Life expectancy rise in rich countries slows down: took 30 years to prove
https://www.nature.com/articles/d41586-024-03244-1The 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.
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...
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.
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 do.
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.
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.
0: most kids, I just got the disease instead and the vax later
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.
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.
"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"
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/
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.
I'm a good example of how it fails. I have long arms and legs which causes my BMI to be fairly low. However, my body fat is fairly high. I need to lose fat but were I to rely solely on BMI I'd think I'm fine.
What I'd want instead of BMI is body fat percentage. I think that gives a much better measure of health problems.
No. If you fall above healthy, you are "overweight". You need a higher BMI to be classified as obese.
We’ve normalised being fat.
I tried adding 10kgs and it said "Overweight".
Seems ok to me.
They even warn that BMI should be used along with other indicators.
Depends. All cause mortality is notoriously lower for "overweight" people than "normal weight" people.
We dance around it and call it 'obesity' but the real medical cause of obesity is an addiction to unhealthy food.
This is compounded by the fact that it is completely legal for people to make their food more addictive and therefore unhealthy and advertise it to addicted people with underhanded marketing techniques that take advantage of their addiction.
Until we recognize this as an addiction issue that is compounded by dealers being able to operate with impunity we won't make any headway -- short of technological advancements like Ozempic that allow people to side step their addiction.
Has it? We've tried a few decades of fat positively and just pretending that being fat isn't a personal failure, and just a symptom of society. People have only gotten more fat in that time. Let's try some serious shaming. If you're fat, you should have to pay more for healthcare, food, flights basically everything related to your burden on society.
Fat positivity? It's not really a popular position, and is in fact regarded as a loathesome movement.
You think every fat kid, especially those bullied, don't want to be thin?
You think shaming is going to work? That's an uphill battle, especially against the human body and the urges it generate, the causes we do not fully understand.
Normal healthy humans are supposed to be able to self regulate their weight at a healthy level. I have seen at least one friend who has an atrocious diet, poor eating habit, and yet remain rail thin.
If shaming did work, then it would have been implemented widely and obesity is solved. But it's not. We don't have anything that works as well as ozempic.
I am all for taking responsibility, but we ought to be cognizant about the current limitations of our tools and flexible at how we would solve problems, rather than sticking to dogma or trying the same thing over and over again and expecting different results.
For example, I found a psychological trick that enables me to work long hours. Tricks for eventually getting rid of bad food addiction(sadly, I am at it again).
https://en.m.wikipedia.org/wiki/Fat_acceptance_movement
Online there's tons of content encouraging fat gain - for example Tiktok women celebrating "BBW" as a sexy thing and the r/PlusSize subreddit, where members encourage each other to remain "big and beautiful" and post anti-science content claiming that being fat is healthy. I saw for example a post by a 20-something woman who was morbidly obese and had had a blood clot in her leg but everyone was still insisting she was a "healthy" type of fat person, herself included.
Of course you will find very few doctors who will endorse this movement or its ideas. And the vast majority of us understand that obesity is unhealthy. But the fat acceptance movement has almost certainly played some role in making people believe that obesity is less dangerous than the research shows.
I won't be shy about my view here, obesity is a terrible disease and if you have it you must take steps to cure it. If you don't your quality of life will be lower in dozens of ways and you will die younger, probably not in a comfortable way. (Not to mention that its economic cost is enormous... a principal way that you can reduce health care costs personally, is to not be fat.)
First and foremost we must renew society's understanding that this is a disease, acceptance is not an option, and it must be prevented, treated and cured.
What kind of reasoning is this? This is only true if you believe good policies always get implemented. You'll notice other countries like Japan don't require every man and child to be drugged to stop eating food, and they have a much stronger sense of shame for being an undue burden on society.
Let's give a few decades of strict control over food suppliers a try, and if that doesn't work, maybe we could look into alternatives.
"Overweight" is longer-lived than "Normal," and "Grade I Obesity" isn't significantly less longer lived than "Normal." So what you're pointing out is misinformation, which is why people are annoyed by it. There is a case that "Normal" includes more sick and dying people because sick people often lose weight, but the difference still can't be as stark as reddit knowledge makes it out to be.
https://pubmed.ncbi.nlm.nih.gov/23280227/
Conclusions and relevance: Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
I don't know why is this even a question. Do people really think being overweight is a net positive?
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.
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
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.
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.
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?
Why not? Humans have been pursuing immortality for time immemorial. "The Epic of Gilgamesh", one of the first known stories, features such a pursuit.
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.
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?
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.
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
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.
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.
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...
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.
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.
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?
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”.
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.
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.
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 is expensive to live a healthy lifestyle in the US.
"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)
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.
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.
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."
https://www.medicalnewstoday.com/articles/how-the-brain-flus...
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.