U.S. Metabolic Health at All-Time Low

Metabolic Health All-Time LowA study published in 2019 shows that only 12% of Americans have optimal metabolic health. This study used data from the National Health and Nutrition Examination Survey (NHANES), which is a large survey of a representative sample of the U.S. population. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016

From 2009 – 2016, 8,721 Americans were surveyed on a wide variety of biometrics that included multiple markers of metabolic health. The study assessed metabolic health against 6 specific criteria:

  • Waist circumference <40 inches for men or <35 inches for women
  • Glucose <100 mg/dL and HbA1c < .7%
  • Blood pressure <120/80 mmHg
  • Triglycerides <150 mg/dL
  • HDL cholesterol >40 mg/dL for men or >50 mg/dL for women
  • Not taking any diabetes, blood pressure, or cholesterol medication

These specific cutoffs were based on current guidelines set by government agencies and scientific groups.


  • Only 42.6% of the participants had healthy waist circumferences
  • Only 42.8% demonstrated blood glucose control
  • Only 49.6% had normal blood pressure
  • 74.8% of the participants had healthy triglyceride levels
  • 72.4% had healthy HDL cholesterol level
  • Moreover, the data showed that 9.0%, 28.6%, and 31.5% of the population were taking diabetes, blood pressure, and cholesterol medication, respectively.

Further, only 12.2% of participants met all 6 criteria and thus, could be considered to be in optimal metabolic health. An additional 1.2% of people met all 5 biometric criteria, however, they were found to be on medication to control blood sugar, blood pressure, or cholesterol. As such, these subjects were not considered healthy, since we know that these medications likely just put a bandaid over underlying metabolic disease risk.

Other Findings from the Study

  • Age was a strong predictor of poor metabolic health. Only 2.1% of those over age 60 were found to be metabolically healthy.
  • Another finding was that exercises was only somewhat protective, as 21.9% of those who exercised regularly were considered metabolically healthy. This, of course, implies that 78.1% were not metabolically healthy.
  • The majority of normal weight people (66.5% of the study participants) were NOT in optimal metabolic health, even when waist circumference was excluded.


The fact that only 12% Americans have optimal metabolic health is downright scary. This problem has gained new significance in the context of the high degree of correlation between compromised metabolic health and the Covid-19 Pandemic. Based on the results from this study, it is clear that the poor state of metabolic health across American is contributing significantly to the overall health-care burden in the U.S.

As mentioned above, exercise is only partially protective. And medications are only a band-aid. Gaining your metabolic health back is about proper nutrition. We, as a nation, have to simply say no to all of the crap junk food. We need to vote with our wallets and be willing to pay a little more for real, whole, unprocessed foods. To be quite clear, your life depends on it.

If you need help, please contact me.

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