
Only 12% of American adults are in good metabolic health, according to recent findings—a rate study authors called “alarmingly low.”
For the study, researchers gathered data on 8,721 American adults from the National Health and Nutrition Examination Survey 2009-2016. They applied the most up-to-date metabolic health guidelines, which they measured based on waist circumference (102 cm for men, 88 cm for women), glucose levels (fasting glucose <100 mg/dL, hemoglobin A1c <5.7%), blood pressure (systolic <120, diastolic <80 mmHg), triglycerides (<150 mg/dL), and high-density lipoprotein cholesterol (≥40 mg/dL for men, ≥50 mg/dL for women), and not taking any medication for the aforementioned parameters.
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The previous guidelines were those of the Adult Treatment Panel III (ATP III); based off those standards, 19.9% of American adults were considered metabolically healthy (95% confidence interval [CI]: 18.3–21.5). Using the updated standards, only 12.2% of American adults—roughly 27.3 million—had optimal metabolic health (95% CI: 10.9–13.6). When not considering waist circumference, the rate increased to 17.6%. Female gender, younger age, higher education level, never smoking, practicing vigorous physical activity, and low body mass index were all correlated with increased odds of having better metabolic health. There were no metabolically healthy adults who were obese, had less than a high school education, were not physically active, and were current smokers.
“Less than one-third of normal weight adults were metabolically healthy and the prevalence decreased to 8.0% and 0.5% in overweight and obese individuals, respectively,” according to the researchers.
“The large number of people not achieving optimal cardiometabolic levels of risk factors has serious implications for public health. More work is needed to understand the mechanisms of risk factor development, with attention given to normal weight as well as heavier adults,” the study authors wrote. They concluded: “Currently available interventions to improve health-related behaviors have met with limited success, and stronger and more widely accessible strategies to promote healthier lifestyles are urgently warranted.”
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