2 November 2020
The latest findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) have just been published, and they convey a sobering message to Australians: we are living more years in poor health than ever before, and it’s largely because of what we put in our mouths.
While Australians born in 1990 could expect to live an average of 77 years (74 for men, and 80 for women), those born in 2019 have a life expectancy of almost 83 (81 for men, and 85 for women). Sounds great, right? Imagine all the fun you could have during an extra 6 years on Planet Earth!
Sadly, for most people those additional years are unlikely to be filled with joy and adventure. You see, while the average Healthy Life Expectancy (HALE) for those born in 1990 is 66, meaning the last 11 years of their lives are likely to be hampered by illness and disability, those born in 2019 have a HALE of 70, translating to 13 years lived out in various states of ill-health.
If you’re a glass-half-full kind of person, you might still be pleased that it takes 4 years longer than it used to for people’s health to fall apart, and that’s a fair point.
However, I don’t know anyone who fancies the idea of spending the last 13 years of their life in pain, disability and misery.
(And that definitely includes my 88 year old mother, whose chronic health problems have destroyed her quality of life, and my recently-deceased stepfather, whose litany of illnesses so marred the last 15 of his 93 years that our most frequent topic of conversation was his wish to not wake up tomorrow. He eventually made his own wish come true by starving himself to death, alone in a hospital bed.)
What is robbing older Australians of their health and vitality in their latter years? The GBD researchers pinned down the top 10 contributors, and with just one exception they all relate to our diet and lifestyle choices. Here they are, in descending order of contribution to our collective late-life misery:
- Tobacco use
- High body mass index
- High systolic blood pressure
- Dietary risks
- High fasting plasma glucose (blood sugar)
- Alcohol use
- Occupational risks
- High LDL cholesterol
- Drug use
- Kidney dysfunction.
While the decreased prevalence of smoking has reduced the contribution of tobacco to the overall burden of disease and disability, and the contribution made by occupation risks and specified dietary risks is holding steady, the sharp rise in other risk factors is wiping out the benefits we should have reaped from our successful tobacco control policies and improved occupational health and safety.
Drug use has made the most precipitous rise in terms of contributions of risk factors to the overall burden of disease and disability, with high body mass index and kidney disease not far behind.
The top five factors contributing to premature death, meanwhile, are:
- High blood pressure (25,500 deaths)
- Dietary risks (21,600 deaths)
- Tobacco use (20,100 deaths)
- High body-mass index (18,700 deaths)
- High fasting plasma glucose (17,700 deaths).
In other words, we die before our time because of what we do with our fingers, forks and feet, as Dr David Katz so aptly summarises it.
The bottom line
In the midst of the constant media barrage of COVID-19 fear-porn, it’s worth remembering that 79 878 Australians died between 1 January and 28 July and had their deaths certified by 31 August (the latest date for which accurate data are currently available), of which 682 (0.85% of the total) were attributed to COVID-19.
Given the heightened risk of serious illness and death from COVID-19 conferred by comorbidities such as obesity, heart disease and diabetes, that death toll would have been considerably lower if we as a nation adopted a comprehensive strategy toward risky dietary and lifestyle practices, as we have toward smoking.
But since our governments and health authorities don’t seem particularly interested in helping us become healthier, to put it bluntly, if you wish to avoid living out your autumn years in misery, and you’d like to add as many years of healthy life expectancy as you possibly can, it’s largely on you.
Sure, we’re all going to die of something, and yes, you could get hit by the proverbial bus even if you do everything ‘right’, but chances are you’re not going to get hit by a bus. Ask yourself, does that junk food really taste good enough that you’re willing to trade the momentary hit of pleasure that you get from it now, for a decade and a half of misery when you’re old?
Your state of health in later life largely comes down to the choices you’re making right now. Sure, some people get dealt a worse genetic hand than others, but with the exception of a relatively small number of genetic disorders, genes are not destiny. As Professor T. Colin Campbell is fond of saying,
“Genetics loads the gun, but lifestyle pulls the trigger.”
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