Doctors have been sounding the alarm for years that good metabolic health is vital to healthy aging, but new research suggests most Americans aren’t listening.
A recent study found just under 7 percent of the U.S. adult population has good cardiometabolic health—defined as having optimal levels of blood pressure, blood sugar, adiposity (being overweight or obese), blood cholesterol, and absence of heart disease. This is lower than we thought; previous research suggested at least 12 percent of Americans were metabolically healthy (which, yeah, still not great).
“A Crisis for Everyone”
Researchers from the Friedman School of Nutrition Science and Policy at Tufts University and Tufts Medical Center looked at a nationally representative sample of over 55,000 people aged 20 years and older in 10 recent cycles of the National Health and Nutrition Examination Survey (designed to assess the health and nutritional status of adults and children in the U.S.) from 1999 to 2018. They found only 6.8 percent of adults have optimal levels of all 5 components and found the steepest declines in percentage of Americans with healthy weights and blood sugar levels. Both obesity and type 2 diabetes are risk factors for cardiovascular disease.
In 1999, 1 in every 3 adults were at a healthy weight compared to 1 in 4 in 2018. Six in 10 adults were free of prediabetes or diabetes in 1999, compared to fewer than 4 in 10 in 2018, the study showed. People with prediabetes have higher-than-normal blood sugar levels, but don’t yet have full-blown diabetes.
“These numbers are striking,” said Meghan O’Hearn, the study’s lead author and doctoral candidate at the Friedman School. “It’s deeply problematic that in the United States, one of the wealthiest nations in the world, fewer than 1 in 15 adults have optimal cardiometabolic health. We need a complete overhaul of our healthcare system, food system, and built environment, because this is a crisis for everyone, not just one segment of the population.”
The study will be published in the July 12 issue of the Journal of the American College of Cardiology.
Researchers focused their attention on optimal, intermediate, and poor levels of cardiometabolic health as opposed to solely focusing on disease. Intermediate health includes pre-conditions like prediabetes and pre-hypertension, which could progress to poor health.
“A large portion of the population is at a critical inflection point,” says O’Hearn. “Identifying these individuals and addressing their health conditions and lifestyle early is critical to reducing growing healthcare burdens and health inequities.”
“We don’t just want to be free of disease,” she adds. “We want to achieve optimal health and well-being.”
Disparities in Cardiometabolic Health
This study found that some groups were more likely to have poor cardiometabolic health than others. Those with lower levels of education were half as likely to be at optimal health when compared to more educated adults.
White Americans also saw an increase in cardiometabolic health while Hispanic, Black, and adults of other races saw a decline.
“This is really problematic,” says Dariush Mozaffarian, Ph.D., senior author and dean of the Friedman School. “Social determinants of health such as food and nutrition security, social and community context, economic stability, and structural racism put individuals of different education levels, races, and ethnicities at an increased risk of health issues.”
Improve Your Cardiometabolic Health
A 2017 study says increasing physical activity and improving your diet quality (a diversified diet) can reduce your risk of cardiometabolic disease. It also notes reducing tobacco and alcohol intake as a way to improve your health.
Getting quality sleep and finding tools to manage stress are key ways to prevent heart disease as well, according to the Mayo Clinic.