Background-Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls.

Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.

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Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education.

This document provides a pediatric-focused companion to the American Heart Association (AHA) Strategic Impact Goal Through 2020 and Beyond, focused on cardiovascular (CV) health promotion and disease reduction in adults and children. The principles detailed in the document reflect the AHA’s new dynamic and proactive goal to promote CV health throughout the lifecourse. The primary focus is on adult CV health and disease prevention, but critical to achievement of this goal is maintenance of ideal CV health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define CV health in children for the clinical or research setting and a balanced and critical appraisal of the strengths and weaknesses of the CV health construct in children and adolescents are provided. Specifically, it discusses two important factors: 1) the promotion of ideal CV health in all children, and 2) the improvement of CV health metric scores in children currently classified as having “poor” or “intermediate” CV health. Other topics include the current status of CV health in U.S. children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal CV health. Importantly, concerns about the suitability of using single thresholds to identify elevated CV risk throughout the childhood years and the limits of our current knowledge are noted, while providing suggestions for future directions and research.

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W ith Ͼ130 million Americans employed across the United States, workplaces provide a large audience for cardiovascular disease (CVD) and stroke prevention activities. Experience has shown that workplace wellness programs are an important strategy to prevent the major shared risk factors for CVD and stroke, including cigarette smoking, obesity, hypertension, dyslipidemia, physical inactivity, and diabetes. An estimated 25% to 30% of companies' medical costs per year are spent on employees with the major risk factors listed above. 1 Employees and their families share the financial burden through higher contributions to insurance, higher copayments and deductibles, reduction or elimination of coverage, and trade-offs of insurance benefits against wage or salary increases. When programs are successful, their influence extends beyond the individual workers to immediate family members, who are often exposed to their favorable lifestyle changes. Worksite wellness programs that can reduce these risk factors can ultimately decrease the physical and economic burden of chronic diseases, including CVD, stroke, and certain cancers.The societal benefits of a healthy employed population extend well beyond the workplace. As such, comprehensive, culturally sensitive health promotion within the workplace can improve the nation's health. The Healthy People 2010 goal is for 75% of all worksites, regardless of size, to develop comprehensive wellness programming. 2 However, the development of comprehensive programs takes time and resources, especially for smaller employers. Because program development and initiation can be resource intensive, the American Heart Association (AHA) supports incremental efforts to achieve a comprehensive worksite wellness program to address CVD and stroke prevention and makes the following recommendations. Summary of Recommendations Components of Wellness Programs• A comprehensive program aimed at improving employees' cardiovascular and general health should include the following: Tobacco cessation and prevention, regular physical activity, stress management/ reduction, early detection/screening, nutrition education and promotion, weight management, disease management, CVD education that includes cardiopulmonary resuscitation and automated external defibrillator training, and changes in the work environment to encourage healthy behaviors and promote occupational safety and health.• Programming should be integrated into the organizational structure of the workplace by use of the following proven strategies: Health education that relies on existing valid sources and is focused on skill development that is consistent with employees' readiness to make behavior changes; initiatives that are incorporated into existing employee assistance programs; and voluntary worksite screening linkedThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the ...

This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.