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Metabolic Health in Americans Alarmingly Low

Metab Syndr Relat Disord; ePub 2018 Nov 27; Araújo, et al

Prevalence of metabolic health in American adults is alarmingly low, even in normal weight individuals, a recent study found. Data from the National Health and Nutrition Examination Survey 2009–2016 were analyzed (n=8,721). Using the most recent guidelines, metabolic health was defined as having optimal levels of waist circumference (WC <102/88 cm for men/women), glucose (fasting glucose <100 mg/dL, and hemoglobin A1c <5.7%), blood pressure (systolic <120 and diastolic <80 mmHg), triglycerides (<150 mg/dL), and high-density lipoprotein cholesterol (≥40/50 mg/dL for men/women), and not taking any related medication. Researchers found:

  • Changing from ATP III (Adult Treatment Panel III) guidelines to more recent cut points decreased the proportion of metabolically healthy Americans from 19.9% to 12.2%.
  • Dropping WC from the definition increased the percentage of adults with optimal metabolic health to 17.6%.
  • Characteristics associated with greater prevalence of metabolic health were female gender, youth, more education, never smoking, practicing vigorous physical activity, and low body mass index.
  • < one-third of normal weight adults were metabolically healthy and the prevalence decreased to 8.0% and 0.5% in overweight and obese individuals, respectively.


Araújo J, Cai J, Stevens J. Prevalence of optimal metabolic health in American adults: National Health and Nutrition Examination Survey 2009–2016. [Published online ahead of print November 27, 2018]. Metab Syndr Relat Disord. doi:10.1089/met.2018.0105.