Children Score Low on Cardiovascular Health Measures

DALLAS — Proactive strategies for promoting good heart health should begin at birth, yet most American children do not meet the American Heart Association’s (AHA) definition of ideal childhood cardiovascular health, according to a new scientific statement published in the AHA journal Circulation.

“Instead of taking a wait-and-see approach by treating disease later in adulthood, we should help children maintain the standards of ideal cardiovascular health that most children are born with,” said Dr. Julia Steinberger, lead author of the new statement, professor in Pediatrics, and director of Pediatric Cardiology at the University of Minnesota in Minneapolis.

Several key health factors and behaviors are used to determine whether a child’s cardiovascular health is ideal: not using tobacco products; maintaining a healthy body weight; getting at least 60 minutes per day of moderate to vigorous physical activity; eating a healthy diet; as well as having healthy cholesterol, blood-pressure, and blood-glucose levels.

“Engaging in these ideal health behaviors early in life can have a tremendous benefit on maintaining ideal health throughout the lifespan,” said Steinberger.

Data from the 2007-08 National Health and Nutrition Examination Survey found that children in the U.S. were not meeting most of the AHA’s definition of ideal cardiovascular health.

“A primary reason for so few children having ideal cardiovascular health is poor nutrition — children are eating high-calorie, low-nutrition foods and not eating enough healthy foods, such as fruits, vegetables, whole grains, fish and other foods strongly associated with good heart health and a healthy body weight,” said Steinberger.

Nearly all children in the study — about 91{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} — scored poorly on diet measures. In fact, the study found that children 2 to 19 years old get the bulk of their daily calories from simple carbohydrates such as sugary desserts and beverages.

Similarly, the level of physical activity was not enough to protect their hearts. Among children ages 6 to 11, half of the boys and just over a third of the girls were active for the recommended 60 minutes or more per day. As children reached 16 to 19 years of age, the percentage meeting the recommended amount of physical activity decreased even further, to 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in boys and 5{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in girls.

Not surprisingly, the effects of poor diet and physical inactivity affected body weight. Among 2- to 5-year-olds, about 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} were obese based on their body mass index, a measure of body weight based on height. In the 12- to 19-year-old age group, the percentage of obesity soared to between 19{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 27{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}. Among these older children, the rate of cigarette smoking was surprisingly high. In fact, approximately one-third of 12- to 19-year-olds reported trying a cigarette.

The healthiest metric for children was blood pressure, with nearly all children in the ideal group. Most children also had ideal measurements for total blood cholesterol and blood-sugar levels; however, when compared with blood pressure, both of these categories had higher percentages of children with intermediate and poor measurements.

“As pediatricians, we see a tremendous opportunity to strive towards true cardiovascular health if we think of the factors that maintain health early in life. It’s much harder to turn back the clock,” Steinberger said.

The new recommendations for ideal cardiovascular health in children are a companion to a similar set of guidelines for adults issued by the American Heart Assoc. in 2010. Together, the recommendations are key components of the AHA’s goal to reduce death and disability from cardiovascular disease and increase cardiovascular health by 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} by the year 2020.