"Fat but powerful'' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

Alcazar, J. ; Navarrete-Villanueva, D. (Universidad de Zaragoza) ; Mañas, A. ; Gómez-Cabello, A. ; Pedrero-Chamizo, R. ; Alegre, L.M. ; Villa, G. ; Gusi, N. ; González-Gross, M. ; Casajús, J.A. (Universidad de Zaragoza) ; Vicente-Rodriguez, G. (Universidad de Zaragoza) ; Ara, I.

Resumen: Objectives: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the fat but powerful'' (F+P) (or fat but fit'') paradox in older adults. Methods: A total of 2563 older adults (65 €''91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. Results: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). Conclusion: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Idioma: Inglés

DOI: 10.1136/bjsports-2020-103720

Año: 2021

Publicado en: British Journal of Sports Medicine 55, 21 (2021), 103720 [8 pp.]
ISSN: 0306-3674

Factor impacto JCR: 18.479 (2021)

Categ. JCR: SPORT SCIENCES rank: 1 / 88 = 0.011 (2021) - Q1 - T1

Factor impacto CITESCORE: 21.3 - Health Professions (Q1) - Medicine (Q1)

Factor impacto SCIMAGO: 3.867 - Medicine (miscellaneous) (Q1) - Sports Science (Q1) - Orthopedics and Sports Medicine (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)