tldr: Have your blood checked.
EDIT: As most follow up comments seem to center around diet as a cause, I wanted to point out that there are several other causes.
The vegan diet is a diet of deficiencies, and since none of them are particularly careful about what they eat, I worry that it is making them all worse off. Iron and B12 may be the most obvious, but also D3, calcium, zing, animal based nutrients like creatine, and I'm sure others.
Unfortunately, this becomes a touchy subject with them very quickly, and most of them believe "being vegan is healthier," but are uninterested in engaging with or supporting this claim.
First off, B12 is important, but most vegan milk-substitute things have 25% or 50% of the US RDA of B12 per serving. Not all - a lot of almond milk isn't supplemented with B12 (to which i grumble). They're often also iron-supplemented. Here, for example, is the nutrition label for Silk Organic Unsweetened Soy Milk:
Note the vitamin D and calcium in there as well. The FDA is generally clever about the requirements they put on things -- the potential for such deficiencies is well-known, and so is addressed at a few places.
Creatine isn't a necessary nutrient - our kidneys and livers synthesize it.
Finally, I, at least get a lot of "zing" in my diet by being creative about what we cook. (Sorry, couldn't resist) Zinc, however, you should pay attention to, but eating a diversity of beans and nuts (and tofu) covers it quite well.
Seriously, though: It's not hard to have the bases covered. If you're really concerned and not just concern-trolling, sit down with your friends and a copy of Cron-o-Meter, which is one of the most comprehensive meal nutrition profilers around. It's what I used when figuring out the overall layout for our family's meals, and it did lead me to a few cheats -- like favoring molasses as a sweetener, throwing flaxseed in place of part of the flour in a bunch of recipes, etc., to make sure we were hitting all the targets. Useful software.
(Not concern-trolling, just a vegetarian who was disgruntled to discover how easy it is to become zinc deficient, after specifically asking a GP if I needed to take any supplements, and was told no. I take a 25mg daily supplement now.)
In other words, you should probably be just as worried about your non-vegan friends who eat too much meat, not enough leafy greens, not enough vitamins, etc.
I was vegetarian for almost a decade, basically my 20s, and what became clear immediately was that I had to figure out different stuff to eat. Default food wouldn't work anymore, so I have to branch out a lot and find foods that I would've never thought about before. I think my experience is relatively common.
That having been said, it IS easier to have a deficient diet, if you're not paying attention. "Carbitarian" is what some people call veg-ns who just hork down pasta, bread, and whatever other unhealthy nonfood is technically animal-free.
So I think it's possible that veg-ns have a more diverse diet on average, and that they also are statistically more likely to have deficiencies (something like a bimodal distribution).
Obviously, these are empirical questions.
I'm typically vegetarian to suit my own wacky body chemistry and slow metabolism (tldr; lowered/normalized my blood pressure, cholesterol, lost weight etc by diet changes and exercise) and would like to underline the point you're making about finding dietary substitutes. Protein consumption was the hardest thing for me to adjust back into nominal ranges. It's pretty easy to overconsume carbs (carbitarianism) on the way to getting the 50-100g of protein needed for a typical semi-active to active day.
The folks who eat frozen pizza every night probably aren't the most balanced eaters.
Vegans trying to find substitutes for some of those general food types doesn't mean they end up being more diverse just that they have to look at more alternatives but the body doesn't really care if you eat iceberg and romain and baby spinach it cares that you eat fibers and protein and minerals.
I am not an expert it just seems to me that by not excluding things from your diet like meat you are getting a for much less (eating meat gives you not just protein but ex. iron)
Things that other protein substitutes doesn't necessarily give you.
Calcium can inhibit iron absorption, but not to this degree. A typical healthy individual will still be able to absorb iron from dairy products, because dairy products themselves contain iron. Where it becomes a problem is for people who are already anemic.
Remember that the body doesn't need very much iron in the first place, since it's capable of recycling it. It only needs to replace the small amount that's lost in this cycle. And furthermore, the body's absorption of iron is already pretty inefficient, so the effects of naturally-occurring calcium in dairy aren't this extreme.
How does it lack diversity? There's far, far more non-animal foodstuffs in the world than types of meat/fish... Also, most traditional and 'varied' diets contain far more vegetable matter than meat anyway.
What omnivores can consume is different from what they do consume.
Furthermore, the combination of meats, vitamin D-added milk, and enriched cereals, the latter two courtesy of the FDA who have centuries of history fighting malnutrition, and who for example introduced hominy grits to the South to combat pellagra, tends to hit everybody's basic nutrition requirements with the exceptions of dietary fiber, vitamin C, and potassium. While good health is still dependent on eating a variety of vegetables, it's important to give the US food system its due -- it produced pretty good results before the modern Age of Excessive Sweeteners.
Founded in 1906.
Iron and calcium are in plants, D is in fact added to milk, and can be added to a plant based diet via a pill as well if you don't synthesize enough. You are an animal; your body creates enough creatine (creatine production is in fact downregulated when you consume meat). B12 can also be added via a pill, and it is already added to many foods like cereal.
When you look deeper into the facts, you will see that the Standard American Diet faces far more deficiencies, the most obvious being fiber.
Eating meat is a fantastic last resort if you don't have enough food and your only other option is malnutrition/starvation, but it's terrible for you as anything other than a stopgap until you can eat some plants/fungi.
Eating meat is fantastic because it contains a lot of macro and micro nutrients. With a vegan diet it is extremely hard to impossible to get all micronutrients.
2/3 of people trying to become vegetarian start eating meat again. Meat reduction simply is more viable.
Of course eating too much of this powerful food is bad for you. But also sunlight causes a variety of diseases and we don't try to live without sunlight. Obesity and cardiovascular diseases are not really an issue if you have a reduced intake of meat. Red and processed meats increase the risks of colorectal cancer with relative increases that seem really high, but with tiny absolute increases as colorectal cancer is extremely uncommon.
Eating meat seems like a viable strategy for many other species, not sure why it isn't a viable one for humans as well, especially given that we seem to be highly evolved as hunters (I mean, we are, by a long shot, the most successful predator in recent evolutionary history).
After allowing for measurement error, a 3% increase in the consumption of energy intake from animal protein was associated with a 15% higher risk (95% confidence interval [CI]: 3-30%; p(trend) = 0.01) and a 2% increase in energy from plant protein intake was associated with a 23% lower risk (95% CI: 36-7%, p(trend) = 0.006).
It makes sense to just eat a balanced diet.
Just an FYI: no diets have been conclusively shown to definitely be good. The science simply has never been done. The two competing diet regimes (high carb, low fat and low carb, high fat), are recommended by their supporters based on proxies for their theoretical long term benefit, not based on their measured long term benefit.
The move away from Milk products & Eggs seems to open a huge nutrient gap that the vegan population hasn't adequately identified how to fill.
Source: The Dietitian's Guide to Vegetarian Diets, 3rd edition, 2011. See page 192.
Indians dont have a practice of regular/ preventive doctor visits, annual checkup and diagnostic testing. They only go to doctor when there are significant medical issues. So these issues are not found until they morph into bigger problems.
I have a quite a few younger cousins who died in their 30's. Not a single one ever was tested for cholesterol despite poor eating habits and obesity.
Recently I noticed a few startups in India focusing on diagnostic testing. But their user base seems to still be elderly than young people.
In India, vegetarians typically do eat dairy products (although not eggs). Dairy doesn't contain a ton of iron and cobalamin (vitamin B12), but it's a non-negligible amount, and it's possible that that alone accounts for the difference. Remember that vegetarians in India also eat a ton of lentils, which are a great source of iron when consumed in large quantities.
(While it's hard to ingest the full daily recommended amount of each from dairy products alone, an otherwise-healthy individual can make do with a lot less than the recommended levels without developing anemia).
Ghee has plenty of fatty acids and vitamins and the vegetarian food you usually get in India is soaked in it.
Indian food is also very heavy in spices many of which contain iron, zinc and many other minierals.
Women lose iron during menstruation and feel anemic sometimes.
There's sects that enforce not eating underground veg (potato/onion/ginger/etc) at anytime. Others avoid eating these only during 4 months of monsoon. Others maintain no restrictions.
One of the the core tenets is non-violence, and the Jain ideology provides levels of life, from animals, to trees, to wind and fire. Violence to sensory animals is seen as abhorrent, whereas violence to plants is unavoidable. Underground plants seem to have a higher level of life as many animals are part of their ecosystem. (One hypothesis I have is that these rules actually came about due to the seasonality of these vegetables during the inception of the ideology -- we no longer are similarly restricted in our farming.)
Lapsed members such as myself form a large part of the community -- hence the above claim is only partially true.
On a sidenote, more and more science fiction I've been reading seem to have elements (like Gaia) that provide a higher level of respect to vegetation than non-life, which has provided for some stimulating ideas.
This is, unfortunately for you, completely fabricated. I'd recommend at least checking Google Scholar before making silly claims on HN.
If you'd like to make a claim, cite your source. If you'd like to circlejerk the "vegan is bad, meat is good" fiction, downvote instead.
As a child, I insisted on being a vegitarian - as long as my parents cooked for me (and were careful to see to it that I had a balanced diet, compete proteins, lots of nutritional yeast, etc... They had spent time as vegetarians themselves, so knew how to do that.) I was quite healthy.
After I moved out? I did very poorly, because I wasn't willing or able to put in the effort to see to it that I had balanced nutrition.
That's the thing; as a meat eater? There are a lot of ways for me to get complete nutrition (and yes, it comes with a lot of other things that I don't need, but at least I get what I do need.) - so even someone who puts minimal effort into eating a balanced diet is not going to suffer from deficiencies very often, if they eat meat in the traditional manner. (Quite the opposite, really.) If you put the same effort in but avoid all meat and animal products? at least in the place and time where I live? You are probably going to make yourself sick.
In a culture where most people eat meat, you need to put in a lot more effort and research in order to avoid deficiencies as a vegetarian.
You could argue that this is a truism and that the same could be said for a meat-eater in a culture that just ate vegetables. Most cultures have evolved a traditional set of foods that won't leave you with severe deficiencies of anything, and so if you cut out certain classes of food from that tradition, you need to pay more attention to what you are consuming in order to see to it that you get enough of the nutrients you need.
I'd wager a sedentary lifestyle and stimulants are a major culprit.
I had IDA for over a year. My doctor tried to fix/ mask it with iron supplements, turns out was a coeliac. Which explains why I was constantly felt lethargic/ hung-over.
Pro tip: Don't trust everything your doctor says (new Dr suspected it and ordered tests straight away).
I've been having some unexplained medical issues lately and asked for some specialized blood tests and was refused (this being Canada, you go to the doctor with your hat in your hand, begging that they actually take your problems seriously, and if they don't want to help you, you're out of luck.)
...is a whopping 10-35 mL per period—hardly enough to cause a nutrient deficiency.
Would whatever tests they do as part of a routine blood tests in a physical include it or is it something separate you'd have to ask for?
That being said, theres nothing about routine physicals/wellness exams that are standard. Every doctor/clinician has a different idea of what a routine physical is and many (most?) ignore official guidelines. I've had routine physicals from many different doctors (I've moved a lot) and ever single one of them do something different. One didn't actually touch me other than blood pressure (which was done by a medical assistant) but ordered a ton of "routine" blood work and talked to me a real lot. One listened to my heart, lungs, looked at my eyes, nose, throat, and felt every single one of my organs (that she could) but didn't order any blood work at all. Some call to see me every year some don't call until a few years later. Then there's this nonsense - https://sciencebasedmedicine.org/32293/
So absolutely nobody knows what your doctor orders, you'll have to ask them. (Which you should do anyways).
Routine screening of individuals without symptoms or other indications can also harm, so caution is warranted: https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...
"I would like to be screened for anemia" is what you would say to your doctor.
I'm not an expert, but from what I understand iron deficiency anemia (IDA) would show in several of these standard blood test values. Not only would Hemoglobin levels be low but also the size of red blood cells be influenced. For a more specific diagnosis of IDA you could ask for ferritin levels, which are not part of the CBC.
Someone I knew took some extra strength Pepto Bismol to treat an upset stomach and diarrhea. Her stool ended up turning black, which I advised is a sign of intestinal bleeding.
She went to the emergency room and learned that bismuth, the active ingredient in Pepto Bismol, can temporarily turn stool black. 
The interesting statistic was the urban regions were less pronounced than the suburbs, which may indicate something either cultural or economic that may drive this change.
Either way, it's unfortunate. We're living in the best possible time in history, and many millennials are being impacted by something which - in some cases - may be completely avoidable.
"Energy drinks" (Red Bull, Monster, Rockstar et. al.) blew up in the late '90s/early 2000s or so. As far as I remember, early marketing for these was heavily targeted at "extreme sports" fans and practitioners of their less-extreme variants (e.g. skateboarding). I wonder if that targeting might have something to do with the urban/suburban split.
I was curious to see if this was actually the case, but the data doesn't really seem to support this claim. Meat consumption overall appears to have remained relatively stable over the past few years, but it's mostly been an increase in poultry intake that's made up for a simultaneous decline in red meat consumption.
Excess iron can be reduced by donating blood.
Also important: cast iron cookware introduces a non-insignificant amount of iron into cooked food, which can be detrimental (or beneficial) depending on the subject.
Increasing incidence of morbid obesity, HTN, type II diabetes, which are risk factors for strokes.
Increased incidence of IV drug abuse, which sometimes leads to endocarditis, leading to septic emboli (I see this very often).
Though I do agree with you in general that we need a fundamental cultural change or we are going to see the average life expectancy.
Every morbidly obese child you see has s good chance of not living past 50-60, and their adulthood is going to be marked by early disability.
>in our data we saw this [youthful stroke] increase independently of that,” says Brett Kissela, professor and chair of the Department of Neurology and Rehabilitation Medicine at the University of Cincinnati, who headed the 2012 work. It is likely drug use among the younger adult population also plays a role, he says
>Ralph Sacco, president of the American Academy of Neurology, notes that “data has been scant” about strokes among younger people. “There has been mounting evidence from different studies suggesting that even though the incidence and mortality of stroke is on the decline, the rates may not be dropping quite as much—and even [may be] increasing—among younger populations,” Sacco says. “The reasons for these trends are not entirely clear but there are concerns about obesity, diabetes and physical inactivity having a greater impact in younger stroke victims.” Drug use may be another factor, he adds.
But that's a really specific situation for a short period of time.
At one place I worked, there was a "crack board", where they would have sweepstakes on who was going to come apart at the seams and lose it. Who knew mental health issues could be so fun? "lol".
Needless to say I no longer work in games, it has done damage to my body and psyche for very little return..
Companies just love "externalised cost". Screw the lives of the employees, environment, etc. Society is pretty broken.
And as long as thousands of developers handle/enjoy the game industry environment, there's no compelling reason to change.
But it should be, per labor law. At a minimum, its wage theft.
It's not universal, but I don't think it's uncommon.
I'd imagine I'm not doing myself any favours there health wise.
Planning on getting out before the next cycle of crazy hours.
But to answer the question - various reasons. It facilitated a relocation to Europe. Rapid career progression to managerial level. Control over what projects I want to do. Multiple rounds of overseas assignments. Minimal supervision. Exposure to new things in a notoriously secretive industry. Pay is decent too, but that's not really a motivation for charging hard.
>is the job market too tight to get a less cruel job
No I can walk into a job with equal pay and far less stress tomorrow. It would kill progression & personal development though. I figure I can always coast later if need be.
Enjoy your health while you have it, it's far more enjoyable than a few more coins in the bank.
I say this as a cardiac arrest survivor. I would be terrified to be stuck in an office for 7 days a week. It's just not right for the body or mind.
The first is strokes are incredibly rare. Going from 5-ish to 10-ish per 10K hospitalizations. "When I was that age" I was never hospitalized once, so you need to factor in how many times that group is hospitalized. I would theorize its extremely rare leading to perhaps better diagnosis or something rather than actual medical effects. Also its worth contemplating that "when I was that age" a kid who stroked out on coke was considered a coke related death not a stroke related death. A classic example when I was that age was the story of "Len Bias" a basketball player who celebrated being drafted by the Celtics by snorting coke until he died. There was quite a circular firing squad of blame but attitudes in that era were unified that coke killed, not strokes, despite the medical definition and all that.
The next numeracy issue is there's about 84 million in the group and unlike previous generations its not white majority and there are considerable differences in race and ancestry and socioeconomic group. Basically that group can't be usefully compared to historical groups because its literally a different people. You wouldn't compare Bolivia with Nigeria and claim the comparison means anything when there's no relationship between the separate and unrelated groups of people. Its entirely possible that (now older) middle class professional Scotts-Irish have a different stroke profile than formerly Mexican peasant villagers. Apples to Oranges means nothing. That group is a different nation merely coincidentally happening to inhabit the same plot of land. Like comparing the medical issues of the pre-Crusades residents of Jerusalem to Crusades ere residents. Or pre- and post- Holocaust ghettos in eastern europe. Its a different people, the comparison means nothing.
The next numeracy issue is there's 84M in the group, as of May 15 2015 Time magazine (per google) claims only 53M are in the workforce. As of 2013 Gallup poll indicated only 43% of the group have a full time job, and 43% of 83M is 36M. So there's a lot of handwaving involved, but when only 36M out of 84M are working full time, overwork is probably not statistically possible to double the instance of strokes. That would imply strokes are something like six times more likely among full time workers. Basically the socioeconomic group is extremely poor and disenfranchised and no percentage of ivy grad programmers dying at their desks at video game companies is numerically high enough to double the entire groups stroke rate. There are not enough SV programmers such that if they all died of strokes it would boost the numbers. Whats killing kids can't be work because the employment stats are so incredibly dire, permanent long term economic decline and all that.
Anecdata: My dad died of a hemorrhagic stroke. My mom of an occlusive stroke. No plaques in my dad. A very few in my mom. It's complicated.
Interestingly, dissections as you mention cause ischemic strokes by (generally speaking) flicking off clots that mess things up downstream that form within a pouch made by the dissection (low blood flow + body trying to patch things up = pro-coagulation). Note in this case there is a tear in the artery wall but the wall remains (ie, no blood exits the artery).
This is different than an aneurysm, when the arterial wall bursts and you have bleeding within the brain. That is termed a hemorrhagic stroke.
Source: hospitalist physician for 7 years who has cared for 100s of strokes at a hospital that specializes in neurology.
"Researchers Find Gut Bacteria Can Trigger Brain Lesions That Lead to Strokes ;
Another connection between the gut and the brain."
I've watched brilliant brains literally get ruined by the overuse of that garbage. I would bet anything that it's more dangerous than any of its users want to admit.
Available data imply a strong association between MDMA abuse and cerebral infraction.
Funny how the downvotes and attacks come when you discuss the possibility of drug-induced brain damage in Millennials to a website full of.... drug-defending Millennials!
I stand by what I said and will double down in fact. Too many people melting their brains with that crap and there are almost definitely unforseen consequences of doing so.
And since it costs nothing to lose weight, it seems fair.
This is only a half truth. Starving yourself is free, but losing weight while still eating a variety of foods (most people can't stomach 24/7 lentils) on extreme financial (including preparation equipment) and time constraints (prep time, time to get ingredients) is nontrivial. Look at the nutritional content of the cheapest and most readily available food you can find (fast food, walmart-brand sausages, etc etc etc). It's typically full of fat and sugars. Higher-quality readily available foods are typically more expensive and harder to come by in poorer areas. Higher-qiality food you prepare yourself is an option, but learning how to do as such is nontrivial and the time investment to prepare these foods can be a major challenge for some.
Takes 20 minutes for oven to eat up and 12 for pizza to cook.
In 32 minutes you can cook a healthy cheap meal with variety.
I ate porridge for breakfast, cottage cheese and salad for lunch and and chicken/veg, fish/veg for evening meal.
And since it costs nothing to post better, it seems fair.
I was seriously overweight for a time. It did not get better until I was diagnosed with a genetic disorder and began getting proper treatment for that. Until I had a proper diagnosis, my body just did not seem to work the way everyone told me bodies worked.
I ate healthy. I exercised regularly. I was well educated and well read. Yet my problems seemed to defy solutions for a lot of years, until I finally got the right diagnosis.
Most people who are overweight wish they could solve it. They often don't know how, even after taking all the usual advice.
New research into things like gut biome is beginning to cast light on such phenomena, but this is hardly a solved problem, contrary to what many people seem to think.
However in general I think pre-existing conditions need to be handled by something other than "insurance" and the trick is to do it in a way that doesn't incentivize people from foregoing insurance until they get sick.
You can almost get away with this if you purport that the actual costs of the pool would go down. However, all it takes is one person having a surprise expense to demolish any small pool's planning.
Seriously, think on this at a level. Try to go in with just 5 friends to cover your costs for health. Works right up to the first time one of you visits the doctor. Which is to say it doesn't work.
What? That doesn't make any sense and it's surely not by definition.
If you have a set of people, and you create a subset with the healthiest people of the subset (so, what you are doing by removing the obese), of course that the costs per person will be lower for the subset than for the all set.
That is, the main variable that gets you to lower rates, is higher participation. Anything else doesn't come close.
You have to let it sink in that you can not have a small subset "save up" enough to pay for "their share." It just doesn't work without having large groups lose out and be completely unable to cover the costs in their group. Instead, this would be akin to group gambling where eventually one loser will bankrupt the entire pool.
Now, there is a related concept that you need to diversify your risk pool such that you don't fall prey to the same risk on everyone. This is what hit some major flood insurance providers after Katrina. I could see similar arguments for not wanting to insure a bunch of folks from the same locale. (Oddly, insurance doesn't typically branch out beyond locales...)
There is a concept of trying to get the higher risk pool to pay more through some rough proxies (typically age, for car insurance) to pay higher premiums. Again, though, most young drivers do not have accidents. Nor do the insurance companies typically actually need such high premiums to cover costs. As evidenced by their fairly mediocre savings plans they offer folks for not having an accident.
All of this, though, really just points out that calling this an "insurance" for health is just silly and is ultimately the wrong model.
Seriously, not only this is clearly not how it works, but it actually makes zero economic sense, it doesn't work like that at all.
Insurance companies have people there calculating the expected costs with the different groups and - whenever legal - they DO DISCRIMINATE amongst them. Why do you think woman pay less for life insurance than men? Or why do woman pay less than men for car insurance? According to your rational that shouldn't be the case, you should just put them all together and everyone would pay less.
Let's just reduce this at absurdum for you to get it.
You have a group of 100 people. 50 completely healthy according to a medical check-up, 50 with HIV needing constant medication: Now, where do you think the health insurance premium would be lower for the 50 healthy ones:
1 - If we charged all the 100 people the same?
2 - If we divided the group and charged the 50 people with HIV differently than the 50 healthy people?
Answer this question and immediately you will understand why what you are claiming is wrong.
Insurance works by getting people to pay in to it that will not get paid out of it. Pretty much by definition. This is why we pay insurance for cars, instead of just avoiding cars. Same for title insurance. Same for life insurance. The vast majority of people that pay into these schemes do not get paid out of them.
Now, the only way you can use a pool of "healthy" people to get low costs, is to have a pool of healthy people that are not using medical procedures. You can do this by discriminating out people that need procedures, but realize this also means you discriminate out people as soon as they start to need these procedures.
Car insurance kind of works here. Many will take on "higher risk" kids for insurance. But as soon as those kids make a claim, they will refuse to re-insure them. Same with houses. Make a claim, find that you have a chance of needing to get new insurance policy.
So, for your little hypothetical. My point is take the 50 that are healthy, and have them pay lower rates. And then, as soon as one of them hits a high cost procedure, find that you don't have enough to cover it. (Just one cancer patient will blow out a pool of 50 people in a heartbeat.)
Could it work to keep costs down? Yes, but only in a way in which would not benefit you. As soon as you needed what those costs were supposed to cover, you would be kicked out of the pool.
This is like the poor sods that think they can do a health savings plan. Only if you are very wealthy, and still only if you never actually get into an accident or need it.
More likely, a common combination of factors causes both obesity and strokes.
Does it cost more to cook smaller portions? I think even worst case scenario is it costs the same, e.g. you cook the same amount and throw 20% away (or it goes bad).
What would help is if people stopped treating weight loss as some insurmountable problem.