Dr. Reubin Andres, a gerontologist who advanced the study of diabetes but gained his widest attention for arguing that weight gain in older people increases longevity, died Sept. 23 at his home in Baltimore. He was 89.
The cause was heart disease, said his daughter, Julie Schwait.
Andres had been clinical director of the National Institute on Aging since 1977 — the first to be named to that federal post — when he began examining weight gain a few years later. He had been asked to address a 1980 conference on obesity and mortality in New York, and not knowing much about the topic, he began investigating the literature.
Of particular use were weight and height data culled from insurance policyholders and compiled by the Society of Actuaries and Association of Life Insurance Directors of America. He compared the society’s weight data on those who had lived the longest with the ideal weights that the Metropolitan Life Insurance Co. recommended to ensure a long life. At the time, the company’s recommendations were widely disseminated by doctors.
In analyzing that and other longitudinal studies, Andres determined that Metropolitan Life’s weight recommendations were too high for the early years and too low for later years. Among other things, he observed that the group with the smallest percentages of deaths, or “minimum mortality," was 10 to 20 percent over the recommended weights and increased with age.
To live longer, he concluded, people should start thin and then gain about 6 pounds a decade beginning in their early 40s. That advice went against the prevailing wisdom, which held that the most healthful way to age was to maintain the same weight throughout adulthood.
“For some reason the idea has grabbed us that the best weight throughout the life span is that of a 20-year-old," Andres said in a 1985 interview with The New York Times. “But there’s just overwhelming evidence now that as you go through life, it’s in your best interests to lay down some fat."
Andres was not advocating obesity. “It is not my contention that the fatter the better," he said. “It is my contention that the desirable range rises with age."
When Andres published his research in a medical textbook and began to speak about it at conferences in the mid-1980s, it provoked an outcry from those in the medical profession who saw fat as the enemy of good health. Even a panel at the National Institutes of Health, the Institute on Aging’s parent agency, declined to accept his conclusions, saying that a body weight 20 percent above the Metropolitan Life Tables was an established health hazard.
Today, Andres’ findings remain controversial. While several studies have seconded his findings that some extra weight as you age is not a risk factor in mortality, the NIH still does not recommend age-specific weight gain. This is in part because disagreements persist about why a little more weight might be beneficial. Some doctors believe that fat allows older adults to better withstand the stresses caused by disease and injury, while others think that those with a little more weight are showing signs that they were healthier to begin with.
In his research on diabetes, Andres developed a method that allowed doctors to increase insulin or glucose in the body without permitting the counter-regulatory mechanisms to kick in. The invention, known as the glucose insulin clamp, gave doctors the ability, for the first time, to quantify insulin sensitivity and insulin secretion in human beings, which is important because it allows researchers to study new drugs and other interventions for people with Type 2 diabetes.
Andres won numerous awards for this, including, in 2000, the Albert Renold Award from the American Diabetes Association.