Study assesses lifestyle behaviors and cardiometabolic diseases in diverse group of US young adults

Research published in the Journal of the American Heart Association reveals that many U.S. young adults have poor lifestyle factors and cardiometabolic diseases—such as obesity, diabetes, and hypertension—with varying rates based on race and ethnicity.

The study included 10,405 individuals aged 18–44 years whose information was available from the National Health and Nutrition Examination Survey, 2011–2018. The prevalence of lifestyle risk factors ranged from 16.3% for excessive drinking to 49.3% for poor diet quality. The prevalence of cardiometabolic diseases ranged from 4.3% for diabetes to 37.3% for high cholesterol. The prevalence of having ≥2 lifestyle risk factors was 45.2% and having ≥2 cardiometabolic diseases was 22.0%.

Rates of current smoking and excessive drinking were higher in white individuals than Hispanic and Asian individuals. White individuals had a lower prevalence of poor diet quality, inadequate physical activity, and inappropriate sleep duration than Black individuals. Asian individuals had the lowest prevalence of all lifestyle risk factors except for inadequate physical activity.

The prevalence rates of obesity, prediabetes, diabetes, and chronic kidney disease were lower in white individuals than Black and Hispanic individuals. Compared with white and Hispanic individuals, Black individuals had a higher rate of hypertension but lower rates of elevated cholesterol and non-alcoholic fatty liver disease. Hispanic individuals had the highest prevalence of metabolic syndrome among all racial and ethnic subgroups.

Generally, individuals with a more favorable social risk factor profile—such as higher education, higher income, higher food security level, and with 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.

"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 co–corresponding author Nannan Feng, Ph.D., of Shanghai Jiao Tong University School of Medicine, in China.