At least the American Heart Association thinks my wife and I are in the 1%:
The AHA 2020 Impact Goal is to improve the cardiovascular health of Americans by 20% while also reducing cardiovascular deaths by 20%. In order to achieve these goals, the AHA adopted a new concept of cardiovascular health, one that is made up of seven components. These components include four ideal health behaviors—not smoking, body-mass index (BMI) <25 kg/m2, physical activity at goal levels, and diet that includes three or more daily servings of fruits and vegetables—and three ideal health factors, including total cholesterol <200 mg/dL, systolic blood pressure <120 mm Hg and diastolic blood pressure <80 mm Hg, and fasting plasma glucose levels <100 mg/dL.
Each of these individual behavior and risk factors are well supported by data, but there have been few studies that have addressed the relationship between clusters of the risk factors/behaviors and health outcomes. "Even though a lot of the health metrics are rooted in sound science, it's still a relatively new index," said Ford. "To me, we needed to learn about how well it predicts and how well it behaves, because this particular index hadn't really been explicitly tested."
In their study, Ford and colleagues collected data on 7622 adults 20 years of age and older participating in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. In the absence of AHA-specific metrics, such as dietary and glycemic measures, they used alternative measurements, such as the use of HbA1cconcentrations as a stand-in for fasting plasma glucose and the Healthy Eating Index (HEI) for dietary assessments.
Overall, just 1.0% of subjects met all seven metrics of sound cardiovascular health, a disappointing number that is in line with previous studies. In total, 13.8% of subjects met five of the seven metrics of cardiovascular health and 5.4% met six metrics, while 1.5% of the study population met none of the ideal cardiovascular health criteria.
The exact seven factors, incuding healthy diet index, are [but note the update below]:
Goal/Metric 'Ideal' Cardiovascular Health
Physical Activity
Adults >20 yrs of age: 150 min/wk moderate intensity or
75 min/wk vigorous exercise (may also combine moderate and vigorous activity)
Children 12-19 yrs of age: 60 min of moderate or vigorous activity each day
Current Smoking
Adults >20 yrs of age: Never smoked or quit smoking >12 months ago
Children 12-19 yrs of age: Never tried, never smoked
Body Mass Index
Adults >20 yrs of age: <25 kg/m2
Children 2-19 yrs of age: <85th Percentile
Total Cholesterol
Adults >20 yrs of age: <200 mg/deciliter
Children 6-19 years of age: <170 mg/deciliter
Blood Pressure
Adults >20 years of age: <120/<80 mmHG
Children 8-19 years of age: <90th Percentile
Fasting Plasma Glucose
Adults >20 yrs of age: <100 mg/deciliter
Children 6-19 years of age: <100 mg/deciliter
Healthy Diet Score
Adults >20 yrs of age: 4-5 Components (see below)
Children 5-19 years of age: 4-5 Components (see below)
1) Sodium: <1500 mg per day
2) fruits & vegtables: 4.5 cups [servings?] per day
3) Fish: two 3.5-ounce servings per week (preferably oily fish)
4) Fiber-rich whole grains:1.1 grams of fiber per 10 grams of carbohydrat, three 1-ounce servings per day
5) Nuts, legumes and seeds: 4 servings per week
6) Processed meats: none (or up to 2 servings per week) [?]
7) Saturated fat: <7% of total energy intake
8) Sugar-sweetened beverages: 36 ounces per seek (450 kilocalories per week)
I'm a bit stunned that only ~1% of the US adult population makes these criteria...they don't seem very strict. I'd say it is closer to 10% or more for my social group. Maybe even 20% or so...where do people fall down? Blood pressure? That's probably the first one that's going to get me.
Update #1: if you look at the paper abstract, it's actually 1.1%.
Update #2: Status of Cardiovascular Health in US Adults suggests, on skimming, that it is the diet score that creates the very low 1.1%. But what aspect of the diet score does it? Am I misunderstanding the diet score (i.e. how do 99% of the population fail more than 3 of the 8 diet categories? I may fail sodium intake -- no idea what my sodium intake is, I don't salt but I also don't avoid salt in say sea food, brines in soy sauce, but I don't add salt or eat processed food either-- and saturated fat intake, but that still leaves me one freebe category to fail, right?).
Update #3: Ah, here we are, Status of Cardiovascular Health in US Adults indicates that a perfect an 'ideal' diet score requires 4 out of these 5:
1)fruits and vegetables, >=4.5 cups per day
2) fish, 2 or more 3.5-oz servings per week
3) fiber-rich whole grains(>1.1 g fiber/10 g carbohydrate), 3 or more 1-oz-equivalent servings per day;
4) sodium, <1500 mg/d;
5) sugar-sweetened beverages, <450 kcal/wk.
So this drops processed meat limitations and saturated fat limitations. I'm clear on all but sodium, where I disagree anyway, not that I know what my sodium intake is.
It appears that we're at 1% of the population since most people fail both sodium and some other component, mostly 'whole grains' or, second to that, not enough fish.