Health behaviors—rather than health factors—contribute to a decline in cardiovascular health, new research finds, highlighting a critical window for targeted interventions to improve long-term heart health in children.
Summary: A study published in JAMA Cardiology reveals that cardiovascular health in children begins to decline around age 10, primarily due to changes in health behaviors such as diet, physical activity, and sleep duration. Using data from over 1,500 children, the research underscores a critical window for interventions to improve cardiovascular health before this decline becomes more pronounced. The study also highlights disparities in health trajectories based on maternal socioeconomic status and race, emphasizing the need for targeted efforts to address these early life influences and reduce future cardiovascular health disparities.
Key Takeaways:
- A new study led by the Harvard Pilgrim Health Care Institute sheds light on the trajectory of cardiovascular health early in life, which may contribute to cardiovascular health disparities in adulthood.
- Across demographic subgroups, cardiovascular health scores begin to decline at approximately 10 years of age and appear driven by health behaviors rather than health factors.
- Key health behaviors to target for improving early-life cardiovascular health include better sleep, healthier diet, and reducing smoking.
A new study pinpoints the age when cardiovascular health trajectories begin to decline, revealing a crucial window for targeted interventions to improve cardiovascular health into adolescence and adulthood.
The findings are published in JAMA Cardiology.
The American Heart Association’s recently introduced Life’s Essential 8 guidelines assess cardiovascular health based on four behavioral (diet, smoking, physical activity, sleep duration) and four health factors (body mass index, blood pressure, blood sugar, and cholesterol levels).
While the guidelines hold promise to enhance cardiovascular health assessment across the life-course, US children’s cardiovascular health remains suboptimal: Only 2% of children aged 2–19 have optimal cardiovascular health scores, and fewer than one-third have high scores (80-100 points).
“Though we know that better heart health in childhood is linked to lower risks of coronary issues later in life, the current state of cardiovascular health in US children is less than ideal,” says lead author Izzuddin Aris, PhD, Harvard Medical School assistant professor of population medicine at the Harvard Pilgrim Health Care Institute, in a release. “Our study provides insight into the trajectory of cardiovascular health in early life, establishing a clear window of opportunity to improve the health of the nation’s children now and into the future.”
Findings on Decline in Cardiovascular Health
Using the Life’s Essential 8 construct, the research team studied data from over 1,500 children from the Project Viva pre-birth cohort in eastern Massachusetts. Participant inclusion required information on at least three cardiovascular health metrics in early childhood or at least four metrics in mid-childhood, early adolescence, or late adolescence. The team assessed six cardiovascular health metrics in early childhood (diet, smoking, physical activity, sleep duration, body mass index, and blood pressure), and up to eight from mid-childhood to late adolescence.
The authors found that cardiovascular health scores start to decline around age 10 across all demographic groups, driven by health behaviors rather than health factors. This decline may reflect social and/or developmental changes that typically occur at this age—such as changes in school schedules that may interfere with meeting guidelines for healthy sleep duration and/or diet—and may affect health behaviors. Improving these health behaviors, especially between mid-childhood and early adolescence, could help optimize cardiovascular health.
They also noted small but significant differences in cardiovascular health trajectories based on maternal socioeconomic status and child race and ethnicity.
“Our study highlights the potential early influence of structural factors linked to socioeconomic status and race and ethnicity—such as residence in favorable neighborhood environments, the ability to access healthy foods, and proximity to safe community spaces that encourage physical activity—that might contribute to future cardiovascular health disparities,” says Aris in a release. “This, in addition to isolating the most vulnerable age for [cardiovascular health] loss, can help improve targeting of preventive efforts to high-risk children, as well as improve our understanding of the early life drivers of [cardiovascular health] loss.”
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