Could losing weight actually be dangerous?

Could losing weight be dangerous? That appears to be the conclusion of a study by U.S. and Australian researchers published April 10. Having studied more than 19,000 people ages 65 and older in the U.S. and 70 and older in Australia, they reported that weight loss appears to be associated with higher mortality rates in both men and women.

That really surprised me. We know that obesity is a factor in many disorders, including disability, hypertension, high cholesterol, diabetes and sleep apnea, not to mention arthritis, cancer and cognitive function. Being overweight can limit mobility and make maintaining independence more challenging due to the strain on lower extremities.

And now we're being told that weight loss of between 5 and 10 percent may be dangerous, too? It's ironic, isn't it, that this comes at a time when drugs that promote weight loss, like Ozempic, are all the rage. As young people like to say, "Mind. Blown."

All of the people in the study were considered "healthy older adults" with no known conditions that might lead to premature death, such as cardiovascular disease, cancer or dementia. And yet, over a four-year period, weight loss was associated with a 33 percent higher risk of mortality for men and 26 percent for women.

Weight gain was not associated with an increased risk of death.

"It is important for older adults to be aware that even a small weight loss of 5 percent, especially in the absence of any evident disease, can significantly increase the risk of mortality," said the study's lead author, Sultana Monira Hussain, a senior research fellow at the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia.

So what could be going on here? I see a few possibilities.

First, correlation is not causation. Weight loss was associated with mortality, which means it's correlated - but that doesn't mean the weight loss caused a person's death.

Another factor is unintentional weight loss. It's not uncommon for older people to lose weight as they lose muscle mass, and because of that lack of muscle, it's harder for them to put weight back on. Being underweight and frail increases the risk of fracturing a bone and can weaken the immune system.

Unintentional weight loss could also be a sign of an underlying physical disorder, so it's important to consult your doctor if that's the case.

There's also the fact that obesity is different in young people versus older people. That loss of lean body mass, mostly muscle, gives way to an increase in fat mass. This condition is called sarcopenia, and even someone with a "healthy" body mass index (BMI) can be considered obese because they are carrying too much fat, not necessarily too much weight.

Some of the risks associated with obesity differ by age group, too. For example, higher BMI is associated with less risk of hypertension in older adults compared to younger adults.

The question becomes: What do we do with this information? Should we all run out and put on 10 or 20 pounds? Nope. Rather, it's important to practice three healthy aging habits to help us maintain and gain lean muscle and reduce fat:

Diet: Protein, protein, protein. As we age, our bodies become less efficient at using protein, so we should be eating more lean protein. Research supports increasing the recommended intake of protein for older adults by up to 50 percent, .45 to .55 grams per pound of body weight. That's about 68 to 83 grams a day for someone who weighs 150 pounds.

High protein foods such as chicken, salmon, Greek yogurt, nonfat milk and beans are some of the best foods to help you gain lean muscle.

Exercise: Resistance training, whether that means free weights, machines, resistance bands or using your own body weight, will help your body retain and build muscle mass. Shoot for three times a week.

Adequate sleep: An older person needs at least seven hours but no more than nine hours of sleep to let muscles rest and rebuild.

As I noted earlier, BMI might not be the best measure of obesity in seniors. Rather, studies have suggested that waist circumference or waist-to-hip ratio might be more useful. The American Heart Association recommends women maintain no more than 35 inches around the middle, and men 40 inches.

We'll see if the findings of this new study hold up over time. Whether they do or not, we can all take steps toward healthier aging.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, "How to Be a Healthcare Advocate for Yourself & Your Loved Ones," is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.