The medical community has been concerned about Americans' cardiometabolic health for years, but the crisis appears to be getting worse.
Less than 7% of U.S. adults are in good cardiometabolic health, a new study suggests. But what exactly does cardiometabolic health refer to? And how can people improve their own health?
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What is cardiometabolic health?
Cardiometabolic health is a spectrum of conditions and risk factors that often occur together and are a significant cause of cardiovascular disease. They include metabolic syndrome, type 2 diabetes, obesity, high cholesterol and blood pressure.
Each of these factors can increase the risk of heart disease. Diabetes, in particular, more than doubles the risk of cardiovascular disease. But when combined, they increase the risk of experiencing an early heart attack, stroke or peripheral vascular disease, according to the Cleveland Clinic.
A lack of physical activity is also a significant contributor to poor cardiometabolic health, the researchers found. Americans are not only not exercising as much, but they also are living more sedentary lives.
"While we know that cardiometabolic health among Americans is a significant problem, we were surprised by the magnitude of the crisis," researcher Meghan O’Hearn, a doctoral candidate at the Friedman School of Nutrition Science and Policy at Tufts University, told U.S. News & World Report. "The lack of good health and well-being across the board is truly devastating and has only been getting worse."
A worsening situation
The number of U.S. adults with healthy weights and blood sugar continues to decline at a fast pace, researchers found. The study included 55,000 adults who answered a national health and nutrition survey between 1999 and 2018.
In 1999, 1 in 3 adults were at a normal weight, but that had dipped to 1 in 4 by 2018. And the number of adults living without prediabetes or diabetes dropped from 6 in 10 to less than 4 in 10. (People with prediabetes have blood sugar levels that are elevated but not high enough for a diabetes diagnosis.)
The researchers also found that cardiometabolic health varied by sex, race, ethnicity and education. Adults with less education, and those who were Hispanic or Black, were less likely to have good cardiometabolic health.
This suggests that social determinants of health, such as food and nutrition security, economic stability and structural racism, may be contributing factors, the researchers noted. They called for better access to healthy foods and more education on how to achieve a healthier diet.
In an editorial accompanying the study, cardiologists Drs. Thomas E. Kottke, Ajay K. Gupta and Randal J. Thomas wrote that the worsening cardiometabolic health of Americans should not be a surprise considering the predominance of unhealthy lifestyle behaviors. They include diets high in saturated fat, sugar, salt and calories; little to no physical activity; high alcohol consumptions; poor sleep habits and too much screen time.
To encourage healthy behavioral changes on the individual level, there needs to be more support on the community level, they wrote. This includes alliances with hospitals and schools to promote healthier eating and to ensure that students have enough opportunities for physical activity throughout the day. Alliances with city planning, transportation and parks and recreation also can increase opportunities for physical activity.
How to improve cardiometabolic health
There are steps people can take to improve their cardiometabolic health.
To start, eat a diet mostly comprised of whole, unprocessed vegetables, some lean meats and fish, whole grains, nuts and seeds, legumes, dairy, and extra virgin oil, spices and herbs for seasoning. Fish, green leafy vegetables, onions, tomatoes, blueberries, yogurt and oats are particularly good for cardiometabolic health. Also, keep alcoholic consumption to an occasional treat.
Finding more ways to move throughout the day is also important. Researchers emphasize that it is not enough to go to the gym a couple times a week. People need to be moving throughout the day, every day.
Some people have found that using standing desks at work or holding "walking" meetings can help decrease sedentary time. So can limiting screen time at home.
Better stress management and getting a good night's sleep every night also can optimize cardiometabolic profile, scientists say.