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Courtesy of Dr. Mark Huffman

The American Heart Association has set a goal to improve Americans' heart health by 20 percent in 2020. The graph shows National Health and Nutrition Examination Surveys data based upon seven criteria, such as cholesterol, smoking and body mass index. The data in the graph suggests the AHA goals for 2020 will not be met if current health trends continue.

Overweight America: More than half of us could be diabetic or pre-diabetic by 2020

by Zack Aldrich
Nov 17, 2011


Lisa Paul/MEDILL

Participation in team sports or a routine of walks in the park can lead to better health. Lack of exercise is a major factor linked to increasing health risks for heart disease, obesity and diabetes. 

By 2020, more than half of all adults in the U.S. will suffer from diabetes or pre-diabetic conditions, report Northwestern University researchers.

The staggering health risk relates to the fact that more than half of adults are expected to be overweight by 2020. The problems could signal the reversal of a 50-year trend of declining cardiovascular disease deaths in the nation, because obesity is linked to heart disease.

“We’ve seen substantial declines in age-adjusted heart disease mortality rates since the 1960s,” said study lead author Dr. Mark Huffman, who teaches preventive medicine at Northwestern's Feinberg School of Medicine. “But, these trends are stalling and can lead to increases in healthcare costs and mortality,” said Huffman.

The positive trend is stalling, particularly among children and young adults, he said. People who are overweight have a body mass index of 25 to 29 kg/m2, or weight divided by height squared. Someone who is 5 feet 10 inches tall and weighs 180 pounds would be defined as overweight with a BMI of about 26.

Feinberg researchers looked at data from the National Health and Nutrition Examination Surveys from 1988 to 2008. They reviewed health records of about 35,000 Americans across the country, aged 20 and older. Then Huffman and his colleagues made the projections for 2020. They reported their findings this week at an American Heart Association conference in Orlando.

About 11 percent of men had diabetes and about 51 percent of men had dysglycemia by 2008. Huffman said. Dysglycemia is a term encompassing both diabetes and pre-diabetic conditions. When his team projected the data forward based on increasing rates of obesity, more than 75 percent of men would have some form of dysglycemia by 2020, a result he said is “staggering.” For women, the dysglycemia outlook would be about 50 percent.

“Blood pressure, blood cholesterol and smoking are getting better,” he said, but not on a scale to offset the toll of body weight and dysglycemia. “So, it’s not looking too favorable.”

One limitation of the study is sampling variability. A study subject might not remember, for instance, what types of food she ate throughout the past week.

Many people who read the Feinberg study might not feel implicated, said Jessica Crandall, a registered dietitian and spokesperson for the American Dietetic Association. “Rarely do you make changes until you’re diagnosed. People have blinders on.”

Holly Herrington, a registered dietitian at Northwestern Memorial Hospital uninvolved in the study, reinforced Huffman’s projections. She works with people 18 and older to help with weight loss and managing diabetes.

“What did stick out was that it says currently 60 to 70 percent of people are overweight or obese,” she said. “But, these people often don’t realize they are. They think, ‘Oh, I look just like everybody else.’ People are getting into a mindset that this is a normal thing.”

While being overweight is not inherently unhealthy, Herrington urges people to live healthy lives. She cited a limited intake of refined sugar, which is included in items such as white bread and candy, as one method of mindful eating.

Huffman said deterring people from smoking is also imperative. He said policies must be enacted to reduce cigarette smoke, increase access to healthy food such as fish and vegetables and offer more public transportation options.

“I’m supportive of Mayor Emanuel’s efforts to expand bike lane access throughout the city,” he said. “There are also expansions of access to fruits and vegetables through the Link Card program, which offers voucher assistance throughout the state.”

He also advocates continuing smoking controls in the city, possibly through increased state-level excise taxes.

An excise tax on sugar-sweetened beverages would reduce soft drink consumption among young people, he said, noting that such policies have not been enacted anywhere in the U.S.

Dr. Rasa Kazlauskaite, an endocrinologist at Rush University Medical Center and not involved in the study, shares Huffman’s view that policy change is important for Chicago.

“We need to think of how we can restructure the environment. Imagine right now if our mayor said, ‘We’ll have a soda-free Chicago,’ and what kind of uproar that would create. ‘I won’t have my diet pop?’ We are not ready for that, but maybe someday.”

The food industry is seductive, she said, but she contends that human beings manufacture the temptations that we succumb to.

“Probably half of us have some sort of diabetes gene that predisposes us to having diabetes, but if we wouldn’t have the environment that was conducive to this, it would never manifest.”

Crandall wants people to understand that losing even one pound helps reduce the risk of diabetes.

“It doesn’t have to be a 360 degree makeover. Before 2020, we still have some time to turn these results around and embrace these changes.”