Lifestyle Behaviors and Cardiometabolic Diseases by Race and Ethnicity and Social Risk Factors Among US Young Adults, 2011 to 2018

Abstract

Background Cardiometabolic health has been worsening among young adults, but the prevalence of lifestyle risk factors and cardiometabolic diseases is unclear. Methods and Results Adults aged 18 to 44 years were included from the National Health and Nutrition Examination Survey, 2011 to 2018. Age-standardized prevalence of lifestyle risk factors and cardiometabolic diseases was estimated overall and by demographic and social risk factors. A set of multivariable logistic regressions was sequentially performed by adjusting for age, sex, social risk factors, and lifestyle factors to determine whether racial and ethnic disparities in the prevalence of cardiometabolic diseases may be attributable to differences in social risk factors and lifestyle factors. Appropriate weights were used to ensure national representativeness of the estimates. A total of 10 405 participants were analyzed (median age, 30.3 years; 50.8% women; 32.3% non-Hispanic White). The prevalence of lifestyle risk factors ranged from 16.3% for excessive drinking to 49.3% for poor diet quality. The prevalence of cardiometabolic diseases ranged from 4.3% for diabetes to 37.3% for dyslipidemia. The prevalence of having ≥2 lifestyle risk factors was 45.2% and having ≥2 cardiometabolic diseases was 22.0%. Racial and ethnic disparities in many cardiometabolic diseases persisted but were attenuated after adjusting for social risk factors and lifestyle factors. Conclusions The prevalence of lifestyle risk factors and cardiometabolic diseases was high among US young adults and varied by race and ethnicity and social risk factors. Racial and ethnic disparities in the prevalence of cardiometabolic diseases were not fully explained by differences in social risk factors and lifestyle factors.

Keywords: cardiometabolic diseases; lifestyle risk factors; prevalence; racial and ethnic disparities; social risk factors.

Figure .. Lifestyle behaviors and cardiometabolic diseases by race and ethnicity and social risk factors among US young adults, 2011 to 2018.

This figure summarizes the prevalence of lifestyle risk factors and cardiometabolic diseases as well as racial and ethnic differences in the prevalence of cardiometabolic diseases among young adults, adjusting for age and sex only vs adjusting for age, sex, lifestyle factors, and social risk factors. Definitions for lifestyle risk factors and cardiometabolic diseases are shown in the footnotes of Tables 1 and 2. Sample sizes are shown in Tables S3 and S4. Error bars indicate 95% CIs. NHANES indicates National Health and Nutrition Examination Survey.