The study, published Jan. 28 in the Journal of the American Geriatrics Society, conflicts with research that suggests that being overweight contributes to a long list of health problems, including heart disease.

“Our study suggests that those people who survive to age 70 in reasonable health have a different set of risks and benefits associated with the amount of body fat to younger people,” lead researcher Leon Flicker, of the University of Western Australia, said in a news release from the journal’s publisher.

Flicker and colleagues looked at a decade’s worth of data regarding the health of more than 9,200 Australians aged 70 to 75 in 1996 when the study began. Australia is ranked as the third most obese country in the world after the United States and the United Kingdom, the study authors noted.

The study defined overweight and obesity levels based on body mass index, a measurement that takes weight and height into account. The four weight categories used in the study included underweight, normal weight, overweight and obese.

Those who were overweight — a step below obese — faced a 13 percent lower risk of death compared with those who were normal weight. But there was no benefit found for those who were obese, the study authors noted.

The researchers also found that being sedentary doubled the risk of death for women and raised it by one-quarter for men.

According to the study authors, it may be time to reevaluate the system that determines who is overweight and obese.

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The study is the first to quantify the relative contributions of food and exercise habits to the growing number of Americans with bulging waistlines.

“In the U.S., over the last 30 years, it seems that the food side of the equation has changed much more than the physical activity side,” Professor Boyd A. Swinburn, director of the World Health Organization Collaborating Center for Obesity Prevention at Deakin University, Melbourne, Australia, noted in a telephone interview with Reuters Health.

Weight gain in the American population seems to be virtually all due to the consumption of more calories, with declines in physical activity playing only a minor role, Swinburn explained.

“We absolutely need to continue to promote increased physical activity and a healthy diet because they are both obviously beneficial factors in terms of obesity,” he emphasized. “But when it comes to placing priorities, I think it needs to be on reducing energy intake. It’s particularly important for policymakers to focus on the energy intake side of the equation.”

In the study, Swinburn and his colleagues calculated how much adults need to eat in order to maintain a stable weight and how much children need to eat in order to maintain a normal growth curve.

They then figured out how much Americans were actually eating, using national food supply data from the 1970s and the early 2000s. This information allowed them to predict how much weight Americans would be expected to gain over the 30-year study period if food intake were the only influence.

Next, the investigators determined the actual weight gained over the study period using data from a nationally representative survey that recorded the weight of Americans in the 1970s and early 2000s.

In children, according to Swinburn and colleagues, the predicted and actual weight increase matched exactly, which indicates that the increases in energy intake alone over the 30 years studied could explain the added pounds, they say.

In adults, the data predicted that they would be 10.8 kg (23.8 pounds) heavier, but in fact they were only 8.6 kg (18.9 pounds) heavier. This finding, Swinburn noted, “suggests that excess food intake still explains the weight gain, but that there may have been increases in physical activity over the 30 years that have blunted what would otherwise have been a higher weight gain.”

“To return to the average weights of the 1970s, we would need to reverse the increased food intake of about 350 calories a day for children (about one can of fizzy drink and a small portion of French fries) and 500 calories a day for adults (about one large hamburger),” Swinburn noted in a statement from the meeting.

“Alternatively, we could achieve similar results by increasing physical activity by about 150 minutes a day of extra walking for children and 110 minutes for adults, but realistically, although a combination of both is needed, the focus would have to be on reducing calorie intake,” he added.

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As reported in The Cochrane Library, Dr. Jill L. Colquitt and colleagues, from the University of Southampton, UK, searched various electronic databases and identified 26 studies that compared weight loss surgical procedures (also called bariatric surgery) with each other or with non-surgical treatments for obesity such as drugs, diets and exercise.

The studies included three randomized trials and three prospective studies that compared surgical with non-surgical treatments. The remaining 20 studies were trials that compared various types of bariatric operations.

Overall, the authors found that surgery provided greater weight loss for any degree of obesity compared with non-surgical treatments. Surgery was also associated with reductions in diabetes, hypertension, and other co-existing conditions. Improvements in health-related quality of life were noted after 2 years, but their long-term persistence was unclear.

The bariatric operations were not free from complications, including serious ones such as pulmonary embolism and even postoperative death, the report indicates.

In the studies that compared different bariatric procedures, there was some evidence that gastric bypass provided greater weight loss than did vertical banded gastroplasty or adjustable gastric banding.

Isolated sleeve gastrectomy and banded gastric bypass both produced weight losses comparable to that seen with gastric bypass.

No statistically significant differences in weight loss or quality of life were seen between procedures performed using conventional open surgery and those using laparoscopic bariatric procedures.

Due to limited data, the authors were unable to reach firm conclusions regarding the relative safety of each bariatric operation.

While surgery produces greater weight loss than conventional obesity treatments, and exactly which procedure provides the best mix of effectiveness and safety is unclear, they note.

SOURCE: Cochrane Database System Review 2009.

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