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CV health declines during childhood, adolescence
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The majority of young children exhibit ideal CV health metrics, but this status appears to decline during the course of childhood and adolescence due to unhealthy behavior, according to recent results.
“Our findings indicate that, in general, children start with pretty good BP,” Donald M. Lloyd-Jones, MD, professor and chair of preventive medicine at Northwestern University Feinberg School of Medicine, said in a press release. “But if they have a horrible diet, it will drive a worsening BMI and cholesterol levels.”
Researchers evaluated representative data collected from 8,961 children aged 2 to 11 years who attended both mobile and home health examinations within the National Health and Nutrition Examination Survey cycles of 2003-2004, 2005-2006, 2007-2008 and 2009-2010. The cohort included 4,518 boys and 4,443 girls, and had a mean age of 6.8 years.
All children with available measurements for one or more of the following indicators of CV health were eligible for inclusion: BMI, total cholesterol, BP and American Heart Association diet score. The researchers assigned each child a rating of poor, intermediate or ideal for each indicator. In order to calculate the diet score, participants’ dietary intake was evaluated at two 24-hour recalls, according to the following components: sufficient consumption of fruits and vegetables, fish and whole grains, and lower consumption of sodium and added sugar.
No children had ideal measurements of all four CV health indicators, but all had at least one ideal measure.
An ideal diet score was least common and occurred in less than 1% of participants, whereas an intermediate healthy diet score occurred in less than 20%. Specifically, less than 10% of the children met dietary targets for consumption of fruits/vegetables (4.5 cups/day or more) or fish (two 3.5-oz servings/week or more). Adequate whole grain consumption (three or more 1-oz servings/day) was the least commonly achieved aspect of a healthy diet and was observed in 3% of boys and 2.4% of girls. Ninety percent of the children ate more than the AHA-recommended amount of daily sodium, and more than 50% consumed more than the recommended number of calories from sugar-sweetened drinks (< 450 kcal/week).
The researchers observed a relationship between intake of specific diet score components and BMI, including consumption of whole grain (r = –0.03; 95% CI, –0.05 to –0.01); sodium (r = 0.04; 95% CI, 0.02-0.06) and sugar-sweetened beverages (r = 0.07; 95% CI, 0.05-0.09). BMI was significantly associated with both systolic and diastolic BP, as well as total cholesterol levels.
Overall, approximately 30% of the children were obese or overweight. Ideal BMI occurred in 70% of the entire population, but was observed less frequently among children aged 6 to 11 years than those aged 2 to 5 years (67% of participants vs. 77%). Elevated or poor levels of total cholesterol were observed in approximately 40% of the children. Ideal BP was the most common favorable measure of CV health observed in this cohort, occurring in from 88% to 93% of participants according to sex and race/ethnicity.
“It seems that children in the U.S. are losing their ideal [CV health] status, thereby undermining achievement of the AHA 2020 Impact Goal to improve [CV health] by 20%,” the researchers concluded. “Efforts to preserve and promote [CV health] in childhood and adolescence are urgently needed to reduce the loss of this precious health asset, a consequence in large part to the rising prevalence of obesity.”
Disclosure: The researchers report no relevant financial disclosures.
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