Key result
Only ~22% of US adolescents have optimal cardiometabolic health, with deficits common despite normal BMI.
Why the study?
A comprehensive evaluation of cardiometabolic health markers in U.S. adolescents had not been reported despite the known overweight and obesity epidemic.
Cross-Sectional
Yes
Less than a quarter of U.S. adolescents have optimal cardiometabolic health, highlighting a significant public health concern even among those with normal BMI.
Highlights cardiometabolic risks in US adolescents; leaves open need for longitudinal studies before guiding interventions.
Background: While the overweight and obesity epidemic in the adolescent population is well described, a comprehensive evaluation of cardiometabolic health markers has not been reported. Our purpose was therefore to determine the prevalence of cardiometabolic risk factors among non-diabetic individuals 12 to19 years of age in the United States. Methods: We analyzed data from nationally representative samples of U.S. adolescents (NHANES, 2007–2016). Optimal cardiometabolic health was defined as an absence of risk factors, that is, at least normal values on each of the following 11 measures: body mass index (BMI) percentile, waist circumference percentile, blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, non-HDL cholesterol, triglycerides, fasting plasma glucose, alanine aminotransferase, and insulin resistance. Domain analyses were conducted with Rao-Scott chi-square tests of independence. Multivariable linear/logistic regressions examined sociodemographic associations with cardiometabolic health. Results: Less than a quarter of the population (22.0%; 95% CI; 19.4%–24.8%) was found to have no cardiometabolic risk factors. Among individuals with a normal BMI, 35.7% (95% CI; 31.6%–40.1%) had no cardiometabolic risk factors. Family poverty-to-income ratio was identified as an independent predictor of cardiometabolic health (P = 0.01). A consistent trend was present between increasing BMI percentile and number of cardiometabolic risk markers. Conclusions: The overall prevalence of U.S. adolescents with no cardiometabolic risk factors is less than 25%. Even among those without increased BMI, less than half meet all metabolic health criteria. In addition, socioeconomic disparities are predictors of metabolic health.
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Choi et al. (2020) conducted a cross-sectional in Cardiometabolic health. Normal BMI vs. Increased BMI was evaluated on Optimal cardiometabolic health (absence of 11 risk factors) (95% CI 31.6-40.1). Only 22.0% (95% CI 19.4%-24.8%) of U.S. adolescents had optimal cardiometabolic health, and even among those with a normal BMI, only 35.7% (95% CI 31.6%-40.1%) met all metabolic health criteria.
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