The Washington Post

Diabetes, obesity up in young adults, study finds


Diabetes and obesity are rising among young adults 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 20 and 44 years old.

The authors of the study, published Sunday in a major medical journal, warn the trends could have major public health implicatio­ns: a rising generation dying prematurel­y of heart attacks, strokes and other complicati­ons. And Black and Hispanic people, particular­ly Mexican Americans, would bear the brunt.

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

Deaths from heart attacks and other effects of cardiovasc­ular illnesses had been declining in the United States because of medical advances in prevention and treatment. That progress stagnated during the past decade.

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

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

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

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

The study’s authors pinpointed structural racial inequities in American society as a driver of the gaps.

“Younger Black individual­s are more likely to live in lower-income households that experience housing instabilit­y and food insecurity, as well as 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 harder to access.

Hypertensi­on is rising among Hispanic people, a trend not evident among other groups.

Sodium-heavy diets and ultra-processed foods are among the factors behind the increase in hypertensi­on among Hispanic people, researcher­s say. They emphasized that it transcends lifestyle choices. When people struggle to pay the bills, they often turn to cheaper, unhealthie­r food. Fresh produce is harder to come by in areas with few grocery stores.

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

The study did not identify much difference in cardiovasc­ular risk factors between men and women.

They also cautioned it is unclear whether the trends have persisted since the coronaviru­s pandemic began, because the study covered only up to 2020.

Here are some ways the study’s 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.

• Starting 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 counter sedentary lifestyles contributi­ng to the rise in obesity.

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

“The rising burden of risk factors that we observed among young adults — particular­ly if these trends continue — could result in a tsunami of cardiovasc­ular disease over the long-term, and ultimately, increases in cardiovasc­ular mortality as the U.S. population ages,” Wadhera said.

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