Health and longevity健康与寿命
Long live the fat American长命百岁 美国胖子！
Obesity may threaten life expectancy. Or maybe not
Jun 30th 2011 | NEW YORK | from the print edition
AMERICA’S obesity epidemic is so called for a reason. Roughly one in three adults is obese. In 2008 close to 25m Americans were diabetic, according to a study published on June 25th. Nevertheless, Americans are living longer than ever. In 2007 the average life expectancy at birth was 78 years. This follows decades of progress. The question is whether obesity might change that.
National progress in life expectancy masks wide local disparities, according to a study published on June 15th and written by researchers at the University of Washington and Imperial College London. Men in Holmes County, Mississippi, for example, have a life expectancy of 65.9 years, the same as men in Pakistan and 15.2 years behind men in Fairfax, Virginia. Gaps between America’s counties have widened since the early 1980s. Most alarming, 702 counties, or 30% of those studied, saw a statistically significant decline in life expectancy for women from 2000 to 2007; 251 counties saw a statistically significant decline for men.
America’s advances on the national level, meanwhile, have lagged behind those of other developed countries. A panel at the National Research Council recently took on the task of studying longevity. For American women, a rise in life expectancy of 3.3 years from 1980 to 2007 amounted to just 60% of the gains in other rich countries.
Much can be blamed on mid-century smoking habits. Obesity’s effect, however, is debated. While both Americans and Australians have ballooning bellies, Australia’s life expectancy has continued to move up nicely. Researchers at the National Research Council estimated that America’s high rates of obesity accounted for between one-fifth and one-third of its lagging life expectancy relative to other rich countries.
It is unclear whether obesity might have a greater impact in future. As medicine continues to advance, the paunchy may lead longer lives. Already, America’s most rotund citizens benefit from bypass surgery and cholesterol-lowering statins. The prevalence of high cholesterol and blood pressure among the obese in 1999-2000 was about half what it was in the early 1960s.
But medical progress may do only so much. “Obesity is being acquired at such young ages that you wonder what the limits of these technologies will be,” argues Eric Reither of Utah State University. In a paper to be published in the August issue of Health Affairs, Mr Reither, Jay Olshansky of the University of Illinois at Chicago and Yang Yang of the University of North Carolina contend that obesity threatens progress in life expectancy. Predictions based on past patterns of mortality, they say, fail to take account of trends among the young. The early onset of obesity may bring severe health problems, such as kidney failure, by the time today’s children reach adulthood.
但医学进步也许只能尽职于此了。犹他州立大学的Eric Reither抱怨：“肥胖症患者的过度年轻化使人对这类医学技术的限度产生怀疑。”在《健康事务》8月号上的一篇论文中，Reither、芝加哥伊利诺伊大学的Jay Olshansky以及北卡罗来纳大学杨洋作出了“肥胖症威胁预期寿命增长”的论断。他们指出，那种基于过去的死亡率的预测方式没有考虑到年轻人的变化趋势。过早患上肥胖症可能会在今天的孩子们成年时给他们带来严重的健康问题，如肾衰竭等。
James Vaupel, director of Duke University’s Population Research Institute, is sceptical of the argument that obesity may reverse future progress in life expectancy. More worrying, he says, is that rising obesity will lead to higher levels of disability. Mr Olshansky remains wary. “We have this hurricane that’s about to sweep across the country,” he insists, “and we can’t see it yet.”
Duke大学人口研究院负责人James Vaupel对肥胖症将颠覆未来预期寿命发展进程的观点表示怀疑。他说，更令人担忧的是日益增加的肥胖病人将带来日趋严重的残障病人。Olshansky保持谨慎态度。 “这是一场即将到来的横扫全国的飓风，”他坚称，“只是我们还看不见它。”