Less than 7% of the U.S. adult population has good cardiometabolic health, a devastating health crisis requiring urgent action, according to research led by a team from the Friedman School of Nutrition Science and Policy at Tufts University in a pioneering perspective on cardiometabolic health trends and disparities published in the July 12 issue of the Journal of the American College of Cardiology. Their team also included researchers from Tufts Medical Center.
Researchers evaluated Americans across five components of health: levels of blood pressure, blood sugar, blood cholesterol, adiposity (overweight and obesity), and presence or absence of cardiovascular disease (heart attack, stroke, etc.). They found that only 6.8 percent of U.S. adults had optimal levels of all five components as of 2017-2018.
Among these five components, trends between 1999 and 2018 also worsened significantly for adiposity and blood glucose. In 1999, 1 out of 3 adults had optimal levels for adiposity (no overweight or obesity); that number decreased to 1 out of 4 by 2018. Likewise, while 3 out of 5 adults didn't have diabetes or prediabetes in 1999, fewer than 4 out of 10 adults were free of these conditions in 2018.
"These numbers are striking. 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," said Meghan O'Hearn, a doctoral candidate at the Friedman School and the study's lead author. "We need a complete overhaul of our health-care system, food system, and built environment, because this is a crisis for everyone, not just one segment of the population."
The study looked at a nationally representative sample of about 55,000 people aged 20 years or older from 1999 to 2018 from the 10 most recent cycles of the National Health and Nutrition Examination Survey. The research team focused on optimal, intermediate, and poor levels of cardiometabolic health and its components, rather than just presence or absence of disease.
"We need to shift the conversation, because disease is not the only problem," O'Hearn said. "We don't just want to be free of disease. We want to achieve optimal health and well-being."
The researchers also identified large health disparities between people of different sexes, ages, races and ethnicities, and education levels. For example, adults with less education were half as likely to have optimal cardiometabolic health compared with adults with more education, and Mexican Americans had one-third the optimal levels versus non-Hispanic white adults.
