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Are people today sicker or healthier than their ancestors?

post #1 of 33
Thread Starter 
I'm confused. I read this article in the NYT. The article argues that people today are much healthier than their ancestors 100 or more years ago. One of the diseases mentioned in the article is heart disease. On the other hand Enig and Fallon say that heart disease was rare before 1920. They specifically mention coronary heart disease. Are the articles talking about different types of heart disease? I don't know much about heart disease, it's never been common in my family.

What about other diseases? I get the impression from reading NT-ish material (and MDC) that more traditional diets, lack of antibiotics and vaccines, etc., contributed to better health for people who were born 100 or more years ago ... Am I mis-reading NT and other NT-ish material? This NYT article claims the opposite. Where can I find objective statistics?

New York Times, "So Big and Healthy Grandpa Wouldn’t Even Know You"

The biggest surprise emerging from the new studies is that many chronic ailments like heart disease, lung disease and arthritis are occurring an average of 10 to 25 years later than they used to. There is also less disability among older people today, according to a federal study that directly measures it. And that is not just because medical treatments like cataract surgery keep people functioning. Human bodies are simply not breaking down the way they did before.

Even the human mind seems improved. The average I.Q. has been increasing for decades, and at least one study found that a person’s chances of having dementia in old age appeared to have fallen in recent years.

The proposed reasons are as unexpected as the changes themselves. Improved medical care is only part of the explanation; studies suggest that the effects seem to have been set in motion by events early in life, even in the womb, that show up in middle and old age.


Today’s middle-aged people are the first generation to grow up with childhood vaccines and with antibiotics. Early life for them was much better than it was for their parents, whose early life, in turn, was much better than it was for their parents.

And if good health and nutrition early in life are major factors in determining health in middle and old age, that bodes well for middle-aged people today. Investigators predict that they may live longer and with less pain and misery than any previous generation.

“Will old age for today’s baby boomers be anything like the old age we think we know?” Dr. Barker asked. “The answer is no.”

Mary Enig and Sally Fallon, "The Skinny on Fats"

Before 1920 coronary heart disease was rare in America; so rare that when a young internist named Paul Dudley White introduced the German electrocardiograph to his colleagues at Harvard University, they advised him to concentrate on a more profitable branch of medicine. The new machine revealed the presence of arterial blockages, thus permitting early diagnosis of coronary heart disease. But in those days clogged arteries were a medical rarity, and White had to search for patients who could benefit from his new technology. During the next forty years, however, the incidence of coronary heart disease rose dramatically, so much so that by the mid fifties heart disease was the leading cause of death among Americans. Today heart disease causes at least 40% of all US deaths.
post #2 of 33
That article doesn't exactly say that people are suffering less from heart disease, just that when it occurs, it statistically does so later in life. I would expect that Fallon et. al. are correct when they say it happens MORE. My guess would be that 100 years ago, heart disease occurred due to genetic flaws occasionally combined with lifestyle choices, whereas today it is lifestyle choices occasionally combined with genetic flaws. So 100 years ago most of the heart disease would show up in people relatively early, but today it shows up in people later on because it is due to different factors.

Do I think that people are healthier now? Yes and no. There are so many factors - less poverty today, for one thing - and in NA and Europe where 100 years ago starvation was a real possibility, things are far different in terms of bulk supply of food. Also, say what you will about vaccines, but they have largely gotten rid of previously devastating diseases like polio and smallpox, which, if survived, left lifelong health issues. Also, food preservation (ie cheap freezing) means that pretty much everyone can afford vegetables throughout the year, somewhat reducing vitamin deficiencies. But if you compare a middle-class desk jockey in America or Canada (the majority of the population now) today to a well-off agriculturalist 100 years ago (the majority of the population then), I doubt the modern person would come off very well.

What is worth pointing out is that if we took care of ourselves, we should be much, much healthier both individually and across populations now than we were 100 years ago, given the abundance of food and access to medical (and dental) care. But the fact that there is any question about it is the shocking thing and shows the lack of regard people have for their own bodies and health.
post #3 of 33
Thread Starter 
Originally Posted by spughy
My guess would be that 100 years ago, heart disease occurred due to genetic flaws occasionally combined with lifestyle choices, whereas today it is lifestyle choices occasionally combined with genetic flaws.
The NYT article says that "eighty percent [of Union Army veterans] had heart disease by the time they were 60, compared with less than 50 percent [of men] today." 80% is a huge number! I don't think that could be due to genetic flaws?
post #4 of 33
That seems oddly high to me. I wonder what their source was?

But if true - hmmm.
post #5 of 33
I read this article earlier today and it gave me pause as well.

But then I looked up what Civil War soldiers ate: hard tack, salted beef, sugar, and coffee and they were often all rotting. Hardly the prescription for a long and healthy life. ;P

Add in bacterial infections, poor sanitation, and constant backbreaking labor, and it's not hard to see how these men became so diseased.
post #6 of 33
This argument reminds me of the OB/GYN argument that childbirth is safer now than it was when birth first started taking place in hospitals- without mentioning that it was even safer BEFORE women routinely birthed in hospitals!

I would have to ask- we're healthier now compared to WHAT?? Perhaps 50 years ago there was a lot of heart disease- but what about 100 years ago? 200 years ago?
post #7 of 33
Thread Starter 
Ruthla, that's why I want to see more data.

kallyn, I know it seems like the conclusions in the article are just about Civil War soldiers, but that's just one of the studies mentioned. The article also says that the same results are showing up in other studies on different populations: "The effects [of better health, less disability and longer life] are not just in the United States. Large and careful studies from Finland, Britain, France, Sweden and the Netherlands all confirm that the same things have happened there; they are also beginning to show up in the underdeveloped world." It's too bad the article doesn't give references!
post #8 of 33
Thanks for posting this link--it's fascinating and I'm always very interested in these kinds of discussions. Some of the questions/challenges raised above make sense; I'd like to hear more about this study.

It seems to me that the author of the article has linked two different studies. The second one (Barker's) seems unsurprising and supported by NT thinking--pre-natal and infant nutrition makes a difference in one's health later in life. The one thing about this study that stands out seems to be that "nutrition" is defined primarily in terms of caloric intake--bad calories are better than too few calories.

But Fogel's study is the one to investigate. I, too, wonder if war veterans are really the best sample demographic, and if we shouldn't be looking at the relationship between nutrition and health prior to the Industrial Revolution. That said, I know that I've made such a commitment to NT ideas that I have to make an extra effort to be objective. Off to do some research. . .
post #9 of 33
Originally Posted by tamagotchi
The NYT article says that "eighty percent [of Union Army veterans] had heart disease by the time they were 60, compared with less than 50 percent [of men] today." 80% is a huge number! I don't think that could be due to genetic flaws?
I am an NT lurker - slowly intergrating the ideas into our diet, but ANYWAY -

I would bet that the heart disease of the Union soilders was due to being diabetic or some other nutritional deficency. Lack of potassium maybe? My dad is a Type 1 diabetic and has terrible heart problems because of it.

I think its been made very clear that the SAD is causing terrible increases in heart problems compared with traditional diets of places like Japan.

I like the saying there are lies, damn lies and statistics.
post #10 of 33
Well, that didn't take long. I'm assuming that the source for the Fogel study is covered in his book, The Escape from Hunger and Premature Death, 1700-2100: Europe, America, and the Third World , amazon link here. Unfortunately, neither of my two local libraries seems to own a copy. ILL, here I come.

Here is a lecture Fogel gave on the subject to some Cornell students (pdf format): The general idea seems to be:

Because of a variety of environmental factors, those of the Civil War suffered considerably greater malnurishment than the WW2 cohort or the cohort of post WW2 folks. Factors affecting the Civil War cohort included a) contaminated water sources (so sewage treatment made a big difference), b) relative poverty of a greater number of people which lead to chronic malnutrition, c) widespread disease (malaria, typhus, tb, etc.), d) excessively long working hours (including for women, which one would assume would affect fetal health), e) um, pastuerization of milk (don't hit me. This is what Fogel says, not me), f) high amounts of horse manure in cities pre-automobile.

I am so not qualified to evaluate Fogel's research and wouldn't be even if I had read the book. Based on just a little poking around, I'm inclined to agree that people are healthier today. I think the crucial questions are a) what are the actual causes of these improvements? and b) to what extent are these improvements at risk from the modern diet? Interestingly enough, the author of the NYTimes article also wrote something on my second question (here).

The author has also apparently been taken to task by Ornish for being critical of a low-fat diet for post-menapausal women (see the bottom of this page).

Can you tell that I'm putting off some things I really should be doing instead of this? Sorry for going on.
post #11 of 33
ugh..I really hate this argument..it is the one that my mom uses to not change her diet...my gma and greatgma..all lived a really long time..so she thinks that she will too even though her diet isn't as good as it could be because theirs wasn't/isn't either...
post #12 of 33
I don't find this surprising. 19th century Americans didn't eat all that great either. Granted, they were not living on Coke and Big Macs. But they ate a lot of white flour and white sugar. And they had more famines than we do -- Americans simply don't have famines now. As for the part about disability -- hernias and such -- a lot of people do get hernias, and have them fixed surgically. They didn't do that then, so people suffered with them. The article talks about people dying in their 50's from cirrhosis -- well, that still happens, it happened to my former husband.

Plus, the article is very anecdotal. They pick out a couple of families and compare them to their ancestors. You could as easily pick on my family. My grandmother died at 68 of cancer. Her mother lived to 90. Her grandmother to 89. Her great-great grandfather lived to be 102, walking the Oregon Trail from Iowa to Oregon at the age of 63. At 50, I had both cancer and diabetes. Without modern medicine and surgery, I would no doubt be dead by now. So in our family, the life span is decreasing.

It's all in how you spin it, I suppose. Nobody is safe from disease or accident, but good nutrition certainly isn't going to hurt.

post #13 of 33
Thread Starter 
Thank you phroggies for the Fogel book reference. I'm going to request it through ILL as well. If it really covers data that goes back to 1700, it could be interesting.
post #14 of 33
Historian of 19th & 20th c. medicine in training here...(PhD student)

I'm really tired now, so I'll just say one quick thing about milk. Pasteurization definitely made a big impact on public health, especially for children, in the late 19th & early 20 centuries. Problems was massive amounts of adulterated (as in watered down, god knows what added to it, etc) and spoiled milk coming into cities for people to buy. (This was a period of massive immigration & urbanization--people moved off the farm in huge numbers and went to work in factories). Up to 50% or more of milk sold in cities was either adultrated, infected with disease organisms, or spoiled. The issue of the good stuff you get from raw milk is just beside the point here--without refrigeration, people were giving their kids milk laced with TB, typhus, & other infectious diseases, as well as being just plain spoiled. Infants and small children died regularly of diarrhea and bad milk was a major reason. Pasteurization may kill good stuff in milk, but it also kills germs that kill you. In most densely-populated urban areas before refrigeration, raw milk just wasn't a real option.

Here are some book recommendations--these are major works in the history of medicine and any good public library should either have them or be able to get them for you via interlibrary loan from an academic library. There should also be used copies available on both Amazon and Barnes & Noble.

James Riley, Rising Life Expectancy: A Global History (2001)
Henry Sigerist, Civilization and Disease (1943)
W.F. Bynum, Science and the Practice of Medicine in the 19th Century (1991)
George Rosen, A History of Public Health (1958, 1993--1993 edition is best)
Charles Rosenberg, The Cholera Years (1963, a classic--fantastic book)

And for a very interesting and well-known book (by a doctor!) that questions the whole concept of medicine having much to do at all with health improvments in the 19th and 20th century: Thomas McKeown, The Role of Medicine: Dream, Mirage, or Nemesis? (1979)

Finally, if you haven't read it, everyone on MDC should read Laurel Thatcher Ulrich's (Harvard professor & mother of 5) book on 18th century midwifery and healing in Maine: A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812.
post #15 of 33
And just to address the OP: In general I'd say that people in wealthy societies are far healthier today than they were 100-150 years ago--that is, in terms of not being permanently disabled by things like childbirth trauma (a real issue in the 19th century because most women were not in the best of health), killed or disabled by childhood diseases (in some places 80% of children were killed in diptheria outbreaks, and diseases like smallpox and scarlet fever could be permanently disfiguring) or by other epidemics, like the 1918 flu epidemic that killed something like 8% of 18-40 years olds and really messed up the lungs of a lot more than that.

No one really knows why life expectancy started to increase so much in the early 20th century (in 1900 it was about 40, in 1930 it was about 60). We do know that vaccination had very little to do with reduction in childhood diseases, which had really gone down by the time most of the vaccines were introduced in the 1940s and 1950s.

People certainly ate whole grains in the 19th and early 20th centuries (That's when Mr. Kellog--yes, the cereal man--and Mr. Graham, inventor of the Graham cracker, were working...)--there was a whole movement there very similar to what people talk about now. In fact, you can find 100-year-old books that are almost identical in subject and argument to what people discuss now re: vegetarianism, meat eating, whole grains, etc. Those are some of my favorite books .

However, life expectancy is now expected to start going down again, in the US at least, because of obesity and diseases related to it, like diabetes and our health system's inability to deal with chronic conditions.
post #16 of 33
When it comes to life expectancy, you have to factor in the fact that the numbers they quote are an average. That's something I learned in my college sociology classes, that infant deaths are included. So if life expectancy was 55, for example, and now it's 75, that doesn't mean that any particular individual would not live to 75 in 1850. It means that more people died young then, for various reasons. For example, in doing genealogical research, I have been amazed by the number of children listed as dying from being scalded. Apparently they tipped over pots on the stove or being boiled for laundry pretty often. Women had lots of babies in quick succession, which added to the likelihood that the mother did not have adequate time to physically and nutritionally recover from each birth, so all the problems associated with poor maternal nutrition would affect the babies, and increase the death rate of both mothers and babies at birth and afterwards. (My great-great grandmother had 17 children, of whom 13 survived childhood.) So those deaths bring the average down. Price found that indigenous cultures spaced their babies a few years apart to allow the parents to rebuild their nutritional status. There must have been a terrible toll on 29th century women who had had so many pregnancies -- their bodies would have been severely worn out, and susceptible to the next infectious disease that came along. Poor sanitation in cities contributed, as well as crop failure. To us crop failure means food prices will go up, which isn't good, but it doesn't mean starvation to most Americans. Back then it did, and semi-starvation would severely compromise your immune system, so you would be more susceptible to flu outbreaks, smallpox, etc.

Anyway, 19th century America isn't a good representation of indigenous traditional food. They didn't have the fast food and processed food problems we have, but they had other problems, and didn't have all of the accumulated traditional wisdom that Price found in indigenous cultures. More than we have, but still they had lost a lot. So I would think the ready access to food, relatively clean water, and birth control would have a lot to do with an increase in health now.

post #17 of 33
Three things not mentioned in the above excellent posts, toxins.

Pollution was much worse in the 18th and 19th century cities.

Lead and Mercury poisoning were real threats to the general population.

Grains were stripped but were not fortified.

Excellent points wrt milk and general disease.

We are blessed by modern medicine and regulation of the food supply, but we could do much better.
post #18 of 33
I don't know if this has been pointed out already, but when we compare today's health with the state of health from "yesteryear", we're not in traditional foods circles generally referring to how it was like 100 years ago. To get a fair comparison you'd have to find an isolated community that has not adopted any kind of modern and denatured foods (such as the people covered in WAP's work). For our ancestors in particular, I think you'd have to go by archeological evidence.
However, the fact that older folks generally tend to have wider skulls, wider noses etc point to a "better" state of health in their times.
post #19 of 33
Thinking about the remark made in the article posted by the OP also-I'm not sure I believe the 'fact' about IQ's going up. I think it might be more like people are being taught the skills used in the IQ tests more than they were before, you know?

I just reread the Little house on the Prairie series (kid stuff I know but I like it) and it always strikes me how they did the long division in their head, and spelling words in grade school that high schoolers now wouldn't be able to even pronounce; IQ may be going up, but I think common sense and general intelligence are taking a huge hit. So few people think for themselves anymore...(Obesity vax, anyone?)

Just my little ol' humble opinion.....

(totally OT-Anyone know how to get a stubborn little baby boy to climb out from under your ribcage and hang out in front like a normal baby? I swear he hooks his toes in my ribs because he knows it tickes me. Little twerp.... )
post #20 of 33
Everybody has brought up excellent points. About the long division, my grandmother could do that -- she tried to explain how she did it in her head, but I could never get it!

By the way, in my post above, I meant to say women of the 19th century, not the 29th! :

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