13 ms·
A Medical Mystery of the Best Kind: Major Diseases Are in Decline
- raverbashing 10y agoThe question I guess is not what diseases are in decline, but which ones are going up
- Gibbon1 10y agoAns: Diabetes
- westoncb 10y agoAny idea if that includes Type I, or only Type II?
- Gibbon1 10y agoType II. Type II is insulin resistance. Which is probably caused by our industrial diet and maybe other factors. The rate is increasing dramatically. Type I is an autoimmune disease. I think it's not increasing. (no idea)
- DonaldFisk 10y agoType 1 diabetes is increasing: http://diabetes.diabetesjournals.org/content/51/12/3353 http://diabetes.diabetesjournals.org/content/51/12/3353 The reasons are unknown: http://www.ncbi.nlm.nih.gov/pubmed/23733895 http://www.ncbi.nlm.nih.gov/pubmed/23733895
- autokad 10y agoits less caused by diet than lack of mobility. we spend most of our waking day sitting down now. active over weight people with 'bad diets' are healthier than skinny inactive people. but its hard to legislate that, and much easier to pound the shoe on the table about sodas than it is to tell people they need to get up and move
- mariorz 10y agoHunger should be correlated with calories expended, our metabolic system is homeostatic. the unnatural consumption of refined carbohydrates, and in such large quantities, is what is causing the Diabetes II epidemic and widespread obesity, both likely symptoms of the same disorder.
- elliotec 10y agoNo... It is absolutely caused by diet. Exercise is a factor, but only because you're expending the calories you brought into your body in the first place. https://www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx#type2 https://www.niddk.nih.gov/health-information/health-topics/D... I hope you're not a doctor!
- gedy 10y ago"Going up" usually just means in percentage, as more serious diseases decline below that percentage.
- transcranial 10y agoApparently Parkinson's disease has been on the rise over the past several disease, some say due to the decrease in smoking. Which is fascinating, as smoking has been shown to be actually protective against Parkinson's.
- amorphid 10y agoOr maybe you die from something smoking related before getting Parkinson's.
- seizethecheese 10y agoOr maybe both.
- deleted 10y ago[deleted]
- ktRolster 10y agoThis is weird: >Until the late 1930s, stomach cancer was >the No. 1 cause of cancer deaths in the >United States.
- mc32 10y agoDoes that take into account refrigeration? Maybe it's totally unrelated --but prior to refrigeration a lot of meats were cured.
- ktRolster 10y agoThe article suggests several possibilities, including increasing use of antibiotics, and less consumption of salted/cured meats, but the actual answer is unknown. And actually that is the crux of the article: it's not that doctors aren't thinking of possibilities to explain the reduction in disease, they just don't know for sure which of the possibilities they are. Basically, if we've thought of a possibility in the last 20 minutes since reading the article (or headline), a doctor has probably already thought of it, too.
- mc32 10y agoTrue enough. One other thing is also the decline of "elixirs" with unknown ingredients, chemicals of then unknown toxicity.
- _mhr_ 10y agoI found a chart showing the prevalence of multiple forms of cancer over time: http://i52.tinypic.com/r9euci.jpg http://i52.tinypic.com/r9euci.jpg.
- tansey 10y agoNot sure what the source is on that chart, but I'll assume it's credible. If that's the case, then despite what the article says, it's hard to believe that most of this decline is not accounted for by the decline in smoking. Surely the decline in smoking accounts for the vast majority of the lung cancer decline, and the peaks for colon and prostate cancer are very close to the same time.
- sgt101 10y agowow - I have no clue (obviously) but possible reasons : - better home heating (less open fires, more heated bedrooms) - increased time from atmospheric nuclear bomb testing (and the various dispersals of plutonium in the 60's and 70's) - better nutrition in general - higher genetic diversity in breeding populations; not many peoples grandparents all come from the same village in the developed world now - less pollution in the west; import of finished goods rather than local manufacturing
- kiba 10y agoWe might actually benefit from some amount of radiation, rather than assuming that increased amount of radiation equals higher cancer risk. It's called radiation hormesis. Though I don't think there's a scientific consensus on this issue.
- sjg007 10y agoUnlikely, we've evolved with ever present background radiation and have a dna repair mechanism to counter act it but that does not mean radiation makes us stronger.
- cperciva 10y agoIIRC genes related to DNA replication are highly conserved; thus our DNA repair mechanism was probably evolutionarily "optimized" for conditions a long time ago. Have background radiation levels remained constant on timescales of hundreds of millions of years? I don't know, but I wouldn't be surprised if it varied significantly considering that cosmic radiation is a significant source and the strength of the Earth's magnetic field fluctuates significantly.
- throwwit 10y agoIt's probably more beneficial for evolutionary 'creativity' than the complex pathways in biology you depend on; and that's gotta be the only reason a quirk like that is still around.
- codecamper 10y ago
- lordnacho 10y agoSpeculation: - People have become more aware of the risk factors, and behave accordingly. Awareness would be connected to prevalence but have a lagged effect. - Deadly diseases cause evolutionary responses. Perhaps a disproportionate number of people with predisposition to these illnesses passed away before having offspring. - Reporting bias? While an illness looms large in the minds of the medical community, doctors are more likely to either wrongly attribute to the illness (false positive), or do false negatives less often. - Highly speculative: combined effects are non-linear. I don't know what they use to do these studies, but typically you hear something along the lines of "for every x, there's m*x effect", which makes things sounds nice and linear. Maybe better prevention and better treatment does better than either on its own summed up, and so you won't be able to find the "reason" by splitting into each feature.
- tlrobinson 10y agoI don't think you'd see any significant evolutionary responses in the timeframes the article is talking about (<100 years or 4 generations)
- Swizec 10y agoHaven't studies shown that high stress (like concentration camp) has immediate effect on next generation's DNA? That would indicate that it's at least potentially possible for evolutionary adaptation to work pretty fast.
- bhouston 10y agoThat isn'y evolution if it is epigenetic, it would be another type of adaption, Lamarckian really: https://en.wikipedia.org/wiki/Lamarckism#Epigenetic_Lamarckism https://en.wikipedia.org/wiki/Lamarckism#Epigenetic_Lamarcki...
- coltonv 10y agoThis is incorrect. Evolution is simply change over generations by natural selection. the mechanism by which that happens, be it DNA or epigenetics or whatever, is not strict
- nxzero 10y agoCurious, if the cause is the decline in cigarette consumption; here's a graph showing roughly 100 years of data for the topic: http://4.bp.blogspot.com/-p4ECPyex_cY/TzSalazW2XI/AAAAAAAAA2o/Wrgj5mSyGHA/s1600/Smoking+1900-2006.JPG http://4.bp.blogspot.com/-p4ECPyex_cY/TzSalazW2XI/AAAAAAAAA2...
- jschwartzi 10y agoThe lines do seem to correlate. In the case of stomach cancer, I'm wondering if there's a similar correlation between the decline in chewing tobacco and the decline in stomach cancer. Chew is full of fiberglass and other stuff, and if you swallow any of the juice you're swallowing that stuff. It's impossible to clear it all from your mouth after you finish chewing, too.
- jalk 10y agoOT: I'm pretty sure fiberglass in chew is a myth.
- DanBC 10y agoWhen smokers give up smoking they start to clear their lungs. They cough up phlegm. many people swallow that, not spit it out. That increases risk of mouth, throat, stomach, bladder, and penis cancer. Tobacco is already pretty harmful. > Chew is full of fiberglass No, it isn't.
- sukilot 10y agoWhy don't active smokers cough up phlegm?
- armitron 10y agoMany reasons. Smoking coats the lungs with a layer of tar and heavy, chronic smokers have coated their lungs to such an extent where there is drastically reduced lung area in contact with the environment (and irritants/allergens). The tar acts like a shield in this case and prevents immune response that can lead to constriction in the lungs and phlegm production. Moreover, active smokers have destroyed the cilia in their lungs (which start to regenerate when one quits smoking) and it's the cilia that do most of the cleaning and phlegm expulsion. When one quits smoking, he goes through weeks or months of coughing and increased phlegm production as the cilia start growing back. Finally, a lot of active (and ex) smokers do cough up phlegm. The co-factors of phlegm production are simply too many for a definite answer. You also have asthmatics and those who suffer from COPD/emphysema.
- mrfusion 10y agoIt mentions statins as something obviously good but is there any evidence they're actually beneficial? I thought cholesterol was good now?
- rollthehard6 10y agoSome doctors and researchers believe the benefit from statins is more to do with the decrease in inflammation caused by them. Possibly widespread use of statins has beneficial effects on other disease processes too.
- Gibbon1 10y agoYeah I think there was a large study done comparing a newer cholesterol lowering drug with statins. The result was the new non-statin drug wasn't effective at all even though it lowered cholesterol levels.
- mrob 10y agoYou might be thinking of CETP inhibitors. This class of drug modifies cholesterol levels to numbers associated with better health, but so far none of them have conclusively improved health outcomes: https://en.wikipedia.org/wiki/CETP_inhibitor https://en.wikipedia.org/wiki/CETP_inhibitor Anacetrapib is still in stage III trials so it's too early to consider the concept a failure, but I think the bad results so far are evidence that hyperlipidemia is a symptom not a cause of cardiovascular disease, and that statins have some mechanism of action beyond just modifying cholesterol levels (eg. anti-inflammatory, as some people have suggested).
- Gibbon1 10y agoYes those drugs. Hard to say conclusively, but the failure of most of CETP inhibitors is troubling news for the hyperlipidemia theory. Meaning possible hyperlipidemia has multiple causes and in and of itself isn't bad. AKA Cause A results in hyperlipidemia. Cause B results in hyperlipidemia. Cause C results in hyperlipidemia and arterial plaques. Cause D results in hyperlipidemia.
- mrfusion 10y agoInteresting about the stomach cancer. Makes me wonder if we should be careful about limiting antibiotic usage too far? Perhaps everyone should take a course every five years or so?
- sukilot 10y agoWhat does one have to do with the other?
- Chinjut 10y agoFrom the article: "Until the late 1930s, stomach cancer was the No. 1 cause of cancer deaths in the United States. Now just 1.8 percent of American cancer deaths are the result of it. No one really knows why the disease has faded — perhaps it is because people stopped eating so much food that was preserved by smoking or salting. Or maybe it was because so many people took antibiotics that H. pylori, the bacteria that can cause stomach cancer, have been squelched."
- rrecuero 10y agoThat sounds a bit extreme, I would eat a couple tablespoons of Coconut Oil every day. On another note, I wonder if the probiotic trend is going to pay off. We'll see in 20, 30 years I guess
- mrfusion 10y agoI always wondered if the removal of lead in gasoline could account for a lot of this. Especially the dementia drop.
- SCAQTony 10y agoIt is never one thing; your lead assessment is probably a serious contender among other pollutants. Then there is better hygiene via food handlers, stiffer USDA rules, cleaner water, less smoking and second hand smoke, more people exercising too.
- JacksonGariety 10y agoSmoking rates are only decreasing in developed nations. Globally it's increasing by ~1% each year.
- Ensorceled 10y agoThe study is talking about wealthy (e.g. developed) nations this doesn't apply.
- JacksonGariety 10y agoI was just replying to his comment. It's a "mainstream" idea that people like to repeat, but it's simply untrue. It's like a stock phrase: "Smoking is actually going down, you know! People really are getting smarter/healthier/happier/whatever." It's just false.
- cma 10y agoThat's lower than population growth so would still be a global per-capita reduction.
- rgarrett88 10y agoI would imagine a global smoking increase statistic would be per-capita as well but without a citation we won't know.
- sjclemmy 10y agoWhat about widespread use of painkillers? Aspirin, paracetamol and ibuprofen have become common place over this period. Calming the body's immune response might have a beneficial effect on overall health.
- autokad 10y agocancer is caused by swelling, thus anything that reduces it will reduce cancer incidents.
- philippnagel 10y agoCancer is caused by swelling?
- SomeCallMeTim 10y agoThe cancers that involve "lumps" are not swelling, but performing angiogenesis [1]. Not sure about the blood cancers because, well, I'm not an expert, but I believe that all cancers involve unrestricted cell division of some kind, at least some of the time as a result of a DNA or RNA error. I believe swelling is typically caused by individual cells or tissues (or even pockets in the body) building up fluids of one kind or another. Unfortunately cancer can cause this kind of swelling when your liver and/or kidneys shut down. Source: My mom died of breast cancer, and things were not pleasant near the end. If OP is talking about systemic inflammation...then there may be a link between the two, but it's certainly not the only cause. [2] [1] https://en.wikipedia.org/wiki/Angiogenesis https://en.wikipedia.org/wiki/Angiogenesis [2] https://en.wikipedia.org/wiki/Systemic_inflammation https://en.wikipedia.org/wiki/Systemic_inflammation
- ryanmarsh 10y agoThis helps to understand the scope of cancer in laymen's terms. http://www.phdcomics.com/comics/archive.php/archive_print.php?comicid=1162 http://www.phdcomics.com/comics/archive.php/archive_print.ph...
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- magila 10y agoOn the other hand, autoimmune diseases have been increasing in prevalence over the last century. While these diseases are rarely immediately fatal, in severe cases they can have a major impact on quality of life. Onset often occurs in early adulthood so the cost of treatment over a lifetime can be extremely high. The usual treatment, immunosuppressive therapy, also has serious risks of its own. While there has been much progress on finding new treatments, their scope has been limited to new and creative ways of suppressing the immune system. There are a multitude of theories which attempt to explain the causes of autoimmune diseases, but we seem to be quite far from truly understanding them.
- alexandercrohde 10y agoAbsolutely. I wish this article wouldn't speak so generally when I hear consistent articles about major spikes in: - Autoimmune issues (especially allergies) - Obesity (particularly in children) and diabetes - Autism - Depression, ADD, and similar disorders
- PhasmaFelis 10y ago> Autism - Depression, ADD, and similar disorders My personal impression is that the rise of mental conditions is an increase in diagnosis, not occurrence. An awful lot of people who, just a few decades ago, would have been dismissed as lazy, stupid, whiny, or the all-purpose "crazy" are actually starting to receive recognition and treatment. That's a good thing.
- duaneb 10y ago> My personal impression is that the rise of mental conditions is an increase in diagnosis, not occurrence Do you have a source for this? It goes against much I've read myself recently—for instance, depression has strong links to inflammation—perhaps shitty diets and no exercise are catching up to people.
- soundwave106 10y ago
- throwwit 10y agoThe largest extrinsic factor (causally effective), should be the environment's physiological interaction with cells that have accumulative exposure: the alimentary system. Lower incidences of alimentary cancers should be the hallmark result of bans on various carcinogenic additives. The question should be how low the rates can inherently go based on diet alone, and to then proceed to narrow down the scope of any further factors.
- lastres0rt 10y agoPut bluntly: All of these 'little increases" are starting to add up in big ways. I'm not that surprised that a decline in one disease is leading to declines in others. As we all live a little longer, we make each other healthier as well, being better able to cope with the expanded safety net. As someone who's seen her grandparents suffer with a cacophony of diseases right before death? Sometimes, one thing really DOES lead to another.
- robbles 10y agoIs it possible that medical advances in the last couple of decades have simply delayed the deaths of many sufferers? Heart disease and cancer survival rates are usually qualified with a number of years, given that they are difficult to fully cure. With a larger aging population just barely hanging on, perhaps an upswing is just around the corner but hard to see now. i.e. the rate of death has not actually dropped, the average survival time is longer.
- codecamper 10y agoI wonder if all the benefits may be coming from people having kids later in life. You'd think this would lead to more disease, but maybe we are actually evolving to be longer living and the kids later in life is what is causing it.
- nxzero 10y agoResearch does show that having kids is correlated to having a longer life expectancy: https://www.psychologytoday.com/blog/iage/201410/having-children-beneficial-living-longer-0 https://www.psychologytoday.com/blog/iage/201410/having-chil...
- allengeorge 10y agoMaybe because the kids born in later in life are born to more educated, and more well-off parents?
- dmix 10y agoBetter home food (popularity of brown bread vs white bread), better take out food (not just McDonald's and diners anymore), and more indoor working conditions (less exposure to pollution) likely play a big part.
- artagnon 10y agoOur genes are somehow improving in quality (survival longevity, quality of life, IQ), and this effect is cascading over generations. I don't know if it can be explained using pure epigenetics, and natural evolution is certainly too slow to explain this, so there might be mutagens in our everyday environment that directly modify the DNA sequence. We recognize cigarette smoke, heavy metals as mutagens, but are there more subtle mutagens that lead to better DNA?
- deleted 10y ago[deleted]
- dm03514 10y agoCoffee?
- alphaoverlord 10y agoOne explanation can be expanding criteria and/or earlier diagnosis. Earlier diagnosis, even with the same treatment efficacy, will lead to records of improved survival, and expanding criteria of particular diagnoses will often identify borderline cases that likely don't have the same morbidity and mortality.
- known 10y agoCheck https://en.m.wikipedia.org/wiki/WHO_Model_List_of_Essential_Medicines https://en.m.wikipedia.org/wiki/WHO_Model_List_of_Essential_... and https://en.m.wikipedia.org/wiki/List_of_bestselling_drugs https://en.m.wikipedia.org/wiki/List_of_bestselling_drugs
- JoeAltmaier 10y agoIs it simply, that fewer people can afford insurance/visit a doctor? So they die of 'natural causes' and never get diagnosed?
- triadicmonad 10y agoOf course hundreds of probable individual causes can be attributed to this phenomenon. The Galileo of medicine will be the one who can unify and make the data sensible without pretending one or two factors caused it all.