Association of body mass index and waist circumference with successful ageing: 16 year follow-up of the Whitehall II study

OBJECTIVE: We examined whether midlife body mass index (BMI) and waist circumference (WC) predict successful ageing. DESIGN AND METHODS: BMI/WC were assessed in 4869 persons (mean age 51.2, range 42–63 in 1991/93) and survival and successful ageing (alive, no chronic disease at age >60 years, not in the worst age- and sex-standardized quintile of cognitive, physical, respiratory, and cardiovascular, and mental health) ascertained over a 16-year follow-up, analysed using logistic regression adjusted for socio-demographic factors and health behaviours. RESULTS: 507 participants died, 1008 met the criteria for successful ageing. Those with BMI≥30 kg/m(2) had lower odds of successful ageing (Odds Ratio (OR)=0.37; 95% Confidence Interval (CI): 0.27, 0.50) and survival (OR=0.55; 95% CI: 0.41, 0.74) compared to BMI between 18.5–25 kg/m(2). Those with a large waist circumference (≥102/88 cm in men/women) had lower odds of successful ageing (OR=0.41; 95% CI: 0.31, 0.54) and survival (OR=0.57; 95% CI: 0.44, 0.73) compared to those with a small waist (<94/80 cm in men/women). Analysis with finer categories showed lower odds of successful ageing starting at BMI ≥23.5 kg/m(2) and waist circumference 82/68 cm in men/women. CONCLUSIONS: Optimal midlife BMI and waist circumference for successful ageing might be substantially below the current thresholds used to define obesity.