Cardiometabolic disease: Young adults' lifestyle choices raise risks

• Researchers say poor lifestyle choices among younger people in the United States are leading to increased risks of cardiometabolic disease.
• Younger Black and Hispanic people reportedly have higher rates of obesity, prediabetes, diabetes, and chronic kidney disease.
• People with higher education, higher income, higher food security level, and health insurance coverage had lower rates of lifestyle risk factors and cardiometabolic disease rates.

A new study seems to confirm that the lifestyle choices younger adults in the United States make don’t necessarily equate to good health.

The research was published today in the Journal of the American Heart Association.

In it, researchers say many younger adults make poor lifestyle decisions that can lead to cardiometabolic diseases, such as diabetes, obesity, and hypertension, with rates varying depending on race and ethnicity.

Details from the study on cardiometabolic disease in younger adults

Researchers looked at 10,405 individuals between the ages of 18 and 44 whose information was available through the National Health and Nutrition Examination Survey from 2011 to 2018.

Five different lifestyle risk factors were evaluated. They were:

• Current smoking
• Excessive drinking
• Poor diet quality
• Inadequate physical activity
• Inappropriate sleep duration

The prevalence of these lifestyle risk factors were calculated, ranging from about 16% for excessive drinking to about 49% for poor diet quality.

Increased prevalence of cardiometabolic diseases ranged from about 4% for diabetes to about 37% for high cholesterol. In addition, the prevalence of having two or more lifestyle risk factors was about 45% and having two or more cardiometabolic diseases was 22%.

Researchers reported that white people had higher rates of smoking and excessive drinking than Hispanic and Asian Americans. White people also had a lower prevalence of poor diet quality, inadequate physical activity, and inappropriate sleep duration than Black Americans. Asian people had the lowest prevalence of all lifestyle risk factors except for inadequate physical activity.

Rates of obesity, prediabetes, diabetes, and chronic kidney disease were lower in white people than Black and Hispanic people. Black individuals had a higher rate of hypertension but lower rates of elevated cholesterol and nonalcoholic fatty liver disease than white and Hispanic individuals.

Hispanic people had the highest prevalence of metabolic syndrome among all racial and ethnic subgroups.

Researchers found that those with a more favorable social risk factor profile — higher education, higher income, higher food security level, and health insurance — had lower rates of lifestyle risk factors and cardiometabolic diseases.

Racial and ethnic disparities in many cardiometabolic diseases persisted but lessened after adjusting for social risk factors and lifestyle factors.

The importance of the cardiometabolic disease research

“Given that cardiometabolic diseases are largely preventable and lifestyle behaviors are theoretically modifiable, devising effective and targeted interventions to improve cardiometabolic health in young adults would deliver long-term health benefits,” said Nannan Feng, a study co-author and a faculty member at the Shanghai Jiao Tong University School of Medicine in China.

Dr. Krista Gonzales, an endocrinologist and educator at Pritikin Longevity Center in Miami, Florida, told Medical News Today that obesity is an epidemic with implications more severe than illustrated by the study.

“As impressive as these statistics are, with nearly half of individuals aged 18 to 44 with self-reported poor diet quality, I am sure this is still a gross underestimation of individuals with poor diet quality nationwide,” Gonzales said.

“According to data from 2017-2020 in the National Diabetes Statistics Report the prevalence of diabetes among those aged 18-44 was higher in more recent years at 4.8% than the survey estimation of 4.3%. Our focus on preventative medicine and basic dietary education is appallingly lacking nationwide with more than one in three individuals reporting high cholesterol within this young age group,” Gonzales added.

A ‘wake-up call’ for health professionals

Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in California, told Medical News Today the study should be a “wake-up call” to medical professionals.

“These findings also suggest that healthcare providers need to pay special attention to young adults during routine check-ups,” Tadwalkar said. “It is not enough to assume that youth equates to good health. This age group may be more vulnerable than previously thought and clinicians should be vigilant in screening for lifestyle risk factors and early signs of cardiometabolic diseases.

“This is a critical window of opportunity for early intervention,” Tadwalkar added. “For example, regular blood pressure checks should be part of routine care for young adults, especially those from communities with higher prevalence of hypertension.

Tadwalkar also found the study’s insights into racial and ethnic disparities “particularly concerning.”

“For example, Black individuals had a higher rate of hypertension, but lower rates of elevated cholesterol compared to white individuals,” he said. “This suggests that tailored interventions targeting specific risk factors within different racial and ethnic groups are warranted. Clinicians must recognize these disparities and work towards equitable healthcare by providing culturally sensitive guidance.”

Young adults and their lifestyle

Kelsey Costa, a registered dietitian and nutrition consultant for the National Coalition on Healthcare, told Medical News Today the study’s findings emphasize the importance of understanding the world in which young adults live.

“Young adults today live in a fast-paced, high-stress environment, often resulting in suboptimal lifestyle choices,” Costa explained. “Factors such as lack of time, limited access to healthy food options, high levels of stress, and sedentary habits contribute to this situation.”

“This demographic is often targeted by marketing for unhealthy food and beverage options, further exacerbating the issue,” she added. “It’s crucial to foster health-promoting environments where healthy choices are the easy choices. Strategies could include increasing access to and affordability of nutritious foods, promoting the benefits of regular physical activity, and implementing public health policies that reduce unhealthy influences.”

“Understanding these unique challenges faced by young adults will assist healthcare professionals in designing targeted interventions to promote healthier lifestyle habits and reduce the risk of cardiometabolic diseases,” Costa noted.

Gonzales said younger people can improve their overall health with better lifestyle choices.

“Remaining active lifelong through exercise (both cardio and strength training), maintaining a diet rich in whole foods, low in salt, low in saturated fats, and minimizing processed foods and trans fats are key,” she said. “Closing the gap in education, food security, and health care access could largely reduce health disparities found amongst individuals of varying races, ethnic backgrounds, and socioeconomic status.”

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