What's incongruous about saying the vast majority of incidences are (probably) related to obviously bad lifestyle and also yes it can happen at a lower rate to just about anyone?
Go take a walk near any elementary/middle school in America and tell me you're shocked that we're seeing increased rates of heart disease among young people. The kids are totally screwed. They're abused by a society that feeds them garbage, keeps them sitting all day long, and makes it impossible for them to walk to a friend's house and play in the street.
If you walk past schools in higher end neighborhoods in wealthy states like California, you'll notice that far far children fewer have this issue. For example in SF and LA, I see very little adult or childhood obese people from casual observation, then when I return home to Illinois, it's shocking. People look afflicted. And this is coming from a not-skinny person, 6 foot, 190 odd lbs. I'm no picture of health.
By and large, the issue seems to be confined to the south and cornfed middle states who have an absolute explosion of childhood obesity. And it seems to have some association with some combination of factors of money, weather, and urbanism, but I don't know how/why.
I've noticed in most of the country, fast food is what it is and eating just one meal makes me feel shitty and lethargic, but on the west coast (Washington, Idaho, California for my sampling) I'm convinced they ban or just don't use certain ingredients (lard?). I can eat way more than I even meant to and not even notice.
Way back in time I used to work at McDonald's. When I started working there, they used lard (beef tallow) in the fryers. This is what made the original McDonalds fries soo good. But there was growing outcry about saturated fat in the 1980s, and under pressure they switched over to using vegetable oil. Unless something has changed, the oil does not contain trans-fats, and the McDonald's nutrition website[1] supports this, but it definitely does not produce the same taste or texture of french fry.
Of course what local restaurants use will vary wildly. Some will use high quality oil and some will use the cheapest food-grade oil they can find that has managed to get FDA/USDA approval (not sure which agency supervises that).
I think the issue is much more obvious and alarming in those areas, but really our perceptual baseline has moved a lot. This does affect everyone and will continue to affect even more people if unaddressed.
Go take a walk near any elementary/middle school in America and tell me you're shocked that we're seeing increased rates of heart disease among young people. The kids are totally screwed. They're abused by a society that feeds them garbage, keeps them sitting all day long, and makes it impossible for them to walk to a friend's house and play in the street.