Health

WEDNESDAY, December 2, 2009 (Health.com) — Although fewer people are smoking—and therefore less likely to die from cigarette-related causes—the obesity epidemic may negate any gains in life span, according to a new study.

By 2020, the typical 18-year-old will gain 0.31 years due to the drop in smoking rates (above and beyond life span increases caused by other factors). But the increase in obesity rates during the same period will reduce life expectancy by 1.02 years, the researchers say.

During the next 10 years, in other words, well lose 0.71 years of our life span, time that we would have gained if so many people werent overweight, according to the estimates published this week in the New England Journal of Medicine (NEJM).

In addition, the increase in quality-adjusted life expectancy—a measure that takes into account levels of disability and other quality-of-life factors—will be reduced by 1.32 years. If all U.S. adults were nonsmokers of normal weight, life expectancy would increase by 3.76 years, or 5.16 quality-adjusted years, according to the study.

“Life expectancy is not going to decline,” says the study's lead author, Susan T. Stewart, PhD, a researcher at the National Bureau of Economic Research, in Cambridge, Mass. “But it could have risen by that much more if it werent for the increases in obesity.”

Stewart and her colleagues forecast life expectancy through the year 2020 using national survey data. Smoking, a major risk factor for lung disease, heart disease, and cancer, has decreased by 20% in the United States in the past 15 years, according to the study.

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Over the same period, obesity has increased by 48%. Obesity contributes to a host of serious health problems, including heart disease, diabetes, joint problems, stroke, and some sleep disorders.

By 2020, the report predicts, smoking will decrease by 21%, but 45% of the population will be obese.

Prior research has examined the effects of obesity on longevity, but this study is the first to examine the combined effects of obesity and smoking.

“No one ever has really done quite this linkage between smoking and obesity,” says S. Jay Olshansky, PhD, a professor of epidemiology and biostatistics at the School of Public Health at the University of Illinois at Chicago. “Some people have suggested were on the verge of dramatic increases in life expectancy because of reductions in smoking, but these authors are saying, ‘Hold on a minute; the negative effect of obesity is much greater.”
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The extent of obesitys impact on life span “might be a real eye-opener,” says Stewart.

Many people will question how a sedentary lifestyle can be as unhealthy as a deadly habit such as smoking, she says, adding that this is exactly why she and her colleagues believe this research is important. "We wanted to bring attention to the health of a population [that] is already not as healthy as it could be, and will continue and worsen,” she says.

The study does have limitations. The authors based their projections on a steady rate of change in obesity, for instance.

However, “childhood obesity has been rising dramatically, so the trends in the future are going to change by how long people have been obese,” says Olshansky, who did not participate in the current research, but projected similar obesity trends in a 2005 paper in the NEJM. “Younger generations are going to carry the obesity with them much longer,” leading to additional or more serious weight-related health risks, he says.

"If we dont intervene, we are in trouble," Olshansky adds.

Reversing the obesity trends reported in the study will likely require a concerted public health campaign similar to the one that has reduced smoking rates.

“There are larger social issues to be addressed in combating the roots of obesity,” Stewart says. “These roots include sedentary lifestyles, widespread availability of high-calorie food in large portions, and reduced time for at-home food preparation.”

“Fixing obesity is going to require a change in our modern relationship with food,” Olshansky says. “Im hopeful that we [will] begin to see a turnaround in this childhood obesity epidemic.”

The smoking trends used in the study were based on data from the National Health Interview Survey, and the body-mass index (BMI) trends were derived from the National Health and Nutrition Examination Survey. BMI levels were classified according to the World Health Organizations guidelines for obesity.

MONDAY, Sept. 28, 2009 (Health.com) — Are you finally ready for some good news about the recession? As it turns out, a shaky economy might actually be good for your health.

Although it seems hard to believe, a new analysis of the Great Depression—the mother of all economic bad times—suggests that mortality dropped and life expectancy increased during that period.

Researchers estimate that around that time, a year with a 5% drop in the gross domestic product (GDP) was associated with a 1.9-year gain in life expectancy, while a 5% rise in the GDP lowered life expectancy by about one to two months.

And its not just the Great Depression, says Jose A. Tapia Granados, MD, of the Institute for Social Research at the University of Michigan, Ann Arbor.

Past research has shown similar results—at least a drop in mortality—in periods of U.S. economic recession during the 1980s and 1990s, as well as in recessions in other countries, Dr. Tapia says.

“In some sense it is good news,” he explains. “The usual view of a period of recession is that everything is bad during these periods.”

In a study published this week in Proceedings of the National Academy of Sciences, Dr. Tapia and his colleague Ana V. Diez Roux analyzed the economic growth and population health in the United States between 1920 and 1940, including the years of the Great Depression, which lasted from 1929 to 1933.

Life expectancy in general increased 8.8 years between 1920 and 1940, but gains fluctuated with the economy.

Next Page: Smoking, drinking tend to drop during recessions [ pagebreak ]They found that mortality declined and life expectancy increased during the Great Depression, as well as in the recessions of 1921 and 1938, compared to other years during that period. Suicides did increase during the Great Depression, but they made up less than 2% of deaths during that time.

When the researchers looked at six other major causes of death—including heart and kidney disease, tuberculosis, and traffic accidents—between 1920 and 1940, they noted that those causes all declined during recessions and rose during boom times. (A similar pattern was found for child and infant mortality too.)

Next Page: New study fits with past research [ pagebreak ]Christopher Ruhm, PhD, has conducted research on mortality during recent recessions. He says the new findings arent “out in left field” and are consistent with research in milder recessions. However, the magnitude of the effect—and that it appeared during a time of almost total economic collapse, not just a recession—was unexpected.

“When you have the collapse of an economy, I would have thought there would be other things going on that are more than reversing that,” says Ruhm, a professor of economics at the University of North Carolina, Greensboro. “The Soviet Union, when it broke up and the economy just collapsed, that wasnt good for peoples health.”

Since doctors have made such strides with life expectancy in the past century (we are now expected to live until 77.7 years of age in the U.S.), the economy may have a smaller impact on health than the gains seen in the new study, he says.

“In a modern economy, I wouldnt think youd see anything near that large,” Ruhm says. His research suggests that for each percentage-point increase in the unemployment rate, mortality drops by half a percent.

“Thats a nontrivial effect, but in terms of major determinants of health, its not the dominant determinant of health or anything close to it,” he says.

Ruhm says his research doesnt provide any clues to coping with a job loss, but he has had people tell him they lost 30 pounds after being laid off because they stopped eating out and started exercising more. “Thats just anecdotal evidence, but it turns out the data provide some support for that,” he says.

According to Ruhm, outplacement counselors and therapists often advise people to take control of things they can do something about, such as paying attention to what you eat, trying to be a little more active, or working harder to connect with family. “At least the parts you can control, try to move those in a positive way—and the data suggest that people actually do that," he says.

Whether or not you get the shot, try these tricks to lower your chances of getting grounded by the flu.

Wash, over and over

Your hands need attention. Use plain old soap and water, and make sure to rub vigorously for 15 to 20 seconds.

Avoid crowds

The flu virus thrives on socializing. Do more shopping online than at the mall, and try to cover your face if someone sneezes near you.

Keep hydrated

Membranes in your nose and throat trap viruses and move them back out in the form of mucus. Drink lots of fluids and gargle to keep your membranes in fighting shape, says Neil Schachter, MD, author of The Good Doctors Guide to Colds and Flu. But avoid humidifiers; they can spread germs.

Do vitamins

Vitamin C may not fight off colds, but several experts still recommend it for keeping you healthy during flu season. Vitamin D and selenium may guard against the flu, too. Foods like orange juice or yogurt are usually fortified with vitamin D. And OJ has plenty of C. Brazil nuts and beef have loads of selenium.