Combined Impact of Negative Lifestyle Factors on Cardiovascular Risk in Children: A Randomized Prospective Study

Purpose: Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. Methods: Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and 64% were assessed again after 4 years. Measures included anthropometry, fasting blood samples, and a health assessment questionnaire. Participants scored one point for each negative lifestyle factor at baseline: overweight; physical inactivity; high media consumption; little outdoor time; skipping breakfast; and having a parent who has ever smoked, is inactive, or overweight. A CVR score at follow-up was constructed by averaging sex- and age-related z-scores of waist circumference, blood pressure, glucose, inverted high-density lipoprotein, and triglycerides. Results: The age-, sex-, pubertal stage-, and social classeadjusted probabilities (95% confidence interval) for being in the highest CVR score tertile at follow-up for childrenwho had atmost one (n¼48), two (n¼64), three (n¼56), four (n¼41), or five ormore (n¼14) risky lifestyle factorswere 15.4%(8.9e 25.3), 24.3% (17.4e32.8), 36.0% (28.6e44.2), 49.8% (38.6e61.0), and 63.5% (47.2e77.2), respectively. Conclusions: Even in childhood, an accumulation of negative lifestyle factors is associated with higher CVR scores after 4 years. These negative lifestyle factors are easy to assess in clinical practice and allow early detection and prevention of CVR in childhood.

Media consumption has no direct effect on cardiovascular risk in children