Bigger & Healthier
Posted in Health on July 31st, 2006 by sam – Be the first to comment
People of the mid-19th Century, like those before them, expected to develop chronic diseases by their 40s or 50s.
In 1900, 13% of people who were 65 could expect to see 85. Now, nearly half of 65-year-olds can expect to live that long.
Scientists used to say that the reason people are living so long these days is that medicine is keeping them alive, though debilitated. But studies like one Dr. Robert W. Fogel directs, using records of of Union Army veterans, have led many to rethink that notion.
The study involves a random sample of about 50,000 Union Army veterans. Dr. Fogel compared those men, the first generation to reach age 65 in the 20th century, with people born more recently.
He discovered that almost everyone of the Civil War generation was plagued by life-sapping illnesses, suffering for decades. And these were not some unusual subset of American men — 65% of the male population ages 18 to 25 signed up to serve in the Union Army.
80% had heart disease by the time they were 60, compared with less than 50% today. By ages 65 to 74, 55% of the Union Army veterans had back problems. The comparable figure today is 35%.
Men living in the Civil War era had an average height of 5-foot-7 and weighed an average of 147 pounds. Today, men average 5-foot-9½ and weigh an average of 191 pounds.
Common chronic diseases — respiratory problems, valvular heart disease, arteriosclerosis, and joint and back problems — have been declining by about 0.7 percent a year since the turn of the 20th century. And when they do occur, they emerge at older ages and are less severe.
The reasons, Dora Costa and others are finding, seem to have a lot to do with conditions early in life. Poor nutrition in early years is associated with short stature and lifelong ill health, and until recently, food was expensive in the United States and Europe.
Dr. Fogel and Dr. Costa looked at data on height and body mass index among Union Army veterans who were 65 and older in 1910 and veterans of World War II who were that age in the 1980s. Their data relating size to health led them to a prediction: the World War II veterans should have had 35% less chronic disease than the Union Army veterans. That, they said, is exactly what happened.
They also found that diseases early in life left people predisposed to chronic illnesses when they grew older.
Men who had respiratory infections or measles tended to develop chronic lung disease decades later. Malaria often led to arthritis. Men who survived rheumatic fever later developed diseased heart valves.
And stressful occupations added to the burden on the body.
People would work until they died or were so disabled that they could not continue, Dr. Fogel said. “In 1890, nearly everyone died on the job, and if they lived long enough not to die on the job, the average age of retirement was 85.” Now the average age is 62.
A century ago, most people were farmers, laborers or artisans who were exposed constantly to dust and fumes.
In one study, Dr. David JP Barker examined health records of 8,760 people born in Helsinki from 1933 to 1944. Those whose birth weight was below about six and a half pounds and who were thin for the first two years of life, with a body mass index of 17 or less, had more heart disease as adults.
Another study, of 15,000 Swedish men and women born from 1915 to 1929, found the same thing. So did a study of babies born to women who were pregnant during the Dutch famine, known as the Hunger Winter, in World War II.
That famine lasted from November 1944 until May 1945. Women were eating as little as 400 to 800 calories a day, and a sixth of their babies died before birth or shortly afterward. But those who survived seemed fine. Even their birth weights were normal.
But now those babies are reaching late middle age, and they are starting to get chronic diseases at a much higher rate than normal. Their heart disease rate is almost triple that of people born before or after the famine. They have more diabetes. They have more kidney disease.
The middle-aged people born during the famine also say they just do not feel well. Twice as many rated their health as poor, 10% compared with 5% of those born before or after the famine.
The flu pandemic arrived in the United States in October 1918 and was gone by January 1919, afflicting a third of the pregnant women in the United States. Dr. Douglas V. Almond compared two populations: those whose mothers were pregnant during the flu epidemic and those whose mothers were pregnant shortly before or shortly after the epidemic.
Dr. Almond found that the children of women who were pregnant during the influenza epidemic had more illness, especially diabetes, for which the incidence was 20% higher by age 61. They also got less education — they were 15% less likely to graduate from high school. The men’s incomes were 5% to 7% lower, and the families were more likely to receive public assistance.
“So Big and Healthy Grandpa Wouldn’t Even Know You,” by Gina Kolata










