Opinion: Living Longer Not the Same as Living Healthy Longer

Blair Roblin wrote . . . . . . .

Of the terms used in the health-care lexicon, “compressed morbidity” is one of the more curious.

Though it sounds rather gruesome, it represents the optimal ending for beings of the mortal persuasion.

The term originated with Dr. James Fries, a professor at Stanford University School of Medicine. Compressing morbidity implies squeezing or compressing the length of time between the onset of chronic illness and death.

Let’s face the stark truth that nothing in life is more certain than our eventual death— taxes are a distant second, despite what Benjamin Franklin claimed.

Realistically, the best any of us can hope for is a long life with a relatively short period of morbidity at the end.

The glass-half-full corollary here is sometimes called “healthspan,” which is the healthy part of the lifespan. You can be excused for assuming that our healthspans have been increasing in lockstep with longer life expectancies in recent years.

Unfortunately, the evidence suggests we’ve been more successful at adding years of chronic illness to the end of life than adding years of health in themiddle.

Many jurisdictions track a healthspan statistic called “health-adjusted life expectancy” (HALE) which measures the average length of time people can expect to live in a healthy state, essentially without illnesses such as diabetes, heart disease and cancer. For Manitoba, Statistics Canada reports a HALE of 67 for males and 70 for females, more than 10 years short of life expectancy.

A quick history of life expectancy for homo sapiens is in order here. Long ago, humans often died rather early— and quickly — from childbirth (both mother and child), trauma caused by accidents or conflicts, infections, contagious diseases, bacteria, viruses and parasites.

As Thomas Hobbes might have put it, life tended to be “nasty, brutish and short.”

Early in the 20th century, worldwide advances occurred in public health, which included immunization, pasteurization and chlorination.

Big increases in life expectancy came simply from more people making it to middle age, never mind old age.

Today, the biggest threats to our health are chronic diseases, with onset typically occurring in adulthood.

These illnesses account for most deaths worldwide, but the incidence is even higher in developed countries such as Canada. Here, rates of chronic disease are now on the rise in the younger adult population as well, due to factors such as obesity.

So, is it feasible that we push out the onset of chronic illness?

The clear answer from the public health sector is that we can, with fitness, diet and lifestyle playing key roles. Most of us deal with these issues as daily challenges, though our success varies individually.

Amore complicated question is whether delaying chronic illness actually shortens it or just shifts it out in time. In other words, if we can forestall chronic illness until we are, say, 80, will we simply experience its full wrath later?

The implications here are profound, including for health economics. Fries and others have argued the lifespan has certain limits, as evidenced by mortality rates that naturally accelerate as we age. Therefore, if we can extend our healthspan, we will necessarily bump into these lifespan limits, thereby compressing the morbidity phase of chronic illness.

Here, my thoughts turn to Ed Whitlock, whom I regarded as a modern-day hero.

Ed was the Canadian who rewrote the record book in masters distance running, most famously running a sub-three-hour marathon when hewas 73 — and then again at 74. Sadly, Ed died last year at the age of 86.

While his lifespan was not exceptionally long, his healthspan was impressive.

In fact, he set another world record for his age group in the Scotiabank marathon just six months before his death.

We can’t live forever — and perhaps don’t want to — but health research tells us that postponing chronic illness can bring important advances in quality of life, even without extending total lifespan.

Health researchers may never win any awards for the terms they introduce — there’s probably no market for “compressed morbidity” T-shirts and collectibles — but the concept itself may lead us to health care’s pot of gold.

Source : Winnipeg Free Press Newspaper

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Infographic: GDPR – EU’s General Data Protection Regulation

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Source : Zero Hedge

Following Five Healthy Lifestyle Habits May Increase Life Expectancy by Decade or More

Maintaining five healthy habits—eating a healthy diet, exercising regularly, keeping a healthy body weight, not drinking too much alcohol, and not smoking—during adulthood may add more than a decade to life expectancy, according to a new study led by Harvard T.H. Chan School of Public Health.

Researchers also found that U.S. women and men who maintained the healthiest lifestyles were 82% less likely to die from cardiovascular disease and 65% less likely to die from cancer when compared with those with the least healthy lifestyles over the course of the roughly 30-year study period.

The study is the first comprehensive analysis of the impact of adopting low-risk lifestyle factors on life expectancy in the U.S. It was published online April 30, 2018 in Circulation.

Americans have a shorter average life expectancy—79.3 years—than almost all other high-income countries. The U.S. ranked 31st in the world for life expectancy in 2015. The new study aimed to quantify how much healthy lifestyle factors might be able to boost longevity in the U.S.

Harvard Chan researchers and colleagues looked at 34 years of data from 78,865 women and 27 years of data from 44,354 men participating in, respectively, the Nurses’ Health Study and the Health Professionals Follow-up Study. The researchers looked at how five low-risk lifestyle factors—not smoking, low body mass index (18.5-24.9 kg/m2), at least 30 minutes or more per day of moderate to vigorous physical activity, moderate alcohol intake (for example, up to about one 5-ounce glass of wine per day for women, or up to two glasses for men), and a healthy diet—might impact mortality.

For study participants who didn’t adopt any of the low-risk lifestyle factors, the researchers estimated that life expectancy at age 50 was 29 years for women and 25.5 years for men. But for those who adopted all five low-risk factors, life expectancy at age 50 was projected to be 43.1 years for women and 37.6 years for men. In other words, women who maintained all five healthy habits gained, on average, 14 years of life, and men who did so gained 12 years, compared with those who didn’t maintain healthy habits.

Compared with those who didn’t follow any of the healthy lifestyle habits, those who followed all five were 74% less likely to die during the study period. The researchers also found that there was a dose-response relationship between each individual healthy lifestyle behavior and a reduced risk of early death, and that the combination of all five healthy behaviors was linked with the most additional years of life.

“This study underscores the importance of following healthy lifestyle habits for improving longevity in the U.S. population,” said Frank Hu, chair of the Department of Nutrition at Harvard Chan School and senior author of the study. “However, adherence to healthy lifestyle habits is very low. Therefore, public policies should put more emphasis on creating healthy food, built, and social environments to support and promote healthy diet and lifestyles.”

Source: Harvard T.H. Chan School of Public Health

Lifetime Risk of Developing or Dying From Cancer in the U.S.

The lifetime risk of developing or dying from cancer refers to the chance a person has, over the course of his or her lifetime (from birth to death), of being diagnosed with or dying from cancer. These risk estimates, like annual incidence and mortality data, provide another measure of how widespread cancer is in the United States.

The following tables list lifetime risks of developing and dying from certain cancers for men and women. The information is from the US National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) Database, and is based on incidence and mortality data for the United States from 2012 through 2014, the most current years for which data are available.

The risk is expressed both in terms of a percentage and as odds.

  • For example, the risk that a man will develop bladder cancer during his lifetime is 3.76%. This means he has about 1 chance in 27 of developing bladder cancer (100/3.76 = 26.6).
  • Put another way, 1 out of every 27 men in the United States will develop bladder cancer during his lifetime.

These numbers are average risks for the overall US population. Your risk may be higher or lower than these numbers, depending on your particular risk factors.


Males

Risk of developing

Risk of dying from

%

1 in

%

1 in

All invasive sites

39.66

3

22.03

5

Bladder (includes in situ)

3.76

27

0.94

106

Brain and nervous system

0.7

143

0.53

189

Breast

0.12

833

0.03

3,333

Colon and rectum

4.49

22

1.91

52

Esophagus

0.76

132

0.77

130

Hodgkin disease

0.23

435

0.04

2,500

Kidney and renal pelvis

2.09

48

0.62

161

Larynx (voice box)

0.55

182

0.20

500

Leukemia

1.79

56

1.02

98

Liver and bile duct

1.39

72

0.99

101

Lung and bronchus

6.85

15

5.96

17

Melanoma of the skin

2.77

36

0.43

233

Multiple myeloma

0.89

113

0.48

208

Non-Hodgkin lymphoma

2.38

42

0.84

119

Oral cavity and pharynx

1.61

62

0.40

250

Pancreas

1.58

63

1.38

72

Prostate

11.55

9

2.45

41

Stomach

1.05

95

0.47

213

Testicles

0.4

250

0.02

5,000

Thyroid

0.63

159

0.06

1,667


Females

Risk of developing

Risk of dying from

%

1 in

%

1 in

All invasive sites

37.65

3

18.76

5

Bladder (includes in situ)

1.12

89

0.34

294

Brain and nervous system

0.54

185

0.41

244

Breast

12.41

8

2.62

38

Cervix

0.62

161

0.22

455

Colon and rectum

4.15

24

1.74

57

Esophagus

0.22

455

0.20

500

Hodgkin disease

0.19

526

0.03

3,333

Kidney and renal pelvis

1.20

83

0.33

303

Larynx (voice box)

0.12

833

0.05

2,000

Leukemia

1.26

79

0.71

141

Liver and bile duct

0.6

167

0.52

192

Lung and bronchus

5.95

17

4.73

21

Melanoma of the skin

1.72

58

0.21

476

Multiple myeloma

0.65

154

0.39

256

Non-Hodgkin lymphoma

1.87

53

0.66

152

Oral cavity and pharynx

0.68

147

0.18

556

Ovary

1.27

79

0.93

108

Pancreas

1.54

65

1.35

74

Stomach

0.65

154

0.31

323

Thyroid

1.79

56

0.07

1,429

Uterine corpus

2.85

35

0.6

167


Source: American Cancer Society

Essay: A Thai Chicken Pizza, Just for Us

Vivian Lee wrote . . . . . . .

“See?” my mom said, pointing to a photo of a pizza topped with cilantro. “They know that we like to eat here, so they have this on the menu.” The Thai Chicken pizza, with its orange carrot slivers and lush green herbs, rendered in near-neon, popped off of the menu. It was 1998, and my family was celebrating the beginning of the school year at California Pizza Kitchen.

While my mother pored over the photo, pleased that an American restaurant was using ingredients she was familiar with, I stared at the BBQ Chicken pizza, slathered with a gloopy, taupe sauce and sprinkled with red onions, then took in everything else: the beach-montage walls that separated the airy space from the rest of the mall, the blond waiters who looked like they spent hours surfing, the palm trees in every corner. While the setting was slightly out of my parents’ comfort zone, it was pure California to me — the California I lived in but, as a child of immigrants, never felt like I belonged in, except at California Pizza Kitchen.

I was born and raised in Torrance, an LA suburb just 10 minutes from the beach, but the Beach Boys never had a song about the way our house looked: The entryway was bordered by two calligraphy scrolls, and during Chinese New Year celebrations, we had a table dedicated to our ancestors whose legs buckled under the weight of oranges, red paper envelopes, and sweets. My whole life mimicked how it would have been if we had grown up in Hong Kong, albeit within the spacious environs of a California suburb. And while I grew up with a lot of Chinese friends in Torrance, their parents been educated in the West. For a long time, my brother and I felt like we had a lot of American catching up to do.

The message drilled into us throughout elementary school, that America was a melting pot and we were all a part of it, only ingrained how fully I needed to assimilate. In fifth grade, my teacher drew a large chalk circle on the black asphalt, then told us to jump into the circle and run around, so that we were “mixing” together. “Throw in some heat and now we’re all one! America is a giant melting pot!” my teacher explained as we all flailed inside the circle, bumping into each other. The exercise, rather than affirming my identity, just made me want to be more like the white kids and second-generation Asian Americans at my school, who had easy access to the cultural touchpoints that felt far out of reach for me and the rest of my immigrant friends, like getting an allowance, going on vacations, having grandparents who lived in the same neighborhood, and eating out at McDonald’s.

Instead, we wore hand-me-downs from cousins in Hong Kong and dined out exclusively at Chinese restaurants where my parents knew the staff — who would pinch my cheeks, tell me I was getting too fat, and then send out extra food anyway. One hazy Sunday afternoon in the summer of 1997, though, my parents, my brother, and I were over at a family friend’s house — also immigrants from Hong Kong, but who had assimilated seamlessly, their English flawless, their kids costumed in sunflower baby doll dresses and bucket hats while I still wore full sweat suits decorated with cartoons. They suggested that we all go to California Pizza Kitchen for dinner, since one had just opened nearby. “They give you free bread,” they said, which sold my parents.

This particular California Pizza Kitchen was inside the South Bay Galleria in Redondo Beach, and like many ’90s Southern California malls, it boasted a huge marquee in neon script at the entryway, flanked by palm trees. The CPK took up the front of the mall, anchored on the left side by a valet station and a little outdoor patio with umbrellas. Inside, two young women clad in sensible black and perma-smiles stood in front of an enormous open kitchen and a wood-fire oven prominently near the bar. They took us to a booth, where instead of hot tea, we were served giant glasses of ice water. The menus were big, glossy, and full of photos; there were no set banquet menus, hot tea cups, or chopsticks; and nothing was served what is now called “family style,” so I found myself confronted by the exotic idea of having your own dish that you did not share with the eight other people at your round table. I got a salad and it was thrilling. From that day forward, I recognized CPK as my gateway to being a real American: I could eat the food I couldn’t eat at home, the things that I saw my American friends eat when I was invited into their houses, like cold lettuce chopped up with dressing, pizza not from a take-out box, and multi-colored drinks with ice.


California Pizza Kitchen was established in 1985 by former federal prosecutors Rick Rosenfield and Larry Flax with a $200,000 lease in Beverly Hills. CPK’s first menu includes the now-famous BBQ Chicken pizza, which was developed by the former pizza chef at Spago — one of the temples of fusion cuisine — and, according to CPK’s “About Us” page, “gave California a place in the pizza pantheon alongside Chicago and New York.” (Even if that were true then, whether California still belongs there now is debatable.) Most importantly, at least on the surface, CPK embraced the hodgepodge of cultures of Southern California with a menu that endlessly combined signature ingredients from the cuisines of the area’s fastest-growing populations, from peanut sauces to avocados, tortilla chips to soy sauce. By 1992, CPK had expanded to 26 locations, including one a 10-minute drive from our house.

After that first visit, my family and I started going for special occasions, since my parents were more easily persuaded to go to CPK than any other American restaurant in our suburb. Just like they continually sought similar families to socialize with, they also sought out restaurants where they could understand the menu, and seeing familiar ingredients in even derivative facsimiles of dishes they recognized — lettuce wraps, Peking duck pizza, Chinese chicken salad — in a thoroughly Western restaurant was a sign of true acceptance.

At the same time, I learned that if I brought CPK leftovers to school, I wouldn’t be made fun of by my classmates. I was tired of seeing my mom wake up two hours before school to cook my lunch — noodles and fermented tofu and rice dumplings — and pack it in an insulated lunch box so that it was still warm when I opened it up at noon, only for me to quickly eat it so that no one would see how different it was from the square lunch meats everyone else was eating. A lunch of CPK leftovers showed all my peers that I belonged, that I knew how to eat like an American. Sure, the BBQ Chicken pizza was crammed into my bento box, but it was so recognizable that everyone knew and immediately understood what I was eating, sparing me the humiliation of explaining, for the millionth time, that I was not eating worms.

Something else was at work, too. As I got older, I realized that while I couldn’t change myself to physically blend in with the white kids or expect my parents to speak perfect, non-accented English, the more that people came to recognize the menu at CPK — the spring rolls, the lettuce wraps — the easier it was for these same people to recognize that the food my family ate could go hand in hand with what they were used to: fried food, and foods you can eat with your hands. In a suburban blandscape of malls and big-box retailers and countless chains, California Pizza Kitchen was the epitome of a cultural exchange.


In 2010, when I was 22, I moved to New York for graduate school. The only person I knew in the city was my high school friend Shazia, who had just moved to the city the year before. When we had both lived in Torrance, we would meet up at the Galleria after school, walk around the mall, then eat at CPK before being picked up to go home. As the child of immigrant parents from India and Pakistan, she too found a salve in the CPK menu, where she could indulge her taste for the American food not found in her family’s pantry. During one of our regular Gchat sessions my first year in New York, she told me that she was missing California, and that there was a CPK in Murray Hill.

We met up for lunch there on a cool spring day, 3,000 miles from where we were both born and raised. While we now had disposable income and lived in a city known for its pizza, we still ended up ordering what we used to get as high schoolers: BBQ Chicken and Thai Chicken pizzas. They tasted like I remembered — tangy sauces, a little crunch on the carrots and cilantro, that unmistakable, slightly raw dough — but the food was slightly cold and gloopy. The julienned carrots were tossed on a single side of the Thai pizza; the cheese of the BBQ was haphazardly strewn across the doughy canvas. Everything was too sweet and made our teeth hurt.

We pointed at the menu and laughed at the ridiculous, Guy Fieri levels of exxxtreme “fusion” CPK had reached: Chicken Tequila Fettuccine, Szechwan Chicken Dumplings, Avocado Club Egg Rolls. But as we sat in an alien forest of fake palm trees and I stabbed a cold piece of chicken, we talked about how we couldn’t feel the magic and awe of this place anymore. While we were happy to grow up seeing some acknowledgement of ourselves at a culturally American institution, this brand of the California melting pot had become unpalatable. After spending so much of our lives trying to make ourselves acceptable to white Americans, we had realized that it was fundamentally Californian to be both Asian and American, not as a mix, but in parallel.

Source: EATER