This global pandemic has given a new meaning to the idea of American exceptionalism. The United States is faring far worse than other countries and shoulders a disproportionate share of global disease burden — with 4% of the global population, yet, at the time of writing, nearly a quarter of global Covid-19 fatalities.

While much of the rationale has focused on our government’s flat-footed response and poor public health infrastructure, this ignores a significant and underrecognized risk factor — the exceedingly poor baseline health of our country’s population. 

Among the most significant risk factors for hospitalization and death in Covid-19 are the presence of diet-related chronic diseases such as hypertension, heart disease and obesity. America’s starting point? Nearly three out of four American adults are overweight or obese.

And half of US adults have diabetes or pre-diabetes. A 2018 study found that only 12% of Americans are metabolically healthy, which is defined as having optimal levels of blood markers and pressures as well as waist circumference. Diet-related diseases are no longer the things you have to worry about down the road. In a pandemic environment, they could hasten death next week.