[HN Gopher] Global trends in incidence, death, burden and risk f...
       ___________________________________________________________________
        
       Global trends in incidence, death, burden and risk factors of
       early-onset cancer
        
       Author : philonoist
       Score  : 89 points
       Date   : 2023-09-06 12:44 UTC (7 hours ago)
        
 (HTM) web link (bmjoncology.bmj.com)
 (TXT) w3m dump (bmjoncology.bmj.com)
        
       | randcraw wrote:
       | The gorilla question: what has changed in the past 33 years to
       | cause this increase? I'd look first at confounding variables like
       | 33 years of improved methods to detect cancer earlier: the rise
       | of MRI, screening for chemical signatures of cancer (like PSA),
       | etc.
       | 
       | The abstract didn't suggest the authors filtered out more recent
       | methods of detection from their data (i.e. detections based only
       | on 1990-era tests like physical exam, 2D X-Ray, etc).
        
         | onlyrealcuzzo wrote:
         | Am I reading the chart wrong or are DALYs (Disability-adjusted
         | Life Years) down for almost everything beside breast cancer?
         | 
         | This seems like we're just getting better at detecting cancer
         | earlier ( _especially_ breast cancer), and preventing it from
         | killing you younger - not that cancer is a way bigger problem.
         | 
         | In fact - if you look at deaths - it also looks like it's down
         | for most things, too - breast cancer being a major outlier.
         | 
         | But everyone else seems to be interpreting this the other way -
         | so I'm hoping someone can explain why the DALY figures don't
         | mean what I think they mean.
        
           | mcpackieh wrote:
           | Since we're much better at detecting breast cancer early, why
           | aren't breast cancer deaths down the most? Is this because
           | treating breast cancer is particularly difficult, more-so
           | than other cancers, or is something causing more breast
           | cancer than before?
        
             | onlyrealcuzzo wrote:
             | Breast cancer isn't particularly fatal now.
             | 
             | Treatment has been pretty decent for at least 10 years.
             | 
             | I'm surprised that deaths per 100k are up. I'm not sure if
             | they adjusted this to account for the fact that the global
             | population is older now than in 1990.
             | 
             | But DALYs should cover that (which is still a strange
             | outlier for breast cancer, but nothing major).
        
         | thfuran wrote:
         | >I'd look first at confounding variables like 33 years of
         | improved methods to detect cancer earlier: the rise of MRI,
         | screening for chemical signatures of cancer (like PSA), etc.
         | 
         | Early detection is one thing, but is cancer generally hard to
         | detect by the time it's fatal?
        
           | rcpt wrote:
           | If something else kills you then yeah
        
           | starkparker wrote:
           | Some of the ones listed in the study certainly can be, like
           | colorectal.
        
             | pastor_bob wrote:
             | young people don't get screened for colorectal cancer.
        
         | giantg2 wrote:
         | Eh, yeah the earlier detection are a factor in the detection
         | numbers. However, the fact that early onset mortality rates
         | have also risen seems to indicate that this isn't only an
         | obversational issue. This still points to a real issue.
        
       | jader201 wrote:
       | Under "what this study adds":
       | 
       | > _Dietary risk factors (diet high in red meat, low in fruits,
       | high in sodium and low in milk, etc), alcohol consumption and
       | tobacco use are the main risk factors underlying early-onset
       | cancers._
        
         | reedf1 wrote:
         | I'm very surprised to see milk negatively correlated with
         | cancer risk - I usually see people calling milk unhealthy. Do
         | we know exactly what the benefits are?
        
           | Qem wrote:
           | I suspect the plant-based "milk" makers are investing a lot
           | of marketing resources in smearing the reputation of milk as
           | unhealthy, just like the margarine makers did before to
           | promote the replacement of butter with cheaper hydrogenated
           | vegetable oils.
        
           | simmerup wrote:
           | Milk has minerals like potassium and a low glycemic index as
           | lactose takes a while to digest. That could help.
        
           | consilient wrote:
           | Somethings are simply bad for you, without qualification, but
           | for the most part it only makes sense to use "healthy" or
           | "unhealthy" to describe a diet, not individual foods.
           | 
           | Milk has lots of protein, minerals, and fat. Whether that's
           | good or bad depends on how much of those you're getting from
           | other sources.
        
           | raverbashing wrote:
           | > I usually see people calling milk unhealthy
           | 
           | Usually with zero actual supporting data
        
         | dham wrote:
         | Low in fruits: What kind of fruits? Not all fruits are created
         | equal and it's important how we consume them. Drinking fruits
         | in smoothies doesn't mean you're healthy. Eating Blackberries,
         | Rasberries, Strawberries, Avocados, yea. Eating grapes,
         | raisins, apples, no
         | 
         | Diet high in red meat: Nope. Only if your diet is also high in
         | carbs (the American diet). Eating a grass fed steak with some
         | broccoli and walnuts on the side. Ok. Eating a steak with baked
         | potato and chocolate brownie for dessert, na.
         | 
         | High in sodium: Nope. Only if your diet is also high in carbs
         | 
         | Low in milk: Lol
         | 
         | Alcohol consumption: Yes
         | 
         | Tobacco use: Yes
        
           | dehrmann wrote:
           | > Eating...apples, no
           | 
           | Apple juice, sure, but whole apples? You're gonna need to
           | back that claim up with some pretty strong evidence.
        
             | dham wrote:
             | Too much sugar in Apples, not enough fiber.
        
           | rafaelero wrote:
           | > Diet high in red meat: Nope. Only if your diet is also high
           | in carbs (the American diet). Eating a grass fed steak with
           | some broccoli and walnuts on the side. Ok. Eating a steak
           | with baked potato and chocolate brownie for dessert, na.
           | 
           | Cope. Of course adding broccoli and walnuts will make it
           | healthier. Now substitute meat for beans and it will be even
           | healthier.
        
             | dham wrote:
             | Meat isn't bad, meat with carbs is bad.
        
               | flerchin wrote:
               | This is the first I've heard of this claim, but you seem
               | adamant that this is proven. Would you mind sharing some
               | evidence?
        
         | odyssey7 wrote:
         | Are they saying milk deficiency causes cancer?
        
         | [deleted]
        
       | xenonite wrote:
       | High BMI and high fasting glucose are a main risk factor, they
       | write. Well what about reducing sugar and carbs altogether
       | instead of promoting whole grains as they do?
        
         | scottLobster wrote:
         | Because whole grains have fiber and other nutrients that makes
         | them extremely healthy.
         | 
         | No one is getting fat off of oatmeal with berries and raw
         | oranges, they're getting fat off all the cinnamon-sugar they
         | slather on top of the oatmeal and the glass of no-pulp orange
         | juice with added sugar they have as a beverage.
         | 
         | Also fast food and sodas.
        
           | myrmidon wrote:
           | Just wanted to add: Neither "non-pulp" nor "added sugar" is
           | the main problem with orange juice.
           | 
           | The real problem becomes _very_ obvious if you prepare the
           | fruit juice yourself:
           | 
           | The fruit needed to produce even a single glass of apple or
           | orange juice (which is quite easy to drink/sip quickly) is _a
           | lot_ if you were to consume it raw (basically not doable, or
           | at least I 'm not gonna eat like 4 apples at once).
           | 
           | Juicing fruit makes it _much_ easier to overconsume fruit
           | sugar.
        
             | saiya-jin wrote:
             | I made a rule to myself - no juices, pulp, no pulp, doesnt
             | matter. Way too much simple carbs for it to be ever
             | healthy. I can literally taste all the sweetness since I
             | generally avoid sugars, even if I make it myself with all
             | the pulp possible. Like that, I don't have any needs for
             | those, no cravings or urges to pour glass ie when eating in
             | hotel, in same way I have 0 craving for sugary/worse sodas.
             | 
             | The thing is, most of the pulp stays in the juicing machine
             | regardless. Thats why you don't drink solid apple, just
             | juice from it. So I eat those fruits, but oranges almost
             | never, apples more so. Vegetables are so much healthier, a
             | good bio carrot is my friend #1 also due to better
             | processing of sunshine in the skin.
             | 
             | You can teach yourself almost anything with a smidge of
             | discipline, but its much easier if your parents just dont
             | fuck up your upbringing and don't make this and other
             | junkfood into some idiotic rewards (or just don't care at
             | all), so you just continue that trend into adulthood.
        
             | kwhitefoot wrote:
             | > Juicing fruit makes it much easier to overconsume fruit
             | sugar.
             | 
             | It's worse than simply making it easier to consume large
             | quantities of fruit. Even if you consume only the same
             | amount of fruit as you would be willing to eat unprocessed
             | juicing it makes the sugars more available so that you over
             | consume even without appearing to consume a lot.
        
         | mcpackieh wrote:
         | For an individual to cut all grain and carbs out of their diet
         | is relatively easy (whether that's actually a good idea is
         | another matter.) For the whole population to do it? You'll need
         | something to replace these for billions of people, ideally
         | without causing mass starvation:
         | https://en.wikipedia.org/wiki/Staple_food#Production Good luck.
        
         | Enginerrrd wrote:
         | Because whole grains have a lot of fiber and high dietary fiber
         | intake has consistently been shown to be critical to several
         | different health outcomes. And intake of whole grains
         | specifically is also strongly linked to positive health
         | outcomes while in most cases low carbohydrate diets of various
         | sorts are not.
        
           | hn8305823 wrote:
           | A healthy diet is helpful of course but the most important
           | thing is exercise. Not just casual going through the motions
           | exercise but _high intensity balls-to-the-wall_ exercise:
           | 
           | https://www.verywellhealth.com/intense-exercise-capacity-
           | can...
           | 
           | https://www.cancer.gov/about-cancer/causes-
           | prevention/risk/o...
           | 
           | https://www.sciencedaily.com/releases/2020/10/201026114229.h.
           | ..
           | 
           | https://www.medicalnewstoday.com/articles/metastatic-
           | cancer-...
           | 
           | ... and so on
        
         | hombre_fatal wrote:
         | Do people gain weight when they switch their SAD out with whole
         | grains and carbs like legumes? I'd wager the evidence says no.
         | 
         | Is that what the diet looks like in obese people?
         | 
         | Frankly it sounds like exactly what obese people should be
         | eating: swap out highly palatable foods with beans, broccoli,
         | and bulgur.
        
         | rafaelero wrote:
         | It would be dumb discouraging whole grains since they are
         | clearly associated with decreased mortality. According to the
         | paper:
         | 
         | "Dietary risk factors (diet high in red meat, low in fruits,
         | high in sodium and low in milk, etc), alcohol consumption and
         | tobacco use are the main risk factors underlying early-onset
         | cancers."
        
           | chrisweekly wrote:
           | "low in milk" (as a risk factor) strikes me as an
           | extraordinary claim
        
         | 876978095789789 wrote:
         | > instead of promoting whole grains
         | 
         | Telling people to eat fewer, not more, whole grains to prevent
         | T2DM and cancer is peak HNism:
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506108/
         | 
         | https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.31198
         | 
         | and high-fat, high-saturated fat diets actually make insulin
         | sensitivity worse:
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291812/
        
           | throwbcuzbusy wrote:
           | I don't have an HN account, because it is a poor use of my
           | time, but I made one to counter your points (which date back
           | decades, and have been already debunked by those more
           | eloquent than I).
           | 
           | 1. High-fat diets, as done in your 3rd paper and as done in
           | most "high fat" studies, are incorrectly labeled such. "High-
           | fat diet (HFD, n = 10: 55 % fat/25 % saturated fat/27 %
           | carbohydrate)"[0] is not what the parent meant by "reducing
           | sugar and carbs altogether instead of promoting whole grains
           | as they do." A more honest interpretation would be "max 40g
           | carbs, the rest fats and proteins." This is because the main
           | benefits of such a diet only come out when carbohydrates are
           | severely restricted -- as has been known for a while now.
           | 
           | 2. Linking papers, without any sort of commentary or notion
           | as to the reason for their inclusion, is in poor taste. In
           | most cases this is done when the poster themselves haven't
           | thoroughly read the articles in question. I won't go so far
           | as to say this has been done today, but I will say it is a
           | disrespect of our time to post lengthy papers without any
           | sort of reasoning behind why they've been posted.
           | 
           | 3. The first two links (technically one paper)[1][2] are
           | statistical analyses of different food groups and their
           | association with type 2 diabetes. The same error is done here
           | as has been mentioned in my first point: without controlling
           | for the whole diet, and using a very low carb, high
           | fat/protein diet, the findings are irrelevant. Risk ratios
           | are a notable finding, not a be-all end-all. Correlation is
           | not causation. Continue platitudes ad infinitum and ad
           | nauseam.
           | 
           | [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291812/ [1]
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506108/ [2]
           | https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.31198
        
             | 876978095789789 wrote:
             | > 1. High-fat diets, as done in your 3rd paper and as done
             | in most "high fat" studies, are incorrectly labeled such.
             | "High-fat diet (HFD, n = 10: 55 % fat/25 % saturated fat/27
             | % carbohydrate)"[0] is not what the parent meant by
             | "reducing sugar and carbs altogether instead of promoting
             | whole grains as they do." A more honest interpretation
             | would be "max 40g carbs, the rest fats and proteins." This
             | is because the main benefits of such a diet only come out
             | when carbohydrates are severely restricted -- as has been
             | known for a while now.
             | 
             | Where's the evidence? I linked to a study, one that isn't
             | confounded by weight-loss (like most studies you people
             | like to cite) demonstrating that as the fat (especially
             | saturated fat) content of the diet increased to an absurd
             | degree (55%!), insulin sensitivity tanked. Why would
             | insulin sensitivity, when measured by an Oral Glucose
             | Tolerance Test, suddenly improve if you restricted
             | carbohydrate even further? Yeah, at some point your intake
             | will be so low that you can "game" an HbA1c or fasting BG
             | test, but underlying insulin sensitivity will be trash
             | (which an OGTT would show), unless maybe you lose enough
             | bodyfat to offset it.
             | 
             | Why do so many people on keto develop "physiological
             | insulin resistance?" Why does all of the epidemiological
             | evidence show strong inverse correlations between low-fat
             | carbohydrate consumption (like whole grains and fruits) and
             | T2DM, but the reverse for high-fat "carbs" like cookies or
             | pizza?
             | 
             | The most reasonable interpretation of the data right now is
             | that high-fat diets make you less insulin sensitive.
        
           | astura wrote:
           | It's peak Reddit bro-science, it's just Reddit bro-science
           | has leaked into HN last several years.
        
             | jamiek88 wrote:
             | The Overton window of weird dietary approaches shifts too.
             | It started with 'Atkins' which became lo carb when he was
             | debunked, which became paleo 'cos that is cooler for the
             | bro's then this got more extreme as a carnivore only diet
             | and some of those weirdos have moved onto only raw meat.
             | 
             | Every internet meme gets more and more extreme.
        
               | EatingWithForks wrote:
               | I wish there was serious consideration that this might be
               | a kind of manifestation of disordered eating. Being
               | overly extreme about your diet can be a form of
               | disordered eating, especially if it's unconnected to
               | underlying condition like keto for epilepsy, gluten free
               | for celiac's, etc. If you're a completely healthy man
               | eating only raw meat, are you seriously any different
               | from a woman who insists on eating only cabbage? I've
               | seen people talk about how great their fasting diet is--
               | going days, upwards over a week without eating at a
               | time-- and how amazing their feel not eating, etc. That
               | basically also sounds like disordered eating.
        
               | grecy wrote:
               | If we're lucky the next one will be 'No calories. Ever.'
        
               | shard wrote:
               | As promoted by Famine in the book 'Foodless Dieting: Slim
               | Yourself Beautiful ("The Diet Book Of The Century!")'
               | 
               | https://wiki.lspace.org/Famine_(Good_Omens)
        
               | J_Shelby_J wrote:
               | Maybe, but cultural opinion about diets has always been
               | shifting and multifaceted.
               | 
               | For example, the high carb SAD being defacto is a new
               | thing. It became the default around the same time as the
               | agricultural revolution and mass media. Before that,
               | there were lots of of options. During the period where
               | mass media ruled, their was only one zeitgeist (brought
               | to you by Kellogg's!), but now with the internet we are
               | back to historical norms where those with means are able
               | to find advice free of commercial incentives and
               | regulatory capture. For example, low carb has been around
               | for centuries.
               | 
               | https://en.m.wikipedia.org/wiki/Low-
               | carbohydrate_diet#histor...
        
           | Helmut10001 wrote:
           | Are you sure? Citation from your first link
           | 
           | > Six out of the 12 food-groups showed a significant relation
           | with risk of T2D, three of them a decrease of risk with
           | increasing consumption (whole grains, fruits, and dairy),
        
             | 876978095789789 wrote:
             | > Are you sure? Citation from your first link
             | 
             | I think you misread my post, or misread the study. Whole
             | grains are some of the healthiest foods you can eat,
             | especially when it comes to reducing your risk of T2DM,
             | while the person I was replying to implied the opposite:
             | 
             | > Thirteen studies with 29,633 T2D cases were included in
             | the high vs. low intake meta-analysis (overall intake
             | range: 0-302 g/day). Comparing extreme categories, a strong
             | inverse association between T2D and whole grain intake was
             | observed (RR: 0.77; 95% CI 0.71-0.84, I2 = 86%)
             | (Supplementary Figure S1). Each additional daily 30 g of
             | whole grains was inversely associated with T2D risk (RR:
             | 0.87; 95% CI 0.82-0.93, I2 = 91%, n = 12 studies)
             | (Supplementary Figure S2). The inverse associations and
             | heterogeneity persisted in additional analyses stratified
             | by sex, age, follow-up length, geographic location, number
             | of cases, dietary assessment, and outcome assessment
             | (Supplementary Table S14). Evidence of heterogeneity
             | between subgroups in stratified analyses was observed for
             | geographic location, dietary assessment method, and outcome
             | assessment. There was significant evidence for small study
             | effects in the high versus low meta-analysis, but not in
             | the dose-response meta-analysis. Visual inspection of the
             | funnel plot suggests that small studies showing positive
             | association may be missing (Supplementary Figure S25).
             | There was evidence of a non-linear dose-response
             | association; the risk of T2D decreased by 25% with
             | increasing intake of whole grains up to ~50 g/day. Small
             | benefits for increasing intake above this value were
             | observed (Fig. 2).
        
         | pastor_bob wrote:
         | >Well what about reducing sugar and carbs altogether
         | 
         | The summary says red meat and low-fruit diets (which obviously
         | have carbs) increase the risk of cancer as much if not more.
         | 
         | Why would they push for a keto diet if the evidence that it's
         | beneficial is contradictory?
        
       | photochemsyn wrote:
       | Having read the study, it does have a major flaw in its risk
       | attribution approach, but the global data is pretty interesting,
       | in particular this:
       | 
       | > "In 2019, after breast cancer, the digestive and respiratory
       | systems of early-onset cancer were mainly responsible for the
       | deaths."
       | 
       | However, it's risk conclusion is that "Dietary risk factors (diet
       | high in red meat, low in fruits, high in sodium and low in milk,
       | etc), alcohol consumption and tobacco use are the main risk
       | factors underlying early-onset cancers." - but, they don't even
       | mention industrial and secondary exposures to carcinogenic
       | chemicals, even though this has been a well-described cause of
       | early-onset cancer for over 100 years, and of course the
       | respiratory and digestive tract - which is where early-onset
       | cancers are showing up - are obvious immediate targets for
       | carcinogenic environmental pollutants. E.g.:
       | 
       | "Outdoor air pollution and cancer: an overview of the current
       | evidence and public health recommendations" (2022)
       | 
       | "Cumulative risk analysis of carcinogenic contaminants in United
       | States drinking water" (2019)
       | 
       | Any study that chooses to _completely ignore_ this factor in
       | favor of blaming the rising rates of early-onset cancer on
       | 'personal dietary choices' should be tossed in the trash, it's
       | the kind of thing an industrial PR group would generate in an
       | effort to stop clean air/water/food regulations from being
       | implemented.
        
         | jvanderbot wrote:
         | I think this is the most important trend in science journalism
         | / communication that needs to be dealt with.
         | 
         | Personal responsibility is basically corporate accountability
         | laundering.
        
           | ekanes wrote:
           | Perhaps, but by far the single greatest way to change health
           | outcomes for an _individual_ (not a society) is their own
           | personal actions. We need both approaches.
        
             | jvanderbot wrote:
             | That is fine if you feel there is a shared responsibility.
             | I can see that. But I don't see a lot of "personal
             | responsibility" happening at the corp level.
             | 
             | I believe that given the power imbalance of individuals vs
             | corps, and the history of corporate messaging being
             | insanely misleading, and of course ongoing regulatory
             | capture, that we need a systematic approach at a high
             | priority much more than we need more recommendations for
             | "common sense" individual approaches.
        
         | pixl97 wrote:
         | Because individually figuring out dietary factors tends to be
         | easier and strongly correlated.
         | 
         | There is no particular reason they study should be tossed in
         | the trash, that is just you being dramatic. Both things are
         | factors, not just one or another.
         | 
         | Things like environmental factors need other studies that show
         | differences in places that increase/decrease pollution and the
         | incident rate change in cancers as that occurs.
        
         | adamredwoods wrote:
         | >> Encouraging a healthy lifestyle, including a healthy diet,
         | the restriction of tobacco and alcohol consumption and
         | appropriate outdoor activity, could reduce the burden of early-
         | onset cancer.
         | 
         | "could"
        
       | PeterWhittaker wrote:
       | One key paragraph: Since 1990, the incidence and deaths of early
       | onset cancers have substantially increased globally. Early-onset
       | breast, tracheal, bronchus and lung, stomach and colorectal
       | cancers showed the highest mortality and burden in 2019.
       | Countries with a high-middle and middle Sociodemographic Index
       | and individuals aged 40-49 years were particularly affected.
       | Dietary risk factors (diet high in red meat, low in fruits, high
       | in sodium and low in milk, etc), alcohol consumption and tobacco
       | use are the main risk factors underlying early-onset cancers.
        
         | [deleted]
        
       | giantg2 wrote:
       | Sort of surprising to see the main factor being dietary and only
       | calling out some specific things but not others. No mention of
       | hormones (or chemicals that act like them), toxins, etc as risks.
        
         | candiddevmike wrote:
         | What is a "toxin" to you?
        
           | hammock wrote:
           | Would imagine pesticides, environmental pollutants, etc
        
             | cromulent wrote:
             | Normally "toxin" refers to a natural poison produced by an
             | animal or plant.
        
               | hammock wrote:
               | Reviewing the dictionary(1) it seems you are right. For
               | some reason I was thinking that anything toxic could be
               | considered a toxin. Apparently that's not the case
               | 
               | (1)https://www.merriam-webster.com/dictionary/toxin
        
               | giantg2 wrote:
               | Some molds have toxic spores which have carcinogenic
               | effects.
        
       | alexfromapex wrote:
       | I bet this can all be explained by the negligence of government
       | to protect the public against dangerous chemicals in the water,
       | food, and consumer products because of lobbying by private
       | industry.
        
         | macinjosh wrote:
         | 100%, I'd also add things like new kinds of pharmaceuticals
         | that are rushed through regulator approvals and are heavily
         | pushed by public health officials, and made free to the public
         | (funded by tax dollars). The influence so strong in some cases
         | that folks lost their jobs for declining the pharmaceutical
         | product while pharma corporations raked in cash.
        
           | hooverd wrote:
           | The COVID vaccine caused this?
        
           | hospitalJail wrote:
           | I don't mind access to untested drugs. I do mind that
           | Physicians have 100% of control over which diagnosis and
           | medicine they decide.
           | 
           | Travel based medicine, science based medicine, AI based
           | medicine, all seem like a welcome change from the US's
           | Authority Based Medicine.
        
         | Pxtl wrote:
         | The problem is that we are exposed to so many chemicals,
         | finding the culprit(s) for this kind of thing will be nigh
         | impossible.
         | 
         | The study said "(diet high in red meat, low in fruits, high in
         | sodium and low in milk, etc)"
         | 
         | which basically means "everywhere in the first world" since red
         | meat is often too expensive in 3rd-world settings. And
         | globalization means that every first world country is using the
         | same products.
        
           | JohnMakin wrote:
           | Everything is chemicals.
        
             | Pxtl wrote:
             | _sigh_ don 't be silly, you know what I mean. Plastics,
             | aromatic hydrocarbons, endocrine disruptors, etc.
             | 
             | You know, novel technologically produced chemicals (or
             | natural chemicals in unnatural quantities) that may have
             | negative impact on your body that we either are unaware of
             | or have underestimated.
        
         | [deleted]
        
         | thinkingtoilet wrote:
         | > Dietary risk factors (diet high in red meat, low in fruits,
         | high in sodium and low in milk, etc), alcohol consumption and
         | tobacco use are the main risk factors underlying early-onset
         | cancers.
         | 
         | It seems it's the chemical we're putting in ourselves. No
         | government blame needed.
        
           | foolfoolz wrote:
           | except these dietary factors make no sense / change so
           | frequently they are almost science fads. tobacco use has
           | dropped significantly in the last 30 years. sodium is now
           | considered not that important, especially compared to sugar.
           | low in milk contradicts the reality that milk is full of
           | hormones and antibiotics
           | 
           | we do an about face on lots of "dietary risk factors" every
           | 5-10 years
        
             | marcosdumay wrote:
             | If I'm reading the article correctly, those factors mean
             | that current young smokers have a higher chance of dying
             | from cancer than young smokers from the 90's. The
             | probability is so much higher that the total of deaths
             | increased by many tens of percent, while the total number
             | of smokers decreased by an order of magnitude or so.
             | 
             | I do agree that it makes no sense to blame the mortality on
             | smoking. The change in smoking is clearly not what is
             | leading it.
        
           | adaptbrian wrote:
           | this sounds like the diet i started per the recommendation of
           | my doctor after he kicked his migraines doing this. i am a
           | long time sufferer of cluster headaches and this looks to be
           | the first year ive been able to abate them for an entire
           | cycle/year.
           | 
           | low carb, low inflammatory, high protein ratio combined with
           | heady/meaty lettuces and non root veggies.
           | 
           | the american food pyramid is a farse and drastically needs to
           | be updated.
        
             | [deleted]
        
           | mellosouls wrote:
           | _It seems it 's the chemical we're putting in ourselves. No
           | government blame needed._
           | 
           | Where does it say that alcohol and tobacco consumption have
           | increased in the time period? In fact for at least one group,
           | as expected, it's decreased as a ranking factor.
           | 
           | So - while it's absolutely true that individuals must take
           | responsibility for their choices, it seems reasonable to
           | associate the increase with trends that have increased -
           | highly processed foods etc. Not alcohol and tobacco.
           | 
           | The criticism of government inaction and lobbying therefore
           | seems a good default position to take.
        
           | mlinhares wrote:
           | The average US diet is a direct result of lobbying and
           | government action based on such lobbying, as it is visible if
           | you go almost anywhere else, including poorer countries like
           | the US neighbors in Latin America.
        
             | seizethecheese wrote:
             | "Direct result"? I mean, sure it has a big effect, but
             | supply and demand matter. For example, do you think
             | Americans developed a taste for avocados due to lobbying?
        
               | J_Shelby_J wrote:
               | No, but the USDA made the food pyramid. The USDA
               | represents agricultural interests. It does not represent
               | consumers interests.
               | 
               | That and the myriad of agricultural subsidies and
               | especially corn subsides. Most Americans are above 50%
               | corn... the same way my cat is made of water and cat
               | food. Whether though consuming it directly or through
               | meat and dairy fed on corn.
               | 
               | The end result has been the SAD as we know it: food
               | that's cheap and profitable but unhealthy.
        
           | coldtea wrote:
           | > _It seems it 's the chemical we're putting in ourselves. No
           | government blame needed._
           | 
           | This has been facilitated by food industry compliant with
           | legislators, so there's a lot of government blame needed.
        
           | tacocataco wrote:
           | Corn subsidies and the lack of regulation and consequences
           | for corporations that pollute.
           | 
           | Norfolk Southern still exists and still makes money off of
           | critical infrastructure.
           | 
           | Deny justice long enough, and people will get their own in
           | the worst way possible one day.
        
           | revscat wrote:
           | This seems incredibly naive. Addiction affects peoples
           | ability to make rational choices.
        
           | [deleted]
        
         | ceejayoz wrote:
         | "Globally" and "worldwide" are right there in the abstract.
         | 
         | edit: Parent post originally stated something about the
         | "enshittification of the US".
        
           | donkeyd wrote:
           | Correct and the previous commenter is practicing some clear
           | 'US Defaultism'. However, unrestricted Western consumerism is
           | a massive part of what's happening worldwide. We all want
           | cheap everything and nobody is stopping western companies
           | from using the absolute worst suppliers and production
           | methods for everything (exaggerated, but not much).
           | 
           | Companies like 3M, Bayer, Dow, Shell and BP are polluting the
           | whole world directly. Companies like H&M and Primark are
           | doing it indirectly by using the cheapest supplier for mass
           | market crap they sell. I recently heard that most bamboo
           | fiber (which westerners buy because they think it's
           | environmentally friendly) is produced in China, because the
           | chemicals needed are extremely toxic and hard to properly
           | process. In China they are just released into nature and as
           | long as the Chinese company says they don't do that, the
           | western companies can say they buy 'good fibers' and turn a
           | blind eye to the pollution. This way we spread our love all
           | around the world.
        
           | sydbarrett74 wrote:
           | The globe is being progressively enshittified by adopting a
           | Western lifestyle.
        
           | alexfromapex wrote:
           | The US has the largest global economy so probably has an
           | outsized impact on this.
        
             | xeromal wrote:
             | Did you read the linked post?
        
               | alexfromapex wrote:
               | Yes, is there a problem with what I've articulated? Have
               | you heard of Composition Fallacy or Simpson's Paradox?
        
           | coldtea wrote:
           | > _" Globally" and "worldwide" are right there in the
           | abstract_
           | 
           | A lot of crappy food choices were spearheaded, exported, and
           | promoted to death, by the US, anyway.
        
         | ramraj07 wrote:
         | Agreed, It's definitely not a conspiracy that US federal
         | regulatory authorities have gotten more lax, beuracratic and
         | ineffective over the decades. One can still generally subscribe
         | to a world view while being critical of its shortcomings.
        
       | ceejayoz wrote:
       | I really appreciate the "what was already known, what this study
       | adds" summary about a page down in this.
        
         | [deleted]
        
         | gjstein wrote:
         | Agreed! I've never seen something like this before, but it
         | seems that all articles in this (nascent) journal have the same
         | sort of information. Does anyone know if this is standard
         | across journals for research in this space?
        
           | hammock wrote:
           | Yes it's pretty standard as far as I know.. it's actually an
           | important part of a grant application to get your study
           | funded in the first place, so most researchers will have this
           | language at the ready when reporting results
        
       | reedf1 wrote:
       | At least from my view as a young millennial, drinking culture
       | among gen x and younger boomers is enormous. Wouldn't be
       | surprised if that plays a role here.
        
         | Pxtl wrote:
         | Right but was it that different in the '90s? Also, you've got
         | the wrong window, 40s is Xennials, not young Boomers. Boomers
         | would be the "40 back in the '90s" generation... and I'm pretty
         | sure they were strong drinkers too.
        
         | [deleted]
        
         | hospitalJail wrote:
         | This will be interesting to see as weed gets legal.
         | 
         | While no drugs are the best, with weed being a replacement for
         | alcohol you can imagine that 1% of deaths from car accidents is
         | going to go down, not to mention liver failure/cancer/etc...
         | 
         | I think millennials will continue to be drinkers, but there is
         | a chance zoomers will make the switch.
        
           | TylerE wrote:
           | Plenty of millennials already have in states where it's legal
           | - and farm bill compliant hemp products essentially make it
           | legal everywhere as long as you're ok with edibles and not
           | flower/vape juice.
        
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