Rising glucose levels drive US cardiometabolic risks despite cholesterol drop
New research finds blood glucose and body mass index (BMI) levels in the US are rising, warning of worsening cardiometabolic health despite improving cholesterol and triglyceride levels. The study, which weighed 52,000 participants, represents 264 million adults.
Lead author Xiaoning (Jack) Huang, research assistant professor of medicine at Northwestern University Feinberg School of Medicine, tells Nutrition Insight that “up to 80% of the changes in the trends” between birth cohort trends and cardiometabolic health are “not related to BMI.”
“The obesity epidemic is a complex issue. Sedentary lifestyles and high consumption of processed and sugary foods likely contribute to these trends, though we did not test these theories in our study. Additionally, disparities are an important consideration — socioeconomically disadvantaged groups are disproportionately affected by these worsening trends.”
Recent research warned over half of US adults’ calorie consumption comes from ultra-processed foods (UPFs), while others linked it with accelerated biological aging next to increased colorectal cancer and non-communicable diseases.
The paper in JAMA Network Open underlines cardiometabolic diseases — coronary heart disease, heart failure and diabetes (types 1 and 2) — affect over 28 million people in the US. “Cardiometabolic-related death rates declined from the 1970s to the 2010s, favorable trends in death rates have since reversed,” it details.
The researchers studied eight ten-year birth cohorts born from 1920 to 1999.
Lead author Xiaoning (Jack) Huang.Preventative health interventions
The authors call for preventative public health initiatives to improve cardiometabolic health across generations.
“Preventive care that promotes healthier lifestyles and behaviors is crucial. As outlined by the American Heart Association’s Life’s Essential 8, this includes maintaining a healthy diet, engaging in sufficient physical activity, avoiding nicotine and ensuring quality sleep,” comments Huang.
Although improvements in cardiometabolic health could be slowing in younger cohorts, diabetes (types 1 and 2) and obesity have increased among adults under 65 years. However, the authors think “it is unclear how trends in cholesterol, triglyceride and glucose levels have changed across different birth cohorts and whether adverse trends in obesity are associated with these patterns.”
Huang suggests that “early preventive interventions focusing on lifestyle and behavioral health are essential” to lower obesity and diabetes. “Innovative approaches, such as social media campaigns targeting younger audiences, could also be effective.”
The study cites that diabetes prevalence has increased by approximately 30% from 2001 to 2018 and age-adjusted obesity prevalence increased from 31% in 1999 to 42% in 2020.
In addition to policy interventions, the authors suggest introducing education on healthy lifestyles in schools and sugary beverage taxes, in addition to regulating the sale of partially hydrogenated oils.
Recently, a new US Scientific Report of the 2025 Dietary Guidelines Advisory Committee recommended including more nutrient-dense plant-based meals in the country’s dietary recommendations. Scientists also say replacing meat with plant protein lowers heart disease risk.
The authors suggest: “Developing and promoting mobile health applications may be an innovative way to track nutrition and physical activity as well as deliver mental health services that could be uniquely effective in engaging younger generations.”
Nutrition Insight recently spoke to Bayer Consumer Health’s head of front-end innovation to learn about advances in precision health for longevity and how AI can improve personalized nutrition to empower consumers.
Although improvements in cardiometabolic health could be slowing in younger cohorts, diabetes and obesity have increased.Medication and trans fat impacts
The study found younger generations had lower total cholesterol and fasting triglyceride levels and higher fasting glucose levels and BMI.
Huang explains factors that have contributed to lower cholesterol and triglyceride levels in recent birth cohorts: “We found that statin use significantly contributed to the lower lipid levels observed in recent cohorts.” Statins are medications that lower cholesterol.
“Other factors, such as regulations on trans fats and public health initiatives promoting lipid-lowering behaviors, may also play a role, though our study did not specifically test these,” he adds.
The paper authors add further research is needed to identify behavioral and environmental factors contributing to these trends.
In related news, a study claiming to reveal the most comprehensive assessment of the 2012 global nutrition targets cautions that countries will not meet all goals by 2030. Over 700 multinational researchers noted progress in child wasting and a status quo in reducing anemia, next to increases in child obesity.
