Current data suggests that cardiovascular health is worsening during childhood and through young adulthood, with marked reductions in the prevalence of individuals with ≥5 cardiovascular health metrics at ideal levels at progressively older ages.
Children should maintain a body weight below the 85th percentile; get more than 60 minutes of moderate-to-vigorous physical activity daily; and achieve various measures for healthy eating (Healthy Diet Score of 4-5 components), good levels of cholesterol (< 170 mg/dL), blood pressure (< 90th percentile), and blood glucose (< 100 mg/dL).
This leads us to the question, What are the Guidelines to maintain ideal Cardiovascular Health from birth through childhood to young adult and Beyond?
The Seven health metrics and behavior indicators that are used to determine if a child’s cardiovascular health is poor, intermediate or ideal include:
- Smoking status: According to the Centers for Disease Control (CDC), nearly 25% of high school students use some kind of tobacco product, and nearly 4,000 kids under age 18 try their first cigarette every day. In fact, 9 out of 10 smokers had started smoking before they finished high school. This means that if children can stay smoke-free in school, they will probably never smoke. More than 90,000 people die each year from heart diseases caused by smoking. Among young people who would otherwise have a very low risk of heart disease, cigarette smoking may cause as many as 75 percent of the cases of heart disease. And, the longer a person smokes, the higher the risk of heart disease.
- Body mass index (BMI): For children and teens, BMI is not a diagnostic tool and is used to screen for potential weight and health-related issues. For example, a child may have a high BMI for their age and sex, but to determine if excess fat is a problem, a health care provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.
- Physical activity level: The American Heart Association advises that all children 5 years and older get at least 30 minutes of exercise every day. This should include a mix of moderate- and high-intensity activities. Limit the amount of time spent watching TV, playing video games, or surfing the Internet. Look into organized sports, lessons, or clubs that suit your child’s interests. Most importantly, spend time with your child, and create family outings that involve some type of physical activity (e.g., biking, walking, hiking).
- Healthy diet score: Eating more calories than they are burning during exercise and daily life. Other causes of obesity may include genetics, aging, gender, lifestyle, and illness. Obesity in children is dangerous because researchers believe that the fat cells we gain as children stay with us as adults. Obese children may have 5 times more fat cells than children of normal weight. Dieting in adulthood will decrease the fat-cell size but not the actual number of fat cells.
- Total cholesterol: Studies have shown that fatty plaque buildup begins in childhood and progresses into adulthood. This disease process is called atherosclerosis. In time, atherosclerosis leads to heart disease, which is the single biggest cause of death. In some cases, high cholesterol runs in families. This is called familial hypercholesterolemia. About 1% to 2% of children have this condition, and they should have their cholesterol levels checked before they are 5 years old. Other risk factors for high cholesterol include obesity, high blood pressure, and smoking.
- Blood pressure: High blood pressure is a serious condition in childhood and often goes undetected because it causes no symptoms. Make sure that your child’s blood pressure is checked at his or her yearly check-up. High blood pressure (hypertension) in children is not a congenital heart disease, but it can have a hereditary link. For that reason, children born into families with a history of high blood pressure need to have their blood pressure watched with special care.
- Fasting blood glucose: (< 100 mg/dL).
Recommended Eating Pattern For Optimum Health
The American Heart Association recommends this eating pattern for families:
- Energy (calories) should be adequate to support growth and development and to reach or maintain desirable body weight.
- Eat foods low in saturated fat, trans fat, cholesterol, salt (sodium), and added sugars.
- Keep total fat intake between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories for children and adolescents 4 to 18 years of age, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable oils.
- Choose a variety of foods to get enough carbohydrates, protein and other nutrients.
- Eat only enough calories to maintain a healthy weight for your height and build. Kids should be physically active for at least 60 minutes a day.
- Serve whole-grain/high-fiber breads and cereals rather than refined grain products. Look for “whole grain” as the first ingredient on the food label and make at least half your grain servings whole grain.
- Serve a variety of fruits and vegetables daily, while limiting juice intake. Each meal should contain at least 1 fruit or vegetable. Children’s recommended fruit intake ranges from 1 cup/day, between ages 1 and 3, to 2 cups for a 14–18-year-old boy. Recommended vegetable intake ranges from ¾ cup a day at age one to 3 cups for a 14–18-year-old boy.
- Introduce and regularly serve fish as an entrée. Avoid commercially fried fish.
- Serve fat-free and low-fat dairy foods. From ages 1–8, children need 2 cups of milk or its equivalent each day. Children ages 9–18 need 3 cups.
- Don’t overfeed. Estimated calories needed by children range from 900/day for a 1-year-old to 1,800 for a 14–18-year-old girl and 2,200 for a 14–18-year-old boy.
This eating pattern supports a child’s normal growth and development. It provides enough total energy and meets or exceeds the recommended daily allowances for all nutrients for children and adolescents, including iron and calcium.
Note that cardiovascular risk factors present during childhood have been shown to be better predictors of future subclinical CVD development (ie, carotid intima-media thickness or coronary calcification) than cross-sectional comparisons performed during young adulthood.
This is nodoubt a Wake-up Call.