Women, want to enjoy good health in your golden years?

Lose weight. Now.

A study published online last night in the British Medical Journal shows that women who are overweight in midlife are at increased risk of various health problems, from chronic diseases to cognitive impairment, once they pass age 70.

Conversely, the study found, women who were lean at midlife were most likely to be healthy after 70.

Researchers at the Harvard School of Public Health and Brigham and Women’s Hospital (both in Boston) analyzed data for more than 17,000 women collected through the ongoing Nurses’ Health Study, which started in 1976. Just under 10 percent of the women in the study who had lived to age 70 or beyond (their mean age was 50 when the Nurses’ Health Study began) reported being free of the 11 major chronic diseases the researchers tracked, maintaining good mental health and cognitive and physical function.

The likelihood of making it into that elite group decreased as BMI (body mass index) increased. Obese women were nearly 80 percent less likely to be healthy after age 70 than lean women. The least likely of all to remain healthy in later years were women who were overweight at age 18 and who gained more than 22 pounds by the time they turned 50. And whether they were lean, overweight or obese at age 18, women who gained weight by midlife had less chance of being healthy over 70 than those whose weight remained steady.

The study controlled for socioeconomic status and for smoking, diet and other lifestyle behaviors that could affect physical and mental health. One caveat: Most of the women studied were white, so researchers aren’t sure their findings extend broadly across the general population.

Still, the study adds new fodder to the often-heated debate about how closely body weight correlates to health. While the common wisdom is that being overweight puts people at increased risk of life-shortening diseases such as cancer, diabetes and cardiovascular disease, others say no such cause-and-effect relationship has been scientifically established and that people can be very healthy even if they’re overweight or even obese. The new research is the first, according to its authors, to examine the role of overweight and obesity in overall health among women who survive to older ages.

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Severe depression may silently break a seemingly healthy woman’s heart. Doctors have long known that depression is common after a heart attack or stroke, and worsens those people’s outcomes. Monday, Columbia University researchers reported new evidence that depression can lead to heart disease in the first place.

The scientists tracked 63,000 women from the long-running Nurses’ Health Study between 1992 and 2004. None had signs of heart disease when the study began, but nearly 8 percent had evidence of serious depression.

The depressed women were more than twice as likely to experience sudden cardiac death — death typically caused by an irregular heartbeat, concluded the 12-year study, published Monday in the Journal of the American College of Cardiology. They also had a smaller increased risk of death from other forms of heart disease.

The big surprise: Sudden cardiac death seemed more closely linked with antidepressant use than with the depression symptoms the women reported.

That might simply mean that women who used antidepressants were, appropriately, the most seriously depressed, cautioned lead researcher Dr. William Whang. But he said the finding merited more research.

Studies of the newer antidepressants most often used today so far haven’t signaled a risk of irregular heartbeat, and some even have suggested protection, noted Dr. Redford Williams of Duke University, a specialist in how psychosocial factors affect health.

The drug question aside, Williams said the work adds to growing evidence that depression is an independent risk factor for heart disease — on top of the classic risks of high blood pressure, diabetes, high cholesterol and smoking.

The predominantly white Nurses’ Health Study may underestimate it, Williams said. “If anything, the impact in African-American women is probably greater,” he said, adding that it’s time for the next step: A study testing whether properly treating depression lowers the risk.

Why might depression have that effect? The study found that the more severe the women’s reported depression symptoms, the more likely she was to have traditional heart risk factors. Also, stresses like depression have been linked to such physical effects as a higher resting heart rate.

Perhaps a more straightforward reason: Depression can make people do a worse job taking care of themselves. Indeed, the American Heart Association last year recommended that everyone who already has heart disease be regularly screened for depression — because depressed patients may skip their medications, sit indoors instead of exercising, and eat particularly poorly.

Spa Health Heart Disease, woman's health Depression, Heart Attack, woman's health