Children’s diets in the United States are holding them back from adequate cardiovascular health, even though the vast majority have excellent blood pressure and total cholesterol and most have a body mass index in the ideal range, according to a recent study.

“The prevalence of ideal metrics declines with age, both during childhood and adolescence,” wrote Dr. Hongyan Ning of Northwestern University in Chicago and associates. “Efforts to preserve and promote cardiovascular health in childhood and adolescence are urgently needed to reduce the loss of this precious health asset, a consequence in large part to the rising prevalence of obesity” (Circ. Cardiovasc. Qual. Outcomes 2015 [doi:10.1161/circoutcomes.114.001274).

Dr. Ning’s team used four criteria of the American Heart Association to assess the cardiovascular health of 8,961 children aged 2-11 years from four National Health and Nutrition Examination Surveys (NHANES) conducted from 2003 to 2010. The criteria were blood pressure, total cholesterol, body mass index, and a healthy diet score – classified as poor, intermediate, or ideal. An ideal diet score met four of five components: at least 4.5 cups of fruits and vegetables daily, at least two 3.5-oz. fish servings per week, at least three 1-ounce servings of fiber-rich whole grains per day, less than 1,500 mg of sodium per day, and no more than 450 calories from sugar-sweetened beverages per week.

Among children aged 2-5 years, 77% had an ideal BMI, compared with 67% of children aged 6-11 years. Meanwhile, 15% of children overall were overweight, and 17% of boys and 15% of girls were obese.

Among children aged 5-11, less than 0.05% had an ideal healthy diet score while 85.6% of boys and 83.1% of girls met none or one of the components. Approximately 10% kept their sodium intake down to the required level, but even fewer got enough fruits and vegetables or fish. Only 3% of boys and 2.4% of girls met the whole grains component, and more than 50% received more than the recommended calories from sugary drinks.

Less than 10% of children had poor total cholesterol levels (at least 200 mg/dL), with 30% in the intermediate range (170-199 mg/dL) and 60% with levels below 170 mg/dL. Just 2.8% of boys and 3.5% of girls had poor blood pressure (above 95th percentile), and 92.5% of boys and 91.5% of girls had ideal blood pressure.

Among the healthy diet components, only whole grain, sodium intake, and sugar-sweetened beverages intake were significantly associated with BMI, and BMI was significantly linked to total cholesterol levels and both systolic and diastolic blood pressure.


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