Just Read: Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016 (Are you in the 12%? here’s how I am)

2018.10.12 Low Carbohydrate and Low Carbon, Washington, DC USA 557
2018.10.12 Low Carbohydrate and Low Carbon, Washington, DC USA 557 (View on Flickr.com)

This paper, written by lead author See: June Stevens, at the UNC Lineberger Comprehensive Cancer Center, is an analysis of 7 years of NHANES data (a United States’ commissioned annual survey of people’s health) and their likelihood of being in metabolic health.

Early Days, We Still only Define Metabolic Disease

As we learned a long time ago to stop framing health in terms of the absence of disease, we are not yet doing that for metabolic health, so the authors used these cutpoints in their analysis, based on the review of literature:

  • Waist Circumference, < 102/88 cm in men/women
  • Systolic Blood Pressure, < 120 mmHG
  • Diastolic Blood Pressure, < 80 mmHG
  • Glucose < 100 mg/dL
  • HbA1c < 5.7%
  • Triglycerides < 150 mg/dL
  • HDL-C >= 40/50 mg/dL men/women

They also looked at taking medications for blood pressure, diabetes, and cholesterol.

Notably absent in the list above is LDL cholesterol, which is consistent with its limited utility in understanding overall metabolic health (see: Just Read: Challenging the role of LDL vs Insulin Resistance in predicting heart disease, via Kaiser Permanente data as an example of research describing this issue)

For a typical person in the health care system, the measures above would be easily obtainable on a regular physical exam. The issue is that

  • many physicians do not put the numbers together in this way
  • many physicians do not know what to advise in situations where the numbers aren’t good, because treatment is mostly diet, not medicines

I am in the 12 %, How I stay there

By these numbers, I am in the 12 %, and I am able to comfortably stay there, mostly through diet and exercise. The image at the top of this post shows a typical day for me diet wise, along with continuous glucose monitor readings.

This is my holiday meal profile, with barely a budge into the low triple digits on glucose after a meal

2018.11.25 Low Carb and Low Carbon 592
2018.11.25 Low Carb and Low Carbon 592 (View on Flickr.com)

America is at risk and the problem is getting worse

Unfortunately, Americans are at risk and the problem is getting worse, as they mostly do not eat the diet that I’ve shared above.

According to this analysis, only 42 % of Americans have glucose under 100 mg/dL. The trend is getting worse:

2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452 (View on Flickr.com)

And most are unaware of their condition

2018.05.29 Low Carbohydrate Meetup Washington, DC Presentation  454
2018.05.29 Low Carbohydrate Meetup Washington, DC Presentation 454 (View on Flickr.com)

Weight and Metabolic Health are two different things

Many studies (and physicians) who use weight or weight loss as a measure of health are using older paradigms, as confirmed here (again):

Even when WC was excluded from the defini- tion, only one-third of the normal weight adults enjoyed optimal metabolic health.Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord [Internet]. Mary Ann Liebert, Inc., publishers 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA; 2018 Nov 27 [cited 2018 Nov 29];met.2018.0105.

There are physicians all over the world working to change this trajectory

Here’s one example, as reported by CBC, The Canadian Clinicians for Therapeutic Nutrition

See: Doctors who champion low-carb, high-fat diets go against the grain

Reference

Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord [Internet]. Mary Ann Liebert, Inc., publishers 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA; 2018 Nov 27 [cited 2018 Nov 29];met.2018.0105.

Conflicts of Interest in the research

None noted. No industry sponsorship

Conflicts of Interest by this post author

None, conflict free is the way to be. Check out my disclosures page for details.

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