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2009-05-25 05:59:49
Emma Wilkinson
Health reporter, BBC News
People who are overweight or obese in middle-age run the risk of being frail in later life, say Finnish researchers.
A study of more than 1,000 men found the highest risk of death and illness in those who put on weight in their 40s but lost it when they got older.
It is thought that the heart risk associated with middle-aged spread puts men at risk of "frailty" even if they have no obvious illness.
The research is published in the European Heart Journal.
The researchers said obesity was a very well-known risk factor for cardiovascular disease. But paradoxically, studies have also shown that in older patients with heart failure, being overweight may be somewhat protective.
In the latest study, the team followed the men from age 25 through to their 70s.
This study reinforces the importance of maintaining a healthy weight throughout our lives to help prevent heart disease
Alasdair Little, British Heart Foundation
As expected, those who put on weight in their 40s had a worse prognosis in middle age than those who stayed a normal weight.
However, when looking at health in later life a different picture emerged.
Those who were overweight in middle age but lost weight in later life had the highest risk of death and morbidity in their 70s.
That group also had the highest cardiovascular risk in middle age.
The weight loss, which was probably not intentional, could not be explained by diseases such as cancer or heart failure.
'Frailty syndrome'
Study leader Dr Timo Strandberg, said it seemed the unhealthy pattern of weight in their 40s was causing frailty in later life probably due to underlying cardiovascular problems, such as high blood pressure and early stages of diabetes.
"Frailty syndrome", where older people have weight loss, muscle weakness, exhaustion and struggle with even small amounts of physical activity, is attracting increasing attention from old-age researchers.
It seems to be common but in these patients there is no obvious reason, such as cancer.
"It is important because frailty is associated with death and a great deal of disability," he said.
He said doctors should pay particular attention to this group.
"It is important to notice it early."
The researchers are planning further work to find out which group has the best health - perhaps those who are normal weight throughout life or those who gain a bit of weight but not until they are in their 60s and 70s.
Alasdair Little, a cardiac nurse at the British Heart Foundation said: "This study reinforces the importance of maintaining a healthy weight throughout our lives to help prevent heart disease.
"Being obese can also lead to the development of other known risk factors for heart disease, such as diabetes and high blood pressure."