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USA: Adults’ cardiometabolic health status sets alarm bells ringing for health authorities

by Vaishali Sharma

According to a recent research, fewer than 7% of the adult population in the United States has good cardiometabolic health, implying that a serious health crisis requires immediate intervention. A group of researchers from Tufts University’s Friedman School of Nutrition Science and Policy uncovered a novel viewpoint on cardiometabolic health trends and inequalities.

The research findings were published in the Journal of the American College of Cardiology. Researchers looked at five aspects of health in Americans: blood pressure, blood sugar, blood cholesterol, adiposity (overweight and obesity), and the presence or absence of cardiovascular disease (heart attack, stroke, etc.). They discovered that just 6.8 percent of persons in the United States had ideal levels of all five components in 2017-2018.

Trends in obesity and blood glucose among these five components deteriorated considerably between 1999 and 2018. In 1999, one out of every three persons had appropriate levels of adiposity (no overweight or obesity); by 2018, that figure has dropped to one out of every four. Similarly, although 3 out of 5 persons did not have diabetes or prediabetes in 1999, fewer than 4 out of 10 adults had in 2018.

“These figures are startling. “It’s profoundly troubling that in the United States, one of the world’s wealthiest countries, fewer than one in every 15 persons has optimum cardiometabolic health,” said Meghan O’Hearn, a PhD candidate at the Friedman School and the study’s primary author.

“We need a full reform of our healthcare system, food system, and built environment, since this is a crisis that affects everyone, not just a small portion of the population.”

The study examined a nationally representative sample of around 55,000 persons aged 20 years or older from the ten most recent cycles of the National Health and Nutrition Examination Survey from 1999 to 2018. Rather than merely the presence or absence of illness, the study team concentrated on optimum, intermediate, and poor levels of cardiometabolic health and its components. “We need to change the discussion because the sickness isn’t the main issue,” O’Hearn explained. “We don’t only want to be disease-free. We want to be in the best possible health and well-being.”

Researchers notice health differences in different ages

The researchers also discovered significant health differences between sexes, ages, races and ethnicities, and educational levels. People with less education, for example, were half as likely as adults with more education to have optimal cardiometabolic health, and Mexican Americans had one-third the ideal levels as non-Hispanic White adults. Furthermore, while the percentage of non-Hispanic White Americans with good cardiometabolic health grew somewhat between 1999 and 2018, it decreased for Mexican Americans, other Hispanics, non-Hispanic Blacks, and people of other races.

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“This is quite troubling. “Social determinants of health, such as food and nutrition security, social and community context, economic stability, and structural racism, put people of different education levels, races, and ethnicities at a higher risk of health problems,” said Dariush Mozaffarian, dean of the Friedman School and senior author. “This draws attention to the other critical work being done throughout the Friedman School and Tufts University to better understand and treat the underlying causes of poor nutrition and health inequities in the United States and around the world.”

The study also looked at “intermediate” levels of health, which include diseases like pre-diabetes, pre-hypertension, and being overweight. “A substantial section of the population has reached a tipping point,” O’Hearn stated.

“It is vital to identify these individuals and address their health issues and lifestyle choices early in order to reduce rising healthcare costs and health disparities.”

The repercussions of the poor health of American adults extend beyond personal health. “It has significant implications for national healthcare expenditure and the financial health of the whole economy,” O’Hearn added. “And the majority of these illnesses are avoidable. We have the public health and therapeutic solutions, as well as the policies, to address these issues.”

According to O’Hearn, researchers at the Friedman School are actively working on a variety of such solutions, including Food is Medicine interventions (which use good nutrition to help prevent and treat illness); incentives and subsidies to make healthy food more affordable; consumer education on a healthy diet; and private sector engagement to drive a healthier and more equitable food system. “There are a variety of approaches that may be used,” O’Hearn added. “We require a multi-sectoral strategy, as well as the political will and ambition to carry it out.”

“We’ve been dealing with a health problem for a time,” O’Hearn explained. “There is now a rising economic, social, and ethical obligation to give this problem far more attention than it has received.”

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