Thursday, March 30, 2023

Diabetes and obesity rising in young Americans, study finds

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Diabetes and obesity are on the rise among young people in the United States, an alarming development that puts them at higher risk for heart disease, according to a study of 13,000 people between the ages of 20 and 44.

The authors of the study, published Sunday in a major medical journal, warn that the trends could have major public health implications: a growing generation dying prematurely of heart attacks, strokes and other complications. And blacks and Hispanics, especially Mexican Americans, would carry the brunt.

“We are witnessing a public health crisis brewing,” Rishi K. Wadhera, an assistant professor of medicine at Harvard Medical School and one of the study’s authors, wrote in an email.

Deaths from heart attacks and other effects Cardiovascular disease had declined in the United States due to medical advances in prevention and treatment. This progress stalled during the last decade.

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The study, published in the Journal of the American Medical Association, aimed to examine whether young people were increasingly at risk, using data between 2009 and 2020.

The results were mixed. There was an increase in obesity (from 33 percent to 41 percent) and diabetes (from 3 percent to 4 percent). Hypertension showed no significant improvement: it increased slightly, from 9 percent to 11.5 percent, but the increase did not quite reach statistical significance.

Hyperlipidemia — high levels of cholesterol or triglycerides — dropped from 40.5 percent to 26 percent.

Black youth face the greatest risk. Hypertension is twice as common among them as in other racial and ethnic groups. Diabetes and obesity are also more common.

The study’s authors pointed to structural racial disparities in American society as a driver of the gaps.

“Young individuals of color are more likely to live in lower-income households that experience housing instability and food insecurity, and in socioeconomically disadvantaged neighborhoods,” Wadhera said. “Black individuals also disproportionately face challenges accessing primary and preventive care, and are more likely to reside in ‘pharmacy deserts'” — a reference to areas where medication is more difficult to access .

Hypertension is on the rise among Hispanics, a trend not seen among other groups.

Diets rich in sodium and ultra processed foods are among the factors behind the rise in hypertension in Hispanics, researchers say. They pointed out that it goes beyond lifestyle choices. When people struggle to pay the bills, they often turn to cheaper, unhealthier foods. Fresh produce is harder to find in areas with few grocery stores.

Researchers suspect that the decline in young adults with high cholesterol is partly explained by greater regulation of trans fats in food.

The study did not identify many differences in cardiovascular risk factors between men and women.

They also cautioned that it is unclear whether the trends have continued since the start of the coronavirus pandemic because the study only covered up to 2020.

Here are some ways the study authors proposed addressing the disparities:

  • Expanding large-scale efforts to screen and treat young black adults for hypertension.
  • Screening people for diabetes earlier in life because current guidelines often apply to people 35 and older.
  • Initiate a public health campaign addressing the rise in diabetes among Mexican-American adults that is culturally competent and shaped by community leaders.
  • Creating more green spaces in communities that encourage exercise to combat sedentary lifestyles that contribute to obesity.

Without action to reverse the trends, the public health consequences could be dire, the study warned.

“The increased burden of risk factors that we have observed in young adults—especially if these trends continue—could result in a tsunami of cardiovascular disease over the long term, and ultimately, increased cardiovascular mortality as the American population is aging,” Wadhera said. .

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