Key result
US older adults have more diabetes, low HDL, and inflammation than English peers, unexplained by BMI.
Why the study?
Stalling improvements in cardiovascular disease and obesity may explain lagging US life expectancy, but whether documented BMI differences explain health disadvantages compared to England remains unclear.
Do older adults in the United States have worse cardiometabolic health compared to those in England, and does BMI explain the difference?
Observational
Yes
Do older adults in the United States have worse cardiometabolic health compared to those in England, and does BMI explain the difference?
Older adults in the US have significantly worse cardiometabolic health profiles than those in England, a disparity not entirely explained by higher obesity rates.
Alerts clinicians to monitor US older adults for cardiometabolic risks; leaves open causal drivers and intervention targets beyond BMI.
Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on "deaths of despair," but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries.
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Pongiglione et al. (2022) conducted an observational in Cardiometabolic health. United States residence vs. England residence was evaluated on Self-reported and objective measures of health including diabetes, low HDL cholesterol, and high CRP. Older adults in the US have a much higher prevalence of diabetes, low HDL cholesterol, and high inflammation compared to English adults, which is not explained by differences in BMI.
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