Associations between body mass index (BMI) and dietary patterns and health conditions were explored in a population-based multiethnic sample of centenarians from northern Georgia. BMI ≤20 and ≥25 was prevalent in 30.9% and 25.3% of study participants, respectively. In a series of logistic regression analyses controlled for gender and place of residence, the probability of having BMI ≥25 was increased by being black versus white and having a low citrus fruit, noncitrus fruit, orange/yellow vegetable or total fruit and vegetable intake. The probability of having BMI ≤20 was not associated with dietary intake. When controlled for race, gender, residence, and total fruit and vegetable intake, BMI ≥25 was an independent risk factor for diabetes or having a systolic blood pressure ≥140？mmHg or diastolic blood pressure ≥90？mmHg, whereas BMI ≤20 was a risk factor for anemia. Given the many potential adverse consequences of under- and overweight, efforts are needed to maintain a healthy weight, even in the oldest old. 1. Introduction Body mass index is a simple index of weight for height that is frequently used in the assessment of nutritional status. A low BMI, or underweight status, is often associated with an increased risk of mortality in seriously ill or hospitalized older adults [1, 2]. Conversely, a high BMI, indicative of overweight or obesity, is associated with an exacerbation in age-related physical and cognitive decline [3, 4] and with an increased prevalence or risk of many chronic health conditions common in older adults such as diabetes, hypertension, and cardiovascular disease [3–5]. Such associations are typically determined across the entire spectrum of older adults (aged 60+), with no further demarcation within this age classification. Our finding of a much higher prevalence of several nutritional deficiencies in centenarians as compared with octogenarians [6, 7], suggests that there is considerable heterogeneity in nutrient status in the “older adult” age group. Likewise, there may also be considerable heterogeneity within the older adult age group with regard to chronic health conditions. Thus, it is not known whether the associations between underweight or overweight/obesity and chronic health conditions as observed in previous studies of older adults extend to the very old. Dietary intake patterns featuring a high intake of nutrient-dense foods such as cereals, fruits, vegetables, and low-fat meat and dairy products have been associated with a number of favorable health outcomes in adults including a decreased prevalence of obesity [8, 9],
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