U.S. Kids Get Low Scores in Heart Health

ORLANDO, Fla.—A new analysis of federal data provides a dismal picture of children's cardiovascular health that suggests the current generation of teenagers could be at risk of increased heart disease.

A new analysis of federal data provides a dismal picture of children's cardiovascular health that suggests the current generation of teenagers could be at risk of increased heart disease. Ron Winslow has details on Lunch Break.

The study, which examined children between 12 and 19 years old in the National Health and Nutrition Examination Survey conducted by the U.S. Centers for Disease Control and Prevention, found that the adolescents performed poorly overall on a set of seven criteria set by the American Heart Association for ideal cardiovascular health.

Diet in particular was a problem, with not one of the 5,450 children randomly selected for the survey from the U.S. population meeting the standards for diet. Taking out the diet measure, still just 16.4% of boys and 11.3% of girls were rated ideal on all of the other six criteria, which included smoking, exercise, weight, cholesterol, blood pressure and blood sugar.

"In this country, essentially all of us are born with ideal cardiovascular health, but we lose it very quickly," said Donald Lloyd-Jones, chief of preventive medicine at Northwestern University Feinberg School of Medicine and senior author of the report.

The findings, presented Wednesday at the annual scientific meeting of the heart association here, come amid continuing concern about the implications of obesity and other factors on the health of children. Just last week, the National Heart, Lung and Blood Institute called for all children between 9 and 11 years old to get a cholesterol test in an effort to detect heart risk at an early age.

The new study provides an unusually comprehensive look at the issue. The results are specific to these AHA standards, and it isn't known what the assessment would be if some other standards were applied.

Cholesterol and especially blood-sugar levels can be naturally elevated during puberty and level out in adulthood, and how that phenomenon might affect the results isn't fully understood. But researchers note that the ideal benchmarks in the seven categories have been shown to be associated with reduced risk of heart disease.

"Often, we just take an isolated focus on one of the risk factors," Dr. Lloyd-Jones said. "The package is much more powerful than any single measure."

Veronique Roger, head of health-sciences research at the Mayo Clinic in Rochester, Minn., called the findings "staggering."

The seven criteria for ideal cardiovascular health are the backbone of a public-health initiative recently launched by the heart association. The goal is to get 20% of all American adults within optimal range on all seven measures.

The focus on children reflects growing awareness that while heart attacks and other consequences of cardiovascular disease typically strike later in life, the biological processes that lead to them begin in childhood. Dr. Lloyd-Jones said some studies indicate that "by six months, you can already see a worsening of cholesterol and blood pressure" because of diet and other factors.

The National Health and Nutrition Examination Survey is conducted by the CDC periodically among a nationally representative sample of Americans to track health issues. The new report, funded by the National Heart, Lung and Blood Institute, is based on an analysis of three different surveys of adolescents aged 12 to 19 between 2003 and 2008, including a sampling intended to accurately represent minorities. The children in the study included 4,157 kids aged 12 to 17.

Researchers found that kids performed best on blood pressure, with more than 90% in the ideal range, and in smoking, where about 80% of those 17 and under had never smoked. (The performance fell to 60% to 70% for those 18 and 19, possibly reflecting legalized sales of tobacco for people 18 and older.)

The toughest measure to hit was healthy diet, said Christina Shay, a researcher at the University of Oklahoma Health Sciences Center, Oklahoma City, and first author of the study. Not one adolescent reported meeting recommended targets on five different nutrition categories: at least 4½ servings of fruits and vegetables a day; three whole-grain servings a day; two or more servings of fish a week; less than 1,500 milligrams of sodium daily; and less than 36 ounces of sugar-sweetened drinks a week.

Indeed, only about 20% of the adolescents met recommendations on two or three of the nutrition factors—considered an intermediate score.

For exercise, 50% of boys and 60% of girls didn't regularly exercise for more than 60 minutes a day, the optimal target. Between 10% and 20% reported getting no exercise. About 30% to 45% had less-than-ideal cholesterol, while about one-third were either overweight or obese.