Posted on 03/16/2005 7:16:40 PM PST by neverdem
BOSTON, March 16 - For the first time in two centuries, a generation of children in America may have shorter life expectancies than their parents, according to a report that contends that the rapid rise in childhood obesity, if left unchecked, may shorten life spans by as much as five years.
The report, to be published on Thursday in the New England Journal of Medicine, says that the prevalence and severity of obesity is so great, especially in children, that associated diseases and complications - like type 2 diabetes, heart disease, kidney failure and cancer - are likely to strike people at younger and younger ages.
The report says that the average life expectancy of today's adults, now roughly 77 years, is at least four to nine months shorter than it would be if there were no obesity. That means that obesity is already shortening average life spans by a greater rate than accidents, homicides and suicides combined, the authors say.
And they say that because of obesity, the children of today may wind up living two to five years less than they otherwise would, a negative effect on life span that could be greater than that caused by cancer or coronary heart disease.
"Obesity is such that this generation of children could be the first basically in the history of the United States to live less healthful and shorter lives than their parents," said Dr. David S. Ludwig, director of the obesity program at Children's Hospital Boston and one of the authors of the report.
Longevity projections are notoriously slippery and politically charged, with consequences for issues like Social Security, corporate pension plans, health insurance and health care costs. The New England Journal report, which wades into several controversial aspects of public health, is likely to stir debate on both scientific and political grounds.
For one, some demographers and obesity experts question whether the authors' estimate is overly alarmist.
"Yes, it is almost certain that the risks of these various disease will rise as obesity rises in the population, but you also have to assume that the medical sciences will get better at treating some of these complications," said Dr. Rudolph L. Leibel, an obesity researcher at Columbia University. "Certainly doing that is going to end up costing more, but it may not end up stripping months or years off life."
An editorial in the same issue of the New England Journal, written by Dr. Samuel H. Preston, a demographer at the University of Pennsylvania, raises similar questions. It suggests that the predictions of decreased life expectancy might be "excessively gloomy," given potential advances in medicine and genetic engineering, and the reduction of harmful behaviors like smoking.
Dr. Preston concludes, however, that "the rising prevalence and severity of obesity are capable of offsetting the array of positive influences on longevity" and "are already reducing life expectancy among the U.S. population." "A failure to address the problem could impede the improvements in longevity that are otherwise in store," he wrote.
The report's lead author, Dr. S. Jay Olshanky, a professor of public health at the University of Illinois at Chicago, said he considered the report's projections of reduced life expectancy to be "very conservative, and I think the negative effect is probably greater than we have shown."
He said he believed that it was a mistake to count on medical advancements or to "make forecasts based on technologies that do not exist."
"Hopefully we can fix obesity so that our projections are wrong," Dr. Olshansky said. "But we're seeing such large increases in obesity in the last couple of decades that it's hard to imagine that we're going to be able to work fast enough to attenuate this problem."
Dr. Ludwig, another of the report's authors, agreed.
"We're in the quiet before the storm," he said. "It's like what happens if suddenly a massive number of young children started chain smoking. At first you wouldn't see much public health impact - you'd see some kids with smoker's cough and increased asthma. But years later it would translate into emphysema, heart disease and cancer, and if you waited until mortality rates increased, it would be too late to stop the impact."
He added: "That's very much like obesity. There is an unprecedented increase in prevalence of obesity at younger and younger ages without much obvious public health impact. But when they start developing heart attack, stroke, kidney failures, amputations, blindness and ultimately death at younger ages, then that could be a huge effect on life expectancy."
Estimating the number of obesity-related deaths has already proved controversial. Last November, the federal Centers for Disease Control and Prevention said its earlier estimate that 400,000 people dieannually from obesity was inflated. A revised, lower estimate is expected soon.
The New England Journal report uses an estimate of 300,000 deaths, which some experts believe is still too high. The report projected life expectancy by calculating how much longer people would live if "everyone who is currently obese were to lose enough weight to obtain an optimal" body-mass index, a measure of the relationship between a person's height and weight. The authors believe it is more accurate than other projections, which are based on extrapolating from past years' health information.
The report comes at a time when the country is embroiled in a debate over Social Security. And while the report's authors say they started their research long before the current debate, they write that "the U.S. population may be inadvertently saving Social Security by becoming more obese" and dying sooner, but that "this 'benefit' will occur at the expense of the economy in the form of lost productivity before citizens reach retirement and large increases in Medicare costs associated with obesity and its complications."
The authors also have a clear view that the way to combat obesity is to get people to change their behavior, a prescription that not everyone believes is feasible. Dr. Ludwig espouses an ambitious program that would include getting food companies not to advertise soft drinks and other unhealthy foods to children, giving schools more money so they could serve healthy lunches and enhance physical education, and getting insurance companies to cover treatment for obesity.
Not everyone agrees.
"It's premature to jump to the conclusion that that's the strategy we need," said Dr. Donna Stroup, director of the coordinating center for health promotion at the Centers for Disease Control. Still, Dr. Stroup said, the New England Journal paper is "very important to us in the sense of building scientific background about what we already know about obesity."
"What it does is to put what we know in a language that is very compelling," she said.
Hey, look on the bright side. Social Security might not be in such bad shape in the future if we can up the early mortality rate. I think we should make people smoke too...
FReepmail me if you want on or off my health and science ping list.
Obsesity Threatens to Reverse Growth in U.S. Life SpansSo ya all stop Obsesing!
You'll just have to pay more taxes on X when we smokers get sent to the gulag.
Shorten lifespan by five years... that's what the alarming headline is all about?
Good catch! The Times doesn't have spellcheckers or proofreaders?
We're all going to check out someday. Alarming headlines or no.
OK, I don't think I should be on this thread as I dunk my chocolate chip cookies in 2% milk. :-)
The same people who think we consume too much and medical care is wasted on too many old people now bitch about us NOT living long enough to use more oil and raw materials? Shut up already and let us enjoy our fatter, shorter lives!
Rinsed my diabetes medication down with a cold beer, I'm ready to post now...
Shocking. We're going to die. Next generation is dumber, fatter, less healthy. More opportunities for my healthy, smart, thin son.
Then I started packing on the pounds like crazy.
It was unbelievable how unhealthy, disgusting and unfit being overweight made me feel.
I finally managed to lose most of weight I gained and at 50 feel healthier and stronger than I have for many years.
I have no doubt that being overweight cuts years off your life.
Hey, who am I to deny a family of worms a good meal because I wanted to be skinny.
oh there's no doubt this child generation will die younger than their parents. drug use? the same, but worse drugs. other drug use? prescription drugs? ridiclously high with severe side effects. no more physical activity. as the article said, worse diet. more fear, more danger. hey, we can't have everyone living forever!
My kids are running around all day and are skinny and hard as oak rails. There is not one packaged piece of crap in this house and the only cakes they ever see are homemade ones on birthdays.
It's all because of the Michael Moore wannabees.
I blame the more sedentary childhoods more kids are experiencing. Less exercise, more television.
I don't know that people have to change their behavior all that much. They just have to use some sense. I'm probably dating myself, but when I was a kid, we drank sodas fairly often. Except they came in 8 oz. bottles, and I had to share one with 2 siblings. Now, they're in 20 oz. servings, and everyone has their own.
Donuts, muffins, cookies, etc. were much less than 1/2 the size of the ones we get today.
A hamburger was more likely to be 3 oz. than the 8-12 oz. ones we see today.
And so on.
More is not better, but there really isn't that much wrong with what people really want to do.
And I'd wager they were better tasting, too. Smaller quantities, higher quality.
We're all going to die, this is true. More importantly, what's our quality of life going to be in our brief period here?
What's the cost to our society because of obesity? I dare say: plenty.
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