Less than 7 percent of the US adult population has good cardiometabolic health, a devastating health crisis that requires urgent action, according to research led by a team from the Friedman School of Nutrition Science and Policy at Tufts University in a groundbreaking perspective on cardiometabolic health trends and disparities published in the July 12 issue of Journal of the American College of Cardiology. Their team also included researchers from Tufts Medical Center.
The researchers assessed Americans on five elements of health: blood pressure levels, blood sugar, blood cholesterol, obesity (overweight and obese), and the presence or absence of cardiovascular disease (heart attack, stroke, etc.). They found that only 6.8 percent of US 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 fat and blood glucose. In 1999, 1 in 3 adults had optimal levels of adiposity (not overweight or obese). that number dropped to 1 in 4 by 2018. Similarly, while 3 in 5 adults did not have diabetes or prediabetes in 1999, fewer than 4 in 10 adults were free of these conditions in 2018.
“These numbers are striking. It is deeply troubling 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 PhD candidate at the Friedman School and lead author of the study. “We need a complete overhaul of the health care system, the food system and the 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 and over 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 simply the presence or absence of disease. “We need to change the conversation, because disease is not the only problem,” O’Hearn said. “We don’t just want to be disease-free. We want to achieve optimal health and wellness.”
The researchers also found large disparities in health among people of different genders, ages, races and ethnicities, and educational levels. For example, adults with less education were half as likely to have optimal cardiometabolic health as adults with more education, and Mexican Americans were one-third as likely as non-Hispanic white adults. Furthermore, between 1999 and 2018, while the proportion of adults with good cardiometabolic health increased modestly among non-Hispanic White Americans, it decreased for Mexican Americans, other Hispanics, non-Hispanic Blacks, and adults of other races.
“This is really problematic. Social determinants of health, such as food and nutrition security, social and community context, economic stability, and structural racism put people of different educational levels, races, and ethnicities at increased risk of health problems.” , Dariush stated. Mozaffarian, dean of the Friedman School and senior author. “This underscores the other important work being done across the Friedman School and Tufts University to better understand and address the root causes of poor nutrition and health disparities in the U.S. and around the world.”
The study also assessed “in-between” levels of health — not optimal but not yet bad — including conditions such as pre-diabetes, pre-hypertension and being overweight. “Much of the population is at a critical tipping point,” O’Hearn said. “Identifying these individuals and addressing their health conditions and lifestyles early is critical to reducing rising healthcare burdens and health disparities.”
The consequences of the dire health status of US adults go beyond personal health. “Its implications for national health care spending and the financial health of the entire economy are enormous,” O’Hearn said. “And these conditions are largely preventable. We have the public health and clinical interventions and policies to be able to address these problems.”
Researchers at the Friedman School are actively working on many such solutions, O’Hearn said, including Food is Medicine interventions (using good nutrition to prevent and treat disease). incentives and subsidies to make healthy foods more accessible; educating consumers about a healthy diet; and engaging the private sector to promote a healthier and fairer food system. “There are many different avenues through which this can be done,” O’Hearn said. “We need a multi-sectoral approach and we need the political will and desire to do it.”
“This is a health crisis we’ve been dealing with for a while,” O’Hearn said. “There is now a growing economic, social and moral imperative to give this problem far more attention than it has received.”
Only 1 in 5 people in the US have optimal heart health More information: Trends and disparities in cardiometabolic health among US adults, 1999-2018 Journal of the American College of Cardiology (2022). DOI: 10.1016/j.jacc.2022.04.046 Provided by Tufts University
Reference: Only Seven Percent of Adults Have Good Cardiometabolic Health (2022, July 4) retrieved July 5, 2022 from
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