Cardiovascular Health of U.S. Early Adolescents Assessed by the Life's Essential 8 Metric

This study aimed to characterize cardiovascular health among U.S. early adolescents using the American Heart Association's Life's Essential 8 metric in a large national cohort.

A cross-sectional analysis of children aged 10-13 years in the Adolescent Brain Cognitive Development Study was conducted, primarily using data from the Year 2 follow-up (2018-2020), with supplemental Year 3 (2019-2021) data to improve completeness of cardiometabolic measures. Life's Essential 8 behavioral factors scores (diet, physical activity, nicotine exposure, sleep) and health factors scores (BMI, blood pressure, blood glucose, blood lipids) as well as overall Life's Essential 8 scores were calculated. Descriptive statistics were generated, and sex (assigned at birth) differences were assessed using Mann-Whitney U tests.

Among participants with complete Life's Essential 8 data (n=1,235; mean age 12.0±0.7 years), the mean overall Life's Essential 8 score was 78.1±10.4. Most adolescents had moderate (52.9%) or high (46.4%) cardiovascular health, whereas very few had low (0.4%) or optimal (0.3%) cardiovascular health. The mean behavioral factors score was 66.8±15.9, and the mean health factors score was 88.1±11.8. Overall Life's Essential 8 scores did not significantly differ by sex; however, males had higher (better) physical activity and BMI scores but lower (worse) diet, nicotine exposure, sleep, and blood pressure scores than females.

In this national sample of early adolescents, fewer than half demonstrated high cardiovascular health on the basis of Life's Essential 8, and optimal cardiovascular health was rare. Poor diet and low physical activity were prominent contributors to suboptimal cardiovascular health. These findings highlight early adolescence as a critical window for interventions to improve long-term cardiovascular health.