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

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.