A large proportion of U.S. children fail to meet the standards set for ideal cardiovascular health, with most having a poor diet and low physical activity, according to a scientific statement from the American Heart Association.
Children often lacked the heart-healthy diet and physical activity components necessary for what the organization deems optimal cardiovascular health, with a large majority of children scoring poorly on dietary measures and only a third to half of children getting the recommended amount of daily physical activity, reported Julia Steinberger, MD, of the AHA, and colleagues.
Writing in Circulation, the authors characterized their findings as a “companion piece” to the AHA’s 2010 report, the organization releasing their definitions of poor, intermediate and ideal health metrics in children and adolescents. The ideal metrics are:
- Never tried or smoked a whole cigarette
- BMI less than the 85th percentile
- At least 60 minutes per day of moderate to vigorous physical activity
- Healthy diet score on four to five components
- Total cholesterol less than 170 mg/dL
- Blood pressure under the 90th percentile
- Fasting blood glucose less than 100 mg/dL
“Engaging in these ideal health behaviors early in life can have a tremendous benefit on maintaining ideal health throughout the lifespan,” said Steinberger in a statement. “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.”
But data from the CDC’s 2007-2008 National Health and Nutrition Examination Survey(NHANES) indicated that children are not meeting these goals. Less than 1% of children ages 2 to 19 had a diet score comprised of the four to five components necessary for a healthy diet, and 86% of boys and 83% of girls had a diet with none or one of these components.
Examining physical activity, 48.9% of boys and 34.7% of girls ages 6 to 11 got the recommended 60 minutes of activity per day. However, those numbers plunged to around 10% of boys and 3% to 5% of girls ages 12 to 15 and 16 to 19 years. Notably, 13% of adolescent boys and 21% of adolescent girls reported “poor levels” of physical activity — meaning no physical activity for the past 30 days.
Unhealthy behaviors continued to rise in prevalence as children got older, with only 50% to 60% of adolescents reporting an ideal BMI, while 19% to 27% report “poor BMI” (≥95th percentile). Around a third of adolescents also reported smoking a cigarette in the last 30 days.
Not surprisingly, these behaviors had an impact on cardiovascular health markers. More than a quarter of boys and girls ages 6 to 11 exhibited “intermediate status” for total cholesterol, while 10% had poor status. These numbers increased to 26% to 35% of adolescents with intermediate or poor cholesterol. Similar numbers (20% to 38%) were seen for the portion of adolescents with intermediate or poor fasting blood glucose.
However, blood pressure is the cardiovascular health metric with the highest prevalence of ideal measurement, with close to 90% of both children and adolescents exhibiting ideal blood pressure.
But for children who fall below these ideal thresholds, pediatricians can play a major role in helping correct at least the behavioral metrics involved in ideal heart health.
“Pediatricians are our most important partners going forward,” co-author Donald Lloyd-Jones, MD, also of the AHA, told MedPage Today. “They have the power, along with the schools and public policy, to really help reverse this epidemic. If we can improve eating patterns and increase physical activity among children, we can dramatically alter their life course.”
To that end, pediatricians can help correct unhealthy habits among kids. The authors argued that promotion of the Cardiovascular Health Integrated Lifestyle Diet (CHILD 1) is beneficial, partially because dietary recommendations begin at birth and last through 18 years of age. Motivational interviewing tools by providers can help to discover which foods kids most enjoy.
Pediatricians also play an important role in primary prevention of smoking among children, as the authors argued that “a major goal for health professionals is to encourage smoking cessation in primary users, to reduce secondhand exposure and to prevent smoking initiation.”
Schools can help improve a child’s physical activity scores through such programs as multi-component physical education classes.
But ultimately, Steinberger and colleagues conclude that more longitudinal research is needed, as well as improved surveillance from surveys such as NHANES, in order to better track cardiovascular health in children.
[Source: Made page Today]
