A Potential Decline in Life Expectancy in the United States in the 21st Century

Olshansky, S. Jay; Passaro, Douglas J.; Hershow, Ronald C.; Layden, Jennifer E.; Carnes, Bruce A.; Brody, Jacob A.; Hayflick, Leonard; Butler, Robert N.; Allison, David B.; Ludwig, David S.

doi:10.1056/nejmsr043743

Cited by 2,323 publications

(1,361 citation statements)

References 40 publications

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“…Globally, the prevalence of overweight and obesity has risen at an alarming rate over the past two decades, with over two billion people now meeting the definition of these two categories 1. From a public health standpoint, it is believed that the prevailing obesity trends in the USA may have the net effect of decreasing life expectancy trends 2. Numerous studies have shown a clear relationship between obesity and risk of developing cardiovascular disease (CVD).…”

Section: Introductionmentioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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Section: Introductionmentioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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“…A steady linear growth of life expectancy to an undetermined biological limit was hypothesized in this study. However, other studies have considerably different aspects and factors limiting duration of life [2] and have even forecasted a declining life expectancy due to factors such as the consequences of the increased prevalence of obesity [3]. Moreover, the prevalence of diseases such as cancer or dementia, all with negative consequences, is clearly increasing because of longevity in our populations.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of age-related hearing loss in Europe: a review

Roth

Hanebuth

Probst

2011

Eur Arch Otorhinolaryngol

269

190

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Populations are becoming progressively older thus presenting symptoms of diminished organ function due to degenerative processes. These may be physiological or caused by additional factors damaging the organ. Presbyacusis refers to the physiological age-related changes of the peripheral and central auditory system leading to hearing impairment and difficulty understanding spoken language. In contrast to epidemiological data of other continents, the prevalence of age-related hearing loss (ARHL) in Europe is not well defined, due in part to the use of different classification systems. We performed a systematic literature review with the aim of gaining a picture of the prevalence of ARHL in Europe. The review included only population and epidemiological studies in English since 1970 with samples in European countries with subjects aged 60 years and above. Nineteen studies met our selection criteria and additional five studies reported self-reported hearing impairment. When these data were crudely averaged and interpolated, roughly 30% of men and 20% of women in Europe were found to have a hearing loss of 30 dB HL or more by age 70 years, and 55% of men and 45% of women by age 80 years. Apparent problems in comparing the available data were the heterogeneity of measures and cut-offs for grades of hearing impairment. Our systematic review of epidemiological data revealed more information gaps than information that would allow gaining a meaningful picture of prevalence of ARHL. The need for standardized procedures when collecting and reporting epidemiological data on hearing loss has become evident. Development of hearing loss over time in conjunction with the increase in life expectancy is a major factor determining strategies of detection and correction of ARHL. Thus, we recommend using the WHO classification of hearing loss strictly and including standard audiometric measures in population-based health surveys.

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“…10 Unless this trend is curtailed, obesity-related disease, disability and death worldwide is projected to increase well into the 21st century, 15 whereas life expectancy at birth and at older ages may begin to decline by the middle of the 21st century. 16 Fundamentally, the etiology of overweight in children and adolescents, as in adults, is attributable to energy (caloric) intake in excess of energy expenditure. Genetic, environmental, socio-cultural, and family characteristics have been identified as key influences on energy expenditure and dietary intake, and subsequent overweight prevalence.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

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A Potential Decline in Life Expectancy in the United States in the 21st Century

Cited by 2,323 publications

References 40 publications

Obesity paradox in heart failure: a heavy matter

Obesity paradox in heart failure: a heavy matter

Prevalence of age-related hearing loss in Europe: a review

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

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