Life expectancy rise in rich countries slows down: took 30 years to prove
nature.com
nature.com
Curiously, however, for a system apparently stultified by the dead hand of government, Australia’s health system far outperforms the free market-based US healthcare system, which spends nearly twice as much per capita as Australia to deliver far worse outcomes — including Americans dying five years younger than us.
Source: https://www.crikey.com.au/2024/10/16/pubic-private-healthcar...
Bypass: https://clearthis.page/?u=https%3A%2F%2Fwww.crikey.com.au%2F...
Overall, we now have the fourth-highest life expectancy in the world.
This is contrary to the narrative that pervades the media about our health system — one in which our “frontline” health workers heroically battle to overcome government neglect and inadequate spending, while the population is beset by various “epidemics” — obesity, alcohol, illicit drugs.
In fact, Australian longevity is so remarkable that in August The Economist published a piece simply titled “Why do Australians live so long?”
The Economist: https://www.economist.com/graphic-detail/2024/08/23/why-do-a...
AU Gov Report: Advances in measuring healthcare productivity https://www.pc.gov.au/research/completed/measuring-healthcar...
market, maybe, "free" market? I doubt it.
It's not a very free market when there is such a large power differential between the buyer and the seller. You can't exactly shop around for the ambulance or the hospital when you need it, nor can you realistically circumvent the artificially constrained supply [1] of doctors to get cheaper healthcare (unless you live next to the border).
When the alternative is a one-sided market like this, government becomes rather more appealing.
1. https://en.wikipedia.org/wiki/American_Medical_Association#R...
>market, maybe, "free" market? I doubt it.
The consumer of healthcare is doubly removed from the price of healthcare. This is the opposite of a free market.
The patient did not pay the doctor, the insurance company does. In most cases the patient does not pay for insurance their employer does.
So the normal pricing forces of a free market are removed.
Then we need to talk about certificate of need laws which restrict the supply...
Thankfully you can often get denials reversed after the fact by calling and complaining, but that takes an hour and is another roll of the dice. The only people who like the US system are wall street people who own stock in the companies.
Not really true, as the employer could otherwise pay that money to the employee who would then shop for his own insurance. So the employee pays, but doesn't have a choice.
and salaries are stagnant. why would they pay extra? at least they're obligated to provide insurance, even if it's terrible and impenetrable
If you’re poor, you’re fucked. If you’re old you’re ok. If you work for the government or certain companies, you have access to world class care. Everyone else is on a spectrum from high quality PPO to the shittiest Cigna plan.
The vast bulk of health care is by appointment, not a dash in the ambulance.
It’s not shopping for a tv. You can’t choose not to buy. It’s often time sensitive even if by appointment. Pricing is incredibly complex as are the details of the product. Your average person does not have the information necessary to navigate the market.
How did we collectively decide that it's okay for insurance companies to overrule medical professionals?
a basic heart ultrasound cost me over $1k while my vasectomy cost me a $60 copay. i was expecting those prices to be flipped.
and don’t get me started on labs. i’ve gotten bills for basic screens years later for thousands of dollars.
you can’t shop around if you don’t know what you’ll pay until months after it happens. if you call the insurance company beforehand you wait on a static filled line with a call center in india, and even with the CPT code they can’t give you a straight answer.
All you gotta do is ask.
This is my main argument against private healthcare: there's no real choice involved. Without even getting into what a free market is and perfect information etc, the main advantage of a capitalist society is you get to choose what you like. Nobody chooses healthcare (at least, not the super expensive part).
Is your argument that there is choice involved in public healthcare? Or simply that it's not even a question?
> Nobody chooses healthcare
Yeah, they do. Root canal vs implant vs dentures, for example. Ozempic vs diet+exercise, for another.
When I am psychotic I cannot exactly choose which psychiatric hospital I want to check into and ponder about the price to put it off for another day.
And this is what the free market did to psychiatric hospitals: https://www.wral.com/holly-hill-hospital/21507953/
Right up until the moment that the CCP decides to purge your entire sector, sure. I don't know if it counts as "free" if the government stands ready to nuke the sandbox they so generously let you play in.
https://www.reuters.com/technology/beijings-regulatory-crack...
They proactively forced interconnectivity and limited the ability for companies to make "walled-garden peudo-monopolies", as we have in the US with Apple and Google.
If the same happens here (through act of congress, or legal outcomes), you can expect their market caps to decline as well. A decline in market cap doesn't speak at all to whether it's beneficial to the industry or consumers
Those are 2 different things.
Monopoly doesn't mean "more powerful than the government". I'm not sure what that means, since the CCP disappears or coerces anyone who might threaten the supremacy of the CCP (or Pooh Bear) in any way.
Capitalism results in a single winner, for many industries. CCP prefers kingmaking in various industries, because it's easier for the government to control a few players than a multitude. This isn't what "fair market" means, in context. It's modern communism. State owned companies that are directed by government, rather than direct investment or day to day management. China learned from Russia's failures, I would say. I would also concede it's less regulated, under a political lens.
While they do have a competitive market, the government very much does pick and choose winners and loosers here like Huawei, resulting in consolidation into a few large conglomerates like every other country. Their (software) tech scene certainly dosen't like more particularly "capitalist" than Big Tech, nor is the Fed pumping subsidies to Tesla like BYD, if anything they're sidelining Elon Musk.
Back in the 1970s the AU Government was running campaigns such as Life. Be In It: https://www.youtube.com/watch?v=GNjEge3Awl8 (many short segments airing with commercials on TV).
Planning requirements typically require open spaces, walking paths, sporting facilities, etc.
A "healthcare system" needs to be more than simply "immediate care for the injured, sick, and|or dying".
> Part of the Australian national, state, and local health care system is policy to encourage healthy life styles and to discourage, limit, or ban food additives, tobacco, etc.
Or its a ticking time bomb: 39.6% of Americans are Obese(BMI 30 or higher). Fast forward 15 years and this will probably collapse the country. It certainly will be the No 1 issue in the country bar none. Ozempic may actually give the country a chance of some sort of future.
You think paying vastly more for much worse outcomes is a good thing??
Boy do I have a GREAT used car for you!
Australians have a weird sense of humour - it's clear from here that most aspects of US economics are decidedly not free markets but so many US citizens never shut up about "free markets" and have such a bicameral Capitalist v. Communist view of the world that it makes sense to just deadpan nod along.
Maybe reread https://news.ycombinator.com/item?id=41856242 and ask yourself if the article really thinks the US health system is a proper Adam Smith free market .. or just a "US free market" with extra heavy air quotes.
For non-seniors, the medical insurance system certainly sometimes doesn’t feel like a free market from the consumer perspective, but the insurance companies are private for-profit institutions, and the medical providers are too, so it may well fit the definition.
What do you mean by this? Fatalities among the young will have a much larger impact on lowering nationwide life expectancy than fatalities among the elderly.
( Describing various systems in various countries as either communist of free market capitalist is pretty simplistic, it's not much as a linear spectrum either )
I'd also argue that the foundation for a high life expectancy doesn't start with good health care for seniors .. unless the metric is "life support via artificial means" .. life expectancy is grounded in healthy living and excerise from an early age well maintained with good health programs.
The US has massive government regulation and dysfunctional state intervention in healthcare if not directly then vicariously with rules around Medicare. The US government helps make the dysfunction that private equity later exploits.
So I’m not sure that it would be correct to use Aus and the US as examples of the either end of the private / public continuum.
I would use UK or France as an example of a public system and Singapore as a light touch private, and perhaps India or Turkey as a laissez-faire system.
The UK and France systems appear to be degrading and do not appear long term affordable and I think they will soon be adopting Canadian style Maid systems to cut cost.
Germany is a weird one because it seems like half the doctors there are homeopaths and the Germans love their insurance but I’m not sure if they get value for it.
Personally I’d prefer the Australian or Singaporean style systems but I’d classify those as mostly private.
The current system grew out of a more fully public system under a many years past Whitlam government, people like the universal health for all aspects and wanted additional private services in the mix. It's evolved from there, with government oversight directed towards keeping things accessable and fair.
The US appears to have "massive government regulation and dysfunctional state intervention" as the end result of a lot of fingers in the pie bending regulation toward "middlecare" providers that don't apply splints or save lives, just diddle about with insurance schemes. (Admittedly that's just an impression from afar).
> The US government helps make the dysfunction that private equity later exploits.
My feeling is the US government is largely an arm of private interests in many matters.
Health Care in Australia embraces public policy such as Food Regulation to ban and limit additives, parks and sports grounds to encourage exercise, limiting access to tobacco, and some interesting national level drug acquisition deals to keep pharmacy costs low.
These cause a flow on of less per capita input into the medical side; lower heart disease, less smoking related issues, etc.
I'm assuming the rational behind drawing the distinction between the US and Aus systems is to somehow inform what the US should do, I don't think giving an already corrupted government system more power will help. It's very hard to uncorrupt things and because of that reason I think the US would benefit from a more laissez-faire system.
Additionally Australia has many advantages that the US does not and the US could not emulate Australia even if they wanted to. I don't know how long that'll last either - mathematically I would assume a country could not get rich and stay rich repeatedly selling houses to each other but it does seem to have lasted a very long time. I assume at some point the Aus government will run out of ways to prop up the housing market. The combination of negative gearing and all sorts of first home buyer grants is just insane.
The upside was that if you needed, say, a brain transplant for ten million Euros, as long as it was medically necessary they would pay for it.
Now I have a policy elsewhere that is cheaper, still covers me when I go to Europe, and has a much better copay structure while being 100% private. Downside is I can’t afford that brain transplant, but I’ll probably be OK for everything else.
I was an employee so this didn’t apply to me, but for my freelancer friends it seemed very unfair that they had to use private.
When you're very sick you hardly have time, money and energy do deal with a lawsuits so that you can get the care you desperately need. By the time you win your lawsuit you could be dead or your condition worse from the stress.
"less likely to die from drug overdoses. Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries, except among American men aged over 65. And Australians are also less likely to die in road accidents than other countries"
Looks like you conflated two unrelated things ?
> she will have a much higher chance of survival in the US.
Without a deep dive it looks ballpark the same, to be honest.
AU Cancer Survival Rates:
The 5-year survival for cancer in 1991–1995 was 55% and by 2016–2020, the rate had increased to 71%. Even with decreasing mortality rates and increasing survival, the number of deaths from cancer has been increasing.
US Cancer Survival Rates:
Five-year survival rates have also been increasing for an even longer period of time. The overall cancer survival rate was 49 percent in the mid-1970s. It currently sits at 68 percent
A few years back my Mum in Australia was diagnosed with stage 4 lung cancer, given 12 months to live.
For just shy of 3 years she had radiation, chemo, trial drugs worth nearly a million a pop all in a brand new cancer Center. Because she lived a couple of hours away she got free transport to and from and free hotel. Not pay and claim it back, fully free.
She was on an enormous cocktail of drugs that dad would get at the pharmacy that raised a lot of eyebrows for the strength of the opiates among other things.
For three years they never paid a cent. They never paid a cent of health insurance, never had private cover, never had a deductible. That would all be the same if they had never worked or took a decade off to pursue some hobby.
Trust me when I say it was stressful and emotional enough without adding money or paperwork or insurance into the equation
The comparison to my friends in the US who couldn’t get a separated shoulder fixed because it was “out of network” or had to move hospitals the day after a C section because the insurance didn’t want to pay anymore is downright disgusting.
For real people living their lives the two systems are vastly different.
There's likely at least one other major factor, and I would assume that it's some variation of "inability to access high-quality care for financial reasons" given how much of a wealth disparity there is in various healthcare outcomes.
Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries
wealth disparity there is in various healthcare outcomes.
Why would it depend just on one factor like hospital access?
less likely to die from drug overdoses. Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries, except among American men aged over 65. And Australians are also less likely to die in road accidents than other countries
The figure I see thrown around is America has a 40% rate of obesity.
Australia looks like it's 32%.
European countries look like 20-30%.
I think these rates alone could explain life expetancy regardless of health care system.
All the medicines they prescribe are merely to manage symptoms. I have GERD and reflux. I was given PPI after many many tests. How does taking PPI extend my lifespan. Whatever has gone wrong with my body is still there.
How is this not obvious to ppl making this absurd correlation between hospital care and lifespan.
Medicine doesn't have shit of new breed of diseases and disorders ppl are dying from. Doctors don't have answers to any of modern illnesses so how does it matter if access to a useless person is govt funded or 'free market'.
It can potentially extend your life by reducing your probability of developing esophageal cancers, improve your quality of life in the meantime, and there are other complications from untreated GERD I can't recall but would negatively impact your life.
In the US, government is elected by people. You can't blame a gvt for not doing what it hasn't been mandated to do.
Are you touring with this material, or is it off the cuff standup?
For example, Medicare.
https://www.crikey.com.au/author/bernard-keane/
Bernard is well across many aspects of US, UK, and AU political views, government systems, media etc. with his own particular views as we all have.
In context he's writing for an Australian audience about a conservative Australian trope that the Australian health system is weighed down with government meddling and would do better with, for example, a "US free market" approach.
I think we all appreciate that's an illusion, a myth spun for children.
It is a carefully constructed plan that will ensure rich people get a whole lot richer and poorer people get worse care. It’s not an accident or nice story. It’s class warfare
The healthcare system in the US is far, far from a free market. Most people would describe it as a crony capitalist market. There's a lack of transparency, lack of competition, and lobbyists of established players have too much say in the lawmaking process.
Could this also (partially) be explained by the cost of healthcare? Something like a downwards spiral where average people end up poor either due to direct costs of healthcare or neglecting their own healthcare due to cost?
- greater usage of surgeries and prescriptions, leading to greater exposure to medical malpractice (the 3rd leading cause of death in the US.)
- higher birthrate. more pregnancies.
- less cultural tolerance of abortion. Greater willingness to take on risky pregnancies
- single parent homes (people with less family support)
- ethnicities which are more susceptible to certain disease and lifestyle risks
- greater exposure to crime in impoverished areas
- more life time spent traveling in cars
- more restricted access to health insurance (as you said only accessing healthcare in dire emergency)
The US is a different world than most countries which tend to be geographically tight and culturally homogenous. It's very difficult to make comparisons, not to mention differences in data collection and reporting ethics.
Not to downplay the malpractice problem, but this doesn’t sound remotely plausible. Do you have some sources to back up this claim?
I googled around a bit and it appears to come from some sloppy misuse of statistics in a journal one time, plus internet amplification.
So, if this was the issue, you'd probably expect outcomes to be better in less diverse, physically smaller US states. Looking at, say, life expectancy by state (https://commons.wikimedia.org/wiki/File:Life_expectancy_map_...) doesn't seem to bear this out, really; on your theory you'd probably expect, say, West Virgina to be handily beating California or Texas.
Also, of course, _Australia_, which started the thread, could hardly be called either geographically tight or culturally homogenous. Australia is roughly the size of the contiguous United States.
> The US is a different world than most countries which tend to be geographically tight and culturally homogenous
I am not sure how much you know about Australia, but homogeneity and geographically tight is definitely not how you would describe it.
West Virginia is extremely poor.
The gist is that this isn't quite as cut and dry as it may seem.
We also paid to make the Nature Aging paper open access.
That’s awesome! Did you make a deal with the authors to pay for the fee during publication or is this something anyone can do by approaching the journal itself?
Edit: if you need to know I would just ask the editor if it's an option
What a world to live in.
Why not just use a preprint server like Medrxiv?
Arxiv is now the default place to publish papers in physics -- and, with that established, it seems to me that it would be for the best if more institutions, researchers, and organizations in biology, medicine, chemistry, and other areas also use preprint servers.
75% American are overweight..
Just let it sink a second, they speak about how many baby born after 2000 will reach 100 years old, how we are reaching the absolute limit of human survival.
75% overweight... Everyone know fat people don't live long. I bet all the studies done in the 90's that predicted we would easily be able to reach 100 years old didn't take that into account.
Quick Google search:
> what percent of australians are overweight?
> Over the last decade, the proportion of adults who were overweight or obese has increased from 62.8% in 2011–12 to 65.8% in 2022.
US NIH says: 73.1% are overweight (includes obese). Ref: https://www.niddk.nih.gov/health-information/health-statisti...
Sure, 73.1% > 65.8%, but Australia is still plenty overweight. Both are appalling.
Both are also largely meaningless because they're based on BMI, which is literally just mass/height^2. No measure of percent body fat, no measure of any other aspect of health, just mass by the square of height.
If you're comparing the BMI of two countries with very similar gene pools it's not a bad point of comparison (though the raw number still doesn't tell you much without more context about build types), but when you're comparing Australia to the US the gene pools of the non-European minority groups are sufficiently different to make BMI pretty worthless as a point of comparison for public health.
This says it's <20% there[1][2]
1: https://en.wikipedia.org/wiki/Average_human_height_by_countr...
So the line between normal and overweight is somewhat blurry. e.g. someone who is 6'3" and weighs 200 pounds is overweight. Which might or might not be the case (but you certainly don’t need to a body builder or invest a lot of time to maintain at least reasonably healthy 18-20% body fat ratio).
It's a pretty straightforward formula, and even though the cutoffs might be arbitrary, there's undoubtedly a u shaped mortality curve centered somewhere around 20-25. At a population level I don't think any of that is a relevant factor. No one thinks that your risk of death hinges on crossing an arbitrary line, but being fatter definitely isn't good for your health.
Bone density, muscle mass, torso height relative to leg height—none of these things are factored into BMI and all of these vary wildly depending on genes.
Similarly, cancer risks may scale with the amount of tissue or the surface area for things like skin / colon cancer but it’s hard to see how being taller is beneficial.
Ozempic's mechanism of action is not "ramp up your metabolism" or "make you absorb fewer calories from food." It's "make the desire to eat less intense, making it easier to remain on a diet plan." That diet plan could be, "eat exactly the same things but less of them," but it will often be, "cut out unhealthy snacks" or whatever.
If people can't be convinced to eat carrots over chips, what makes you think they're going to suddenly eat carrots over chips after eating medication that makes them want to eat less?
i.e. the benefits of the weight loss almost certainly outweigh any side effects that are likely to manifest.
Similar to zero-calorie sugar substitutes, "too good to be true" isn't always the case. Sometimes new inventions really are just better.
Only fools would convince themselves a drug has no sideeffect.
The worst is that these drugs were created for legitimate use but are now being abused by what I would call lazy fat who can't get their finger out of their arse and start eating healthy.
When there is a natural, effective and no side effects alternative, why go the medication way.
A few years after graduation, for unrelated reasons, I was on antidepressants. I massively over-ate, became obese, gained stretch marks that will likely remain for life.
There was no voice in my head telling me I was even over-eating, there was no awareness of what I was doing to myself even when I felt the weird tingle in my belly that in retrospect was the tearing flesh that has the outward sign of a stretch mark — I ate without thought.
There is no "natural, effective" solution, because our natural instincts are at odds with our unnatural world.
Would you also tell people suffering from depression to just cheer the fuck up instead of going the medication way?
0: most kids, I just got the disease instead and the vax later
studies estimate that moderate obesity takes about 2-3 years of life expectancy (defined as having a BMI of 30-35), only people with severe obesity (BMI of 40-45+) lose on average 6-13 years, comparable to smoking.
Given that severe obesity is still uncommon even in the rich world it only has a small impact on life expectancy overall.
This is really hard to believe. Moderate obesity has to shave at least 10 years off life expectancy.
A 70 year old man 6' tall with a BMI of ~35 weighs 260 lbs. That is pretty overweight.
Anecdotally, I just don't see many people that overweight or heavier making it into their 80s.
When you're old, setbacks that cause you to lose your appetite are much more common and much bigger threats to the health of skinny people.
I don't know where you live, but I've met tons of moderately fat people in their 70s and 80s.
Hunched over old people do not have the muscle mass to help keep them upright, I guess amongst other things.
Most people still have a car but you wouldn't think about taking the car to go buy bread for instance.
Americans walk the least out of all, followed by Australians. When I visit the the US for work. People sometimes stop and asked me if I'm ok because I'm carrying my groceries home from the store. People would say: "What are you doing? do you need help?" lol
Virtually nowhere is designed for walking outside of say New York, parts of San Fran etc.
The worst life expectations are in underweight category.
It's hard to take seriously the aversion especially Americans seem to have against overweight and obesity
Funny the land of the free is so incredibly intolerant on this one point
These definitions are arbitrary anyway. In india they define a bmi of 25 as obese. The same indian after moving to America is not obese until a bmi of 30.
Meanwhile, the average height is also going up, which also correlates with lower life expectancy.
Cardiologists already had to back off their blood pressure guidelines when they defined the average middle aged man as hypertensive in the past.
Also in Asia, average bmi is 23, and average bra size is B. In the usa, average bmi is 29, average bra size is DD. Probably same thing applies for men in relation to bench press and deadlift numbers.
"here is the theoretical limit given adherence to modern recommendations on cardiovascular health, exercise, etc."
and
"you all didn't listen and got fat instead"
I don't know what they based "normal" bmi weight on, but it's not by setting the middle of the range to max longevity.
So dangerous to extrapolate from anecdotal observation like this. If I see old people smoking, doesn't mean smoking is safe. It just means it doesn't kill at 100% effectiveness.
If you wait long enough, everything has a 100% effectiveness.
Depending on your priors, This may be a lot or not
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”.
The exact quote you gave had a pretty solid answer, certainly not just "theories".
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/ [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
Regarding other factors, American culture is fairly similar to Canadian culture. However Canadians have free healthcare, meaning more Canadians see doctors than Americans. So I wonder if they have lower levels of obesity, heart disease and diabetes, and if their lifespans have also been decreasing.
> However Canadians have free healthcare
Also, Canadians are pretty fat. It looks like 65% are overweight, which includes obese. Ref: https://www.statista.com/statistics/1317268/overweight-obesi...
I've been hearing this complaint (that the guidelines claim fat are the worst) for way too long, when in (my) reality, all the guidelines I've seen in the last 25 years has put more emphasis on carbs than on fats (i.e. too many carbs is evil).
I know "low fat" diets were the craze a long time ago. And sure, advertisers still like to slap "low/no fat" labels. But I believe the actual recommendation has been to lower carbs since around the 90's.
This is ultimately a strawman.
The modern lifestyle is incredibly sedentary and every civilisation is built on staple foods that can feed hours of manual labour (with modern snacks thrown on top).
Calling a major food group evil is just a good scapegoat because it’s much more palatable than telling people that they don’t move enough and eat too much food.
Whether that leads to actual heart disease is iffier, but not terribly controversial among cardiologists as far as I can tell. It's only doubted on the Internet where everyone wants to be a galaxy brain with some answer the doctors don't want you to know.
But nobody ever demonized fat in general, and demonizing carbs is just as stupid. Eating enormous amounts of carbs is fine as long as you actually use them. My daily calories right now are around 3,900 with carbs at 650 grams a day, a fair amount being syrups I eat early in the morning while running. If you listened to the Internet, you'd believe I was diabetic already, yet basically every remotely serious endurance athlete eats like this and is fine. Glucose that is continuously and immediately shuttled into muscle cells to power mitochondria and provide energy for movement does no harm whatsoever. It's roughly the entire point of animal metabolism. Glucose that sits around in your blood forever because you're sitting around staring at a screen for 16 hours a day while stuffing your face is what causes problems because of all the oxidizing effects of glucose when it isn't taken apart quickly and turned into ATP.
My BMI is 21.6 for what it's worth. As far as I can tell, the whole "mystery" behind why no diets work is because no diet can magically make people eat less when they spend the overwhelming majority of their time not moving and hunger decouples from energy expenditure. If you're sufficiently active as a lifelong athlete, every diet works. I ate super sized McFlurries, entire boxes of Entenmann's donuts, and Little Debbie's treats as a teenager as staples of my diet. As an adult, I've tried paleo, zone, mediterranean. Right now, I pretty much just eat the standard American food pyramid. None of these has managed to magically poison my brain or destroy my metabolism because metabolic function can be trained just like any other bodily function and it is trained by doing regular athletic activity with a high energy demand. Just like your muscles atrophy if you never do any resistance training, your metabolism atrophies if you never do any aerobic exercise.
I can't claim to know the secret to weight loss but I know how to never get fat in the first place. On every team I was ever on from middle school to college to my time in the Army, whether that be cross country, track, volleyball, basketball, tennis, or general outdoor adventurism and long-haul hiking with a weighted pack, the overweight rate was never 0 but it sure as shit wasn't 70%. And we were all eating the same "poisons" and manufactured foods from evil Nestle that the rest of you were eating.
Nestle ? McDonalds ? Burger King ?
edit: you really think insulin prices don't have an effect on the lifespans of diabetics?
We're talking years of increased life expectancy.
Sadly statin is not without its downsides.
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/
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.
That is to say, I'm not clear that "beating aging" is what is required for "long life." Is that definitionally required and I'm just being dense?
I'm assuming this is a tiered discussion? In that nobody thinks we should freeze aging at baby stages for someone. Such that we would still want some aging, but would then try and fix a point where all aging can be stopped?
Ageing is not a perfectly understood process, so what it would mean to overcome aging wasn’t clear, and there was some hope decades ago that maximum human lifespans would just keep going up indefinitely as medicine slowly eliminated the various causes of death.
But now this research concludes what has been suspected for a while - that even under perfect conditions the average human lifespan isn’t going to hit 100. Even if you eat and exercise well and have the best medical treatment, and avoid all the other things that might kill you, ageing will get you.
The medical term for this is “mortality compression”, the idea that as we remove all the ways people die early, the ages of death for everyone end up being squashed up against a limit.
It will take significant breakthroughs in technology (probably some combination of gene therapy, cancer treatments and nanotechnology) to actually stop, or reverse aging.
I still think calling this "defeating aging" is an odd framing. But it makes sense in the standard context here.
As I said down thread, this could just be a potato/potahto thing? If this is just definitionally beating getting frail, then that makes sense. But I don't know that I could pin down an age that I would want to freeze progress at. Nor do I think I expected that there would be a general age to freeze aging at. Let me keep my strength longer, but I expect I will be/look/appear older and older the older I get.
Now, granted, I'd be delighted if I have the same strength my 90 year old grandfather in law did. In his 70s, I'm pretty sure the only thing I could beat him at was a race. Lifting things or doing manual work outside, and he was far beyond what I was in my 30s.
I have a suspicion that something is being miscommunicated between you and many others here. (I admit that I might be wrong. But hear me out.)
It sounds like you are thinking about the visual signs of aging. Like wrinkling of the face, or salt-and-pepper hair. That kind of thing. And sure, there is a lot of vain people who would like to stop that from happening.
But in general the aging people want to defeat is not the wrinkled face. It is things like our immune system demonstrably going to crap as we turn older. Or losing muscle mass. Or becoming senile. Or our bones becoming more fragile.
For young people the flue is basically an inconvenience (by and large). But as we age things like seasonal flue becomes huge issues. People's immune system used to work for decades without a hitch, and then suddenly it decides to crap out. Why?
I can also put it into a more mathematical framework. If maybe that helps? Imagine plotting the probability of a human dying in their x'th year assuming that they have survived before x-1 years. If you plot this now you would see a sort of bath-tub like curve. There is some chance a newborn dies in their first few years of life due to birth defects. Because of that the first few years have a higher probability of death. Then the plot plateaus, and the probability remains basically constant low number for multiple decades. People can still die due to violence, or accidents, or random health issues, but the chance of that doesn't really change much from year to year. And as you approach the other "side" of the bath-tub you see that the probability starts climbing again. And this climb is quite rapid. By the time you are 100ish (plus minus a few years) you have fairly good chances of dying in any given year. And then around 105ish you have about even chances of dying or staying alive in each year. And then we don't have anyone who ever lived to 130.
On this kind of plot if we were to defeat aging what you would see is that the plateau remains constant. That is the chances of a 35 year old dying in the next year where the same as the 135 year old dying in the next year.
Which is why I balk at the framing of "defeating aging." We want to defeat the decline that comes with advanced age. But this doesn't necessarily mean we have to freeze the clock at some age, as it were. May be that that is the way it happens.
Why not? Humans have been pursuing immortality for time immemorial. "The Epic of Gilgamesh", one of the first known stories, features such a pursuit.
So, if you limit aging to "getting frail," I am fully there. But there are other things that happen as you age.
Fair that I don't expect to be as strong in my 60s as I am now. Or when I hit 70+. If I get that far. Light weight training is plenty to get to be in good physical shape, though? Get to where you can do 10-30 pushups and run a continuous mile, and you are probably doing fine?
So, what does it mean to "beat aging in a medical sense?" If it is just definitionally to not have any of the bad effects of aging, then sure. Of course I would want that. What are the names for the good things that are generally along for the ride with aging?
Going back to my earlier quip, if you could turn off aging for babies/toddlers, how would that be a good thing?
Perhaps there are other shared variables besides genes? For one thing, blindness is associated with higher mortality [1]. And even within a country, life expectancy can vary dramatically by region, city, and even neighborhood. Or perhaps the people you know happen to be more likely to share certain occupations, mindsets, levels of physical activity, or diets?
Or maybe it's just coincidence.
[1] https://www.thelancet.com/journals/langlo/article/PIIS2214-1...
King County in Washington State, which contains the Seattle metro area, has a life expectancy of 86.3 years. This is higher than any country in the world. If you move one county south (Pierce), it is 75.7 years, slightly worse than the US average currently. Not surprisingly, there are many obvious factors that may contribute to this e.g. the obesity rate in Pierce County is 50% higher and the obesity rate in King County is roughly half the US obesity rate. The Seattle metro is a relatively walkable city and people do, Pierce County is not. As a matter of demographics, King County is significantly more Asian than Pierce County. And so on.
Both counties are geographically large and contain many municipalities. It is difficult to come up with a theory where pension fraud in King County is so high relative to Pierce County that it explains a >10 year difference in life expectancy.
The underlying source of 86.3 matches San Juan county from other sources. Seattle metro areas are a bit over 83, and King County is somewhere between 81-82 from sources that seem more primary.
Internet search is straight garbage these days.
I'm not noticing people eating more healthily, so it only makes sense that life expectancy isn't going up anymore.
[1]: https://ourworldindata.org/causes-of-death [2]: https://www.who.int/news-room/fact-sheets/detail/cardiovascu...
I’ve had to make very few compromises to still enjoy life while staying alcohol free - I can even have a decent bottle of wine, or a rum and Coke should I be in the mood for one.
https://theconversation.com/youth-drinking-is-declining-myth...
What little life expectancy they gain by drinking less - and not stopping completely - is completely overshadowed by their high-sugar, high-sodium, meat-heavy diet.
More people die of Suicide than Malaria aparently.
Somehow what actually kills people, is different from what you think kills people.
To show that we are hitting a limit on our ability to extend lifetime, we really should look at having reached 95, how many people reach 105 or something like that.
To say that the average life expectancy is dropping and therefore we have reached our limit on their ability to extend the lifetimes ignores the fact that much of the reason for a stage life expectancy drop in my country is lifelong maltreatment, often self-inflicted--death-oriented decisions on drugs, nutrition, and activity.
Our world in data hasn't updated life expectancy past 2021.
I've half wondered if it's because the article is optimistic but life expectancy has stalled since 2020. Coild also be the underlying data hit a snag. Would love to see an update
By doing so, historical events outside of the study period don't have a major effect. In this study, they deliberately avoided the covid pandemic as it would have caused a significant drop in life expectancy that is not representative of a general trend. Of course, the future is not taken into account either. Despite what the name may suggest, life expectancy is like a snapshot of the studied period (1990-2019 here), not a prediction.
I do not understand how some of the conclusions about reaching the limitations of reducing aging or reached given this simple data. not to mention a direct quote that is very inspirational in the article itself
"if we cannot imagine it today, does not mean it is not possible"
Overall, the study found that children born since 2010 have a relatively small chance of living to 100 (5.1% chance for women and 1.8% chance for men). The most likely cohort to see a full century are women in Hong Kong, with a 12.8% chance.
Many demographic trends like fertility rate are treated the same way. While it is not a very accurate prediction for how long a current young person will actually live, it's a consistent metric that doesn't rely on a particular model of future events. It's good for discussions like this where we're more interested in how the value is changing than the actual value itself.
It is expensive to live a healthy lifestyle in the US.
“Our analysis also revealed that resistance to improvements in life expectancy increased while lifespan inequality declined and mortality compression occurred.”
Spending an other 100 years like say from 80 to 100... Well you are alive, but still...
It's not his lifespan I aspire to, but his healthspan.
Our economic system is incompatible with the next 200 years irregardless of what specifically gets invented.
At 5%/year, that's a factor (not percentage) of 17292 growth; in energy terms that's not quite boiling the oceans, but it is making the poles the only barely livable zone.
In any sense besides energy, this kind of growth implies automation that makes the meaning of work radically different than today. Human or superhuman AI would be an example of that, but the successful creation of that has other complications that we can currently only guess at with less awareness than the Victorians had of climate change or biodiversity loss.
I think we need to distinguish between longevity and health though. Lots of people live with chronic disease and giving them more quality of life counts for more than longer life IMO.
The information that something stopped or slowed down is still useful without having to think it was going to go on eternally. It allows you to adjust your plans for the future.
> did you expect her to live forever?
I understand some tech billionaire want to live forever by eating hundreds of pills a day for nutrition, anti-aging, disease control etc. Their life may be "great" for some definition of great.
But do billions of people on earth think that their life will become great in another 50 years even if it is rather miserable right now? I just live under rock to not know the desires of modern human.
When antibiotics were first invented some people thought we'd be taking them daily as a vitamin. Turns out that's not such a good idea despite them being life saving in some scenarios
The accepted view is a lot like the accepted views to mono-cultures for crops. In that they are bad. The practiced take, though, is quite the opposite? Crops are dominated by mono-cultured fields. And though antibiotics are known not to be used constantly, farms seem to use them at an amazing rate.
I'd love to see a longer exploration of this. Why is it farms seem to be full of practices that we are taught are bad?
Not exactly. We have crop rotation because over time a strict mono-culture wasn't very good.
At any rate, I'll be reading more on this some. I have real work I should be doing, after all. :D
I guess we’ll soon be able to measure the impacts on what it does to the children of parents that take it.
How have McDonalds Happy Meal sales been looking lately?
https://www.reuters.com/business/retail-consumer/mcdonalds-p...
Life expectancy is a weighted average (no pun intended), and so it's unusually sensitive to outliers. People who die early drag the average down much more than people who live close to the mean life expectancy. The biggest premature killers of Americans are obesity, drugs, car accidents, and suicide. Anything that addresses one of those causes of death has an outsize effect on life expectancy. There are 100M+ obese Americans. There are about 100,000 overdose deaths per year. Obesity, while not as lethal as drugs or suicide, afflicts 1000x as many patients, and so a treatment for it can have a large effect on the numbers.
https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-...
> According to the CDC, 9.4% of adults in the United States were severely obese between August 2021 and August 2023. This is higher for women (12.1%) than men (6.7%). The prevalence of severe obesity varies by age group, with the highest rates in adults aged 40–59 (12.0%)
Only 9.4% of people are severely obese. Moderately obese people have only a ~4% shorter life-span than healthy weight individuals - much of which can probably be attributed to other lifestyle issues besides simply being overweight.
This will move the needle, but I doubt as much as you think.
There's a lot more smokers than there are severely obese people.
Which, I recognize is a pretty privileged way of putting it—people struggle with weight, mental health, and drugs, and those are real struggles that shouldn’t be ignored. I just also want to see where things are developing on the upper-bound for reasonably plausible lifespans.
Sure, if all the weights are 1. Where i come from, we just call that an average.
>People who die early drag the average down much more than people who live close to the mean life expectancy.
This is true of all averages where all weights are the same.
https://www.wired.com/story/the-benefits-of-ozempic-are-mult...
> Known as GLP-1 agonists, these drugs were originally developed to help control diabetes. But there's increasing evidence that they have other health benefits, beyond controlling weight. They seem to boost heart health, protect the kidneys, improve sleep apnea, and lower the risk of certain obesity-related cancers.
It has a side effect of reducing muscle gains from exercise.
As for life extension by GLP-1 active drugs, it's much more of a guess. Mechanism is relatively similar. Side effects might not be...
And there are potential bad side effects too.
If a doctor tried to push that on me I would fire that doctor.
Well the ozempic helps you do the discipline and hard work. You don't take ozempic, eat everything, and get skinny. No, it makes it easier to diet and exercise.
For some they don't need the "motivation". For others, their mind is constantly under attack and pushed to eat, like an addict. For them it can be very helpful.
It wont. This is about maximum lifespans. Weight loss might mean more people reach their maximum, but that maximum has proved, to quote the article: “resistant to improvements”.
Same thing is happening in Europe and other developed nations. UK considering giving ozempic to unemployed? How about subsidized or free gym memberships instead? Things are going to get alot worse before getting better. The established intuitions will continue to double down no doubt.
Get an apartment on at least the third floor, in a building without a lift.
Get a pet dog which needs to be walked several times a day.
Eat lots of chili peppers[0]:
"The analysis included data from more than a half a million people in multiple countries. When compared with people who never or rarely ate chili pepper, those who ate it regularly had lower rates of death due to cardiovascular disease (by 26%), cancer (by 23%), or any cause (by 25%)."
[0] https://www.health.harvard.edu/blog/will-eating-more-chilis-....
A little bit of high-intensity workout each week?
I know people who are incapable of eating lunch or any meal without a large can/bottle of full-strengh coca cola or such, ever single day. Most of whom complain about not being able to lose weight.
The science is pretty clear. Breaking out of old habits is much more challenging.
EDIT: Typos: whole -> whom, mean -> meal
"Although nuts are high in fat, it’s mainly healthier unsaturated fat. They contain protein, B vitamins, vitamin E and minerals, including iron, potassium, selenium, magnesium, zinc and copper."[0]
[0] https://www.bhf.org.uk/informationsupport/heart-matters-maga....
"The idea that saturated fats cause heart disease, called the diet-heart hypothesis, was introduced in the 1950s, based on weak, associational evidence"[0]
>These studies have two main messages: When you eat saturated fat in moderation (contributing 10% or fewer of your daily calories), it has little effect on cardiovascular disease. When you cut back on saturated fat, replacing it with unsaturated fats or whole grains is good for your heart and arteries, while replacing it with easily digested carbohydrates isn't.
Since when are polyunsaturated fatty acids considered unhealthy? As I recall, the real enemy is saturated fats.
“The analysis looked at the period of 1990 to 2019, to avoid the distorting impact of the COVID-19 pandemic.”
At least life expectancy was still growing before COVID. Now after the introduction of dirty (mass production was not the same quality as the small batches used in leading studies) COVID vaccines, plus the virus itself which caused some trouble to not fully healthy people, we will see a life expectancy decline. Excess deaths did already rose worldwide.
Meanwhile they want you to get more dirty vaccines..
Edit: typo
"Millions long for immortality who don't know what to do with themselves on a rainy Sunday afternoon." — Susan Ertz, Anger in the Sky (1943)
It's not binary I guess (sleep "once a week" is less than "sleep once a day"), but even some incremental improvements seem very far off.
One also has to wonder if it's actually desirable to have less sleep and be "on" with fewer or no breaks.
While in practice, what would happen is that we’d be doing more of the same. Bosses would be demanding more time in the office, people would be spending more time doomscrolling, nothing would change. It’s a pipe dream to think that if we had more time in the day we’d suddenly start using it more respectfully and responsibly.
seems decent to me. I hate sleeping, the problem is i get tired and cant avoid it.
This is the great future the visionary OP envisions for us.
The real and staggering excellence of the series is the speculation - it's not such hard SF that it explains the mechanisms by which everything happens, and there are real characters who do more than stand as cardboard observers to technology, but it's crunchier than most.
https://www.medicalnewstoday.com/articles/how-the-brain-flus...
A book on sleep and how important it is to learning and health: https://en.wikipedia.org/wiki/Why_We_Sleep "Walker spent four years writing the book, in which he asserts that sleep deprivation is linked to numerous fatal diseases, including dementia. ... The values of sleep and the consequences of sleep deprivation are also brought up in the book. One particular research conducted in the past, where people volunteered themselves to sleep for only six hours in a span of 10 nights, is brought up by Walker. This resulted in the volunteers being "cognitively impaired" along with their brains being heavily damaged, regardless of the three week eight-hour sleep schedule they received later."
I'm all for getting rid of sleep, but given how society is structured I worry that the extra time will just end up being used for longer commutes and more zoom calls. Hardly advancement.
We really don’t know and have made it nigh impossible to study. Obviously governments are trying to hide something.