{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T07:58:24Z","timestamp":1789372704064,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,29]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Middle\u2010aged adults with ideal blood pressure, cholesterol, and glucose levels exhibit substantially lower cardiovascular mortality than those with unfavorable levels. Four healthy lifestyle components\u2014optimal body weight, diet, physical activity, and not smoking\u2014are recommended for cardiovascular health (\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              ). This study quantified associations between combinations of healthy lifestyle components measured in young adulthood and loss of the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile into middle age.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Analyses included 2164 young adults in the Coronary Artery Risk Development in Young Adults study with the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile (defined as untreated blood pressure &lt;120\/80\u00a0mm\u00a0Hg, total cholesterol &lt;200\u00a0mg\/\n              <jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content>\n              , fasting blood glucose &lt;100\u00a0mg\/\n              <jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content>\n              , and absence of cardiovascular disease) at baseline. Cox proportional hazards regression models estimated hazard ratios for loss of the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile over 25\u00a0years according to 4 individual and 16 combinations of optimal healthy lifestyle components measured in young adulthood: body mass index, physical activity, nonsmoking status, and diet quality. Models were adjusted for age, sex, race, education, study center, and baseline blood pressure, cholesterol, and glucose. Eighty percent (n=1737) of participants lost the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile by middle age; loss was greatest for young adults with no optimal healthy lifestyle components at baseline. Relative to young adults with no optimal healthy lifestyle components, those with all 4 were less likely to lose the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile (hazard ratio 0.59, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.44\u20130.80). Combinations that included optimal body mass index and nonsmoking status were each associated with lower risk.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Optimal body mass index and not smoking in young adulthood were protective against loss of the ideal\n              <jats:styled-content style=\"fixed-case\">CVH<\/jats:styled-content>\n              profile through middle age. Importance of diet and physical activity may be included through their effects on healthy weight.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002048","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T19:46:10Z","timestamp":1536954370000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Optimal Lifestyle Components in Young Adulthood Are Associated With Maintaining the Ideal Cardiovascular Health Profile Into Middle Age"],"prefix":"10.1161","volume":"4","author":[{"given":"Holly C.","family":"Gooding","sequence":"first","affiliation":[{"name":"Division of Adolescent\/Young Adult Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"Shay","sequence":"additional","affiliation":[{"name":"Gillings School of Global Health, University of North Carolina Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Gillman","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E.","family":"Chiuve","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared P.","family":"Reis","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norrina B.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M.","family":"Lloyd\u2010Jones","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.21.2012"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.548206"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012848"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.339"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.13.1588"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.09.099"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.07.015"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.081083"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.049122"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000152"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192703"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.073585"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.060681"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e3283315888"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005445"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90080-7"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(91)90002-4"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-198911000-00003"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115835"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000278"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.01.014"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(21)01299-2"},{"key":"e_1_3_3_24_2","first-page":"15","article-title":"A study of the reliability and comparative validity of the CARDIA dietary history","volume":"4","author":"Liu K","year":"1994","unstructured":"Liu K, Slattery M, Jacobs D Jr, Cutter G, McDonald A, Van Horn L, Hilner JE, Caan B, Bragg C, Dyer A. 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