Starting young: promoting a healthy lifestyle with children

Data accumulated over the past 4 decades provide convincing evidence that confirms the associations between established risk factors, adverse health behaviors, and accelerated atherosclerotic and hypertensive processes in childhood and adolescence. Patterns of major lifestyle behaviors associated with cardiovascular disease are established early in childhood and influence risk factors for cardiovascular disease in childhood and adolescence as well as in adulthood. Within a life course ecological framework, this article summarizes the evidence for "starting young," identifies behaviors and contexts as targets for health-promoting lifestyle interventions, and addresses implications for individual and population-based practice, future research, and multilevel policies.