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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About the Author

Chris Melore

Chris Melore has been a writer, researcher, editor, and producer in the New York-area since 2006. He won a local Emmy award for his work in sports television in 2011.

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Comments

  1. No shock here.
    Most folk are just too lazy and undisciplined to break away from their couches to exercise. They’re always looking for that minimum effort or fast working pill. we’ve become such a nation of slugs.

    1. Well, parents’ schools, churches, ect., all require children to “sit and be good”. Massive increases in school hours and homework have cemented that pattern. (Increases in school hours were deemed necessary because Japan and other countries schooled their children better, and the USA decided much more school hours was the answer, but it isn’t)) So when you grow up in America, you are supposed to be in good shape now? Kids learn more playing together than they learn in school, and the balance is skewed, towards sitting in classrooms most of the time.

      1. Very well said. When I was a kid in the 60’s and 70’s, most kids were not overweight and the few that were had parents that way and usually a genetic health issue. We didn’t have GMO foods or fast food on every corner. No computers and TV’s were three stations. We moved, summer and winter.

      2. More to the point, High Fructose Corn Syrup hadn’t been introduced as a bulk filler/sweetener in the nation’s food supply yet. t

        That distinction happened in 1986 when Coke came out with New Coke.. the difference? no more cane sugar. This is also the point at which “Adult-onset diabetes” started to show up in children. (Something that mostly those over 55 got when we were kids in the 60’s and 70’s.) By 1990 the numbers of diabetic kids began to tick up enough so by some point in the mid-90’s the medical industry stopped calling it ‘Adult-onset’ and changed the name (quietly) to “Type-2”.

        You’d have though the AMA would have gone off like air-raid sirens about it but no. The push to get the now younger Americans onto the diabetic meds treadmill was too profitable to go bother going to war with King Corn and the UDSA.

        Nearly 40 years later, here we are.

    2. 3/5 vs 6/10…..same…..still good point….if you are reading be the 2/5 or 4/10….. And shut off devices….

      1. 3 out of 5 were free of diabetes/prediabetes (1999) and the 6 out of 10 had diabetes/prediabetes (2018). It was poorly worded. It should have said 2/5 (4/10)had diabetes/prediabetes in 1999 and 6/10 had diabetes/prediabetes in 2018. So a 50 percent increase in 19 years.

  2. Do you NOT know that bringing attention to the appalling state of America’s health is “fat shaming?” We’re all supposed to be “body inclusive” and accept as normal the tons of human lard waddling around the grocery store barely able to push carts loaded with cookies, chips and frozen dinners. A quote I recently came across: “You go into Walmart for eggs and milk and leave brooding about the fate of the nation.”

  3. No surprise. Big Food has been offering nothing but cheap, highly profitable, sugar-laden, and totally unhealthy food for decades. Not just here, but in Europe and Latin America as well.

    The government has been pushing (largely under the influence of Big Food) an inverted “food pyramid” which encourages us to eat carbohydrates while avoiding healthy fats (which should be a primary fuel for our bodies). Nutrition education is largely absent in our schools. No wonder by 50 most of us are insulin resistant, in fact we are seeing insulin resistance and pre-diabetes in 20 year-olds.

    The entertainment industry turns into couch potatoes who are only interested in being entertained, and receive instant gratification, rather than people who are willing to work and sacrifice (and actually have to endue discomfort of some kind) to make our lives better.

    Big Pharma pushes ever increasing amount of insulin injections as the “cure”, when in fact the effective treatment is a low carb diet and high intensity exercise.

    Yes, this nation, and much of the world, is in a health crisis.

    1. BigPharma & BigFood is killing everyone for profit. I work as an EMT & the list of medications the elderly take is staggering. It’s the simple things to improve health, a strenuous hour-long workout at least twice a week, eliminate all sugar-snacks/junk-food and stop drinking sugar-water(soda). Most employers are also killing their workers. Sitting in a chair for 8 hours a day isn’t healthy. I’m 165 pounds, but should be 155-160– it’s astonishing the number of bariatric patients I transport, we literally have a winch and a ramp in the ambulance because these people weigh 300-500 pounds after eating 3000 calorie junk diets.

      1. I was an EMT all through the 80’s and we rarely saw obese people. I remember picking up a few overweight and one beached whale that died in an attic, but people still were not that overweight. The weight problem has been since GMO foods and fast food everyplace. Take those two things away and see weigh return to normal.

    2. Pure nonsense. The main problem is people eat TOO MUCH. You cannot exercise your way out of this. You are just contributing to the problem when you push this nonsense about carbs and fats. Carbs do not cause health problems. Fats do not cause health problems. Eating excessive amounts of calories from either will increase your chances of having health problems. All you have to do is look around the world and you see many cultures who eat mostly carbs in their diet. Or cultures who eat high percentages of fat in their diet. They don’t have health problems like we do in America because they are not OBESE because they don’t eat more than they need to survive.

      1. The food chain to the water, air we breath is all unhealthy, unhealthy planet = unhealthy people!

      2. Not true about the carbs and fat, Nishi. Read Metabolical, about the rise of metabolic syndrome when we began changing our diets from real foods to processed foods. The most interesting point to me from the book was that a calorie is not a calorie. We were brought up thinking that if you just eat the right amount of calories based upon the calories you burn, you will be fine. But calories in real food, like fruit and nuts, are processed by the body differently because they are embedded in fiber. Your body only takes in about 70% of the calories of a nut versus 100% from carbs. Carbs are processed into sugar just like alcohol and both are fueling the rise of metabolic syndrome, including diabetes and fatty liver disease.

  4. As a society we’re de-naturalized and over urbanized. The joy and stress release that comes from sport and exercise is not widely appreciated. We watch the talent on TV and get stimulation from social media instead of our own self efficacy. I grew up playing outside and going in the woods at four and never stopped. Now I’m 70. I know what it takes to be fit and what it feels like. This experience must be fostered in youth in schools, and encouraged through our lifetime with active leisure. Vitality is worth the struggle. It’s not an achievement. It’s just a way of being fully alive.

  5. Instead of building schools for third worlders whose capacity for learning is extremely limited,we should be building parks with running tracks.

  6. Everytime I go to the store and see the ever expanding aisles of junk offerings, I wonder if anyone ever reads these articles or even cares what they put into their pie hole! Wherever I go, I see people stuffing their faces with endless amounts of garbage food, as their bodies become more and more misshapen. Even their conversations rap nostalgic about everything crap that they consume, and which fast-food restaraunts they frequent. It’s mind-boggling. Just look in the frozen food section: fruits and vegetables take up two cases. Pizza takes up one whole aisle and ice-cream/deserts take up two whole aisles. As a nation, we are doomed.

  7. Tom
    Your capacity for understanding “third worlders” is either extremely limited, or you’re one doozie of a racist.
    ‘If we build it, they will come’?
    Wow!

  8. More public swimming pools would be one of the few good uses of tax dollars.

    Swimming offers one of the best cardio exercises. Lifeguard shortage? Subsidize this training.

    1. They closed most of the public swimming pools after the “woke” crowd forced them to let black people used them too. Thanks, racists!

  9. During the entire pandemic, you never saw a shortage of soda, chips, ice cream. Also, the cost of eating a heart healthy, Mediterranean diet has increased. The regimes that want U.S. society to fail think that is it hilarious that we are so gullible.

    1. The future the elites have planned for us is to eat bugs. I guarantee everyone will lose weight on that diet.

  10. Lets not discuss the part that poverty plays in all this. Y’all ain’t ready for that.

    1. I thought the article’s emphasis on racial outcomes, and your point about income, are misplaced when 93% of Americans are impacted. That’s the headline. I frankly don’t care if low income people are more likely to be impacted by rich people, when all of our health outcomes are absolutely abysmal. Like so many fights, we are in this together.

    2. Lots of people grew up poor and ate healthy and were not obese. There are lots of healthy cheap food, Broccoli, Onions, Spinach, Potatoes, Sweet Potatoes, Canned Tomatoes, Carrots, Cabbage, Squash, Brown Rice, Oatmeal, Beans, Lentils, Quinoa, Bananas, Oranges, Apples, Canned Fish, Eggs, Milk, etc. Just because you are poor does not mean you have to eat at McDonalds every day.

  11. This is a result of a few different issues. One is the cost of nutritional food vs non healthy options. The quality of said nutritional food is not always that great in certain areas. People tend to work more hours or more often so either you don’t have the time to prep a good meal or your forced to go for the quick option which is junk food. Lack of areas where people can go exercise if they do have the time. The economic inequality is another. The large amount of activity thrown into electronics and such can deter someone from having the will to go out and exercise.

  12. MODERATION! Americans are not educated to be healthy. We are too busy calling each other names. To be in the 7% you have to work at it & educate yourself. Doctors have tests which you can test yourself in your home. Conflicting messages is biggest problem.
    No.1 problem is excess weight. Doesn’t mean to starve your self & drink alcohol to excess or smoke to excess or drink coffee & energy drinks to excess.
    Doesn’t mean to completely eliminate sugars, but to realize sugar raises blood sugar..Your body produces insulin to bring levels to normal. But too much leads to insulin resistance to diabetes.
    I heard one decathlon guy on YouTube say, “It’s better to eat all the fat on a steak because it fills you up better & you won’t eat so much” Unbelievable..
    How stupid… That’s not the way to get healthier.
    First thing is to start eating healthier foods. Get the weight down & fat OFF the body. Exercise in moderation. You don’t know the condition of your blood vessels & organs. Take your blood pressure at home occasionally. Cholesterol is easier to get down to acceptable levels. Absence of cardiovascular disease has heritary history as a factor you can’t change. Walking, lifting even light weights, breathing outside air. (yes , it’s often healthier than indoor) paying attention to risk factors will definitely help. Don’t carry more weight than you need. It will stress your bones, joints, & cardiovascular system.

  13. Not to worry— The gov’t will come up with a program to pay the laziest to exercise. We might even see therapeutic massages and food stamps for non—unhealthy foods. What a great country!

  14. According to new thinking the food pyramid is dangerously misleading.

    See the work of Benjamin Bikman, Peter Attia, Rhonda Patrick and others in this space for generally contrary opinion on how to eat.
    It is obvious that how the broader population is eating now isn’t working.

  15. What I wonder is what will happen when the obese can no longer consume non-stop if there is a food shortage crisis? Or rations, then what? There will no longer be a pig-out free for all and they may have no choice but to lose weight.

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