I agree with your premise, people are by and large not designed to live to their 70s or 80s. However that is the world we find ourselves in. It is like Cuba vs the US regarding cars. In the US, the average car lasts 15-20 years but in Cuba because of the embargo, there are cars that are 50+ years old. So Cuba has to make do with making crappy cars be road worthy long after their time has passed. Yes, most of us would’ve died before age 45 in prehistoric times, but this is the environment we find ourselves in and we have to make the best of it.
According to the Social security administration, almost 80% of people will live to age 70, and a little more than half survive to age 80.
This is true, but every wealthy country (and many middle income nations) have a life expectancy at birth that is 75-85. Aging is something that the world has to deal with.
I’m not trying to be an asshat here, but how on earth is worrying about it going to help anything? Answer: it’s not, and it may make things worse.
Follow healthy living guidelines, and don’t worry too much. Enjoy your life, however long it is.
By the bye, I’ve read that once you control for childhood deaths from vaccine-preventable diseases and death in childbirth, life expectantcies in previous ages wasn’t half bad. I don’t have the source in front of me – it’s from a book by Liza Dalby – but once women got past childbearing years, they did pretty well.
Yes, this is something I meant to say, but you said it better. And the standards for what is OK keep getting stricter as well. For example, fasting blood sugar of up to 110 was considered “normal,” until recently, but now anything over 100 is considered “pre-diabetic.”
Not long ago, no one would even have taken such a test. People would go to their physical, have no bloodwork done, and feel they were in great physical health because the doctor was able to detect a pulse and their blood pressure was under 140/100 or whatever standard they used back then.
The obesity epidemic is NOT a matter of people being the same shape while the goal posts have moved. All it takes is a quick look at any group photos from the 1960s or before to instantly recognize that something is very different about the shape of rank & file Americans today.
What has changed with topics other than obesity is medical knowledge of the shape of the descent curve for various leading indicators. IOW, 50 years ago nobody thought about fasting blood sugar. 100 years ago they didn’t even know what it was. Now we have a pretty good idea that as it goes up, bad stuff becomes more likely.
Lots of people in the 60s knew smoking was harmful, but the attitude was more like: “The incremental risk is there, but small compared to the incremental risk of ordinary living. So I’ll keep on puffing.” The recognition now is that the incremental (and most importantly, controllable) risk is much larger than previously thought.
Do you find any difference of say old doctors than new young doctors? Old med students than new med students today? When comes to this?
New young doctors, new young med students and new young nurses more hypochondriac? More fear and anxiety and denial of mortality? Where old doctors, old med students and old nurses not the case?
I’m not in the medical biz & don’t have nearly enough contact with medical folks to wager more than a guess.
In general people become more in tune with mortality as they age. The famously indestructible teenager gradually turns into the over-cautious 70 yo.
In the medical biz folks are first exposed to the diseases and malfunctions in training as a student. Then to actual trauma, disease, and death as a junior worker/apprentice. And finally achieve some measure of balance and reality-based understanding as an experienced practitioner.
I’d bet overall the region of highest fear / hypochondria would be shortly after they finish training and begin practice. I’d also bet that some fraction of the folks who leave medical work early do so because they can’t achieve that final state of acceptance of the human condition and their membership in it given their occupational immersion in the wartier parts of that condition.
I hope some of the real medical folks will chime in to tell me how cluefull / clueless this thinking is.
I know sick, neurotic people who incessantly talk about the health benefits of particular foods, diets and exercise like they’re taking a New Years oath 365 days a year. I also know healthy people who seldom discuss health issues per se but tend to stay active and eat whatever they want in moderation so their health is just a side benefit of their optimistic outlook on life.
Personally I think one of the ways that this is expressed is in the belief that lifestyle and preventative care is some magic bullet against death and disease. Cancer and heart disease are fundamentally diseases of aging. But we don’t have a cure for aging, so we convince ourselves they are diseases of lifestyle. And to the degree that they are, it really doesn’t matter because aging will just kill you from something else. Rather than face the reality of aging, or find ways to combat aging itself, we convince ourselves that things under our control like lifestyle and preventative medicine are the real causes of death and disability, then push the hell out of them.
We don’t come out and say ‘live a healthy lifestyle and you will never get sick and die’ but we are at the point where we might as well say it. However healthy lifestyle reduces morbidity, but it only adds a few years to life expectancy in your 70s and 80s. People are not going to live to 100 due to healthy lifestyle. Healthy living may help you reach 85, but it won’t make nearly as much a difference when it comes to reaching 100 (I think only 1 in 6000 people live to 100 right now). That is more due to luck and genetics.
Empirically, now and in the past, a not insignificant number of people do remain healthy and lively into their 70s and 80s, and not because their life was artificially prolonged. I’m not sure how you can say their bodies were not built to live past 30.
Evolutionarily, the advantage to living long past 30 is that you can help ensure that your grandchildren (and thus, your genes) survive and thrive.
Aeschines, I know how you feel. I have a lot of anxiety my health, with my biggest fear being cancer. On my mother’s side, both of her parents died of colon cancer (within a year of each other) and her brother died of pancreatic cancer. The parents were in their 60s and the brother in his mid-50s. My mother died at 53 from other causes, so I don’t know if cancer would have gotten her as well.
I’m now 47, and I worry about cancer a lot. For the last two months, I’ve had a regular back ache, and I worried myself sick last week that it might be a symptom of cancer, though realistically I go to the gym 5-6 days a week and it’s far more likely I wrenched my back two months ago and never gave it time to heal. I went so far as to make a doctor’s appointment for today. I finally got a grip on myself on Wednesday and decided to take the rest of the week off from exercise, and I haven’t had any pain at all for the last two days. I’m irritated with myself for spending most of Monday and Tuesday in a deep state of dread.
I also spend a lot of time reading articles and threads on cancer, always looking for tell-tale signs, and feeling really badly for those who are afflicted. I realized yesterday that I actually feel guilty for being healthy, when so many others are suffering from a disease that I so thoroughly dread.
To start on a pessimistic note: yes, we all age and it’s 100% fatal.
In the developed world, if you’re not stupid (traffic accidents, alcohol/drug abuse) or unlucky (traffic accidents that aren’t your fault, cancer) you can expect to live to at least around 80 and some people as old as 110.
We can now do a lot about infections: most are prevented through hygiene, others through vaccines, most of the remaining ones are cured with antibiotics or managed with drug cocktails. (Of course once severely weakened from something else or simply old age, an infection may do you in.)
Then there are many diseases that are extremely treatable. For instance, lung embolism: one moment you’re close to death, but minutes later the drugs take effect and soon you’re basically as good as new, no lasting effects. So people get these diseases, are treated and then live just as long as anyone else.
As far as I know, coronary artery disease is not really an age related disease. Yes, the risk increases as people get older, but it’s not like eventually everyone has a heart attack. Unless I’m mistaken, heart attacks were rare until fairly recently. A few decades ago many people died from them in middle age but now they can be treated in a variety of ways and survival is much better. So many of these people live long enough to die from something else.
Cancer is also not really an age related disease. Cancer is basically playing a round of Russian roulette every day. Your DNA is corrupted by all kinds of stuff: free radicals, UV, cosmic radiation, radioactive exposure, toxins in food and the air. 99 point many nines percent of the time the cell in question dies without causing trouble. But if you’re unlucky, a mutation happens that makes the cell turn into a tumor.
Cancer treatment is getting better, but it doesn’t always work or the cancer comes back. So cancer is still a / the leading cause of death and it’s unlikely that this will change, as there doesn’t seem to be a path towards a magic bullet cure and deaths from other diseases keep going down so people live long enough to get cancer.
The trouble with cause of death statistics is that they always add up to 100%. It would be interesting to see historical CoD stats that end at (say) 75 years. In those stats, cancer may actually be going down as more and more people cross the 75 year mark.
Healthy living will give you much better odds at the cancer roulette and will lower the risk of many diseases that today won’t kill you (coronary artery disease, diabetes) but will make that final decade before something else gets you much more pleasant.
To the OP: worrying is pointless. So figure out what information makes you worried and avoid that information. (As long as NOT having it isn’t worse.) You could tell your doctor that you don’t want to know border line blood test results. If you eat a decent diet and get some exercise anyway, knowing that your cholesterol is on the high side isn’t going to be helpful until it’s so high that you need to start taking drugs.
Yes, because we want to be in control. Plus, it’s something to sell.
Yes, the image is of the 75-year-old couple taking an extra-brisk, extra-healthy walk together, and they are so damn healthy because they’ve followed all the rules. And if you haven’t, well that’s why you’re sick, ya dumb putz!
Although your intentions are good and most of what you said was true (with some key exceptions), I would say that what you wrote rather much jibes with the perspective Wesley Clark and I were talking about that ends up emphasizing sickness and guilting people for getting sick.
This is one of the “exceptions.” What would you call “fairly recent”?
One trope of the paleo movement is that heart disease and cancer were rare until the modern era and are still rare among people with traditional diets. Statistics get spun to support this position, and sometimes they are bogus. For example, sometimes the Inuit are cited as having no heart disease, despite eating nearly 100% meat. But then if you look at the actual data upon which this conclusion was based, it turns out they have the same amount of heart disease as anyone else. I also read that the Masai in Africa were found to have high rates of atherosclerosis, but their high level of exercise was cardioprotective.
Interested in this topic, I looked at mortality and population statistics from modern times and the 1870s and calculated that, based on the data, people died of heart disease back then at 1/3 the current rate back then–at a time when heart disease was almost certainly massively underdiagnosed. So that’s certainly not nothing.
Right, that’s why it’s age-related! The older you are, the greater the chance that you’ve lost the game. Same thing with atherosclerosis: plaques build up over time, and something bad happens to the part of the body where the plaques clog something up. Time = age.
True. Deeper analysis is required. There is a lot of data-spinning to support various agendas, as I said above.
Here’s another area where I think your perspective is off. Healthy living and medical care doesn’t necessarily improve QoL: sometimes it just keeps you alive so that you can suffer. There are a lot of old people who have survived major diseases so that they can now enjoy constant aches and pains, health scares, and Alzheimer’s. Personally, I’d rather drop dead at 75 than suffer on to 85.
Ah, well, see, that really doesn’t add up, does it?
The thing is, doctors are rather dumb. I had my cholesterol in the mid-200s, and my doctor was asking me if I eat a lot of eggs. But dietary cholesterol only affects some people and even then not to such a very high degree. I.e., dropping one’s egg consumption by a couple a week isn’t going to do anything. And there’s a whole debate out there about statins and their side-effects. But again, getting back to the OP, nothing is clear these days, and we have to worry about all these contradictory opinions on treatments and diet.
Worry is useless. Get appropriate counseling or read (and live!) a few books on CBT to learn how to not do it. Worry is a habit, just like chewing with your mouth open or cursing or slouching. It’s absolutely a habit you can control (at least partially). Choosing not to do so is choosing to be mentally unhealthy. And therefore incrementally less physically healthy.
Mind over matter will not cure cancer. But … a body always full of stress hormones due to lousy mental hygiene will have more issues than one not so stressed.
But I read this sensible book a few years ago. Amazon.com
Relevant to this discussion his major point was that one can be vigorous & healthy until, say, 79, then decline quickly & be dead at 80, OR one can slide into debility and infirmity at age 65 then slowly wither away while existing until 80.
Either way you’re dead at 80, but the former has much more quality of living in the same quantity of life. As such he offers (and apparently lives) the sensible mantra of continuous appropriate exercise, active social involvement, avoiding excesses of food & drink, and avoiding smoking at all costs.
Bottom line for this: You don’t control (or even much influence) the end-point, but you do have massive influence and a good measure of control of the path you take to get there.
As to dread diseases such as cancer the situation is a bit different. Absent smoking (or not) or choosing to work (or not) in an asbestos plant or chemical factory, most of us don’t have much influence (much less control) there.
[Caution: made-up numbers follow]For any given sort of cancer: 2 of 100 people are going to get it regardless. 96 of those same 100 people are not going to get it regardless. There are only two people on the bubble where what they do (lifestyle, occupation, etc) *might * tip the balance one way or the other. As of today we have no way to know which one of the 100 is you or me. [/Caution]
For most real world specific cancers the numbers are more like 1 in a 1000 will get it, 2 in a thousand might, and 997 in 1000 won’t. Collectively across all cancers we get the bigger scarier numbers.
So for that disease viewed in isolation, worrying and eating weird and avoiding polyester or electric blankets or whatever … are almost certainly counterproductive.
By happy coincidence the lifestyle choices that lead to less elder morbidity also tend to be at least slightly cancer-protective. So there’s no dilemma here. Stay slender, don’t smoke, & work out so you can walk, not walker, in your late 70s and you’ll be doing all you can (which isn’t much) to keep the cancers at bay as well.
As I said way back in post #3, we have a population where it seems like 75% of people are actively trying to cause themselves a miserable and short period of later years. If you simply don’t do that you’ll (probably) beat 80% of your peers at this silly game called healthy life. Easy Peasy and low stress.
As for the guilt: I find it a useless concept. Always try to do the best you can and you never have a reason to feel guilty.
Some years ago I heard about a study that showed that people who believed they have no influence over their circumstances are happier, but people who believe they do are more successful.
So choose your poison.
It of course helps when your doctor isn’t talking to you from the opposite perspective.
Well, I don’t have any data to back up my previous statement, it has come to me through a lifetime of absorbing random facts of various hardness.
I’m sure coronary artery disease was massively underdiagnosed. But fatal heat attacks? Those seem hard to miss.
[cancer == Russian roulette]
Yes, it takes some time for this stuff to develop. (And I gather that 10-year-old kids are already showing plaques!) However, that doesn’t mean that everyone gets cancer and/or a heart attack eventually if they live long enough.
As I learned in both computer science and philosophy school (logic is the only class those two have in common): when the logical implication “if A then B” holds, that doesn’t mean “not A thus not B”.
I.e., if it’s possible to have so-called healthy habits and then still have a bad quality of life, then eschewing those healthy habits is not going to give you a good quality of life.
It makes sense to me to optimize for keeping health as high as possible for as long as possible, as a slow decline into poor health can easily be artificially accelerated to reach its ultimate conclusion more swiftly…
It’s true that there are many conflicting insights about what is healthy and what isn’t. What that usually means is that the differences are too small to worry about. You’re not going to live five years longer or shorter by eating more or fewer eggs. That is not to say you can’t do anything.
Obviously, don’t smoke and don’t do drugs.
Second, avoid accidents. Driving is somewhat dangerous. Drinking too. Both at the same time? Very bad idea. Also avoid times (saturday nights), places and weather conditions that are more dangerous than normal.
Third, don’t eat too much. All those unused blood sugars and lipids have to go somewhere, and they usually end up in a place where they’re not going to do you any favors.
Fourth, exercise. As long as you don’t overdo it, exercise has all kinds of benefits: you burn off excess calories and it makes you feel good. You keep your bones and muscles strong into old(er) age and train your sense of balance, so you’re less likely to fall and if you do, less likely to break a hip or other bones.
Fifth, avoid excessive toxins. Note the excessive. We now have such sensitive equipment that we can and will detect background levels of all kinds of bad stuff everywhere. Usually governments are pretty good at setting reasonable maximum exposure levels. So wash that fruit and then stop worrying about the pesticides. One place where I think we have to catch up is endocrine disruptors. Hopefully that will happen before girls start menstruating in kindergarten.
Well, I have always had OCD tendencies and a lot of anxiety. For me, it’s clearly genetic. Seeing my father die a horrible death of heart disease after suffering for 16 years didn’t help much, either. And I already do lots of stuff to control my worry and head content already. But you are engaging in a bit of victim-blaming here. There are a lot of people who have anxiety and worry, and it’s really not their fault.
I was reading a comprehensive book on health from 1940 (some sort of manual for the home), and there was barely any material on heart health, and the level of understanding of the symptoms was extremely primitive. Dial that back to 1870, and I think they could have missed an awful lot. Someone drops dead of a stroke or heart attack, and it goes on the death certificate as “apoplexy” or some such thing.
Another thing that was clear from the 1940 manual is that there was very little fear of heart disease. Probably because people dropped dead of it in their 60s, and people dropping dead of anything in their 60s simply didn’t surprise anyone. Heck, my grandma came to live with us in 1977 after a heart attack. They basically did nothing for her–there wasn’t a whole lot to do, since open heart surgery was still in its infancy, and she was 61 anyway (old, right?). She died in our house, and I found her in the morning on the day after Christmas.
By the way, I’m adopted, so these early deaths of heart disease (my dad was also not quite 61) don’t instill any fear for genetic reasons.
Oh I agree with you. We should follow best health practices, which, really isn’t a whole lot. Don’t smoke is #1 for sure. You know, don’t horribly abuse your body with alcohol and drugs. Everything beyond that is a bit iffy, though. And again per Wesley Clark, all of the modern lifestyle advice is sold to us as something that’s really going to make a difference.
Here’s another dumb doctor comment (and this is from a guy I really like and am currently considering as my primary care physician!). A Japanese guy (I’m the interpreter) is asking the doctor for general dietary advice. “Uh oh,” I think. Anyhow, the doctor is suggesting less red meat and more seafood, but not shrimp and lobster (presumably because of the cholesterol content, though he didn’t even bother to say that). Just pretty fucking meaningless advice overall. This Japanese dude is as thin as a rail, by the way. He probably could use more fat and protein and a trip to the gym or two.