Dying to Live, Living to Die

The modern diet condemns so many of us to chronic degenerative disease and premature death that it is dragging average life expectancy down (1, 2). If we all shifted to a healthier diet the incidence of non-communicable diseases would fall, likely by up to 90% (ie 3), and first health and then life expectancy would rebound.

How could we achieve this shift? How could we best measure it? If we could affect such a change, what would this do to us as individuals, and to society? And finally, what might our experience then be of living, dying and death?

When considering average life expectancy people generally think of the mean value, as opposed to median and modal ages at death. Between 1900 and 2000 mean life expectancy at birth increased by roughly 30 years, but these extra years were not shared equally between different age groups. They were mostly front-loaded.

Prior to 1900, between 1 in 5 and as many as 1 in 2 children died before the age of 5 (4-6). This high rate of infant mortality brought down mean life expectancy at birth by 30-40%, making its relevance to a 19th-century population very different than it is to our own. Their expansive demographic pyramid has become our stationary demographic tombstone, their broods of 8 or ten children replaced by our singletons and child-free zones (7).

Family psychodynamics have surely been transformed by this profound change (ie 8, 9).

Today, in advanced nations such as Norway, death rates in children below the age of 5 hover between 1 and 2% (ie 10). The impact of infant mortality has become almost negligible at the population level, and mean life expectancy has improved as a direct mathematical consequence. This does not mean that the population of Norway has become any healthier, as can be seen in life expectancy measured at different ages.

According to the Norsk Statistisk Sentralbyrå (11), between 1900 and 1980, mean life expectancy at birth increased by over 20 years. For 30-year-old Norwegians, mean life expectancy increased over that same time period by 5 years, while for 60-year-olds, life expectancy increased by a mere 2 years.

A large part of the 20th-century improvement in mean life expectancy therefore derives from improved infant health; but not all of it. There has also been a relatively small increase in the modal age at death, thanks partly to more people surviving childhood and into old age, and probably more so to increased survival of older subjects (12). In the Norwegian experience this was due to improved health care (for some), and to increased awareness (by some) of pro-health behaviors regarding nutrition, exercise, body shape, not smoking etc.

These latter manifestations of 20th-century progress, however, are now being substantially eroded. Positive changes in the modal age at death due to improved healthcare for the elderly are now either static (13), or rolling back. The Norwegian pattern, which showed a small increase in mean life expectancy at the age of 60, appears to be fading.

In the USA and the UK, between 2019 and 2020, age-specific death rates increased for every age group from 15 years and over (14, 15). Among older groups there were increased deaths from neurodegenerative disease, sepsis, diabetes, heart disease, and cancer; and among the young and middle-aged, more deaths of despair and more deaths likely due to the experimental mRNA covid shots (ie 16, 17).

The widely-reported excess deaths are officially linked to poorer management of acute and chronic diseases caused by disruption to health services during the ‘pandemic’. The fact that the bulk of increased mortality occurred in young and middle-aged adults demolishes this argument.

John Hickam was right (18). Our toxic lifestyle is producing more and more people with multiple morbidities, and patients can have as many diseases as they damn well please.

Between 2006 and 2010 the number of Americans with more than one chronic condition increased by 14% (19, 20), a degenerative change that runs in parallel with and just behind the increase in those with a single known chronic condition (21, 22). These alarming shifts, evident also in the UK (23), manifest in secondary and tertiary care; patients being admitted into hospitals have increasingly complex pathology and are on more complex drug regimens when they arrive (24).

This deeply negative trend has cancelled out any of the gains in mean late life expectancy which the Norwegian statisticians could see back in 1980 (9), and which should have been extended by medical advances since that time (21).

This indicates that life expectancy at birth and the mean and modal age at death are all falling in tandem; providing yet more evidence that reactive, pharmaco-centric models of healthcare have reached their medeconomic and technical limits (25).

Based on the science presented in multiple earlier posts I am confident that improved nutrition would improve health and life expectancy at all ages, and do so safely and cost-effectively. It would also improve many aspects of motor and mental performance – and might even, by making better people, contribute to a better society (ie 26, 27).

How could we reach this nutritional Shangri-La? If a major retailer were to undergo a change of heart, and launch a range of processed or ultra-processed foods which were cheap, convenient, tasty and genuinely pro-healthy, would they be accepted by those who could gain from them?

According to a well-known market analysis company that focuses on the food, drink, and nutrition markets, affluent young adults aged 25-44 are the most likely to buy health-promoting foods (28). But these are the last people who need such products. Adults over 60 with money and growing health concerns are also more likely to pay a premium for healthier food (28, 29), and will benefit more obviously from them.

In these difficult times, however, and as the West moves into a politically driven recession (30), the number of consumers able to afford even small price premiums for health will decline. Even worse, as incomes fall, consumers turn to foods with lower cost per calorie. These tend to be more energy-dense foods that are higher in sugars and fats and lower in nutritional value (30-32).

Given current socioeconomic and nutritional trends, health and life expectancy will go nowhere but further downhill.

To reverse these declines, and achieve across the board improvements in national diet and health, we need substantive regulatory and marketing reform. This will require political involvement. Sadly, as our politicians are largely owned by corporate interests, pharmaceutical beatings are likely to continue until morale improves or the economy collapses.

The medical profession, for the most part, will go along with it. Most doctors are not trained in nutrition, and many of them may not be psychologically suited for the task.

According to a recent survey, 85% of doctors have experienced mental health issues including stress, anxiety, low self-esteem and depression (33). Post-Covid, the incidence of PTSD among frontline healthcare workers spiked at 36% (34). More particularly, they have problems with food. Between 2019 and 2022 the incidence of eating disorders among medical students seems to have nearly doubled, from a reported 10.4% (35) to 17.35% (36).

Being highly driven, goal-oriented and self-critical might create good medical students and doctors, but also a tendency to develop problems with body image and food control.

Are these the right people to advise us on healthy eating? (Hint: probably not.)

In our bright, AI-enabled future, virtual supermarket checkout staff will do a far better job at advising us what to consume. After the reactive models of healthcare collapse (25), de-centralised, disintermediated and preventative systems will take their place, with the front line now located among the food retailers and restaurants.

The first major retailer to make this move will likely become (or remain) dominant in the new health/life space. One or two of them are clearly preparing for this. And once the food manufacturers and retailers have restored pre-transitional health we can start to re-imagine medical education, and the definition of a doctor.

The non-communicable syndromes that dominate today’s medical landscape will still be present but at far lower levels, representing approximately 10% of cases that involve strong genetic risk factors.

There will still be a need for a diminishing number of specialists to treat these patients, aided and increasingly displaced by AI systems.

Most of today’s medical professionals, however, will be replaced by bare-foot equivalents trained to provide social and psychological support, together with pharmaconutrition and basic pharmaceuticals. Bone-setting when appropriate, blood-letting optional, live leeches on aisle 5 (37).

In this scenario, life expectancy at birth will revert to its former 20th-century pattern of increase (38) and, due to substantially reduced rates of non-communicable diseases, mean, modal and median ages at death will once again start to creep up the leaderboard.

The next generation of diseases – the real diseases of ageing – will emerge, driven by mitochondrial disrepair, telomeric shortening, loss of proteostasis, stem cell exhaustion, widespread cellular senescence … The next generation of medical researchers will grapple with these, if AI does not get there first.

Will birth rates recover from their current nadir, once our currently dark skies lighten? Given the rise of MGTOW and silicon succubi (39-41), I’m not so sure. If societies continue to grey, they will likely become more conservative, and more risk-averse. Fewer parents will have even fewer children, though they may see more generations of them.

We will have more time, if we wish, to learn. We may become more critical, more aware of the inter-connectedness of things, perhaps kinder. Maybe the West will regain its sanity. Perhaps we will learn to extend the kindness of the death we now offer our pets, to our human friends and relatives.

Next week: The Suicide Squad. Now accepting new members.

References

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