They sit all day in the classroom and then sit some more while doing homework or playing videogames. It's no wonder, then, that most U.S. children do not meet the American Heart Association's (AHA) definition of ideal childhood cardiovascular health. The association's scientific statement, published in the AHA's journal Circulation, highlights the importance of promoting good heart health as early as possible.
"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," said Julia Steinberger, MD, MS, lead author of the statement, professor in pediatrics and director of pediatric cardiology at the University of Minnesota in Minneapolis.
Seven key health factors and behaviors are used to determine whether a child's cardiovascular health is ideal:
"Engaging in these ideal health behaviors early in life can have a tremendous benefit on maintaining ideal health throughout the lifespan," adds Steinberger.
Data from a 2007-2008 National Health and Nutrition Examination Survey found that children in the United States were not meeting most of the American Heart Association's definition of ideal cardiovascular health.
"A primary reason for so few children having ideal cardiovascular health is poor nutrition — children are eating high-calorie, low-nutrition foods and not eating enough healthy foods, such as fruits, vegetables, whole-grains, fish and other foods strongly associated with good heart health and a healthy body weight," said Steinberger.
Nearly all children in the study — about 91% — scored poorly on diet measures. In fact, the study found that children 2 to 19 years old get the bulk of their daily calories from simple carbohydrates such as sugary desserts and beverages.
Similarly, the level of physical activity was not enough to protect their hearts. Among children ages 6 to 11 years old, half of the boys and a little more than a third of the girls were active for the recommended 60 minutes or more per day. As children reached 16 to 19 years of age, the percentage meeting the recommended amount of physical activity decreased even further, to 10% in boys and 5% in girls.
Not surprisingly, the effects of poor diet and physical inactivity affected body weight. Among 2 to 5 year olds, about 10% were obese based on their body mass index (BMI). In the 12 to 19 year-old age group, the percentage of obesity soared to between 19% and 27%. Among these older children, the rate of cigarette smoking was surprisingly high. In fact, approximately one-third of 12 to 19 year-olds reported trying a cigarette.
The healthiest metric for children was blood pressure, with nearly all children in the ideal group. Most children also had ideal measurements for total blood cholesterol and blood sugar levels. However, when compared with blood pressure, both of these categories had higher percentages of children with intermediate and poor measurements.
"As pediatricians, we see a tremendous opportunity to strive toward true cardiovascular health if we think of the factors that maintain health early in life. It's much harder to turn back the clock," Steinberger said.
The new recommendations for ideal cardiovascular health in children are a companion to a similar set of guidelines for adults issued by the American Heart Association in 2010. Together, the recommendations are key components of the American Heart Association's goal to reduce death and disability from cardiovascular disease and increase cardiovascular health by 20% by the year 2020.
Especially because kids sit for so many hours at a time in their classrooms, it's important to make sure they don't remain sedentary when the opportunity for any sort of physical activity arises. That's where recess comes in, according to a recent study that thinks schools can do their part to encourage students to move. A research team from the University of Missouri found that zones set up so children can play specific games can improve their chances of engaging in the recommended 60 minutes of "play per day." After all, not every kid can make the varsity baseball, basketball, volleyball or etceteraball team or necessarily wants to, but running around in the schoolyard during recess will go a long way toward making sure a child remains active.
While teachers may not be thrilled by the idea of a classroom full of fidgeting kids, another recent study did find that tapping your toes or moving your legs when sitting can protect the arteries in legs and potentially help prevent arterial disease. Being a distraction in the classroom is probably not a good idea, but once they're home doing their assignments they can certainly fidget to their heart's content.
Many kids get hours and hours' worth of homework, so finding extra time for them to do cardiovascular exercise — while making sure they get to bed at a reasonable hour — can be challenging. But if there's time to park it on the couch in front of the television or on their cell phone, then they can be encouraged to play videogames that promote physical activity instead. Remember the Wii Fit? And don't forget Pokemon Go.