Índice de massa corporal em pessoas idosas e o paradoxo da obesidade – uma breve revisão abrangente da evidência atual
DOI:
https://doi.org/10.12957/demetra.2026.89368Palavras-chave:
Índice de Massa Corporal. Obesidade. Paradoxo da obesidade. Pessoas idosa.Resumo
A utilização do Índice de Massa Corporal (IMC) para avaliar o estado nutricional em adultos mais velhos pode ser controversa. De acordo com o paradoxo da obesidade, as pessoas idosas com excesso de peso podem apresentar melhores resultados em comparação com indivíduos com peso normal. Foram propostos por algumas entidades pontos de corte específicos de IMC para pessoas idosas. Esta breve revisão narrativa do tipo umbrella tem como objetivo verificar se é adequado recomendar valores mais elevados de IMC para classificação depessoas idosas, considerando a evidência mais recente sobre o paradoxo da obesidade. Foram identificadas e selecionadas revisões sistemáticas e meta-análises disponíveis na base de dados PubMed, de acordo com critérios definidos, tendo sido apresentados os principais resultados. Na presente revisão, foram analisados 27 estudos extraídos dessas revisões, mas apenas 12 (44,5%) apresentaram resultados significativos relativamente ao paradoxo da obesidade. Observou-se que potenciais benefícios de valores mais elevados de IMC são menos frequentes para valores de IMC ≥ 30 kg/m². Assim, permanece a controvérsia quanto à utilização do IMC em grupos etários mais avançados. O efeito de confundimento epidemiológico pode estar associado aos melhores resultados observados com valores mais elevados de IMC. É importante garantir que esta discussão não envolva a promoção da obesidade em pessoas idosas, uma vez que a obesidade é um fator de risco indiscutível para o desenvolvimento e agravamento de várias doenças crónicas.
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