TLDR Only 7% of Adults have optimal metabolic health! 93% are compromised. This is the single largest health issue the world knows, costing us billions of dollars per day, and millions of lives needlessly cut short.
Background -Few studies have assessed U.S. cardiometabolic health trends—optimal levels of multiple risk factors and absence of clinical cardiovascular disease (CVD)—or its impact on health disparities.
Objectives -The purpose of this study was to investigate U.S. trends in optimal cardiometabolic health from 1999 to 2018.
Methods - We assessed proportions of adults with optimal cardiometabolic health, based on adiposity, blood glucose, blood lipids, blood pressure, and clinical CVD; and optimal, intermediate, and poor levels of each component among 55,081 U.S. adults in the National Health and Nutrition Examination Survey.
Results - In 2017-2018, only 6.8% (95% CI: 5.4%-8.1%) of U.S. adults had optimal cardiometabolic health, declining from 1999-2000 (P trend = 0.02). Among components of cardiometabolic health, the largest declines were for adiposity (optimal levels: from 33.8% to 24.0%; poor levels: 47.7% to 61.9%) and glucose (optimal levels: 59.4% to 36.9%; poor levels: 8.6% to 13.7%) (P trend <0.001 for each). Optimal levels of blood lipids increased from 29.9% to 37.0%, whereas poor decreased from 28.3% to 14.7% (P trend <0.001). Trends over time for blood pressure and CVD were smaller. Disparities by age, sex, education, and race/ethnicity were evident in all years, and generally worsened over time. By 2017-2018, prevalence of optimal cardiometabolic health was lower among Americans with lower (5.0% [95% CI: 2.8%-7.2%]) vs higher education (10.3% [95% CI: 7.6%-13.0%]); and among Mexican American (3.2% [95% CI: 1.4%-4.9%]) vs non-Hispanic White (8.4% [95% CI: 6.3%-10.4%]) adults.
Conclusions- Between 1999 and 2000 and 2017 and 2018, U.S. cardiometabolic health has been poor and worsening, with only 6.8% of adults having optimal cardiometabolic health, and disparities by age, sex, education, and race/ethnicity. These novel findings inform the need for nationwide clinical and public health interventions to improve cardiometabolic health and health equity.els of risk factors, even in low-risk groups, has serious implications for public health.
Full Text - https://doi.org/10.1016/j.jacc.2022.04.046
Rather than focusing on abnormal levels of isolated risk factors and disease conditions, cardio- metabolic health is characterized by optimal levels of multiple risk factors jointly.
Optimal cardiometabolic health was defined by optimal levels of adiposity, blood glucose, blood lipids, blood pressure (BP), and absence of prior clinical CVD events, adapted from the American Heart Association (AHA) definition of ideal cardiovascular health with extension to include metabolic health
- BMI < 25kg/m^2 && WC < 88cm (34.6in) women || WC<102cm (40.1in) men
- Fasting Blood Glucose < 100mg/dL && HbA1c <5.7% && No diabetes medication
- TC/HDL <3.5 && No lipid medication
- SBP <120 && DBP <80 && No BP medication
- No history of CVD
Everyone can check to see if they have optimal metabolic health! You should have all these figures available to you at least on your last checkup paperwork.
If you want to improve your metabolic health, the most impactful thing you can do is reduce sugar and carbohydrate intake. The less carbohydrates (sugar, fructose, and carbs) you eat, the less you spike your blood glucose, the less you spike your insulin, the better your body works.
You can do that by (in order of easy {fairly effective} to hard {very effective}):
- Eating a whole food diet (nothing from a factory or in a box)
- Doing a low carbohydrate diet (<100g carbs per day)
- Doing time restricted eating (only eat for 8ish hours per day)
- Doing a ketogenic diet (<20g carbs per day)
- Doing a zero carbohydrate diet (carnivore)