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Old 03-17-2015, 08:29 AM   #21
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---and if they didn't ask about it and you had some disease with a genetic factor you would sue them.
Rather knee-jerky by someone who I know knows better but I understand completely. No surprise
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Old 03-17-2015, 08:40 AM   #22
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I think it's really hard to separate all the factors behind longevity. It's partly what you inherited. It's partly how you were raised. (Dad once worked in a steel mill where the kitchen was run by nice Polish ladies who tried to feed him sausage, bacon and buttered vegetables. Many had sons who had died of heart disease in their 50s.) It's also advancements in medical science that mean you may not die of what killed your parents/grandparents because it can be treated.


Others have raised all of the above points, and I think it would be hard to do a study that adjusts for the lifestyle factors and new medical developments.


I had one great-grandma who lived till age 93 and died a few days after she entered a nursing home. She was shaped like an apple dumpling and never took statins or had a mammogram or a colonoscopy. My parents are alive and still living independently in their mid-80s although Dad just had a hip replacement. I'm planning on being around for awhile.
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Old 03-17-2015, 08:53 AM   #23
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Yes, doctors just want to scare people and move the goalposts and push needless medicine on people...they are horrible people
---and if they didn't ask about it and you had some disease with a genetic factor you would sue them.

Gee, why did I retire early from medicine?


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I just knew that was why our docs spent all those years and $$$ in med school and beyond honing their specialities.
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Is Longevity Inherited?
Old 03-17-2015, 08:56 AM   #24
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Is Longevity Inherited?

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Rather knee-jerky by someone who I know knows better but I understand completely. No surprise
Really? Knee-jerky, or fact of life?
It could easily be a breech of standard practice to NOT get a family history...

Your patient whom you have followed since he was 25, is now 43 and just showed up with obstructing colon cancer with incurable spread throughout the body. You never asked about family history which it turns out includes a father and two uncles who each had colon cancer in their 40's. Had you known that you might have followed the medical standard practice of recommending a colonoscopy starting in the patient's 30's, something you never would routinely recommend to someone so young otherwise. But you never got a family history...so you did not screen and find this in a curable state years earlier.....and you don't think that doctor is getting sued?..


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Old 03-17-2015, 08:56 AM   #25
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Hey man, as somebody else here would say: Anybody who disagrees with me must be a troll. See how easy it is? Like I said, kinda knee jerky.
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Old 03-17-2015, 09:02 AM   #26
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Let's step back and take a deep breath. There's no need to be insulting towards other people or their professions simply to discuss longevity. Please read our Community Rules.

If another member is annoying, you can put them on "ignore" by clicking on User CP (above) and editing your ignore list.
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Old 03-17-2015, 09:08 AM   #27
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Your patient whom you have followed since he was 25, is now 43 and just showed up with obstructing colon cancer with incurable spread throughout the body. You never asked about family history which it turns out includes a father and two uncles who each had colon cancer in their 40's. Had you known that you might have followed the medical standard practice of recommending a colonoscopy starting in the patient's 30's, something you never would routinely recommend to someone so young otherwise.
Darn, that's sad- for both the doctor and the patient. You'd think that someone with that family history and with all the public education about colon cancer would have taken responsibility to get themselves tested early. When I had my first colonoscopy around age 55 and they found a moderate nasty (not cancerous but could have been if left untreated for 5-10 years), I told DS it was important for him to get tested in the recommended time frames. He's 30 now but you can bet if I'm around when he has to get his first one I'll be nagging him. That's what mothers do.


And it's too bad the doctor of the father/uncles didn't emphasize the need for family members to be cautious. I know one young woman who developed colon cancer (seems to have survived it after extensive treatment) and was advised to tell her family members they should be checked. It turned out her father had it, too- much earlier stage and more easily treatable.
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Old 03-17-2015, 09:31 AM   #28
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I find the study recounted by Gawande perplexing, and struggle to find a possible way to reconcile with popular belief that genetics matter, but am not successful.

Let's read the statement again.
"... only 3 percent of how long you’ll live, compared with the average, is explained by your parents’ longevity; by contrast, up to 90 percent of how tall you are is explained by your parents’ height. Even genetically identical twins vary widely in life span; the typical gap is more than fifteen years.”

Suppose they did not discount death due to accidents, then this finding would still be significant. It would mean that the extraneous non-medical factors are so overwhelming that good genes hardly matter, unless you never leave your home so you can avoid that proverbial bus.

I assume that they discount death due to unnatural causes, meaning accidents. Then how can this be explained?

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I think you get more from your genes then you get from your behaviour. That is yes it is inherited.

Now if you smoke 5 packs a day good genes may not help you.
If you are a smoker, good genes may not help you live longer than the average, but should we not expect that you still live longer than the smoker with bad genes? Statistically, would that not show up?

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I believe this finding.

If your parents smoked or drank too much or didn't exercise, your lifestyle impact on longevity will easily outweigh the genetic inheritance. Look around - how many people live exactly like their parents?

Siblings could live very different lifestyles - if one leads a healthy lifestyle and the other is a couch potato, there goes the correlation to genes!
Again, good genes should still show up statistically that it helps.

Well, it does, but the quoted study says a measly 3%.

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Does this mean that the health factors that lead to the premature death of a parent do not play a significant role in the health of their children, or does it mean these factors are still inherited but modern medicine is able to treat these conditions and minimize the impact?
I would think that the parents' age was compared to their peer, while the children's age was compared to the average lifespan of the younger generation. This way, the benefits of modern medicine get accounted for equally for people with good and bad genes.
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Old 03-17-2015, 09:41 AM   #29
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We all know people who smoke and get to live till 80 or 90. Conversely, we also know people who are not smoker, yet die of lung cancer.

We have been told that eating vegetable helps with colon cancer risks, but I have read blogs of young colon cancer patients who died in their 20s and 30s, and they were vegetarian. Recently, a study in Europe that follows a large group of people (hundreds of thousand, if not millions) over a couple of decades has found little correlation of colon cancer avoidance to vegetable consumption. Regarding red meat, they said that it was not a strong factor, but could not be ruled out. This led me to believe that the linkage is not that strong.

And people talked about families having 2 or 3 generations of unusual long or short longevity, but is that meaningful statistically? One can always roll head or tail 2 or 3 times in a row. Are you going to roll head or tail again the next time?

I fear there's a lot more randomness in health and longevity than we care to acknowledge.

PS. This does not mean one should live with abandon. Rather, I am going to stay as healthy as I can, and to avoid bad habits. It's just that I cannot be cocky sure that it will get me to live to 90 or even 80.
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Old 03-17-2015, 09:47 AM   #30
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what is the number one underwriting criterion for life insurance?


(family history?)
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Old 03-17-2015, 10:34 AM   #31
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And not just health/longevity is genetic.

So is beauty and intelligence.

It is good to pick healthy, good looking, educated and smart parents. At least that is the way looks to me.
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Old 03-17-2015, 03:54 PM   #32
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You left out rich parents, which reminds me of this music: Summertime by Ella Fitzerald and Louis Armstrong.

Time for some music. It's appropriate too, for where I am. Temperature hits 88F today.

Summertime
And the livin' is easy
Fish are jumpin'
And the cotton is high

Oh your daddy's rich
And your ma is good lookin'
So hush little baby
Don't you cry

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Old 03-17-2015, 06:05 PM   #33
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If people were bred for traits, we could predict traits more confidently. But, people are usually mutts. Which is a good thing.
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Old 03-17-2015, 06:42 PM   #34
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But aren't we all descendants of Adam and Eve?

Ah hah! Then, that explains why longevity has nothing to do with genes. They are all the same.
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Old 03-18-2015, 04:39 AM   #35
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Well, according to my Bible (see the "begats" section), the earlier descendants of A&E (or of Cain and Abel and their unnamed sisters, one supposes) were living to be 800 - 900 years old. Obviously, we've been doing something wrong of late.

A.

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But aren't we all descendants of Adam and Eve?

Ah hah! Then, that explains why longevity has nothing to do with genes. They are all the same.
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Old 03-18-2015, 08:41 AM   #36
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And people talked about families having 2 or 3 generations of unusual long or short longevity, but is that meaningful statistically? One can always roll head or tail 2 or 3 times in a row. Are you going to roll head or tail again the next time?

I fear there's a lot more randomness in health and longevity than we care to acknowledge.
You're right- I bragged about my great-grandmother and my still-active parents in their 80s, but my Uncle (mother's brother), a magnificent specimen who ran marathons and didn't allow white bread in the house, dropped dead of a heart attack at age 42. (I later heard that he was getting signs of cardiac problems and ignoring them.)
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Old 03-18-2015, 06:22 PM   #37
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IMHO- It is too simplistic to generalize population-based observations of family/genetic effects on life span to any specific person. For an unfortunate child dying of a uniformly fatal inherited condition, life span was (almost) 100% determined by genetics. OTOH- For a healthy child who died in a car wreck, genetics had essentially zero influence on their life span. Obviously, genetic influence on LE for the vast majority of folks will fall somewhere between those extremes. And their LE will be influenced by personal behaviors like smoking, diet, and exercise.
In the future, some genetic influences may affect LE less as medical science advances. Members of families prone to serious problems like cancers, heart diseases, etc. may begin living longer, on ave, as those problems are detected earlier and treated more successfully... or even avoided in the 1st place. But that assumes folks won't use those medical advances as an excuse to start smoking, eating poorly, and drinking heavily.
Optimal LE will always depend on doing the best you can with the genetic hand you've been dealt
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Old 03-21-2015, 11:53 PM   #38
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My training in research methodology and statistics says comparing a random sample of people to their parents is a great way to find little relation between a rare trait and genetic inheritance. The Christian Albrechts University study had the right idea, study the antecedents of really old people.

We have the family tree of one grandmother back to 1793. The percentages of those who died in childhood or in war were comparable to their generations. About 80% of everyone else lived into their 80s and early 90s in eras when that was unusual.

That longevity may explain why everyone underestimates my age. I've never told people the age of when I was first able to buy alcohol without an ID check, or the age when it last happened because no one would believe me. There was a downside. When I was 40, young women got creeped out when they realized I was 15 years older than they thought, while the women my age were dismissive until I mentioned my age. I think they thought I was cougar hunting.
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Old 03-22-2015, 07:04 PM   #39
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You're right- I bragged about my great-grandmother and my still-active parents in their 80s, but my Uncle (mother's brother), a magnificent specimen who ran marathons and didn't allow white bread in the house, dropped dead of a heart attack at age 42. (I later heard that he was getting signs of cardiac problems and ignoring them.)
Running marathons, and other "long-term excessive endurance exercise" can damage the heart. Lots of studies coming out now that confirm this. Here is one: http://www.mayoclinicproceedings.org...473-9/abstract

I believe in moderate exercise myself, but definitely not running marathons, and that type of extreme cardio.
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Old 03-23-2015, 08:17 AM   #40
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Running marathons, and other "long-term excessive endurance exercise" can damage the heart. Lots of studies coming out now that confirm this. Here is one: http://www.mayoclinicproceedings.org...473-9/abstract

I believe in moderate exercise myself, but definitely not running marathons, and that type of extreme cardio.
I'd seen those results, too. My limit is my 35-mile charity bike rides, although I do have 2 scheduled one weekend after the other this summer. It's about 4 hours of riding (with breaks) but I finish feeling comfortably worn out and hungry- not near-death. I once worked for a guy who ran a 50-mile race. We all told him he was nuts. He's in his late 30s; I wonder what shape he'll be in 20 years from now if he keeps that up.
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