Association of Concurrent Healthy Eating and Regular Physical Activity With Cardiovascular Disease Risk Factors in U.S. Youth

Am J Health Promot. 2015 Sep-Oct;30(1):2-8. doi: 10.4278/ajhp.140213-QUAN-71. Epub 2014 Nov 5.


Purpose: Examine whether concurrently consuming a healthy diet and regularly being physically active among U.S. youth is more favorably associated with cardiovascular disease (CVD) biomarkers than other physical activity and dietary patterns.

Design: Cross-sectional.

Setting: United States (National Health and Nutrition Examination Survey) 2003-2006.

Subjects: Two thousand six hundred twenty-nine youth (6-17 years).

Measures: Healthy Eating Index (HEI), accelerometer-determined physical activity, biomarkers, and anthropometry. Four categories were created: consuming a healthy diet (top 40% of HEI) and active (sufficient to meet guidelines); unhealthy diet and active; healthy diet and inactive; and unhealthy diet and inactive.

Analysis: Multivariable regression.

Results: Children consuming a healthy diet and who were active had significantly lower waist circumference (β = -5.5, p < .006), C-reactive protein (CRP) (β = -.2, p < .006), and triglycerides (β = -27.9, p < .006) than children consuming an unhealthy diet and who were inactive. Children engaging in both healthy behaviors had significantly lower CRP (β = -.11, p < .001) and total cholesterol levels (β = -7.8, p = .004) than those only engaging in sufficient activity; there were no significant differences in biomarker levels among children engaging in both healthy behaviors and those only consuming a healthy diet. No associations were significant for adolescents.

Conclusion: Concurrent healthy eating and regular physical activity among children is favorably associated with CVD biomarkers when compared with unhealthy diet and inactivity.

Keywords: Epidemiology, Diet, Physical Activity, Biomarkers, Health, Prevention Research. Manuscript format: applied research brief; Health focus: physical activity and nutrition; Outcome measure: biometric; Research purpose: modeling/relationship testing, descriptive; Setting: national; Strategy: education, behavior change; Study design: cross-sectional; Target population age: youth; Target population circumstances: education.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Cross-Sectional Studies
  • Diet, Healthy*
  • Exercise*
  • Humans
  • Nutrition Surveys
  • Risk Factors*
  • United States
  • Waist Circumference


  • Biomarkers