Less Than 7% of US Have Good Cardio Metabolic Health

The research was led by the Friedman School of Nutrition Science and Policy at Tufts University and included scientists from Tufts Medical Center.

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).

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.

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."

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

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1 Get America Standing
2 Centers for Disease Control and Prevention, Adult Obesity Facts
3 Centers for Disease Control and Prevention, Facts About Hypertension
4 Centers for Disease Control and Prevention, March 11, 2022
5 Cardiology Review, 2022; 30(3)
6 NewsWise, June 28, 2022
7 Journal of the American College of Cardiology, 2022;80(2) Section Snippets
8 NewsWise, June 28, 2022
9 NewsWise, June 28, 2022
10 NewsWise, June 28, 2022
11 NewsWise, June 28, 2022
12 NewsWise, June 28, 2022
13 NewsWise, June 28, 2022
14 American Journal of Health Promotion, 2009; doi.org/10.4278/ajhp.24.1.iv
15 NewsWise, June 28, 2022
16 Medium May 25, 2020
17 Medium May 25, 2020
18 Environmental Science and Technology 2015;49(19)
19 Impossible Foods, Sustainable Foods, Impact Report Archives 85% DTP
20 Lancet Oncology 2015; 16(1)
21 American Journal of Clinical Nutrition, 2005;81(2)
22 Credit-Suisse October 22, 2013, Sugar Consumption at a Crossroads (PDF) page 20
23 BMJ Open, 2016;6(3)
24 Cells, 2021; 10(4)
25 Foods, 2020;9(1)
26 European Journal of Clinical Nutrition, 2008; 62 (5)
27 BitChute, February 18, 2022
28 HuffPost February 20, 2019
29 BMJ Nutrition February 23, 2020 DOI: 10.1136/bmjnph-2019-000053 (PDF)
30 Nature Microbiology 2019 Apr;4(4)
31 Brain, Behavior and Immunity 2015;48
32 medRxiv, 2020; doi.org/10.1101/2020.07.06.20147025
33 BMJ Public Health, 2017;17(462)
34 Time Magazine, May 30, 2017
35 Journal of Personality and Social Psychology 2015; 109(6) 



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