Table 1: Characteristics of study participants. Mean ± SD, or % (minimum − maximum) 100.5 ± 1.9 (98–108) 84.6 15.4 79.0 21.0 Journal of Aging Research Age (y) Gender Race Women (%) Men (%) White (%) African American (%) Living arrangements Skilled nursing facility (%) 43.4 Community (%) 56.6 Total food score1 3.1 ± 1.6 (0–5) BMI (kg/m2) 22.5 ± 4.2 (14.0– 35.2) Mid-arm circumference 23.8 ± 4.3 (7.5–37.1) Triceps skin fold 11.1 ± 5.7 (2.8–34.0) Blood pressure (mm Hg) Systolic 127.7 ± 15.1 (90–190) Diastolic 73.8 ± 9.4 (38–100) Hemoglobin (g/dL) 12.0 ± 1.5 (7.5–16.7) 1 Total food score ranged from 0 to 5 and one point was given for meeting each recommended serving from ﬁve food groups as follows: two or more servings of meat, poultry, or ﬁsh daily, two or more servings of dairy foods daily, four or more servings of green vegetables weekly, three or more servings of orange or yellow vegetables weekly, and three or more servings of fruit daily [16]. P-values are unadjusted for multiple comparisons, because all comparisons were preplanned. Analyses were conducted using SAS 9.2 (SAS, Cary, NC). 3. Results Approximately one-third (31.3%) of the centenarians included in the ﬁnal analytical sample had a BMI of ≤20 (underweight), 43.8% were classiﬁed as being in the normal weight range, and 24.9% met the NIH classiﬁcation for overweight/obesity (BMI ≥25). Triceps skin fold (TSF) and mid-arm circumference (MAC) of centenarians in the lowest BMI classiﬁcation averaged below the 5th percentile for females 80+ years in USA based on 2003–2006 NHANES data [21]. Both parameters increased with BMI classiﬁcation in a stepwise manner (data not shown) and were highly cor- related with BMI (Pearson Correlation Coeﬃcient between BMI and TSF = 0.482; and between BMI and MAC = 0.624; P < .0001 for both). Chi-square analysis indicated that those with a BMI ≤20 were more likely to be women, live in a skilled nursing facility, eat a modiﬁed food diet, have experienced a weight change in the past three months, and have anemia as compared to centenarians classiﬁed as normal weight or overweight/obese (Table 2). Conversely, those with a BMI ≥25 were more likely to be black, diabetic, have a higher systolic blood pressure, and/or have a diastolic blood pressure ≥90 mm as compared 3 to centenarians classiﬁed as underweight or normal weight. There were no diﬀerences according to BMI classiﬁcation with regard to history of CVD, cancer, stroke, depression, or past or current tobacco use. Bivariate analysis of diet intake patterns suggested that centenarians with BMI ≤20 had the highest total food scores and were more likely to report eating two or more servings of meat, ﬁsh, and poultry per day and three or more total servings of fruit per day as compared with centenarians in the other BMI classiﬁcations. In contrast, those with a BMI ≥25 were more likely to report eating less than one serving of citrus or noncitrus fruit per day, less than four servings of orange/yellow vegetables per week, or three total servings of fruit and vegetables per day (Table 2). A series of logistic regression analyses indicated that when controlled for gender, race, and place of residence the odds of having a BMI ≥25 were about two to three times higher in centenarians with lower intakes of citrus and noncitrus fruit (less than one serving per day), orange and yellow vegetables (less than four servings per week), or total fruits and vegetables (less than three servings per day), but were not related to intake of the meat group or dairy group (Table 3). Similar analyses with BMI ≤20 as the dependent variable, failed to show any signiﬁcant association with dietary intake categories (Table 3). Finally, associations between BMI classiﬁcations and chronic health conditions were determined in a series of logistic regression analyses that included either BMI ≤20 or BMI ≥25 as an independent variable (Table 4). When controlled for gender, race, and place of residence, the odds of having anemia, based on blood hemoglobin values, were over twofold higher in centenarians with BMI ≤20 versus those with BMI >20 whereas the odds of self-reported CVD tended to be reduced in those in the underweight classiﬁcation (BMI ≤20; P = .053). The latter ﬁnding became signiﬁcant in regression models further controlled for total fruit and vegetable intake (Model 2; P = .048). In analyses controlled for gender, race, and place of residence, the odds of having self-reported diabetes or systolic blood pressure ≥140 mmHg were approximately three- and twofold higher, respectively, in centenarians with BMI ≥25 versus those with BMI <25. Being overweight/obese (BMI ≥25) also tended to increase the odds of having diastolic blood pressure >90 mmHg (approximately three-fold; P = .055) or cardio- vascular disease (approximately twofold; P = .074). Further controlling for total fruit and vegetable intake (Model 2) strengthened the associations between BMI ≥25 and diabetes and systolic blood pressure >140 mmHg, and resulted in a signiﬁcant association between BMI ≥25 and diastolic blood pressure ≥90 mmHg. There were no associations between BMI ≤20 or BMI ≥25 and stroke, depression, or cancer in any of the regression models. 4. Discussion To our knowledge, this is the ﬁrst study to explore asso- ciations between dietary patterns and body weight status in the oldest old segment of the population. Prevalence of overweight/obesity in this population-based study of