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Comment by vfc1 | Hacker News Reader

Liver disease is likely linked to the continuously rising obesity levels:

> "adult obesity rates now exceed 35% in nine states, 30% in 31 states and 25% in 48 states."

https://stateofchildhoodobesity.org/adult-obesity/

More people are now dying earlier from liver disease, instead of dying later of for example diabetes or heart disease. In more cases, the liver is failing first due to lifetime obesity problems.

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> "adult obesity rates now exceed 35% in nine states, 30% in 31 states and 25% in 48 states."

The source for the above data is a telephone survey for the CDC. The NCHS regularly conducts a survey on the same subject for the same CDC, but with added physical examinations. Their data is much worse, over 39.5 % of USA adults were obese in 2016. The rate was almost constantly increasing over the past years.

Source: https://www.cdc.gov/nchs/data/databriefs/db288.pdf p.5

Yes, obesity is an epidemic, and we are also seeing drug overdose and suicide as two major causes of death for white men in America. Those disproportionately affect rural, middle aged folks with less economic and social prospects.

Could it also be alcohol consumption? Seems consistent with drug use.

Don't make speculation. Compare US drinking across other countries, and compare it against prior years and look at correlation. That isn't it. Read https://www.cdc.gov/nchs/data/hus/hus17.pdf which is the source for the article. You can look at page 29 of that report or https://www.niddk.nih.gov/health-information/liver-disease/c... for more information and trend data. It is NAFLD and obesity.

The top decile of American drinkers average 74 drinks a week. A lot of people. A lot of drinks.

https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...

That is mind boggling! Let's say it was 10 bud lights, LIGHTS mind you... at 145 calories each, that'd be 1,450 calories, or 73% of someone's daily 2000 calories EVERY DAY.

Calories from ethanol don't really work like other calories. The body is incredibly inefficient at using or storing calories from Ethanol. This is why most heavy drinkers aren't incredibly obese.

This is what I don't get with regards to calorie labels.

As far as I can tell they either burn stuff to see how much energy gets released or count up macro nutrients and multiply by x calories.

But if you pay attention it should be obvious that you don't digest all foods equally well and I would say the variance can be on the order of 20-30%. Do they account for this when labeling food ?

Just for clarity you're not talking about top decile of the general population; just drinkers? I've heard numbers more like 5% - 1/20. Either way it's a ton of people

No, it’s the top decile of all people (presumably adults). The bottom three deciles don’t drink at all.

Interesting, the numbers that I looked at a few months ago weren't quite so pesimistic. 1 out of 20 and the average amount was also lower (like 40). Perhaps I remember incorrectly, or am thinking of another country.

40 is about a six pack a day seven days a week.

Not according to CDC. Increased mortality is caused by nonalcoholic fatty liver disease.

The rise of NAFLD is pretty crazy. Took doctors by surprise about a decade ago. “What do you mean you don’t drink? Look at your liver!”

That disease is also not related to obesity. Funny thing that NAFLD.

No? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575093/

Well, I know of at least one case that isn't. So the better way to put would be not always related to obesity.

It is. It has been also linked with bacteria that produce alcohol endogenously.

As long as we are speculating, I wonder if sleep deprivation is another. I have no data, but my hunch is that the rise of smartphones, never ending feeds of infotainment on the internet, on-demand streaming services, and the decline of the "9-5" work culture in favor of the gig-economy and startup "hustle porn" mean people aren't getting nearly as much sleep as they used to, which leads to all kinds of disastrous health outcomes.

Ever do shift work?

Later: Seriously. Shift work is terrible for sleep and has been a fact of industrialized life for a lot longer than the gig economy.

It's probably both, obesity has been continuously rising but has alcohol consumption too? Alcoholics drinks also contribute to obesity as they pack quite a bit of calories, and are addictive in nature.

Drug use has been declining for decades though, so don't think it'd be that

I am almost certain that this is 100% alcohol-related. The book headstrong opened my eyes to the problems of alcohol even in moderation.

I agree about alcohol use being more problematic than people realize. That said, has there been a rise in drinking over that timespan? According to other comments, the answer is no.

The book by the Bulletproof Coffee guy? Do tell.

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