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Ed. Note: The following
is a press release from the National Institutes of Aging.
March 16, 2005
Over the next few decades, life expectancy for the average American could
decline by as much as 5 years unless aggressive efforts are made to slow
rising rates of obesity, according to a team of scientists supported in
part by the National Institute on Aging (NIA), a component of the National
Institutes of Health (NIH) of the Department of Health and Human Services
(DHHS).
The U.S. could be facing its first sustained drop in life expectancy in
the modern era, the researchers say, but this decline is not inevitable if
Americans — particularly younger ones — trim their waistlines or if other
improvements outweigh the impact of obesity. The new report in the March
17, 2005 issue of The New England Journal of Medicine appears little more
than a year after the DHHS unveiled a new national education campaign and
research strategy to combat obesity and excessive weight.
The new analysis, by S. Jay Olshansky, PhD, of the University of Illinois
at Chicago, Leonard Hayflick, Ph.D., of the University of California, San
Francisco, Robert N. Butler, M.D., of the International Longevity Center
in New York, and others* suggests that the methods used to establish life
expectancy projections, which have long been based on historic trends,
need to be reassessed. This reevaluation is particularly important, they
say, as obesity rates surge in today’s children and young adults.
“Forecasting life expectancy by extrapolating from the past is like
forecasting the weather on the basis of its history,” Olshansky and his
colleagues write. “Looking out the window, we see a threatening storm —
obesity —that will, if unchecked, have a negative effect on life
expectancy.”
Unlike historic life expectancy forecasts, which rely on past mortality
trends, the Olshansky group bases their projection on an analysis of body
mass indexes and other factors that could potentially affect the health
and well-being of the current generation of children and young adults,
some of whom began having weight problems very early in life. The authors
say that unless steps are taken to curb excessive weight gain, younger
Americans will likely face a greater risk of mortality throughout life
than previous generations.
“This work paints a disturbing portrait of the potential effect that life
styles of baby boomers and the next generation could have on life
expectancy,” says Richard M. Suzman, Ph.D., Associate Director of the NIA
for Behavioral and Social Research. Indeed, Suzman notes, obesity may
already have had an effect. The sharp increase of obesity among people now
in their 60s, he suggests, may be one explanation why the gains in U.S.
life expectancy at older ages have been less than those of other developed
countries in recent years.
“But it is critical to note that the reduced life expectancy forecast by
the study is not inevitable, and there is room for optimism,” Suzman says.
“Government and private sector efforts are mobilizing against obesity, and
increased education, improved medical treatments, and reduced smoking can
tip the balance in favor of reduced mortality and continued improvements
in life expectancy.”
For instance, smoking significantly reduces the life expectancy of the
average smoker, Suzman says, so obesity is just one of many factors that
will need to be accounted for, together or separately, in projecting how
Americans will age. The NIA supports several projects on population
demography that forecast life and health expectancy, research which is
critically important to policy makers looking at the implications of an
aging population.
According to the NEJM report, studies suggest that two-thirds of American
adults are overweight (having a body mass index — BMI — of 25 or more) or
obese (having a BMI of 30 or more)**. One study cited by the authors
indicates that the prevalence of obesity in U.S. adults has increased
about 50 percent per decade since 1980. Additional research has shown that
people who are severely obese — with a BMI greater than 45 — live up to 20
years less than people who are not overweight. Some researchers have
estimated that obesity causes about 300,000 deaths in the U.S. annually.
In addition, obesity is fueling an epidemic of type 2 diabetes, which also
reduces lifespan.
To estimate the overall effect of obesity on life expectancy in the U.S.,
Olshansky and his colleagues calculated the reduction in death rates that
would occur if everyone who is currently obese were to achieve the
difficult goal of losing enough weight to reach an “optimal” BMI of 24.
The calculation was based, in part, on age, race, and sex-specific
prevalence of obesity in the United States from the Third National Health
and Nutrition Examination Survey. Based on these calculations, the
researchers estimated that life expectancy at birth would be higher by
0.33 to 0.93 year for white men, 0.30 to 0.81 year for white women, 0.30
to 1.08 year for black men, and 0.21 to 0.73 year for black women if
obesity did not exist.
The overall reduction in life expectancy of one-third to three-fourths of
a year attributed to obesity in this analysis exceeds the negative effect
of all accidental deaths combined, and could deteriorate over time, the
researchers said.
“These trends suggest that the relative influence of obesity on the life
expectancy of future generations could be markedly worse than it is for
current generations,” Olshansky and the authors conclude in their report.
“In other words, the life-shortening effect of obesity could rise …to two
to five years, or more, in the coming decades, as the obese who are now at
younger ages carry their elevated risk of death into middle and older
ages.”
The projected decline contrasts with estimates by other leading
researchers, which predict a continuation of the historic trend of
increasing life expectancy in America and Europe dating back to the 1850s,
according to Dr. Suzman. In fact, he points out that the experience of
other developed nations is instructive as a barometer of how much room
might exist to increase U.S. life expectancy. More than 20 other developed
nations, including France, Japan, Germany, Sweden, and the United Kingdom
have a higher average life expectancy than the U.S. Women in Japan, for
example, live about 5 years longer than women in the U.S. There is little
evidence that life expectancy in these countries is approaching any kind
of limit, Suzman says.
In March 2004, the DHHS launched public awareness campaign, entitled
Healthy Lifestyles and Disease Prevention, to encourage American families
to take small, manageable steps within their current lifestyle, such as
using the stairs instead of the elevator, to ensure effective, long-term
weight control. The campaign includes multi-media public service
announcements (PSAs) and a new interactive website, http://www.smallstep.gov/.
In addition, the NIA has developed a free exercise guide for older adults,
which is available online at http://www.nia.nih.gov/. The NIH and other
Federal agencies also offer free information about excessive weight and
what can be done about it, including the National Institute of Diabetes
and Digestive and Kidney Diseases http://win.niddk.nih.gov/publications/choosing.htm,
the Food and Drug Administration http://www.cfsan.fda.gov/~dms/wh-wght.html,
and the Federal Consumer Information Center http://www.pueblo.gsa.gov/cic_text/health/works4you/weightloss.htm.
This research was also supported by the Institute of Government and Public
Affairs at the University of Illinois at Chicago and the Charles H. Hood
Foundation.
The NIA is one of 27 Institutes and Centers at the National Institutes of
Health (NIH), part of the U.S. Department of Health & Human Services. The
NIA leads the Federal Government effort conducting and supporting research
on the biomedical and social and behavioral aspects of aging and the
problems of older people. For more information on aging-related research
and the NIA, please visit the NIA website at http://www.nia.nih.gov/. The
public may also call for publications describing these efforts and
offering health information for older people and their families at
1-800-222-2225, the toll free number for the National Institute on Aging
Information Center.
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* Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J,
Hayflick L, Butler RN, Allison DB, and Ludwig DS, “A Potential Decline in
Life Expectancy in the United States in the 21st Century,” New England
Journal of Medicine, 352:11, pp. 1138-1145.
** BMI is a number that shows body weight adjusted for height. BMI can be
calculated with simple math using inches and pounds, or meters and
kilograms. For adults aged 20 years or older, BMI falls into one of these
categories: underweight, normal, overweight, or obese. Based on BMI, a
6-foot-tall man, for instance, is considered overweight if he weighs more
than 190 pounds and obese if he weighs greater than 220 pounds. A 5-foot-4
woman is considered overweight if she weighs more than 150 pounds and
obese if her weight exceeds 173 pounds.
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