Joana Araujo, a UNC post-doc research associate, published a new study in the Metabolic Syndrome and Related Disorders journal detailing the low level of optimal metabolic health in the American adult population.
Over the last decade, the guidelines for determining metabolic health have changed, so Araujo and her team wanted to determine the most updated proportion of metabolically healthy American adults. The guidelines they followed provided test points for five variables of metabolic health: blood pressure, waist circumference, glucose, high-density lipoproteins and triglycerides. The test points outlined the level of each variable necessary for optimal metabolic health.
Araujo’s team then compared the test points to data of American adults from the National Health and Nutrition Examination Survey, a nationally representative database available to the public.
They found that only 12.2 percent of American adults are considered metabolically healthy. In terms of public health, this means that a majority of the American adult population, including many with a normal weight, are not achieving optimal levels of the five cardiovascular risk factors tested without the use of medication.
The study also looked at how this percentage would change if the NHANES data was separated into certain population subgroups according to factors such as weight, physical activity level or smoker versus nonsmoker.
“For example, among people that are normal weight, we found that approximately one-third is metabolically healthy, but less than one percent of obese adults are metabolically healthy,” Araujo said. “Even if you are normal weight, you still need to think about all of your behavioral factors, all of your lifestyle factors.”
From examining these different subgroups, the study discovered that smoking, leading a sedentary lifestyle and being overweight reduces a person's chances at achieving optimal metabolic health and increases a person's risk of cardiovascular disease and other health complications. Metabolic health was found to be higher in highly educated individuals, nonsmokers, females and those who engage in physical activity. There was also a correlation between increasing age and decreasing metabolic health.
Based on these findings, the best way to improve a person's metabolic health would be to improve lifestyle choices such as controlling weight, not smoking, reducing sedentary time and practicing physical activity, Araujo said.
“In terms of public health intervention, I think it’s really important that we have the most recent and updated data showing that only one in eight adult Americans are metabolically healthy,” Araujo said. “We need to take action in terms of population-based intervention, trying to improve the lifestyles of our population.”
By identifying those in the American adult population who have optimal metabolic health and examining their lifestyle choices, Araujo and her team were able to find trends in lifestyles or behaviors that are most compatible with optimal metabolic health.
“We’re not talking about people having disease or not having disease,” said Araujo’s mentor and co-author June Stevens. “We are talking about higher level health.”
The study, which began in January of this year, is important to the future of public health because it offers the most up-to-date picture of higher level metabolic health in the United States, Araujo said.
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