While doing some background reading for the last few articles on health, diet, and energy drinks, I kept coming across more and more information on just how unhealthy we’ve become in this country. I mentioned last month that processed foods were leading to earlier and more deadly colon cancer in young people (<50 years old) due to poisoning and premature aging (senescence) of the cells lining the GI tract that render them unable to fight off tumor formation. Increasing cancer rates in younger generations is not unique to just GI cancer; it turns out that every generation of Americans has a progressively higher rate of lots of different types of cancer than the preceding generation. An article published just this month in The Lancet with the ominous title “Differences in Cancer Rates Among Adults Born Between 1920 and 1990 in the USA” reports some pretty scary data backing up my conclusions from last month that our diets are literally killing us. There’s some statistical and medical mumbo jumbo to wade through in the article but everyone should read it. Don’t think it’s just a little overview; it’s another one of those meta-analysis studies I’ve talked about before that combines data from 23,654,000 patients (7,348,137 deaths—32%) to base their statistical analysis. If you’re not interested in the topic for your own health, read it for your children’s since it finds that “trends in cancer incidence in recent birth cohorts largely reflect changes in exposures during early life and foreshadow the future disease burden.”
Let’s take a look at what’s in this article and some of their conclusions as to why this is happening. The study follows both the incidence rate (IR) and the mortality rate (MR) for cancer development in successive generations born since 1920 and found that both incidence and death increased with each generation. GI malignancies were 2–3 times higher in those born in 1990 than in people born in 1955, 2.9 times higher for kidney cancer, 2.6 times higher for pancreatic, and 2 times higher for liver and bile duct cancer. Additionally, the IR and MR increased in younger patients for breast cancer, uterine cancer, stomach cancer, gallbladder cancer, ovarian cancer, testicular cancer, and rectal cancer in males (due to HIV-related Kaposi sarcoma). The number of women with malignancies increased from 12% for ovarian cancer to 169% for uterine cancer! Following right along, and not at all surprisingly, the death rate for cancer increased in successively younger birth cohorts for liver cancer, uterine cancer, gallbladder, testicular, and colorectal cancers. 1 out of every 3 patients (32%) they followed died of their disease.
These data are truly shocking, so what’s up and what are those changes in early life that have such a profoundly negative impact on health and cancer rates as we age? Right from the start the data picks up where I left off in the past few articles and pinpoints diet, processed food, environmental toxins, and sedentary lifestyle choices as the major culprits. As I’ve said, highly processed food is a major culprit in obesity and the paper found that “fully 60% of cancers with increasing incidence in younger birth cohorts are obesity-related.” Over the last half decade, “the obesity epidemic in the USA has skyrocketed affecting individuals across all age groups; however, the most rapid rise in obesity rates has been seen among individuals aged 2–19 years.” Obviously this is one of the key factors that “reflect changes in exposures during early life and foreshadow the future disease burden.” It’s also not surprising that the influence of body weight in early life is associated with excess body weight during early adulthood (ages 18–40 years) that lead to increases in 18 different cancer types.
Their data from the more than 20 million people they studied confirms that poor diet (see last month for details of “poor diet”) and high intake of ultra-processed foods in the US lead to increasing odds of developing obesity, type II diabetes, and metabolic syndrome. Metabolic syndrome is a witches’ brew of health badness; you only need three of five medical conditions: obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL) to qualify. HDL is one of those cholesterol tests your doc measures at your yearly physical exam blood work; the lower the HDL level the greater the risk of cardiovascular death. The data is just as ominous for generations born from 1946–64 (“Baby Boomers”) and subsequent years that indicate an increase in premature cardio-metabolic mortality associated with decreasing life expectancy. These data fit right in with the studies I talked about last month going back Dr. Monteiro’s work in Brazil in the 1990s on diet, obesity, and ultra-processed foods and the CDC study on autism, diet, and life choices.
More details on the effects on our kids is also bad news and show dietary patterns, “high in saturated fats, refined grain, ultra-processed foods, and sugar, as well as meat vs. plant diets and sedentary behaviors during adolescence and young adulthood are associated with consistently increased risk of cancers like colorectal and breast cancer.” The paper reports that the causes for this epidemic of bad health relate to “substantial changes in food preparation and antibiotics use in preparation of highly processed foods.” Changes in how our food is processed have caused an alteration in our GI microenvironment (called “microbiome”) that contributes to changes in GI cells making our GI tract more susceptible to cancer formation and less able to fight it off. Not only are we dying earlier, but replacing our population more slowly: “All of these unhealthy factors line up with trends in fertility rates too that have been reduced in patients born between 1957 and 1976.”
It’s hard to figure out how we let this happen to ourselves. In the US we have the highest health care dollar spending among “industrialized nations” as defined by the Organization for Economic Cooperation and Development (OECD), an association of 38 nations in Europe, the Americas, and the Pacific. For each American citizen we spend exactly twice as much ($12,555) on health care as the average of these 38 countries ($6,651). Our return on that investment isn’t very impressive either since we rank 29/38 (bottom quartile) in life expectancy at 76.1 years. That’s over 8 years less than the life expectancy in Japan, Switzerland, Spain, Italy, and Korea, with life expectancies of 83.5-84.5 years. Following right along, we’re also the fattest country in the industrialized world. Comparing body mass index we have an obesity (defined by BMI values >30) rate of 73% of our adolescent and adult population (up from 53% in 1970) while our closest competitor (Iceland) weighing in at 58% of their population with a BMI>30. It follows right along that treating obesity-related illnesses also takes up a higher percentage of our health care budget than any other industrialized nation. We spend 65% more health care dollars per capita ($644.80 or 15% of our total budget) on obesity-related illnesses than our closest neighbor, Germany ($411.20, 11% of their budget).
As I said a couple of times already, we are quite literally killing ourselves. Recent data from the CDC points to the huge impact this has on those of us approaching retirement age. For the first time in over 100 years, “progressive American generations are facing a shorter life expectancy than previous generations.” Life expectancy in the United States declined by nearly a whole year from 2020 to 2021, from 77.0 to 76.1 years, bringing the U.S. life expectancy to its lowest level since 1996. The 0.9-year drop in life expectancy in 2021, along with a 1.8-year drop in 2020, was the biggest two-year decline in life expectancy since 1921–1923 (the era of the Spanish Flu epidemic and WWI).
The paper concludes by stressing the importance of “early lifetime risk exposures that offer crucial opportunities to prevent a substantial fraction of cancer occurrence through modification of environmental and lifestyle risk factors.” I’ve been saying over the last few months to “be careful what you put into your tanks,” but these data push the bar up on that simple admonition. We all need to be crazy careful about our diet and life choices and really get our kids to buy into it along with us. Our lives, and our children’s, literally depend on it.
