Posts Tagged ‘Life Expectancy’

Weight Issues Not as Harmless as Study May Suggest

January 5th, 2013 at 2:12 pm by timigustafson

Obesity may have multiple negative health effects, but higher mortality rates are not among them, according to a study that was recently published in the Journal of the American Medical Association (JAMA). Researchers found that people with weight problems don’t necessarily have shorter life expectancies than their normal-weight contemporaries. In fact, a few extra pounds could even lower the risk of an untimely death.

The findings were greeted with great interest in the press and welcomed as good news for the two-thirds of all Americans who, according to the Centers for Disease Control and Prevention (CDC), are considered overweight or obese.

Based on the results of this study, the government ought to redefine the meaning of “overweight” and “obese” and re-categorize a large part of the population as normal-weight and healthy, writes Paul Campus, author of “The Obesity Myth: Why America’s Obsession with Weight Is Hazardous to Your Health” (Penguin Group, 2004), in an op-ed piece in the New York Times.

“If the government were to redefine normal weight as one that doesn’t increase the risk of death, then 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead,” he says.

If only it were that easy.

What this particular study does say is that among all causes of mortality, not overall health risks, being overweight does not seem to stand out as a particularly significant factor. But that doesn’t mean the obesity crisis should no longer be treated as such.

In fact, the study, which investigated the causes of 270,000 deaths from around the world, also found that the morbidly obese had a 29 percent increased risk of dying prematurely compared to normal-weight and moderately overweight people.

It would be a mistake to conclude from this one study that Americans can keep overeating, says Dr. Thomas Frieden, director of the CDC department that conducted the research. “I don’t think anyone would disagree with the basic fact that being more physically active and eating a healthier diet is very important for your health,” he said in an interview with the Wall Street Journal.

Other experts agree. The body mass index (BMI) by which weight levels are commonly measured is an imperfect assessment of the risk of mortality, and additional factors like blood pressure, cholesterol and blood sugar must also be considered, says Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, Missouri, in an interview with the New York Times in response to the study release.

But many of these diseases are diet and lifestyle related, and together they amount to over 60 percent of all causes of death in the world today, according to the World Health Organization (WHO).

Maintaining a healthy weight range may not automatically produce longevity. It may have little or no influence on one’s life expectancy at all, as this study seems to indicate. But we can say with certainty that struggling with weight problems and other related health issues significantly takes away from the quality of life a person can enjoy, and increasingly so with age. A report published in the American Journal of Preventive Medicine (AJPM) found that “Quality-Adjusted Life Years (QALYs) lost to U.S. adults due to morbidity and mortality from obesity have more than doubled from 1993 to 2008 and the prevalence of obesity has increased 89.9 percent during the same period.”

If we only look at statistics, we may not understand how weight problems affect people in so many ways. Being unable to move without pain, being dependent on medications, getting out of breath at the slightest physical strain, those are the consequences that may not actually shorten life but make it so much harder – and unnecessarily so.

If you enjoyed this article, you may also enjoy reading  “Nearly Half of All Americans Will Be Obese Within Two Decades, Study Projects.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Enhancing the Quality of Life Wherever We Can

October 31st, 2012 at 12:45 pm by timigustafson

For the longest time, there has been nothing but bad news coming from Greece: An economy in complete shambles, high unemployment, drastic tax hikes and cutbacks in social services, unrest in the streets, a society at the brink of collapse. And yet it is precisely in this region where people seem to live longer, healthier lives than about anywhere else on the planet. What’s their secret?

Based on years of research, Dan Buettner, best-selling author of “The Blue Zones: Lessons in Living Longer from the People Who’ve Lived the Longest” (National Geographic Society, 2008), and two of his colleagues found that the inhabitants of the Greek island of Ikaria were reaching the age of 90 at two and a half times the rate Americans do.

“Ikarian men in particular are nearly four times as likely as their American counterparts to reach 90, often in better health. But more than that, they were also living about 8 to 10 years longer before succumbing to cancers and cardiovascular disease, and they suffered less depression and about a quarter the rate of dementia.” By contrast, Buettner says, almost half of American seniors show signs of Alzheimer’s by the age of 85.

Despite of its remoteness and rugged, mountainous landscape, the island has been known for centuries for its health-promoting climate and soothing hot springs. A slow-pace, leisurely lifestyle is still prevalent among the people here who savor tasty meals and long afternoon naps. Time seems to stand still – most villagers don’t even wear watches.

Many of the young people who once left the island in search of better paying jobs in the cities have returned, disillusioned with their fading prospects. Because of high unemployment rates, some have no choice but to move back in with parents and grandparents, but others see the lifestyle of their forbearers as a viable alternative.

Besides tourism, small-scale agriculture is the only industry on Ikaria. When it comes to food supply, most families are self-sufficient. Gardening and tending to livestock fills the day that starts late in the morning and ends with dining and socializing with family, neighbors and friends.

The latter is as crucial as the diet the Ikarians adhere to. The social structures might turn out to be even more important, says Buettner. The cultural attitude that honors and celebrates old age keeps seniors more engaged in their communities. Studies have shown that the concept of retirement, common in industrialized countries, actually reduces life expectancy. Such “artificial punctuations” in life, as he calls it, deprive retirees unnecessarily of a sense of purpose and meaningful existence.

Another puzzling phenomenon is that Ikarians also live longer than other islanders in the region who share a comparable environment. Obviously it’s not one specific thing that sets these people apart, says Buettner, but rather a host of “subtly powerful, mutually enhancing and pervasive factors are at work” such as a healthy diet, sufficient sleep, lack of stress and time pressure, daily physical activity through walking and manual labor, and being part of a functional community. In other words, it’s the high quality of life that results in the extraordinary longevity.

Obviously, not everyone can move to an idyllic island and grow vegetables, milk goats, bake bread and snooze the afternoon away. But what we all can do is to stop once in a while and consider whether our days really have to be as hectic and exhausting as they often are. Perhaps we would be better off if we took regularly inventory and separated what’s necessary from what just crept in on us.

We don’t have to aim at living forever. Longevity itself doesn’t have to be the primary goal. Being around a few years longer is not worth the effort if we’re only getting more of the same. A better quality of life, on the other hand, is something we can always strive for at any time and anywhere.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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How Can Education Make You Live Longer? It’s Complicated

April 4th, 2012 at 4:39 pm by timigustafson

The average life expectancy of all Americans has continuously increased over the past few generations for a number of reasons, including advances in nutrition, hygiene and medical care. But there are significant disparities within the population, which seem to be linked to social, economic and – as it turns out – educational differences.

According to a new study by the University of Wisconsin Population Health Institute, sponsored by the Robert Wood Johnson Foundation, there could be a direct correlation between a person’s education and the number of years he or she can hope to live.

For this study, researchers analyzed over 3,000 counties nationwide and ranked them within their respective states by a number of diverse measures, including access to quality healthcare, obesity rates, tobacco sales, unemployment, environmental pollution, crime rates, even the density of fast food outlets. The significance of education levels stood out.

“If you have a community with a high number of high school dropouts, with a high unemployment rate and with children living in poverty, you can absolutely predict that poor health outcomes will be coming down the road,” said Dr. Pat Remington, associate dean at the University of Wisconsin School of Medicine and Public Health and director of the study.

Unemployment and poverty do not only lead to deprivation of essential resources such as good nutrition and basic health care but often also to self-destructive behaviors like smoking and alcohol- and drug abuse. “All these things are part of a web of health,” Dr. Remington added.

The Wisconsin study is not the first that has found a link between education and longevity. A study from Harvard University, published in 2008, described “a stunning correlation between the longer lifespan of people with at least one year of college compared to people with a high school education or less,” according to Dr. David Cutler, dean of social sciences at Harvard. Better educated adults gained on average 1.5 years of life expectancy over 10 years and an additional 1.6 years over 20 years compared to those with a high school diploma or less.

Going to college by itself, of course, does not automatically make you live longer. But the study does suggest that better education often leads to better lifestyle choices. “It turns out that across the board, if you look at any health behavior, better educated people do better than less educated, said Dr. Cutler. “Anything from smoking, obesity, wearing seat belts, having a smoke detector in your house, not using illegal drugs, not drinking heavily, better educated people do better,” he said.

Conversely, the average life expectancy of obese people, smokers and those without access to preventive health care has begun to plateau. Due to growing childhood obesity, some experts predict that the lifespan of significant parts of the population will likely decline in the future.

Needless to say that none of these findings are clear-cut. There are plenty of folks with PhDs and beyond who are overweight and smoke and drink heavily. “Sometimes, even a good education can’t keep smart people from doing dumb things,” said Lee Dye, a science writer for the Los Angeles Times who reported on the Harvard study.

And even centenarians have bad habits. Researchers at the Albert Einstein College of Medicine found that the 100 plus crowd does generally not adhere to dramatically healthier lifestyle choices than the rest of us. There seems to be no particular formula that allows some people to live exceptionally long lives. Even genetic factors have turned out to be less important than some have suggested, as demonstrated in studies that followed identical twins who were separated at birth, lived under vastly different circumstances and died at different ages.

Besides reasonably healthy diet and lifestyle choices, one thing, however, seems to matter greatly. People who remain free of debilitating illnesses at old age, physically as well as mentally, are typically very active. They enjoy a vibrant social life, pursue multiple interests, maintain a positive attitude and know how to take care of their needs. They may be well educated, but not always in terms of formal education. An open mind and an insatiable curiosity may have gotten them just as far.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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How Long Will You Live? A New Set of Assessment Tools May Be Able to Tell

January 15th, 2012 at 4:54 pm by timigustafson

Researchers at the University of California, San Francisco (UCSF) have come up with new assessment tools to determine the likelihood of death within a certain period of time.

For this, they established a number of prognostic indices to predict the life expectancy in older and terminally ill patients. The main purpose of this project is to provide doctors, care givers as well as patients and their family members with information that can help prevent overtesting and overtreatment.

The UCSF team has also posted an interactive website online, called “ePrognosis.org,” which can be used to calculate a person’s mortality risk based on specific data, including age, health conditions, cognitive status, functional ability, etc.

“This is the first time such tools have been assembled for physicians in a single online location,” wrote Paula Span of the New York Times who reported on the project (1/11/2012) after a review was published in The Journal of the American Medical Association last week.

Among experts, responses have so far been mostly positive. “This kind of synthesis is very helpful for [health care] providers, researchers and some patients,” said Dr. Susan L. Mitchell, a geriatrician at Harvard University and researcher at Hebrew SeniorLife in Boston who was quoted in the Times article.

“A more frank discussion of prognosis in the elderly is sorely needed,” said Dr. Sei Lee, a geriatrician at UCSF and one of the authors of the review. A more accurate assessment of a patient’s life expectancy could help doctors and families evaluate, for example, whether an older person with a terminal disease should continue receiving treatments that may cause more pain and discomfort than relief, according to Dr. Lee. It may also be useful in determining how vigilant a patient has to be in observing and maintaining certain treatment- and lifestyle measures.

Since no calculation of life expectancy – other than based on data collected by U.S. Census Bureau – has so far existed, there is now hope that relatively easily accessible assessment tools like ePrognosis will be able to better assist health care providers with their decision making process.

In fact, many clinical decisions for older and terminally ill patients include considerations of life expectancy. But “at present, physicians are often shooting in the dark when they recommend tests, treatments and medications for older patients. […] Even when interventions do work, the benefits can be years away. Doctors have no easy way to know whether their elderly patients will live long enough to experience them. The potential for complications and side effects, however, is immediate,” wrote Ms. Span.

While it is true that with declining life expectancy some treatments may do more harm than good, it is not altogether clear whether accurate predictions can ever be made for an individual patient, cautioned Dr. Kenneth Covinsky, professor at the Department of Medicine, Division of Geriatrics at UCSF. “The accuracy of prognostic indices is often tested under ideal and controlled conditions,” he said. “When you see a research report of a prognostic index, you see how well it did in a group of patients specified by the researchers. But how accurate will the index be in your patient? […] Your patients are never quite the same as the patients in the research study.”

As a prognostic aid, programs like ePrognosis may turn out to be quite valuable, “if used to supplement clinical judgment,” said Dr. Covinsky. “Clinicians (and patients too) now have easy access to these prognostic indices. […] But perhaps the danger of ePrognosis is that it is too easy. In a matter of minutes, you can input a few elements of patient data and the calculator will spit out a probability of survival,” he added.

Some critics have pointed out that the very idea of basing decisions in medical care on calculations such as these may be a slippery slope. They say that assessing a patient’s life expectancy should never be the starting point of any form of treatment. Dr. Lee freely admitted there are potential problems. Because it is not clear whether calculating prognostic indices will ultimately improve patient care in clinical settings, he said, the researchers stopped short of urging widespread use at this time, according to the Times.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

About Timi Gustafson, R.D. As a clinical dietitian, health counselor, book author, syndicated newspaper columnist and, as of late, blogger, she has been able to reach millions of people, addressing their concerns about issues of health, lifestyle and nutrition. As Co-founder and Director of Nutrition Services for Cyberdiet.com (now Mediconsult.com), she created the first nutrition-related interactive website on the Internet in 1995. Many of the features you find on her blog, www.timigustafson.com, are based on the pioneering work of those days. Today, her goals remain the same: Helping people to achieve optimal health of body and mind. She received a Bachelor of Science degree in Clinical Nutrition and Dietetics from San José State University in California and completed a Clinical Dietetic Internship at the University of California Medical Center in San Francisco. She is a registered dietitian and Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Academy of Nutrition and Dietetics, a member of the Diabetes Care and Education, Dietitians in Business and Communications, Healthy Aging, Sports, Cardiovascular and Wellness Nutrition, and the Vegetarian Nutrition Practice Groups. For more information about Timi Gustafson R.D. please visit: www.timigustafson.com

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