Tom Moffatt
Sheril KirshenbaumHow a country’s healthcare expenditure correlates with its citizens average life expectancy.
With one notable anomaly.
Source: Latinometrics using World Bank data
According to OurWorldInData, the leading causes of a lower life expectancy in the US compared to other nations include smoking, suicides, road accidents, opioid overdoses & higher rates of obesity. /2
s1m0n4@Sheril it's insane to spend that amount per capita. The graph scale has been increased just to fit USA in it 😲
Travis Briggs@Sheril I finally found Mexico, which is somehow not labelled as N America? Though I guess it's weird because it's both, since two of the categories are continents and one is a broad characterization.
BigD@Sheril some similarities to many countries. Ours included.
Road crashes, not accidents, is a more correct term I feel.
Road crashes, not accidents, is a more correct term I feel.
aardvark@BigD yep, unsafe roads, operator error, unsafe vehicles, none are accidents.
Paul Peace@Sheril Too much dietary fat is largely overlooked: inflammation, CVD, endothelial damage, minor strokes, T2 diabetes. It doesn't help that the scientific literature so often compared two fatty diets - meat instead of UPFoods, heck, nuts compared to pretzels in one study. So it goes largely unnoticed. Loads of potentially misleading stuff on olive oil being healhty - again - compared to other oils (not no free oils).
Sophie@paulpeace @Sheril Poverty. It’s the poor who are mostly suffering from obesity and other ills that shorten life expectancy
Elizabeth@paulpeace @Sheril Dietary fat, I assume you mean animal fat, has been demonized long enough. There is zero science proving that a macronutrient humans have eaten for millions of yrs is trying to kill us. After my dad died of a heart attack, when he had done everything "right" for decades & his "cholesterol" numbers were good, I went in search of info to make sense of it. I found a shocking lack of science & a great deal of lies twisted into PR spin for $$.
@paulpeace @Sheril The dietary fat that is killing us is seed oils. A product used to grease the machines of the industrial revolution is not a food source for human beings. Our bodies cannot recognize it as a food and cannot process it as food. Super high carb diets with "vegetable" oils, becoming the official Dietary Guideline in the 70's, have lead to the triple epidemics of heart disease, obesity and type 2 diabetes. Butter is not the problem.
@akaBeth10 @Sheril zero science. We're expected on my server to be able to back up any claims with scientific articles. I have studies here showing animal fat and free plant oils from nuts, seeds, and legumes are unhealthy. If you'd like to see some and debate research and some of the issues in a considered way, I'm happy to share some. This is part of my research area.
@paulpeace @Sheril Please share these studies. I'd love to see them.
@akaBeth10 @Sheril Thank you. It makes a change to meet someone genuinely interested. So one of the problems in nutrition research, as you might know, is industry funding or comparing nuts, legumes, seeds, oils and meat to terrible ultra-processed foods making them look healthy.
This study compares nuts to pretzels! This puts nuts in a favourable light (full of fat) and focuses on weight. Endothelial function?
https://www.tandfonline.com/doi/abs/10.1080/07315724.2010.10719834
Pistachio Nuts Reduce Triglycerides and Body Weight by Comparison to Refined Carbohydrate Snack in Obese Subjects on a 12-Week Weight Loss Program
Objective: There is a widely held view that, due to high fat content, snacking on nuts will lead to weight gain, ultimately causing unhealthy changes in lipid profiles. This study is designed to st...
@akaBeth10 @Sheril it's not always the intention of the researchers, but this goes off into the media as 'eat loads on pistachios'.
Approx 28g of nuts is the recommendation (and only because people eat such junk and it displaces junk - not really healthy - the protein, vits, minerals are available in foods with a lower fat burden.
They add up over a day in cereals, baking, butters/spreads, cereal bars, and sitting munching in front of the TV.
@akaBeth10 @Sheril I'll get your thoughts on this 'relativity/comparison' issue first and then dig out the endothelial studies if you want them.
@akaBeth10 @Sheril my partner lost her dad to heart disease, although he ate a lot of red meat and smoked.
@paulpeace @Sheril I'll come back to the previous posts, but have to point out a major confounder here: smoking. This is a big problem in much of the research. Smoking is not adjusted for while red meat is automatically demonized bc it's what we've all been conditioned to believe. My dad did the opposite, stopped smoking & substantially reduced red meat for decades. Perhaps the endothelial damage of the smoking yrs played a role.
@paulpeace @Sheril I'm sorry to hear that's how you're partner lost her dad. It's a heartbreaking experience.
@paulpeace @Sheril So, that was a pretty limited study, what else ya got : ) You might find this interesting https://www.bmj.com/content/353/bmj.i1246
Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)
Objective To examine the traditional diet-heart hypothesis through recovery and analysis of previously unpublished data from the Minnesota Coronary Experiment (MCE) and to put findings in the context of existing diet-heart randomized controlled trials through a systematic review and meta-analysis. Design The MCE (1968-73) is a double blind randomized controlled trial designed to test whether replacement of saturated fat with vegetable oil rich in linoleic acid reduces coronary heart disease and death by lowering serum cholesterol. Recovered MCE unpublished documents and raw data were analyzed according to hypotheses prespecified by original investigators. Further, a systematic review and meta-analyses of randomized controlled trials that lowered serum cholesterol by providing vegetable oil rich in linoleic acid in place of saturated fat without confounding by concomitant interventions was conducted. Setting One nursing home and six state mental hospitals in Minnesota, United States. Participants Unpublished documents with completed analyses for the randomized cohort of 9423 women and men aged 20-97; longitudinal data on serum cholesterol for the 2355 participants exposed to the study diets for a year or more; 149 completed autopsy files. Interventions Serum cholesterol lowering diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). Control diet was high in saturated fat from animal fats, common margarines, and shortenings. Main outcome measures Death from all causes; association between changes in serum cholesterol and death; and coronary atherosclerosis and myocardial infarcts detected at autopsy. Results The intervention group had significant reduction in serum cholesterol compared with controls (mean change from baseline −13.8% v −1.0%; P<0.001). Kaplan Meier graphs showed no mortality benefit for the intervention group in the full randomized cohort or for any prespecified subgroup. There was a 22% higher risk of death for each 30 mg/dL (0.78 mmol/L) reduction in serum cholesterol in covariate adjusted Cox regression models (hazard ratio 1.22, 95% confidence interval 1.14 to 1.32; P<0.001). There was no evidence of benefit in the intervention group for coronary atherosclerosis or myocardial infarcts. Systematic review identified five randomized controlled trials for inclusion (n=10 808). In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27). Conclusions Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.
@akaBeth10 @Sheril fats are very damaging but we need to take it slower as we're making too many points to track and we''ll have multiple side-threads. So I'll just comment on this study first. It compares fats. Meat AND free plant oils are damaging.
@paulpeace @Sheril Good point about multiple threads. We can stay on "meat is damaging", since we agree about seed oils. I'm interested to see what you base that on.
@akaBeth10 @Sheril fat is damaging. Meat contains fat, and inflammatory and/or cancer-carusing agents - N-nitrosos, MelQX, heterocyclic amines, polycyclic aromatic hydrocarbons, Neu5Gc, etc.
Along with these molecules, fats/oils in larger or sudden amounts (from plants or animals), damage our endothelial linings. Cholesterol is part of a wider mix. Here's an intro, then we could get into the specific scientific studies on endothelial. https://www.wholefoodsplantbasedhealth.com.au/heart-health/endothelium/
@paulpeace @Sheril Reading what you sent, but how does one do this: "Direct observation of blood flowing through these capillaries..."
@paulpeace @Sheril So, that's really just an opinion article repeating multiple ideas born from the Diet-heart hypothesis that have been debunked. There isn't one link to an actual study. It's extremely overbroad and nonspecific at the same time. Let's start with cholesterol. It is in every cell and we die without it. Our brains are 20% cholesterol & the obsession w/ lowering it is being linked to causing Alzheimer's & dementia epidemics.
@paulpeace @Sheril "Fats" include a wide array of chemical make-ups, and we must have fats to survive. There are Essential Fatty Acids and Essential Amino Acids that we must consume. They're called Essential for a reason. There is NO essential carbohydrate. We can live just fine without them. That's basic human biology. Here's a review of the evidence & the history https://www.jacc.org/doi/10.1016/j.jacc.2020.05.077
@paulpeace @Sheril Going back to the 1st link, it states, for example: "Despite studies on animal models supporting the cancer-promoting effect induced by high fat intake [26], epidemiological studies reported opposite results [27]" And here's the link to the actual study for [27]: https://pubmed.ncbi.nlm.nih.gov/20697723/?dopt=Abstract
If you go through every link listed you can go to the actual studies on PubMed and read them.
Is dietary fat associated with the risk of colorectal cancer? A meta-analysis of 13 prospective cohort studies - PubMed
This meta-analysis suggests that dietary fat may not be associated with the increased risk of CRC. More well-designed studies with larger population performed among Asians are needed to further evaluate the associations. In addition, probable bias caused by measurement error should be noticed in thi …
@paulpeace @Sheril One of the most mind blowing things I discovered was the history of how cholesterol became so demonized. Did you know, it started in the 19th century w/ Russian scientists who used rabbits, herbivores, to prove it "clogs" arteries? Rabbits were fed pure cholesterol, which can only come from animal products, which they cannot process or tolerate. In the 1950's Ancel Keys picked up the idea & ran with it. Have you read about his work?
@akaBeth10 @Sheril You agreed to make fewer points and we'd discuss via dialogue, taking our time, rather than talking at one another in bursts of monologue.
I shared an overview with you to ease in before the science papers, which are heavier for us, not as a definitive scientific guide to endothelial function. You're not a scientist. It's an easier read.
@paulpeace @Sheril True, you're right. But there were several claims you were making between those 2 links so I was trying to respond to them. I didn't even touch on the claims against red meat. I don't need overviews, I am well aware of the general claims that have been pounded into us for the last 50 yrs. I want evidence that supports all or any of them.
@akaBeth10 @Sheril Sure. Well, to manage claims, perhaps we should start with your evidence for the claim that butter does not harm (unlike seed oils). In particular, we'd need to tackle the notion that (LDL) cholesterol and SFAs are not health concerns. What's the best scientific article you have saying this?
@paulpeace @Sheril Ok, what I want to send you is not available for the general public. I don't know why. But it's this study, https://academic.oup.com/eurjpc/article-abstract/29/18/2312/6691821
I subscribe to the work of a researcher in the UK, so I have her extensive review of this study, so I know what's in it, but can't share it since it's behind a paywall. But this article from her PhD work is free. https://bjsm.bmj.com/content/53/22/1393
@paulpeace @Sheril As for LDL this is a good review of the evidence, or lack thereof:
https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391
And, just to point out the obvious again, there is only one kind of cholesterol, chemical formula C27H46O. Lipoproteins are what carry them. So "good" & "bad" cholesterol isn't really a thing. Which creates a problem in the logic right there.
https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391
And, just to point out the obvious again, there is only one kind of cholesterol, chemical formula C27H46O. Lipoproteins are what carry them. So "good" & "bad" cholesterol isn't really a thing. Which creates a problem in the logic right there.
LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature
Introduction: For half a century, a high level of total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C) has been considered to be the major cause of atherosclerosis and cardiovascul...
@akaBeth10 @Sheril okay a lot of stuff again, so I'll pick the first article and you can repost others one by one to avoid overwhelm as agreed. That article says 'demonising'. I'm always cautious when someone uses that word. I believe you did earlier in the thread. To me, esp. in an article, it whiffs of a 'preferred outcome' - to rail against witchcraft and present a superior science, which isn't the spirit of science.
@paulpeace @Sheril 28 grams?? That's 2 Tablespoons. That won't displace much of anything by itself. I agree the media sucks when it comes to "nutrition" headlines. They have plenty of blame for how we got here. They always twist the findings to make splashy headlines, turning barely associative relationships into hard facts. No wonder everyone is constantly confused. Also, I eat over 100 grams of real food fat/day, have lost weight & lowered blood pressure.
@paulpeace @Sheril including butter in that list of junk food is a mistake, it is very nutritious. Eggs in lots of real butter is how I start every day now. No more cupboards of cereal and granola bars and oatmeal. Much as I love them I have no more craving for them & my hypoglycemia has never been better controlled. There is no plant food that provides as many nutrients as animal products, in amount, type, or bioavailability.
@paulpeace @Sheril I don't claim to be a scientist but I am a fan of facts and good research. I've sadly discovered, as you said, a great deal of nutrition research isn't based in either but does have a lot of funding from Big Food. They are primarily bad epidemiological studies based on horrible Food Frequency Questionnaires. Lower triglycerides in the nut group is exactly what I would expect.
@paulpeace @Sheril Trading any amount of carbs for real food is going to have a positive change in triglycerides. They mention no change in insulin, I'm not sure if that's the same as insulin resistance.
@akaBeth10 @Sheril they do this all the time and you have to keep your wits about you - scientist or not. Many dietitians don't spot it.
TomGregoryI suspect the difference in suicides are are result of the insane lack of gun regulations in the US.
Anti-Fatalist@TomGregory @Sheril it's mostly the lack of mental wellness due to having no hope in our lives due to ruthless capitalism.
dr2chase@Sheril do they show the math behind that claim? I once tried to derive an adjusted estimate, backing out our egregious infant mortality, car crashes, and murders (forgot to do suicides) and that didn't move it a lot. And there's plenty of smoking in other countries.
Badwolf303@Sheril Yet America spends more per capita than any other country. It’s almost as if all that healthcare money isn’t going to provide healthcare to most Americans. I wonder where it is going. #RulingClassCriminals ? #bigpharma #healthcaremonopolies #PrivateEquityIsTheft
@Sheril How is gun violence not on that list?
Menno@akaBeth10 @Sheril because compared to other causes of death, is pretty low.
Entirely preventable, but low.
Entirely preventable, but low.
infinite_loopy@akaBeth10 @Sheril Guns kill roughly the same number of people as cars, but ~2/3 of those gun deaths are suicides until the last two years of available data.
It's still the case that gun homicides are one of the leading causes of death in children, though.
@infinite_loopy @Sheril So I guess that chart wasn't including children or suicide. In which case I have to question it's value.
chef 😎@Sheril
...but universal healthcare is communism!!11!!11111
Shocking.
Jakob Thoböll - R.I.P. Natenom@Sheril Very interessting result. DId they discuss reasons for that? I would guess the large discrepancy between rich and poor peoples health care in US (especially considering BIPOC).
@Sheril I see Ukraine at the bottom. It probably has reason to be there at present.
Followed by Russia.
Followed by Russia.
HistoPol (#HP) 🏴 🇺🇸 🏴Yes, the #US wastes a lot of $$$ when it comes to #HealthSpending. #DrugPrices and very unequal distribution of the benefits are likely culprits.
However, #LifeExpectancy also heavily depends on your eating habits (and others).
The #MediterraneanDiet seems much more effective than assumed:
we all remember the pictures from #Bergamo in the #Pandemic of 2020. #Italy's healthcare is not great, nor is #Greece's, or the ones in the #LatinAmerica.
Mrinappropriate@Sheril Wow! Just watch the U.K. as we migrate to the same system as USA
Reboot Robotnik@MrInappropriate @Sheril why would anyone willingly do that
Mark Mason@Sheril one of the major causes of the anomaly is that much of US ‘health spending’ goes to health insurance company profits. Actually spending on health is much lower and would bring the data point much closer to the norm.
AskYourLocalGerman
gavinisdie 
@Sheril honestly surprising our life expectancy is as high as it is (USA)
PJT North@Sheril Wow, that’s an obvious tell isn’t it?
Terri Henry@Sheril Looking at health expenditure: Switzerland and U.S. at far right—greatest expense per capita—with Switzerland having the higher life-expectancy. If I’m reading the chart correctly.
Does a large proportion of poor, of immigrants, influence the results? The expense? Switzerland having fewer than U.S.—accounting for the more life years—at same high expense per capita?
@Sheril Or, is U.S. high cost per capita related to the Insurance Company “pass-thru” fees for care? Would government controlled providers: net better result?
Tom Ritchford@Sheril It isn't "waste" responsible for the US being far out in right field.
No, tt is the moral equivalent of theft, again the rich stealing from the poor.
The obsession with the free market means that some businessvermin has to have the right to cheat you at each and every step of the war, and you as an individual have no leverage.