What is it about?
This 6-year study followed 756 older adults with diabetes to examine how daily energy (calorie) intake relates to all-cause mortality. Researchers calculated energy intake relative to three body-weight concepts—actual weight, standard weight (BMI 22), and an age-related target weight (slightly higher BMI for older adults)—and compared death rates across intake quartiles using Cox regression.
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Why is it important?
Personalizing diets for older adults is hard: physical function, comorbidities, and activity levels vary widely. Key finding: A U-shaped relationship—both too little and too much energy per kg body weight were linked with higher mortality. Practical range: The lowest risk generally corresponded to about 25–35 kcal per kg of actual or age-related target body weight (with the “optimal” quartile shifting slightly by age group). Beyond averages: Using an age-related target weight may better reflect healthy BMI ranges in older adults than the conventional “standard weight.” Independent of macros: The low-energy–higher-mortality signal persisted even after adjusting for protein, fat, carbohydrate, and fiber intake.
Perspectives
Avoid under- and over-feeding: For older adults with diabetes, aim broadly for ~25–35 kcal/kg/day, tailoring within this band to age, activity, and clinical status. Use age-appropriate targets: Age-related target weight can be more suitable than BMI 22–based standard weight when setting energy prescriptions. Think beyond BMI: Higher risk at low intake may relate to sarcopenia/frailty; BMI alone can miss this. Clinical application: Combine calorie targets with assessment of ADL, cognition, renal function, and hypoglycemia history, and monitor outcomes over time. Future work: Confirm findings in contemporary cohorts and test how specific diet compositions and exercise within this energy range affect function, quality of life, and survival.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Assessing the association between optimal energy intake and all‐cause mortality in older patients with diabetes mellitus using the Japanese Elderly Diabetes Intervention Trial, Geriatrics and Gerontology International, December 2019, Wiley,
DOI: 10.1111/ggi.13820.
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