![]() Precedent for such an approach is found in research on human growth, within which auxological anthropometry provides the measurement techniques that underlie the well-recognized standard growth curves for attained height ( Figure 1), weight, and BMI by age. ![]() 18 Therefore, understanding of risk factor development, and the opportunities for preventing adverse changes, might be advanced through close monitoring of many individuals over time, from childhood through adolescence. Many of these factors (e.g., blood total cholesterol concentration) fluctuate markedly with age during childhood and adolescence, and the true dynamics of change are revealed only when year-to-year or even shorter-term variation can be observed. This work revealed differences among risk factors in their development with age from childhood through and beyond puberty, especially when data were examined across single year-of-age categories rather than broader age groups. 13 The article noted a strong focus of this research on patterns of variation by age in these risk factors as well as BMI (kg/m 2). Knowledge from epidemiologic studies about blood lipids, blood pressure, and body composition in childhood and adolescence, accumulated in the 1970s and since, was highlighted in this supplement to the American Journal of Preventive Medicine. 16, 17 Public health intervention is needed on an unprecedented scale of scope, intensity, and sustainability if the mounting burden, disparities, and costs related to CVDs are to be contained and ultimately reduced. Such intervention has been seen as a singularly promising approach to preventing the major cardiovascular diseases (CVDs) of contemporary society. 15 Prevention of the risk factors in the population as a whole depends fundamentally on interventions that begin in childhood and adolescence. 14 The major risk factors-adverse blood lipid profile, high blood pressure, tobacco use, and diabetes-with their behavioral determinants, including dietary imbalance, physical inactivity, and consequent obesity, are themselves epidemic. The data provide valuable insights into risk factor development and suggest a fresh approach to understanding influences on blood lipids, blood pressure, and left ventricular mass during the period of childhood and adolescence, a period of dynamic change in these risk factors.ĭecreasing the public health impact of coronary heart disease, stroke, and other forms of atherosclerotic and hypertensive diseases is widely recognized as an immense global public health challenge. These trajectories are then related to concurrent measures of multiple indices of body composition and sexual maturation and adjusted for energy intake and physical activity. The mixed-longitudinal design provides trajectories of change with age, for total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides systolic, and fourth-phase and fifth-phase diastolic blood pressure, and left ventricular mass. Overlap in ages at examination among three cohorts (aged 8–12, 11–15, and 14–18 years at baseline) and use of multilevel modeling methods permit analysis of some 5500 observations on each principal variable for the synthetic cohort from ages 8 to 18 years. Data were collected from 1991 to 1995, and study investigators continue data analysis and reporting. Interviews were conducted at entry and annually on diet, physical activity, and health history of participants and their families. All resided in The Woodlands or Conroe TX. Growth, body composition, sexual maturation, major CVD risk factors, and cardiac structure and function were monitored every 4 months for up to 4 years among 678 children and adolescents (49.1% girls 20.1% blacks) aged 8, 11, or 14 years at study entry. Project HeartBeat! studied early development of these risk factors as growth processes. Major cardiovascular disease (CVD) risk factors begin development in childhood and adolescence.
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