The association between weight history and physical
performance in the Health, Aging and Body
DK Houston1, J Ding1, BJ Nicklas1, TB Harris2, JS Lee3, MC Nevitt4, SM Rubin4, FA Tylavsky5and
SB Kritchevsky1, for the Health ABC Study
1Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA;2Laboratory
of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD,
USA;3Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4Department of
Epidemiology and Biostatistics, University of California, San Francisco, CA, USA and5Department of Preventive Medicine,
University of Tennessee Health Science Center, Memphis, TN, USA
Objective: Although the association between current obesity and physical disability is well known, the cumulative effect of
obesity is unknown. Using data from the Health, Aging and Body Composition study, we examined the association between
weight history in young and middle adulthood and weight status in late adulthood with physical performance in late adulthood.
Design: Longitudinal cohort study.
Subjects: White and black men and women aged 70–79 years at study baseline (n¼2803).
Measures: Body mass index (BMI; kg/m2) was calculated using recalled height at age 25 and weight at age 25 and 50 and
measured height and weight at ages 70–79. Physical performance at ages 70–79 was assessed using a short physical
performance battery (SPPB) and a 400-m walk test.
Results: In this well-functioning cohort, approximately 24% of men and 8% of women reported being overweight or obese
(BMI X25kg/m2) at age 25, 51% of men and 37% of women reported being overweight or obese at age 50, and 69% of men
and 66% of women were overweight or obese at ages 70–79. Men and women who were obese (BMI X30kg/m2) at ages 25,
50 and 70–79 had significantly worse SPPB scores and 400-m walk times than those who were normal weight. Women who
were overweight (BMI 25–29.9kg/m2) at ages 25, 50 and 70–79 also had significantly worse physical performance.
Furthermore, men and women who had a history of being overweight or obese at ages 25 or 50 had worse physical
performance compared to those who were normal weight throughout or who were overweight or obese at ages 70–79 but not
in midlife or earlier.
Conclusions: Maintaining a healthy body weight throughout adulthood may play a role in preventing or delaying the onset of
International Journal of Obesity (2007) 31, 1680–1687; doi:10.1038/sj.ijo.0803652; published online 22 May 2007
Keywords: BMI; aging; physical performance; physical function
The elderly US population is growing and is expected to
double by the year 2030 to approximately 20%.1In addition,
US adults are, on average, increasingly heavier at every age
studied with approximately one-fourth of young adults and
one-third of middle-aged and older adults classified as obese
(body mass index (BMI) X30kg/m2).2It is well known that
obesity increases the risk of cardiovascular disease, several
cancers, diabetes, as well as other chronic conditions.3,4
Obesity in middle-aged and older adults has also been shown
to increase the risk of physical disability,5–10possibly as a
result of these chronic conditions or by other mechanisms.
Some have suggested that the growing prevalence of obesity,
particularly among younger age groups, could reverse the
Received 11 October 2006; revised 31 January 2007; accepted 2 April 2007;
published online 22 May 2007
Correspondence: Dr DK Houston, Section on Gerontology and Geriatric
Medicine, Department of Internal Medicine, Wake Forest University School
of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1207,
International Journal of Obesity (2007) 31, 1680–1687
& 2007 Nature Publishing Group All rights reserved 0307-0565/07 $30.00
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Association between weight history and physical performance in the Health ABC study
DK Houston et al
International Journal of Obesity