Scientists at Tuffs University have uncovered a devastating health crisis requiring urgent action: less than 7% of the U.S. adult population has good cardiometabolic health.

Cardiometabolic health includes several risk factors including type 2 diabetes and insulin resistance, cardiovascular disease, cholesterol levels, high blood pressure, and overweight and obesity.

Researchers assessed 55,081 U.S. adults age 20+ years from the 10 most recent cycles of the National Health and Nutrition Examination Surveys (1999-2000 to 2017-2018).

To be considered in “good cardiometabolic health”, a person would have to have optimal levels of all five components include body fat tissue (adiposity), blood glucose, blood lipids, blood pressure and clinical cardio vascular disease - and only 6.8 percent of U.S. adults cleared that bar.

U.S. adults significantly worsened, with more people having poor levels of cardiometabolic health compared to 20 years ago. These declines were primarily related to worsening levels of body fat and glucose, and to a lesser extent, blood pressure, the study revealed.

“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,” says Meghan O’Hearn, a doctoral candidate at the Friedman School of Nutrition Science and Policy at Tufts University in Boston and lead author of the study, which was published in the July 12 issue of the Journal of the American College of Cardiology.

Other key findings outlined in the study included:

• Of the five risk factors measured, overweight (or obesity) and blood glucose levels has become worse over the last 2 decades.
• In the last 2 decades, we now have only 1 out of 4 with healthy weight (BMI), vs 1 of 3 in 1999. BMI is calculated based on a person’s weight and height.
• About 60 percent of adults now have diabetes or prediabetes, in comparison, in 1999 there were only 40% of adults who had diabetes or prediabetes. Today, nearly 7 out 8 people with prediabetes in the United States have not yet been diagnosed.
• Blood pressure levels worsened a small amount during the study period, and cardiovascular disease has remained stable. The study noted this could be due to the widespread use of pharmaceutical drugs to manage blood pressure and statins for cholesterol. 

“Diet is one of the primary contributors to unhealthy weight gain and poor blood glucose levels, and diet quality in the U.S. is poor, and getting worse,” says O’Hearn.

This is a crisis that impacts everyone, not just one segment of the population. The results demonstrate a dire situation for the health of the U.S. population, and an urgent need for clinical and public health strategies that prioritize obesity treatment as well as prevention, especially given its foundational role in aggravating each of the other cardiometabolic components, the study stated.

The researchers suggest the following measures to improve the current situation:

1. Using “food is medicine” interventions, in which good nutrition is used help prevent and treat illness
2. Enhancing existing U.S. food policies with incentives and subsidies to make healthy food more affordable
3. Education for both medical providers and consumers around the importance of a healthy diet and physical activity
4. Early interventions for improving lifestyle choices among U.S. youth
5. Private sector engagement to drive a healthier and more equitable food system

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