Researchers in Iran checked the heart health of over 25,000 adults using a simple 7-point checklist from the American Heart Association. The good news: most people had healthy cholesterol, blood sugar, and didn’t smoke. The concerning news: almost nobody was eating a truly healthy diet, and only 1 in 8 people exercised enough. The study shows that while some heart health markers look good, Iranians need major help with diet and exercise to prevent heart disease, diabetes, and kidney problems.
The Quick Take
- What they studied: How healthy Iranian adults’ hearts are by measuring seven important factors: smoking, weight, exercise, diet quality, cholesterol, blood pressure, and blood sugar.
- Who participated: 25,202 Iranian adults aged 25 and older, with slightly more women (55.5%) than men. The study was done in 2020-2021 and included people from across the entire country.
- Key finding: While 80% of people didn’t smoke and 69% had healthy cholesterol, only 13% exercised enough and almost nobody (0.4%) ate a truly healthy diet. People with ideal scores on all seven factors had much lower chances of heart disease, diabetes, and kidney disease.
- What it means for you: If you’re Iranian or live in a similar region, this suggests you may be doing okay on some heart health basics, but diet and exercise are major weak spots. Even small improvements in eating better and moving more could significantly reduce your disease risk.
The Research Details
This was a cross-sectional study, which means researchers took a snapshot of people’s health at one point in time (2020-2021) rather than following them over years. They used data from Iran’s national STEPS survey, which is designed to measure health risk factors across the entire country in a representative way—meaning the results should reflect the general Iranian population.
Researchers measured seven specific heart health factors on each person: whether they smoked, their weight relative to height (BMI), how much they exercised, what they ate, their cholesterol level, blood pressure, and fasting blood sugar. Each factor was scored as either poor, intermediate, or ideal based on American Heart Association guidelines.
The study included over 25,000 people from different provinces across Iran, making it large enough to spot patterns and differences between regions and between men and women.
This approach is important because it gives a complete picture of heart health rather than looking at just one or two factors. The American Heart Association’s 7-factor system is well-established and used worldwide, so these results can be compared to other countries. By studying the entire Iranian population rather than just one city or group, the findings show what’s really happening across the country.
This study is reliable because it used a nationally representative sample of over 25,000 people, which is a large and diverse group. The data came from an official government health surveillance system designed specifically to track disease risk factors. However, because it’s a snapshot in time rather than following people over years, we can’t prove that poor diet and exercise directly cause disease—only that they’re connected. The study was published in BMJ Open, a respected medical journal.
What the Results Show
The study found a striking pattern: Iranians scored well on some heart health measures but poorly on others. About 8 in 10 people (80%) were not current smokers, which is excellent. Nearly 7 in 10 (69%) had healthy cholesterol levels, and 6 in 10 (61%) had normal blood sugar levels.
However, the picture changed dramatically for weight, exercise, and diet. Only about 1 in 3 people (33%) had a healthy weight, and only about 1 in 3 (31%) had normal blood pressure. The biggest problems were exercise and diet: only 13% of people exercised at the recommended levels, and almost nobody—just 0.4% of the entire population—followed a truly healthy diet.
When researchers looked at people who achieved ideal scores on all seven factors, these individuals had significantly lower rates of serious diseases like heart attacks, diabetes, and kidney disease. This shows that all seven factors working together matter for overall health.
The study also found some differences between regions in Iran and between men and women, though these differences were modest. Some provinces had slightly better or worse scores on various factors. These regional differences suggest that public health efforts might need to be tailored to specific areas. The researchers noted that while some areas did better on diet and exercise, no region came close to the ideal of having most people eat well and exercise regularly.
This study aligns with what researchers have found in other countries: smoking rates are often better than diet and exercise adherence. Similar studies in other nations using the same 7-factor system have shown comparable patterns—people tend to do better on medical factors like cholesterol and blood pressure (which can be managed with medication) than on lifestyle factors like diet and exercise (which require sustained behavior change). The extremely low percentage of people eating an ideal diet (0.4%) is particularly striking and suggests this is a major challenge in Iran specifically.
Because this study took a snapshot rather than following people over time, we can’t say for certain that poor diet causes heart disease—only that they’re connected. The study measured what people reported about their diet and exercise, which might not be completely accurate (people sometimes overestimate good behaviors or underestimate bad ones). Additionally, the study was done in Iran, so results may not apply equally to other countries with different food systems, climates, and cultures. The study also didn’t explore why so few people eat well or exercise, which would be helpful for creating solutions.
The Bottom Line
If you’re Iranian or in a similar region: (1) Focus on diet and exercise as your biggest opportunities for improvement—these are where most people struggle. (2) Aim for at least 150 minutes of moderate exercise per week (like brisk walking). (3) Gradually shift toward more vegetables, whole grains, and less processed food. (4) Have your cholesterol, blood pressure, and blood sugar checked regularly, as these are easier to manage with medical help if needed. (5) If you smoke, quitting should be a priority. These recommendations have high confidence because they’re based on large-scale data and align with international health guidelines.
This research matters most for Iranian adults and healthcare providers in Iran, but also for people in other Middle Eastern and similar regions with comparable health patterns. It’s especially relevant for people aged 25-65 who want to prevent heart disease, diabetes, and kidney disease. If you’re already exercising regularly and eating well, you’re ahead of most of the population. If you’re struggling with diet and exercise, this research shows these are the areas where improvement would help you most.
You won’t see dramatic changes overnight, but research shows that improvements in diet and exercise can lower disease risk within 3-6 months. Blood pressure and cholesterol can improve within weeks to months. The biggest benefits come from sustained changes over years—people who maintain healthy habits for 5-10 years have substantially lower disease risk.
Want to Apply This Research?
- Track the ‘Life’s Simple 7’ factors weekly: (1) Smoking status (yes/no), (2) Weight/BMI monthly, (3) Minutes of exercise per week (goal: 150+), (4) Diet quality score (count servings of vegetables, whole grains, fish), (5) Cholesterol level (annual check), (6) Blood pressure (monthly), (7) Fasting blood sugar (annual check). Create a simple scorecard showing how many of the 7 factors you’re achieving at ‘ideal’ levels.
- Start with one small change: commit to 30 minutes of walking 5 days per week, or add one extra vegetable serving to each meal. Use the app to set reminders for exercise and to log what you eat. Set a goal to move from ‘poor’ to ‘intermediate’ on diet and exercise within 3 months, then to ‘ideal’ within 6 months. Celebrate small wins to stay motivated.
- Check your progress on all 7 factors monthly. Schedule annual medical checkups to measure cholesterol, blood pressure, and blood sugar. Use the app to identify which factors are your biggest challenges and focus improvement efforts there. Share your progress with a healthcare provider to get personalized advice. Consider finding an exercise buddy or joining a community program to maintain motivation for diet and exercise changes.
This research describes patterns in a large population and should not be used to diagnose or treat individual health conditions. The findings suggest associations between lifestyle factors and disease risk, but cannot prove cause-and-effect. If you have concerns about your heart health, cholesterol, blood pressure, blood sugar, or weight, please consult with your healthcare provider for personalized medical advice. This study was conducted in Iran and may not apply equally to all populations. Always discuss major lifestyle changes or health concerns with a qualified healthcare professional before making significant changes.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.