New Study: Prevalence of Optimal Metabolic Health in American Adults

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MarcR
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New Study: Prevalence of Optimal Metabolic Health in American Adults

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Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016

Mind blown - the overall prevalence of metabolically healthy adults is only 12.2%. Even among people of normal weight, less than a third are truly healthy.

With the exception of the blood pressure standard the criteria seem soft to me ...

Waist circumference: men < 102 cm (40") or women < 88 cm (36")
Glucose: fasting < 100 and HbA1c < 5.7
Blood pressure: systolic < 120 and diastolic < 80
Triglycerides: < 150
High density lipoprotein (HDL): men > 40 or women > 50
Medicine: nothing related (e.g. metformin, lisinopril, atorvastatin)

Much of the data comes from the 223 million adults in the National Health and Nutrition Examination Survey; a probabilistically representative sample (n=8,721) is used for correlations to gender, age, education, ethnicity, exercise, smoking, and BMI. Another shocker for me is healthy adults over age 60 - only 2.1%! The study has several fascinating tables summarizing the correlations. For example, people who engage in both "vigorous and moderate" physical activity are 54% more likely to be healthy.

I like the way this study reframes the elements of metabolic syndrome, which is defined as having three or more of the above risk factors. Instead of feeling relieved to be experiencing only one or two elements of poor health, I think we should feel inspired to achieve the worthier goal of full metabolic health, the absence of all five risk factors without pharmaceutical assistance.
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Julie G
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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W.O.W- This is both stunning and alarming. Grave consequences for all chronic disease...
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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Thanks for sharing. Very interesting. And worrying.

Julie, I think this even more support for the interest in a broad prevention campaign.
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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Julie, I think this even more support for the interest in a broad prevention campaign.
EXACTLY! I just listened to a recent 30 minute podcast put out by the CDC re. their initiative to advance cognitive health and they're primarily focused on education to promote early detection as well as tracking & supporting those affected and their caregivers. In terms of Alzheimer's prevention, the message was weaker and not an area they are currently emphasizing. One explanation for this is that "we don't know the exact causes of Alzheimer's disease..." They did mention that 95% of those stricken with the disease are suffering with other chronic conditions; like obesity, hypertension, diabetes, heart disease and more... so certainly the broad advice put out by their own curriculum is very appropriate TODAY. And, you're absolutely correct, the study that Marc shared underscores the importance of this effort.
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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This could also serve as a reminder of the importance that anyone who can, join their national precision medicine initiative to help collect vital genetic, lifestyle, medical and other data across millions of people. This should help elucidate just how Alzheimer's fits in data-wise and assist with Alzheimer's research. I know the US and UK both have such an initiative. I got my fitbit back out so I can send its data to the database within my account, along with all my other stats.

US All of Us Research Program

UK The 100,000 Genomes Project - Unfortunately I've just realized this is only genomes. Good to have but the US program is far more comprehensive in the data they're collecting.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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Thanks for mentioning All of Us, circular. I had not heard of it previously. I signed up and am looking forward to participating.
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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MarcR wrote:Thanks for mentioning All of Us, circular. I had not heard of it previously. I signed up and am looking forward to participating.
Yea Marc! You get a cool badge! 8-)
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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SusanJ
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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Marc, thanks for sharing this. It is alarming, and points to even more problems for the US health care system, which is already failing to keep people healthy, down the road. Unfortunately if we just look around us, including family and friends, we can see the creep of bad eating, obesity and sedentary lifestyle quite plainly.

Did anyone else notice that they did not choose any measures of LDL as one of their 5 criteria for cardio-metabolic health? Perhaps just because it's lacking in the data? But, very interesting in my book especially given the recent Attia-Feldman discussion where they focused primarily on LDL. :!:
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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SusanJ wrote:Did anyone else notice that they did not choose any measures of LDL as one of their 5 criteria for cardio-metabolic health?
Why yes, Susan, I certainly did. ;)

I think LDL is absent because the study uses the metrics of metabolic syndrome (MS), and LDL is not an MS component. MS definitions evolved from 1998-2005, but all versions rely on triglycerides and HDL rather than LDL.

I value the MS biometrics because my personal journey from sickness to health was a march from meeting all five criteria to meeting none of them. As each biometric improved, I experienced greater vigor and wellbeing.

LDL on the other hand has been an outlier. Some of the lowest values have been when I was sickest, and I have seen high values when I felt terrific and was the picture of health according to other biomarkers. For example:

2003: TG 373, HDL 36, LDL 101 (5/5 MS criteria, 230 lbs)
2018: TG 66, HDL 89, LDL 133 (0/5 MS criteria, 172 lbs)

And as I regularly explain, most recently here, the disconnect between LDL guidelines and my personal wellbeing is reflected in the research.
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Re: New Study: Prevalence of Optimal Metabolic Health in American Adults

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Makes sense, but they did refer to cardio-metabolic health more than once.

Good numbers, Mark. I also carry slightly higher LDL numbers (nothing that alarms my conventional doc) and I have to agree, I do feel better than my stellar numbers on a very high carb, vegetarian diet. Still tweaking a bit here and there to see the effects and drive them down a little more where I can.
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