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Author Notes:

Correspondence to: Amber L. Fyfe-Johnson, PhD, ND, 1100 Olive Way, Suite 1200, Seattle, WA 98101. E-mail: afj@wsu.edu

Acknowledgments: The authors thank Annie Mathews, Erin Hurley, and Cameron Naughton for their expert study coordination and management and the participants in this study for donating their time to the project.

Disclosures: Dr Kelly serves as a consultant for Novo Nordisk, Orexigen, and Vivus Pharmaceuticals; he does not accept personal or professional income for these activities.

Dr Kelly also receives research support from Astra Zeneca Pharmaceuticals in the form of drug/placebo.

Dr Fox is a site principal investigator for a pediatric obesity clinical trial sponsored by Novo Nordisk Pharmaceuticals.

The remaining authors have no disclosures to report.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


Research Funding:

Funding for this project was provided by the National Heart, Lung, and Blood Institute (R01HL110957, PI: Kelly), the National Center for Advancing Translational Sciences (UL1TR000114, PI: Blazar), and the National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK050456, PI: Levine & Bernlohr).

Dr Fyfe‐Johnson was supported by National Heart, Lung, and Blood Institute of the National Institutes of Health (T32HL07779, PI: Folsom).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • adolescence
  • ideal cardiovascular health
  • obesity
  • pediatrics
  • risk factor

Ideal Cardiovascular Health and Adiposity: Implications in Youth


Journal Title:

Journal of the American Heart Association


Volume 7, Number 8


, Pages e007467-e007467

Type of Work:

Article | Final Publisher PDF


BACKGROUND: The American Heart Association set 2020 Strategic Impact Goals that defined cardiovascular risk factors to be included in the concept of ideal cardiovascular health (ICH). The prevalence of ICH among differing levels of adiposity in youth, especially severe obesity, is uncertain. METHODS AND RESULTS: The cross-sectional study measured ICH metrics in 300 children and adolescents stratified by adiposity: normal weight, overweight/obese, and severely obese. ICH incorporates 7 behavioral and health metrics, and was characterized as poor, intermediate, or ideal. Individual ICH metrics were transformed into standardized sample z-scores; a summary ICH sample z-score was also calculated. Multivariable linear regression models were used to estimate differences in ICH sample z-scores by adiposity status. Of the 300 participants, 113 were classified as having normal weight, 87 as having overweight/obesity, and 100 as having severe obesity (mean age 12.8 years, SD 2.7; 48% female). No participants met the criteria for ICH; 80% of those classified as having normal weight, 81% of those with overweight/obesity, and all of those with severe obesity were in poor cardiovascular health. After multivariable adjustment, those with overweight/obesity (sample z-score: -1.35; 95% confidence interval, -2.3, -1.1) and severe obesity (sample z-score: -1.45; 95% confidence interval, -2.9, -0.92) had lower overall ICH sample z-scores compared with participants with normal weight. Results were similar for individual ICH metrics. CONCLUSIONS: Poor cardiovascular health was highly prevalent in youth; ICH sample z-scores increased across levels of adiposity. Youth with obesity, particularly those with severe obesity, remain a rich target for primary prevention efforts. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01508598.

Copyright information:

© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).

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