Don't Eat Poop

Don’t eat poop

…and other lessons from Tudor times.

When it comes to death and disease, we’re all magical thinkers. If we just do x, or do it hard enough or often enough, then y (in this case death or diabetes or cancer) won’t come.

It’s a useful fantasy in some ways, but in other ways it’s not so helpful. Because when fantasy intersects with public policy, then you have problems.

For instance, the other day the National Health Service poohbahs in the UK were having one of their regularly scheduled meetings to declare they were experiencing various crises, and especially they were way over budget. And one of the reason was spending on what were considered various preventive health programs.

Ah, preventive health! See magical thinking above. If we can just educate the great unwashed (for surely if they were taught properly they would do what we think they should do) about “healthy” habits, disease would magically disappear. We’re saving money, really, when we spend it on these programs.

Is that really true? Why don’t we look at some actual people in the 16th century (i.e. born and died between approximately 1470-1620) and see what we think. After all, people back then lived what we would now consider an exemplary lifestyle. Tobacco use didn’t really take off until later in the 17th century. People drank wine, and a lot of really weak beers and ales, but distilled alcohol was rare. Since most people didn’t interact with any technology more complicated than a sundial, they all got plenty of healthy walking and other exercise in, whether they wanted to or not. All their food was organic and non-GMO, and virtually all the meat was free-range and grass fed. Fish was a major protein source and eaten frequently. Most of the bread was whole grain. Tudors loved sugar, but it was mostly an expensive, special treat and was not present in large amounts in the everyday diet. They’d barely heard of coffee, tea or chocolate.

So how did that work for them? We did a quick and dirty study by collecting the lifespans of:

40 aristocratic adult Englishmen of the period.
40 Englishmen of arts and letters from the period –as to be fair a lot of aristocrats died violent deaths. Instead of elections, the Tudors handled political power shifts with executions.
40 upper class Englishwomen of the period
40 Italian men of arts and letters to contrast with another region

Decade of Life End with list of actual ages

20s      30s         40s         50s         60s           70s            80s          90s

1.29       36            43           52          63             70            81

               35            44           50           62           72            80

               31            40           57           66            74           82

               39            49           53           65            71

               33            44           55           63            72

                                               56           60            78

                                               57           65            77

                                                               69

 

2. 29      32           47            52           68           73           84

               30           46            59           65           75           80

               39           42            56           60

               34           41            52           65

               36           49            51           63

               34            49           53           67

                               49            57           68

                               44            55           67

                               41            57           62

                                               50           67

 

3.28     37             42            54            61            78          84             90

   20     37             48            53            62            74          89

             37            43            57            61            73          87

             30             40            50             64          78

             39            49            57             63           74

             32             45            56             64          72

             38             44                                            71

                              48

 

4.         37            47          58              68              72          82              90

            33            46           59             60               71         89              93

                             45           55             63              72         89              91

                             47           51             68              76         87

                             46           55             66              73

                             42           58                                74

                                             57                               75

                                             51                               72

                                                                                 70

                                                                                 70

                                                                                  71

                                                                                 79

                                                                                  77

 

We present the data in this way because it makes a nice visual-you can see the beginning of the curve and the distribution. Although this small data set has some anomalies, the survivorship curve is identical to every other done for pre mid-19th century humans—depending on your sex you had a 40-50% chance as an adult of living to see age 60. As always, prior to the mid-20th century, women died earlier then men. Why did the Italians seem to do better? Hard to say—could be something that would regress to the mean with more data, or as these are not verified ages, perhaps it was customary to add a few years when you got older, or maybe Italy was just healthier than England. However, avoiding Tudor politics does not seem to increase your survivability.

 

Survivorship by %

Tutor aristocrat Englishmen

Reaching age 20+  40/40   100%

Reaching age 30+  39/40   98%

Reaching age 40+  33/40  83%

Reaching age 50+  29/40  73%

Reaching age 60+  20/40  50%

Reaching age 70+  10/40  25%

Reaching age 80+   3/40  8%

 

Tudor arty Englishmen

Reaching age 20+ 40/40  100%

Reaching age 30+  39/40  98%

Reaching age 40+  33/40  83%

Reaching age 50+   24/40  60%

Reaching age 60+   14/40  35%

Reaching age 70+  4/40  10%

Reaching age 80+  2/40  5%

 

Tudor upper class women

Reaching age 20+  40/40  100%

Reaching age 30+  38/40  95%

Reaching age 40+  31/40  78%

Reaching age 50+   23/40  58%

Reaching age 60+  17/40  43%

Reaching age 70+  11/40  28%

Reaching age 80+  4/40  10%

Reaching age 90+  1/40  3%

 

Arty Italians

Reaching age 20+  40/40  100%

Reaching age 30+  40/40  100%

Reaching age 40+  38/40  95%

Reaching age 50+  32/40..80%

Reaching age 60+ 24/40  60%

Reaching age 70+  19/40  48%

Reaching age  80+ 6/40  15%

Reaching age 90+  2/40   5%

(US 2010  Reaching age 60+ 85-90%, 70+ about 80%, 80+ about 60%  90+ about 20%)

People are starting to die off in their 40s, and really dropping in their 50s and 60s. Interestingly, although we tend to attribute excess female mortality to childbirth, women seem to be dying later (if still earlier than men) than one would expect from childbirth, as most women in this class would have started having children in their early to mid-twenties. At least some of the excess may be due to the indirect effects of childbirth—and female sex, such as a greater susceptibility to autoimmune disease, hyperthyroidism in particular, uncontrolled uterine bleeding later in life, Sheehan’s syndrome, and so on.

A big problem for the Tudor world was that, as John Donne, (one of our arty Englishmen listed above) said, “No man is an island.” If their individual lifestyles had some healthy aspects, their group life was grounded in filth. No one was slurping down at the nearest cesspool, but the idea that it was a bad idea to have poop in your water supply, even if the water looked and smelled OK, was about 300 years away.

Food preservation was hit or miss. Rats and mice peed and pooped all over the grain supply, which was also at times contaminated with fungi that cause cancer, gangrene and death. There were no insecticides, so lice and fleas were rampant. Any kind of large group gathering was an invitation not just to a party or a fight but also exposure to contaminated water, new pathogenic (for example syphilis and tuberculosis) germs, and vermin.

Another factor taking out the middle aged are age related illnesses, such as coronary artery disease. We’re so brainwashed into seeing heart or endocrine disease (wrongly) as just lifestyle diseases, that we don’t realize that we’ve had these for hundreds of thousands of years. Evolution works by a sort of reverse Peter Principle—it causes things to rise to their level of minimal competence and then stay there. So once you’ve past reproductive age, there’s no benefit to having cellular repair mechanism that work, as far as nature is concerned, so your endocrine system falls apart or your cell growth goes haywire.

In contrast there is actually evolutionary pressure that favors coronary artery disease. We don’t see it so much today, but the classic coronary disease sufferer, if male, was relatively young—in their 40s when they died. Young to us, but to a tribe of hunter/gatherers? That’s an age when your hunting and fighting prowess have declined and you’re starting to use more resources than you provide the group. Coronary artery events remove you quickly and expeditiously. Therefore coronary artery disease has a survival advantage for the group as a whole, so that group is more likely to pass along its genes.

There’s no reason to assume that these diseases weren’t just as potentially prevalent 400 years ago, although this was masked by the presence of so many other ways to die first. We see this in the 20th century, as well, as countries become more developed. Sixty years ago infectious diarrhea and tuberculosis killed a great many Mexicans. With improved public health and medical treatment these scourges decreased and now they have more cancer, heart disease and diabetes, because more people are living long enough to express them.

What’s different today? Why do so many more of us live to be 60, 70, 80 or older now? It’s not because we are all living some Whole Foods shopper’s dream lifestyle. We already see that had no magic properties for the Tudors. What has made the difference (in descending order of importance):

 

Waste management and food containment systems that keep us from eating poop.

Vaccinations

Antibiotics

Safe and sterile surgery, obstetrics and gynecology

Treatment of stroke causing conditions

Getting rid of tuberculosis infected milk

Heart disease treatment

You might notice that none of these are DIY. They are all group processes and require the use of experts, and thus unlikely to fire the imagination of today’s magical thinker.