Fitness crisis? Just 7% of U.S. adults have good cardiometabolic health

MEDFORD, Mass. — More than nine in 10 American adults may want to think about skipping the summertime barbecues. A new study finds that less than seven percent of the nation’s adult population have what health experts consider good cardiometabolic health.

Researchers from Tufts University say this measure includes five key components of health: blood pressure, blood sugar, blood cholesterol, adiposity (being either overweight or obese), and the presence or absence of cardiovascular disease.

Weight and blood sugar spiraling out of control

Using information on roughly 55,000 people over the age of 20, the results show just 6.8 percent of American adults reached optimal levels of health in all five categories in 2018. Moreover, the study found American health has been in steep decline over the last 20 years.

In 1999, one in three adults had healthy levels for adiposity, meaning they had a healthy weight and were not overweight or obese. By 2018, that number fell to just one in four Americans.

At the same time, three in five people were free of diabetes and prediabetes in 1999. By 2018, however, more than six in 10 adults had one of these conditions!

“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,” says Meghan O’Hearn, a doctoral candidate at the Friedman School of Nutrition Science, in a media release. “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.”

Instead of just looking for signs of disease, the team focused their study on the signs of good, moderate, and poor cardiometabolic health.

“Disease is not the only problem,” O’Hearn explains. “We don’t just want to be free of disease. We want to achieve optimal health and well-being.”

Are societal disparities part of the problem?

Researchers also found large health gaps between U.S. adults of different genders, ages, ethnic backgrounds, and education levels. Specifically, the study found Americans with less education were half as likely to be in peak cardiometabolic health.

While there was a slight increase in the number of non-Hispanic White Americans reaching good cardiometabolic health between 1999 and 2018, study authors say those measures dropped off 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 individuals of different education levels, races, and ethnicities at an increased risk of health issues,” says senior author Dariush Mozaffarian, dean of the Friedman School.

It’s important to note that this study used data coming from a period before the coronavirus pandemic — a time where physical activity fell off significantly. Previous studies have shown that sedentary lifestyles during the pandemic have contributed to even further declines in health and fitness since 2020.

‘A large portion of the population is at a critical inflection point’

Not everyone in the study has passed the point of no return when it comes to their health. Researchers say many fall into the category of “intermediate” levels of health, meaning their cardiometabolic health is not optimal, but not yet poor. These individuals may be dealing with certain conditions including prediabetes, pre-hypertension, or they may be slightly overweight.

“A large portion of the population is at a critical inflection point,” O’Hearn adds. “Identifying these individuals and addressing their health conditions and lifestyle early is critical to reducing growing healthcare burdens and health inequities.”

“Its impacts on national healthcare spending and the financial health of the entire economy are enormous,” O’Hearn concludes. “And these conditions are largely preventable. We have the public health and clinical interventions and policies to be able to address these problems.”

The study is set for publication in the Journal of the American College of Cardiology.

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