Association Between Ideal Cardiovascular Health and Executive Function in Chinese Primary School Children

Aims: Little information exists on the associations of cardiovascular health, a new metric proposed by the American Heart Association, and executive function, particularly in children. We aimed to explore this topic. Methods: We studied 3,798 children aged 6-12 years from 5 schools in Guangzhou, China. The executive function of children was evaluated using parent reports of the Behavioral Rating Inventory of Executive Function, which included 2 composite indexes and 8 subscale scores. We calculated the number of ideal cardiovascular health (range: 0-7) based on smoking, body mass index, physical activity (PA), diet, blood pressure, cholesterol, and glucose. A generalized linear mixed model was used to assess the association of the number of ideal cardiovascular health metrics and executive function. Results: Compared with children exhibiting 1-3 ideal cardiovascular health metrics, decreases of 1.37-2.63 points (indicating better performance) in metacognition index and its 5 subscale indexes (initiate, working memory, plan/organize, organization of materials, and monitor) were observed in children who attained 5 or 6-7 ideal metrics (all p for trend <0.001). Ideal diet and ideal PA were independently associated with lower indexes of behavioral regulation and metacognition. Conclusions: The number of ideal cardiovascular health was positively associated with performance of executive function in children.