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> The decline in the United States is driven by increasing numbers of deaths because of conditions such as diabetes and heart disease in people aged roughly 40

> The decline in the United States is driven by increasing numbers of deaths because of conditions such as diabetes and heart disease in people aged roughly 40 to 60. People are asking if we should be surprised by the headline but are missing this. As suggested in the article by the researchers, there is something dragging down the average since the 2010s. Not even hitting the general expectation of ~75 years. We don’t have solid answers yet, only theories. So yes, generally while going up against the process of aging is going to create barriers (eg can we get to 130 years old), we are also failing to raise the baseline which is the bigger issue that people might not grasp when it comes to “life expectancy rates”.

hn_throwaway_99 2y ago
> We don’t have solid answers yet, only theories. The exact quote you gave had a pretty solid answer, certainly not just "theories".
- daveguy 2y ago
  I think the distinction there is between immediate cause and root cause. Heart disease and diabetes (or complications thereof) is the immediate cause of death, but what is causing an increase in those diseases is theory at this point.
  - orionsbelt 2y ago
    Is it not clearly obesity? Why everyone is obese is perhaps unclear (although portion sizes, ultra processed foods, screen time and sedentary lives, etc, all seem to likely play a clear role), but I’d be surprised if the level of obesity that exists didn’t cause more heart disease and diabetes.
    - safety1st 2y ago
      Yes. Why is everyone tiptoeing around this? The obesity rate has increased by something like 50% since the turn of the century. It is a major risk factor for all the causes of death being discussed here. Sure there are probably many factors but this is clearly a big one.
      - hu3 2y ago
        Yeah if I try to handwave obesity impact on diabetes and cardiovascular diseases to the average cardiologist, they are going to tear me a new one within minutes. I don't know why is this even a question. Do people really think being overweight is a net positive?
        pessimizer 2y ago
        https://pubmed.ncbi.nlm.nih.gov/23280227/ https://pubmed.ncbi.nlm.nih.gov/23280227/ Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis > Conclusions and Relevance: [...]overweight was associated with significantly lower all-cause mortality.
        watwut 2y ago
        You gotta go higher in BMI for those to kick in. Basically, where you are within normal and slightly overweight bounds is mostly an aesthetic concern with slight lifespan advantage for slightly overweight people. When you move toward obese or into underweight category, health problems kick in.
      - lovethevoid 2y ago
        Go here https://www.cdc.gov/bmi/adult-calculator/index.html https://www.cdc.gov/bmi/adult-calculator/index.html and enter your height and weight. If you fall above the healthy category, you are part of the obesity rate and are what most research points to when it comes to increased cardiovascular risk. Also for asians the numbers are slightly lower. I find that when I point this out, people often get mad. They feel they aren't obese. But the research doesn't support them, if you are anywhere outside of the "healthy" categorization you are at the same risk (that we know of so far) as "clinically obese" people.
        hu3 2y ago
        My result: 18.5 to 24.9. "Healthy Weight". I tried adding 10kgs and it said "Overweight". Seems ok to me. They even warn that BMI should be used along with other indicators.
    - lovethevoid 2y ago
      Kind of. The tricky thing here is that most people have a rigid view of "obesity" in their minds as it's easier to shift blame to, but the only thing research has shown is that abnormal BMI leads to increased cardiovascular issues. Which includes slightly overweight people.
      - derektank 2y ago
        Higher levels of body fat (which is almost always the cause of a high BMI unless you are an active athlete) is pretty directly tied to inflammation and pre-diabetic insulin resistance. This subsequently results in the liver producing more triglycerides and lipoproteins that clog the circulatory system and the inflammation itself promotes hypertension. All of this together results in more heart attacks and strokes. There's a pretty clear mechanistic link between obesity and cardiovascular disease. That doesn't mean obese people are "to blame" for any medical complications they might suffer from obesity. It also doesn't mean that obesity is a death sentence; people's bodies function differently and we've all heard stories of pack a day smokers that lived into their 90s. But there is absolutely a connection between the two.
    - shadowmanifold 2y ago
      I am on track to lose about 40lbs in 2024 and I suspect the main variable is really as simple as we have mastered the art of making really incredible tasting food. It is so pervasive though it is hard to tell until you go on a really boring and restrictive diet. It is just hard to not gain weight on average when the food tastes this good with such incredible variety. That is even if you buy something at the store. With our "foodie" culture, restaurants are an entire other level of choice and taste on top of that.
      - throwaway2037 2y ago
        I hope this isn't a throwaway account(!). This is a good post. Can you share what/why it is working for you? The best stories always share small experiments that people tried where they learned what didn't work.
      - zeroonetwothree 2y ago
        I don’t think the taste itself is an issue, it’s the availability. If I have to cook a delicious steak every time I want to eat I’m not going to randomly snack all day since it’s quite a process. My food consumption will remain at a reasonable amount. Whereas if I just pull out a bag of $chips from the pantry I could eat the whole bag without feeling sated.
      - bluedino 2y ago
        >> we have mastered the art of making really incredible tasting food. Corporations have intentionally created incredibly addicting food.
      - cocothem 2y ago
        1) Taste is very overrated, IMO. Too much gratification in our society. 2) SALTY is a taste. Once you remove salt and give it a few weeks, you will start finding about tastes you didn't know existed. 3) Once you cook your own food from scratch using quality and healthy ingredients , what you find tasty can change. It has in my case.
    - llamaimperative 2y ago
      All those things you mention are almost certainly contributors. Another one for you to investigate if you'd like to get pissed off: endocrine-disrupting chemicals. They are everywhere and many of them are strongly tied to metabolic disorders including obesity.
- lovethevoid 2y ago
  That's not what I meant. A solid answer as to why those conditions are happening, not the fact that they are happening at all. We have research on what can affect heart health, like what things might be linked to it, such as smoking and alcohol. We also know genetics plays a huge role. So we don't actually have solid answers, actionable answers as to the rise of heart health issues. Look at this analysis[1] regarding how dietary guidelines specifically for fats (saturated, trans) have very little substantial evidence supporting it. Yet this gets repeated by the average person, that fats are the ultimate evil you must avoid. In another study[2] we find that reducing your fat intake still resulted in the same rates of mortality as those who ate more. This is also why more in the space are shifting away from these sort of claims ("only eat x amount of saturated fat per day") and more to general food composition (eg who cares if a fish has saturated fats, eat the fish with vegetables). It's quite challenging to figure out, everyone has their theories. All I'm saying is we don't actually have the answers yet. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
  - hu3 2y ago
    I recommend studies about stain medication in increasing life expectancy. We're talking years of increased life expectancy. Sadly statin is not without its downsides.
    - joe_the_user 2y ago
      We're talking years of increased life expectancy. Huh? Statins are a medication type in which increases in life expectancy are extremely hard to point to all. I think they're almost a "poster child" for medications that correct a problem to an extent but whose overall benefit is quite dubious. (and given that these medications were highly prescribed before any long term studies were finish - creating considerable incentive for people to find benefit - I'd personally wager they are overall harmful but that's me guessing - the main point is they definitely aren't boost-life-expectancy-by-years drugs but probably aren't reduce-life-expectancy-by-years drugs either, given the studies) Link from google: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/
Am4TIfIsER0ppos 2y ago
[flagged]
- skirge 2y ago
  Epicureans. No point to live long which means being old for a long period of time. Better to be happy when you are young.
  - IncreasePosts 2y ago
    Eating yourself to a point where it hurts your knees to walk, or you get winded going up a flight of stairs, is not the kind of hedonism Epicurus had in mind.
    - skirge 2y ago
      everyone is sick when old
briandear 2y ago
What has been the role in demographic shifts?
dyauspitr 2y ago
Wow so ozempic is going to cause expectancy to jump by 10 years over the next decade or so.

hn_throwaway_99 2y ago

> We don’t have solid answers yet, only theories. The exact quote you gave had a pretty solid answer, certainly not just "theories".

daveguy 2y ago
I think the distinction there is between immediate cause and root cause. Heart disease and diabetes (or complications thereof) is the immediate cause of death, but what is causing an increase in those diseases is theory at this point.
- orionsbelt 2y ago
  Is it not clearly obesity? Why everyone is obese is perhaps unclear (although portion sizes, ultra processed foods, screen time and sedentary lives, etc, all seem to likely play a clear role), but I’d be surprised if the level of obesity that exists didn’t cause more heart disease and diabetes.
  - safety1st 2y ago
    Yes. Why is everyone tiptoeing around this? The obesity rate has increased by something like 50% since the turn of the century. It is a major risk factor for all the causes of death being discussed here. Sure there are probably many factors but this is clearly a big one.
    - hu3 2y ago
      Yeah if I try to handwave obesity impact on diabetes and cardiovascular diseases to the average cardiologist, they are going to tear me a new one within minutes. I don't know why is this even a question. Do people really think being overweight is a net positive?
      - pessimizer 2y ago
        https://pubmed.ncbi.nlm.nih.gov/23280227/ https://pubmed.ncbi.nlm.nih.gov/23280227/ Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis > Conclusions and Relevance: [...]overweight was associated with significantly lower all-cause mortality.
      - watwut 2y ago
        You gotta go higher in BMI for those to kick in. Basically, where you are within normal and slightly overweight bounds is mostly an aesthetic concern with slight lifespan advantage for slightly overweight people. When you move toward obese or into underweight category, health problems kick in.
    - lovethevoid 2y ago
      Go here https://www.cdc.gov/bmi/adult-calculator/index.html https://www.cdc.gov/bmi/adult-calculator/index.html and enter your height and weight. If you fall above the healthy category, you are part of the obesity rate and are what most research points to when it comes to increased cardiovascular risk. Also for asians the numbers are slightly lower. I find that when I point this out, people often get mad. They feel they aren't obese. But the research doesn't support them, if you are anywhere outside of the "healthy" categorization you are at the same risk (that we know of so far) as "clinically obese" people.
      - hu3 2y ago
        My result: 18.5 to 24.9. "Healthy Weight". I tried adding 10kgs and it said "Overweight". Seems ok to me. They even warn that BMI should be used along with other indicators.
  - lovethevoid 2y ago
    Kind of. The tricky thing here is that most people have a rigid view of "obesity" in their minds as it's easier to shift blame to, but the only thing research has shown is that abnormal BMI leads to increased cardiovascular issues. Which includes slightly overweight people.
    - derektank 2y ago
      Higher levels of body fat (which is almost always the cause of a high BMI unless you are an active athlete) is pretty directly tied to inflammation and pre-diabetic insulin resistance. This subsequently results in the liver producing more triglycerides and lipoproteins that clog the circulatory system and the inflammation itself promotes hypertension. All of this together results in more heart attacks and strokes. There's a pretty clear mechanistic link between obesity and cardiovascular disease. That doesn't mean obese people are "to blame" for any medical complications they might suffer from obesity. It also doesn't mean that obesity is a death sentence; people's bodies function differently and we've all heard stories of pack a day smokers that lived into their 90s. But there is absolutely a connection between the two.
  - shadowmanifold 2y ago
    I am on track to lose about 40lbs in 2024 and I suspect the main variable is really as simple as we have mastered the art of making really incredible tasting food. It is so pervasive though it is hard to tell until you go on a really boring and restrictive diet. It is just hard to not gain weight on average when the food tastes this good with such incredible variety. That is even if you buy something at the store. With our "foodie" culture, restaurants are an entire other level of choice and taste on top of that.
    - throwaway2037 2y ago
      I hope this isn't a throwaway account(!). This is a good post. Can you share what/why it is working for you? The best stories always share small experiments that people tried where they learned what didn't work.
    - zeroonetwothree 2y ago
      I don’t think the taste itself is an issue, it’s the availability. If I have to cook a delicious steak every time I want to eat I’m not going to randomly snack all day since it’s quite a process. My food consumption will remain at a reasonable amount. Whereas if I just pull out a bag of $chips from the pantry I could eat the whole bag without feeling sated.
    - bluedino 2y ago
      >> we have mastered the art of making really incredible tasting food. Corporations have intentionally created incredibly addicting food.
    - cocothem 2y ago
      1) Taste is very overrated, IMO. Too much gratification in our society. 2) SALTY is a taste. Once you remove salt and give it a few weeks, you will start finding about tastes you didn't know existed. 3) Once you cook your own food from scratch using quality and healthy ingredients , what you find tasty can change. It has in my case.
  - llamaimperative 2y ago
    All those things you mention are almost certainly contributors. Another one for you to investigate if you'd like to get pissed off: endocrine-disrupting chemicals. They are everywhere and many of them are strongly tied to metabolic disorders including obesity.
lovethevoid 2y ago
That's not what I meant. A solid answer as to why those conditions are happening, not the fact that they are happening at all. We have research on what can affect heart health, like what things might be linked to it, such as smoking and alcohol. We also know genetics plays a huge role. So we don't actually have solid answers, actionable answers as to the rise of heart health issues. Look at this analysis[1] regarding how dietary guidelines specifically for fats (saturated, trans) have very little substantial evidence supporting it. Yet this gets repeated by the average person, that fats are the ultimate evil you must avoid. In another study[2] we find that reducing your fat intake still resulted in the same rates of mortality as those who ate more. This is also why more in the space are shifting away from these sort of claims ("only eat x amount of saturated fat per day") and more to general food composition (eg who cares if a fish has saturated fats, eat the fish with vegetables). It's quite challenging to figure out, everyone has their theories. All I'm saying is we don't actually have the answers yet. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
- hu3 2y ago
  I recommend studies about stain medication in increasing life expectancy. We're talking years of increased life expectancy. Sadly statin is not without its downsides.
  - joe_the_user 2y ago
    We're talking years of increased life expectancy. Huh? Statins are a medication type in which increases in life expectancy are extremely hard to point to all. I think they're almost a "poster child" for medications that correct a problem to an extent but whose overall benefit is quite dubious. (and given that these medications were highly prescribed before any long term studies were finish - creating considerable incentive for people to find benefit - I'd personally wager they are overall harmful but that's me guessing - the main point is they definitely aren't boost-life-expectancy-by-years drugs but probably aren't reduce-life-expectancy-by-years drugs either, given the studies) Link from google: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/

Am4TIfIsER0ppos 2y ago

[flagged]

skirge 2y ago
Epicureans. No point to live long which means being old for a long period of time. Better to be happy when you are young.
- IncreasePosts 2y ago
  Eating yourself to a point where it hurts your knees to walk, or you get winded going up a flight of stairs, is not the kind of hedonism Epicurus had in mind.
  - skirge 2y ago
    everyone is sick when old

briandear 2y ago

What has been the role in demographic shifts?

dyauspitr 2y ago

Wow so ozempic is going to cause expectancy to jump by 10 years over the next decade or so.