Less Than 7% of US Have Good Cardio Metabolic Health

Cardiometabolic health encompasses a spectrum of conditions and risk factors. Issues in cardiometabolic health are one of the biggest burdens on the health care system and modern society. The progression from a society in which most people were moving throughout the day to one where many people spend an average of 10 hours a day sitting1 has greatly contributed to the problem.


Each of the factors that contribute to your cardiometabolic health has an impact on your risk of heart disease, diabetes, peripheral vascular disease and early death. Not only are Americans not exercising as much as they once did, but they're also leading more sedentary lives, which has contributed to a rising rate of obesity,2 high blood pressure3 and high blood sugar.4

Thankfully, there are simple strategies you can use to make a significant difference in your cardiometabolic health, and therefore your longevity. Although it may feel overwhelming to consider changes to your eating or exercise habits, as we have discovered in 2020 and 2021, those with good cardiometabolic health were more resilient to infectious disease and had a reduced risk of severe illness from COVID-19.5

Since SARS-CoV-2, the virus that triggered COVID-19, is likely not the last pandemic society will face, your best strategy to improve your quality of life and reduce your risk of early death is to make the necessary changes to improve your cardiometabolic health.

Only 6.8% of American Adults Have Good Cardiometabolic Health

The research was led by the Friedman School of Nutrition Science and Policy at Tufts University and included scientists from Tufts Medical Center.6 The scientists looked at data from 55,081 adults who were 20 years and older from the 10 most recent cycles of the National Health and Nutrition Examination Survey (NHANES).7

Based on this nationally representative sample of U.S. adults, the researchers found that fewer than 1 in 14 adults (6.8%) had optimal cardiometabolic health. The researchers evaluated five components: blood pressure, blood sugar, adiposity, blood cholesterol and the presence or absence of cardiovascular diseases.

Those who were healthy had optimal levels in all five categories in the NHANES data collected as of 2017-2018. When the data were compared against the 1999 survey data, they found that 1 out of 3 adults had optimal levels of adiposity and that number declined to 1 out of 4 by 2018.8

When the researchers evaluated the number of adults with diabetes or prediabetes, they found in 1999 that 3 out of 5 were free of disease but by 2018 fewer than 4 out of 10 were. Megan O'Hearn, from the Friedman School and the study's lead author, said:9

"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. 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."

Optimal Health Is Not Just Free of Disease

The study10 also identified large disparities between education level, age, sex, race and ethnicity. For example, in the data from 1999 and 2018, they found the percentage of those with good cardiometabolic health improved among non-Hispanic white Americans but declined for Hispanics, Blacks and adults of other races.

The study also looked at intermediate levels of health where individuals may have had prehypertension, were overweight or had prediabetes. O'Hearn found there was a large portion of the population who were at a critical point where addressing lifestyle factors could reduce the growing healthcare burden.11

O'Hearn noted, "This is a health crisis we've been facing for a while. Now there's a growing economic, social and ethical imperative to give this problem significantly more attention than it has been getting."12

She added that the consequences of the state of health in adults don't only impact individuals personally. Instead, largely preventable conditions have a significant impact on national health care spending. She continued:13

"We need to shift the conversation, because disease is not the only problem. We don't just want to be free of disease. We want to achieve optimal health and well-being."

As O'Hearn points out, health is not just the achievement of being free from disease. The U.S. Office of Population Affairs uses the definition of optimum health from the American Journal of Health Promotion,14 which says:

"Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health … Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice."

Overhaul of the Food System Means Getting Back to Basics

O'Hearn mentions overhauling the food system to encourage more people to eat healthier foods.15 However, this does not mean eating fake meat and soy-based food products but, rather, getting back to the basics of clean living.

Although industrial agriculture has been one of the most unsustainable practices, the answer is not replacing farms with a chemistry lab. Producing meat substitutes requires water, chemicals and fossil fuel. In that respect, it differs very little from conventional agriculture. Additionally, the nutrient value of lab-grown meat and meat substitutes is highly questionable.

For example, Seth Itzkan, environmental futurist and cofounder and codirector of Soil4Climate, suggests16 fake meat products are destroying the environment by perpetuating a harmful reliance on genetically engineered (GE) grains while accelerating soil loss and detracting from regenerative agriculture, which may be why Impossible Foods holds 14 patents, with at least 100 more pending. He writes:17

"It's not food; it's software, intellectual property — 14 patents, in fact, in each bite of Impossible Burger with over 100 additional patents pending for animal proxies from chicken to fish."

Although the development and production of fake meat are based on sustainability claims, these should be backed up by environmental impact studies. According to a 2015 study,18 lab-grown meat actually requires more energy than conventional agriculture.

Creating patented lab-grown meat products is not about feeding the world or eliminating animal suffering. It's about dominating billionaires looking to put patents on the food system — and, as Impossible Foods put it, "to transform the global food system."19

While many view lab-created meat substitutes as the lesser of two evils compared to conventional factory-farmed meat, taking nature out of the equation is not the answer.

Instead, as I have promoted in the past, regenerative agriculture is a holistic herd management system that is an integral part of the regenerative agriculture equation and creates a complete ecosystem that both heals the land and is productive for the farmer. It is not eating meat that harms the environment but rather industrial farming practices that inflict damage.

Six Tips to Improve Cardiometabolic Health

While this is not an inclusive list, it's an important place to start. By making simple changes to your eating and exercise habits, you may help balance your nutritional status and improve your cardiometabolic health. This in turn can help you become more resilient, which will become more important in the coming years.

I believe one of the most important changes you can make is to transition to a cyclical ketogenic diet plan. For those who may find it challenging to drastically reduce carbohydrates, you'll find tips here to help lower your carb intake, reduce your cravings and help lower the impact carbs have on your health.

1.Eliminate processed foods — The primary reason why processed foods are so pernicious is that they are loaded with seeds oils and high amounts of the omega-6 fat, linoleic acid (LA). The amount of LA in our diet has increased more than 25 fold since 1860.

This results in a dramatic increase in oxidative stress that contributes to ruining the quadrillions of mitochondria in your body. The most important strategy for your health is to eliminate all processed foods from your diet as they are loaded with LA.

Additionally, junk food manufacturers have taken flavor science to an extraordinary level and created artificial ingredients that produce the sought-after "bliss point" your body craves. These foods contribute to the obesity epidemic, which increases rates of obesity-related cancers20 and chronic illnesses.21

It's been estimated22 that as much as 40% of American health care expenditures are for diseases directly related to the overconsumption of sugar. Research23 has demonstrated that 21.1% of calories in ultraprocessed foods come from sugar.

They increase how quickly you eat and cause delays in feelings of satiety. This contributes to obesity and metabolic dysfunction. Ultraprocessed foods made people more vulnerable to COVID-19 during the pandemic.24 Improving your cardiometabolic health today can help increase your resilience against future infectious diseases.

2.Cool your carbs before you eat them

Research studies have demonstrated that by cooling carbohydrates before eating them, you may create more digestive-resistant starches. This can trigger a lower insulin and glucose spike and the starches may act as prebiotics for healthy bacteria in your gut. In this short video, you see the results of 10 people taking part in a three-day experiment to evaluate the glycemic changes triggered by eating cooked, cooled and reheated pasta.

A study published in 2020 confirmed the results that cooking pasta, cooling it, and reheating it had a significant effect on blood glucose spikes in 45 volunteers.25 Similar results were found in a study26 published in 2008 looking at freezing and toasting white bread and the response to the glycemic index.

This is interesting insight you may consider as you are reducing the number of carbohydrates you eat each day. It's also important to remember that most of these products are made with wheat, which contains lectins and is often contaminated with glyphosate that impairs tight junctions in your gut. Consider transitioning to healthier choices, including sweet potatoes and purple varieties.

3. Intermittent fasting helps lower carb craving — As has been increasingly shown through research, it's not only what you eat that factors into how the food affects your health, but also when you eat it. Fung believes the answer to Type 2 diabetes is to use time-restricted eating (TRE). In an interview in early 2022,27 he discussed how metabolic treatments such as TRE are the only way to resolve diabetes.

One of the keys to lowering your carbohydrate intake is to help eliminate your carbohydrate cravings. The key to getting rid of cravings, in my experience, is eating a diet that's high in healthy fats and low in refined carbohydrates. I am a big advocate of combining a cyclical ketogenic diet with TRE. Eating real food and selecting healthy fats are keys to reducing your carbohydrate cravings, no matter what ratio of fat, carbs and protein you eat.

4. Get help for emotional eating — Emotional eating and food addictions are very real and can lead to obesity and related health problems. As clinical psychologist Susan Albers told HuffPost, "… [E]ating to avoid facing feelings is like putting a 'Band-Aid on a broken arm.'"28

Fortunately, there are solutions and the two most effective ones I know are intermittent fasting with a cyclical ketogenic diet and Emotional Freedom Techniques that release you of negative thoughts and feelings while you're taking steps to improve your physical health. If you feel that your emotions or your own self-image are sabotaging your efforts, I recommend my free EFT manual and consider trying EFT.

5. Fermented foods boost mental health — Incorporating fermented foods into your nutritional plan has a multitude of benefits, not the least of which is improving your gut microbiome and your mental health. A review29 of seven clinical trials found probiotics and or prebiotics could help those struggling with depression and anxiety.

The review built on earlier studies that have shown people with depression have higher amounts of specific gut bacteria than those who are not depressed.30,31 Reducing your risk of depression and anxiety, as well as improving your overall health and resilience against infectious disease,32 may raise your motivation to take the steps needed to improve your cardiometabolic health.

6. How to learn to love movement and exercise — There is a long list of benefits from exercise for your physical and mental health, including improving muscle strength and flexibility and improving cognitive skills. One study33,34 of 40 women found those who were relatively inactive viewed exercise as counterproductive to their goals, had a different view of what "exercise" entailed and how it would feel and felt it would take too much time.

On the other hand, the highly active women believed that exercise fit their goals for relaxation, achieving success and connecting with others. The researchers theorized that inactive women could improve their motivation by shifting the way they think about exercise and their definition of what exercise should look like.

The type of exercise you choose is a personal choice, but the objective is to do something that raises your heart and breathing rate. How you frame the idea may help change your perspective, so you enjoy the activities you've chosen.

For example, some of the top reasons that people start a workout routine are to lose weight and lower their risk of disease. However, these are extrinsic motivators and are not enough to overshadow discomfort for the benefit of a future reward.

An analysis of six studies35 demonstrated that people who placed a greater value on their internal feelings while exercising, rather than on the benefits they might experience later, stayed motivated to continue their activity. You'll find how to enjoy the benefits of walking and how to incorporate this simple activity into everyday life in "How to Step Out of Your Sedentary Lifestyle."

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