Happy, accepted teens more likely to maintain good cardiometabolic health
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Teens who feel happy, accepted and loved are more likely to maintain good cardiometabolic health as adults, and data show Black youths in particular were more harmed by fewer psychological assets, researchers reported.
“Early investments in youth mental health may be an important new frontier in cardiovascular disease prevention and the advancement of health equity,” Farah Qureshi, ScD, MHS, assistant professor in the department of population, family and reproductive health at the Johns Hopkins Bloomberg School of Public Health, told Healio. “Physicians typically focus on encouraging healthy diets, avoiding smoking and engaging in regular physical activity as the main ways to guard against cardiovascular disease, but our findings suggest that taking care of our mental health may also play an important role, especially early in life.”
Psychological assets and cardiometabolic health
Qureshi and colleagues analyzed data from 3,478 adolescents who participated in the National Longitudinal Study of Adolescent Health, a school-based survey of adolescents in the U.S. that followed participants into adulthood. Within the cohort, 49% were girls, 15% were Black and 11% were Hispanic. In wave 1 (1994-1995; mean age, 16 years), researchers used data on five psychological assets (optimism, happiness, self-esteem, belongingness and feeling loved) to create a composite asset index ranging from 0 to 5. For wave 4 (2008; mean age, 28 years) and wave 5 (2016-2018; mean age, 38 years), researchers defined cardiometabolic health using seven clinically assessed biomarkers: HDL; non-HDL; systolic BP; diastolic BP; HbA1c; C-reactive protein; and BMI.
“We did not examine LDL because most participants did not fast before their blood draw and LDL was ascertained using the Friedewald equation, which may provide invalid estimates in non-fasting samples,” the researchers wrote.
Participants with healthy levels of at least six biomarkers at waves 4 and 5 were classified as maintaining cardiometabolic health over time.
The findings were published in the Journal of the American Heart Association.
Overall, 55% of youths had zero to one assets, 29% had two to three assets and 16% had four to five assets. Although 21% reached mid-young adulthood in optimal cardiometabolic health, only 12% maintained it into late young adulthood. Researchers found that having more psychological assets was associated with better health in adulthood, with an OR of 1.12 (95% CI, 1.01-1.25).
In subgroup analyses, researchers found substantive associations only among Black participants (OR = 1.35; 95% CI, 1-1.82). Additionally, there was some evidence that race and disparities in cardiometabolic health maintenance may be less pronounced among participants with more assets, the researchers wrote.
Future directions
Qureshi said collaborative care models and efforts to incorporate mental health competencies into current practice may be a promising future direction for clinicians.
“Even in the absence of mental health assets, Black youths in our study were still much less likely to be in good cardiometabolic health in adulthood compared with white youth, pointing to the role structural racism plays in shaping cardiometabolic health,” Qureshi told Healio. “We would love to see more research aimed at tackling structural racism and the barriers to health it creates for Black youth.”
Qureshi said large-scale studies are needed to monitor positive factors starting in childhood, so researchers can better understand how these assets are distributed in the population and how they influence health disparities over the life course.
For more information:
Farah Qureshi, ScD, MHS, can be reached at fqureshi@jhu.edu; Twitter: @fqureshi_epi.
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