AHA News: Healthy Hearts and Brains Get Their Start in Childhood

High blood pressure, high cholesterol and other risk factors for poor heart and brain health are problems people typically don't think about until they hit midlife.

A growing body of research suggests they should start sooner – decades sooner.

"These factors that can be modified through lifestyle choices are already very important in childhood," said Dr. Juuso Hakala, a PhD student at the Research Centre of Applied and Prevention Cardiovascular Medicine at the University of Turku in Finland. Hakala was lead author an analysis of data from the Cardiovascular Risk in Young Finns study, which tracked 3,596 children and adolescents for three decades. In 2011, researchers gave 2,000 participants a computerized cognitive function test and found managing weight, cholesterol and blood pressure early in life could impact cognitive function in adulthood.

Children with consistently high blood pressure and cholesterol levels had poorer memory and learning abilities by midlife than those with better heart health measures, the study found. Those who were obese throughout life were less able to process information or maintain attention as they got older. By the time they reached their 40s, those who had all three heart risk factors performed poorest on all measures of brain health.

The link between heart and brain health is well established. Good blood flow keeps both organs working properly. Research has shown conditions and behaviors that damage blood vessels, such as high blood pressure and cholesterol, put both heart and brain at risk and can lead to heart attacks, strokes and dementia.

With the increase in childhood obesity in recent decades and growing evidence that poor heart health begins to develop as early as childhood, health experts are increasingly focused on the importance of setting the stage early in life to prevent harm later.

"Lifestyle needs to change at a much earlier age," said Dr. Mitchell Elkind, immediate past president of the American Heart Association and a professor of neurology and epidemiology at Columbia University Irving Medical Center in New York City. "We need to get the message out there to young people, starting with children. We know the behaviors you adopt in childhood often are the ones that persist throughout life."

Federal guidelines recommend children and teens ages 6 to 17 get at least one hour of moderate to vigorous physical activity each day, with that hour including more intense activities at least three times a week to keep muscles and bones strong. They also suggest it's important to limit sedentary time in front of a screen.

"It's not just what you do, but also what you don't do," said Gabriel Shaibi, a professor at Arizona State University's Edson College of Nursing and Health Innovation and director of its Center for Health Promotion and Disease Prevention in Phoenix.

Regular physical activity – independent of weight – "has been shown to have effects on cognitive function, academic achievement and outcomes in general," he said.

And, while studies show children who are obese have higher mortality and greater heart risks later in life, the added risk disappears if they lose the extra weight when they grow up, Shaibi said. "So do we focus on weight loss, or instead do we focus on improving health by meeting physical activity guidelines and avoiding too much sedentary screen time?"

Many kids don't get enough physical activity in their daily lives to reap heart and brain health benefits. Just getting them up and moving, Shaibi said, might be a better strategy than focusing on weight loss, which can be very difficult to achieve.

"By shifting the focus away from weight and into behaviors, we have a better chance of improving outcomes in the interim that are associated with long-term benefits," he said.

That doesn't mean people who have been inactive most of their lives can't take steps now to improve heart and brain health.

"Of course, if you have lifelong good habits, it's better," Hakala said. "But it's never too late to start."