-dwelling older women (n = 94, 73.6 ± 5.4 y) stratified by BMI (normal weight: 20.0–24.9 kg/m²; overweight: 25.0–29.9 kg/m²; obese: ≥ 30.0 kg/m²).

Measurements

Body mass index using height and weight, leg extension power via the Nottingham power rig, body composition using dual-energy X-ray absorptiometry, and physical function (6-minute walk, 8-foot up-and-go, 30-second chair stand). Muscle quality was defined as leg power (watts) normalized for lower-body mineral-free lean mass (kg).

Results

Following adjustments for covariates, muscle quality was significantly higher in women of normal BMI compared to overweight (10.0 ± 0.4 vs 8.7 ± 0.4 watts/kg, p = 0.03). Muscle quality was a significant predictor of performance on the 6-minute walk and 8-foot up-and-go in normal and overweight women (all p < 0.05) and performance on the 30-second chair stand in normal and obese women (both p < 0.05). Body mass index did not significantly impact the association between MQ and physical function (all p > 0.05).

Conclusions

Muscle quality varies by BMI, yet the relationship to physical function is not significantly different across BMI groups. The results imply that interventions that increase MQ in older women may improve physical function, regardless of BMI.     

The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers

Purpose

Literature suggests a relationship between overweight and obesity, and mental health problems, but data regarding prevalence rates are scarce. This study aimed to determine the prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers.

Methods

Data were used from the Netherlands Working Conditions Survey (NWCS), which is representative for Dutch employees (n?=?43,928). Based on self-reported body mass index (BMI), workers were classified into underweight, healthy weight, overweight, and obesity. Respondents indicated whether they suffered from chronic psychological complaints. Emotional exhaustion was measured by using the UBOS subscale. Logistic regression analyses were used to test differences in prevalence across weight categories, with healthy weight as the reference group. Analyses were stratified for gender, age, education, and occupation.

Results

Of the obese workers, 15.7% reported emotional exhaustion and 3.7% reported chronic psychological complaints. These prevalence rates were significantly higher than among healthy weight workers. A significant J shape was found with healthy weight workers reporting the lowest prevalence of both indicators of mental health problems. This J shape was generally also seen among the gender, age, education, and occupation subgroups, though not consistently significant.

Conclusion

Considering the proportion of obese workers that also suffers from psychological co-morbidities, interventions targeting obesity should take this into account. As weight-related stigma may play a role in the risk for mental health problems among obese workers, future longitudinal research on the mechanisms for the relation between overweight and mental health problems are recommended.     

Peer Reviewed: Validity of Self-Reported Height,Weight, and Body Mass Index: Findings from the National Health and Nutrition Examination Survey, 2001-2006

Introduction

Our study extends previous studies that have evaluated the level of bias in self-reported height and weight and corresponding body mass index (BMI). Results are evaluated by age, sex, income, race/ethnicity, and BMI classifications.

Methods

Analyses are based on the National Health and Nutrition Examination Survey (NHANES) from 2001-2006. The sample was 8,208 men and 8,606 women aged 16 years or older.

Results

On average, men overreport their height by 1.22 cm (0.48 in) and their weight by 0.30 kg (0.66 lbs), and women overreport their height by 0.68 cm (0.27 in) and underreport their weight by −1.39 kg (−3.06 lbs). Overreporting of height significantly increases with age after age 50 for men and after age 60 for women. Overreporting of weight in men is significant in the age groups 16 to 49 years and 70 years or older. Women significantly underreport their weight in each age group but more so in the age group 16 to 49 years, followed by 50 to 69 years, and then 70 years or older. Men are more likely than women to think their weight is about right if they are at a normal weight or are overweight or obese, but women are more likely to think their weight is about right if they are underweight.

Conclusion

Men and women significantly overreport their height, increasingly so at older ages. Men tend to overestimate their weight, but women underreport their weight, more so in younger ages. Corresponding BMI is underestimated, more so for women than for men at each age and increasingly so with older age for both sexes.     

Birth Weight,Maternal Body Mass Index,and Early Childhood Growth: A Prospective Birth Cohort Study in China

Background

The relations of birth weight and maternal body mass index (BMI) to overweight remain unresolved. We prospectively examined the relations of birth weight with various anthropometric measures at age 3 to 6 years, the effect of maternal BMI, and the patterns of these relations in an analysis using 9 birth weight categories.

Methods

The subjects were 210 172 singleton infants born alive with a gestational age ≥28 weeks between October 1993 and December 1996; the subjects were followed up in 2000. Birth weight, maternal height and weight, and other relevant information were measured or collected prospectively. Overweight and underweight were defined by using National Center for Health Statistics/World Health Organization reference data. Logistic regression models were used to estimate relative risks. Analyses stratified by quartile of maternal BMI were performed to examine the effects of maternal BMI on the associations of birth weight with overweight and underweight.

Results

Birth weight was linearly associated with height, weight, and BMI at age 3–6 years. Adjustment for maternal BMI did not alter this association. Birth weight was positively associated with overweight and negatively associated with underweight. The relation curves for both overweight and underweight resembled half of a flat parabolic curve. The associations for overweight and underweight were slightly stronger for the highest and lowest quartiles of maternal BMI, respectively.

Conclusions

Higher birth weight is associated with an increased risk for childhood overweight, and lower birth weight with an increased risk for underweight. The associations between birth weight and early childhood anthropometric growth measures could not explained by maternal BMI.Key words: birth weight, overweight, underweight, maternal body mass index     

Trends of Underweight and Overweight/Obesity Among Japanese Schoolchildren From 2003 to 2012, Defined by Body Mass Index and Percentage Overweight Cutoffs

Background

We investigated the prevalence and trends of underweight and overweight/obesity in a population-based sample of Japanese schoolchildren from 2003 to 2012, defined by body mass index (BMI) and percentage overweight (POW).

Methods

Subjects comprised fourth and seventh graders from the town of Ina, Japan, from 2003 to 2012. The height and weight of each subject were measured. Children were classified as underweight, normal weight, or overweight/obese using two criteria: BMI cutoff points proposed by the International Obesity Task Force and cutoffs based on POW in Japan.

Results

Data from 4367 fourth graders and 3724 seventh graders were analyzed. The prevalence of underweight and overweight as defined by POW criteria were lower than those based on BMI criteria. There was a decrease in the prevalence of overweight among fourth-grade boys and girls and seventh-grade girls according to BMI; this decrease was also observed when POW criteria were used for the definition of overweight.

Conclusions

The prevalence and trends of both underweight and overweight as defined by POW were underestimated among Japanese schoolchildren compared to those determined using BMI. The results of this study also suggest that trends in underweight and overweight/obesity using POW criteria are similar to those based on BMI criteria among schoolchildren in Japan.Key words: body mass index, percentage overweight, schoolchildren, secular trends, Japanese     

Health-related quality of life and body mass index among US adolescents

Purpose

To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents.

Methods

From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes—self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days—in four BMI categories—obese, overweight, normal weight, and underweight—of approximately 6,000 US adolescents aged 12–17 years. We also estimated the percentages for boys and girls separately.

Results

Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95 % CI 15–22) of obese adolescents reported fair or poor health compared to only 5 % (95 % CI 4–7) of normal-weight adolescents. Thirty-seven percent (95 % CI 33–42) of obese adolescents reported excellent or very good health, compared to 65 % (94 % CI 63–67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls.

Conclusions

Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.     

Trends in health-related quality of life and health service use associated with body mass index and comorbid major depression in South Australia, 1998–2008

Purpose

To investigate 10-year trends in health-related quality of life and health service use associated with body mass index (BMI) and comorbid major depression in South Australia.

Methods

Data were obtained from 9,059 people aged ??15?years who participated in representative surveys of the South Australian population in 1998, 2004, and 2008. Major depression was determined using the mood module of the PRIME-MD. Health-related quality of life was assessed using the SF-36 and 15-item AQoL instruments.

Results

Mean health-related quality-of-life scores were 8?C55% lower (worse), and health service use was 58?C85% higher in all unhealthy BMI groups (underweight, overweight, and obesity) with major depression than in the healthy weight group independent of all covariates (socio-demographic and chronic medical conditions), consistently over the 10-year period. In contrast, only some unhealthy BMI groups without major depression had worse SF-36 physical component scores (overweight/obesity), AQoL scores (underweight/obesity), and health service use outcomes (overweight/obesity), and by only 2?C6%.

Conclusion

Comorbid major depression explained most of the excess health-related quality of life and health service use in people with unhealthy BMI, consistently from 1998 to 2008. Interventions and policies that can mitigate the persistent excess population health and economic burden of major depression are needed.     

Change in maternal body mass index is associated with offspring body mass index: a 21-year prospective study

Purpose

To examine whether changes in maternal overweight and obesity from pre-pregnancy to two decades postpartum predict the body mass index (BMI) of adult offspring.

Methods

We used a subsample of 1997 mother–offspring pairs from the 7,223 original cohorts of women who gave birth in Brisbane, Australia, between 1981 and 1984. Multiple linear regression and multinomial logistic regression were used to examine the relationship between change in maternal BMI from pre-pregnancy to 21-year postpartum, and offspring BMI at 21-year, adjusting for potential confounding factors.

Results

At 21-year postpartum, 31.15 % mothers were overweight and a further 30.80 % were obese. Mothers gained a mean weight of 16.07 kg over the 21 year. We found that the offspring of mothers who became overweight or remained overweight at 21-year postpartum were at greater risk of being overweight and obese at 21 years. In the adjusted model, offspring of mothers who had normal BMI before pregnancy but became overweight by 21-year postpartum were (odds ratio) 1.72 (95 % CI = 1.20, 2.47) times more likely to be overweight. Compared to offspring of mothers who maintained normal weight over two decades, offspring of mothers who remained persistently overweight were (odds ratio) 5.39 (95 % CI = 3.50, 8.30) times more likely to be obese by age 21 year.

Conclusions

The findings of this study suggest that long-term changes in maternal BMI from pre-pregnancy to 21-year postpartum are independently associated with BMI in their young adult offspring.     

The anthropometric status of elderly women in rural Ghana and factors associated with low body mass index

Objectives

To describe the anthropometric and physical status of a sample of elderly women in rural Ghana and examine factors associated with a low body mass index (BMI).

Design

A cross-sectional survey.

Setting

Two rural villages in Ashanti Region, Ghana.

Participants

Fifty-nine elderly women aged 60 to 92 years.

Measurements

The weight, height, half armspan and mid-upper arm circumference (MUAC) of each woman was measured; body mass index (BMI) and body mass for armspan (BMA) were calculated. The state of each woman??s teeth and visual acuity was assessed. Data on food security, eating habits and socio-economic status were collected by questionnaire.

Results

41% (95%CI 27.8, 53.6) of women were underweight and 16.9% (95%CI 7.18, 26.8) were overweight or obese. Factors associated with a low BMI (<18.5 kg/m²) were: age (P=0.001), chewing tobacco (P=0.002), drinking alcohol (P=0.012), a visual acuity score of <30% (P=0.038), using a walking aid (P=0.016) and the number of children who gave the women cash (P=0.005). BMI was strongly positively correlated with BMA (r=0.999, P<0.001) and with MUAC (r=0.91, P<0.001), and a BMI of 18.5 was equivalent to a MUAC of about 23cm.

Conclusion

Elderly women in Ghana with poor teeth and eyesight are at risk of undernutrition. Measurements of MUAC, which is simple, or BMA, which is based on weight and half armspan and is more easily measured and calculated than height and BMI, could be used to identify undernourished elderly women in rural Africa.