Trends in Heart Health*

Ideal heart health is more common in American children and young adults than in middle-aged and older adults, largely because the levels of risk factors in US children and young adults are better than in older individuals. However, this fact is balanced by the recognition that health behaviors that increase the risk of heart disease in children and young adults were similar to or even worse than those of middle-aged and older adults. They were similar in terms of physical activity but worse in terms of dietary behaviors. Poor diet and physical inactivity in childhood and adolescence are strong predictors of poorer health factors later in life.

The measures with the greatest potential for improvement are behaviors associated with a healthy body weight, including good food choices and regular physical activity. Obesity has been a recognized risk factor for heart disease since the 1990’s.

According to 2013 National Health Interview Survey data, only half of American adults met the current aerobic physical activity guidelines recommending greater than 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equivalent combination) each week.. Unfortunately, the proportion of individuals meeting physical activity recommendations is likely to be even lower than indicated by self-report data. Studies examining actual physical activity using pedometers or accelerometers found that both men and women overestimate their physical activity substantially by self-report. Men reported 44% more than was measured and women reported 138% more than was measured. Greater efforts to increase physical activity are needed. 

Although healthier diets cost modestly more than unhealthful diets, comparing extremes of unhealthful versus healthful food-based diet patterns, the more healthful patterns cost on average ≈$1.50 per day more. Similarly priced options are also common; in a comparison of 20 fruits and vegetables versus 20 common snack foods such as cookies, chips, pastries, and crackers, the average price per portion of fruits and vegetables was 31 cents, with an average of 57 calories per portion, versus 33 cents and 183 calories per portion for snack foods.

Much of the literature on CVD has focused on factors associated with increasing risk for CVD and on factors associated with poorer outcomes in the presence of CVD; however, in recent years, a number of studies have defined the potential beneficial effects of healthy lifestyle factors and lower CVD risk factor burden on CVD outcomes and longevity. These studies suggest that prevention of risk factor development at younger ages may be the key to successful aging, and they emphasize the need for evaluating the potential benefits of intensive prevention efforts at younger and middle ages once risk factors develop to increase the likelihood of healthy longevity.

*The American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The latest update available was reported in 2015 and reported on prior available data.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131: e29-322.