![]() It will be shown that the prevention of a great proportion of the major cardiovascular diseases is far from being a utopian expectation, provided-and this is the point-it is started early in life. The focus on childhood became explicit in a subsequent essay 9: Implicitly, this would require protecting children and young adults from influences that, unopposed, would result in high blood pressure, high cholesterol levels, and smoking. In 1978, Strasser 8 introduced the term “primordial prevention” to describe a strategy for preventing epidemics of the onset of risk factors in whole societies. The concept of preventing CVD beginning in childhood originated at least 30 years ago. Strasser and “primordial prevention,” 1978/1980 Especially in view of the recent impetus to prevent overweight and obesity in childhood and adolescence, these findings have broader relevance than to CVD risk factors alone they add to further appreciation of differences among common measures of body composition as they develop through childhood and adolescence and thus to considerations in the design and evaluation of interventions to prevent childhood obesity. 7 Project HeartBeat! can now contribute to further development and implementation of such recommendations and stimulate further research on prevention of CVD risk factors in youth. This article places these findings in the context of prior policy development and recommendations addressing CVD prevention, including obesity prevention, blood pressure monitoring, and blood lipid control, beginning in childhood. 5, 6 Where appropriate, measures of diet, physical activity, and sexual maturation were included in the models. Several articles in this supplement to the American Journal of Preventive Medicine from Project HeartBeat! present findings on the growth curves, or trajectories of change with age, in blood lipids (four components) 3 and blood pressure (three components), 4 as well as several indices of body composition, including BMI and its components, fat free–mass index (FFMI) and fat mass index (FMI). Multilevel analysis provided models for change with age in each measure for the entire synthetic cohort from ages 8 to 18 years. ![]() 1 Participants were enrolled in the Conroe Independent School District in The Woodlands or Conroe TX, two communities located near Houston, and included 50.9% boys and 20.1% blacks. Follow-up examinations extended on average for eight occasions. Project HeartBeat! was a longitudinal “growth” study of cardiovascular disease (CVD) risk factors and body composition in childhood and adolescence involving 678 participants aged 8, 11, or 14 years at entry to a program that included follow-up examinations at 4-month intervals. Opportunities to strengthen interventions for CVD prevention in childhood and adolescence include updated algorithms for monitoring body composition, blood lipids, and blood pressure throughout childhood and adolescence through use of the Project HeartBeat! study results. Intervention to prevent obesity can have a major impact in preventing CVD risk factors more broadly. A new impetus to action is the recognized increase in the prevalence of childhood overweight and obesity. Policy development and public health recommendations for CVD prevention beginning in childhood have evolved over 30 years or more. Especially noteworthy are differences among associations between the two components of BMI (kg/m 2)-the lean or fat-free mass index, and the fat mass index-and each of several CVD risk factors. ![]() Its findings demonstrate patterns of change from ages 8 to 18 years in anthropometric indicators of adiposity, blood lipid components, and blood pressure measurements, as well as the varying inter-relations among these patterns. Project HeartBeat! was a longitudinal “growth” study of cardiovascular disease (CVD) risk factors and body composition in childhood and adolescence. ![]()
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