Ideal Health Research Articles

Association of Sleep Quality with Dietary Diversity and BMI

Adequate quality sleep is important for ideal health condition. The recommended hours of sleep are 7-9 hours for children, adolescents, adults and elderly to maintain good health. Recent developments in the field of technology have changed the habits and lifestyles of students which causes sleep disorders among students. Sleep quality of the people is affected by several factors such as gender, age, occupation, psychological state but recently it has been recognized that dietary diversity and BMI are also implicated in sleep quality of people. Dietary diversity is the variety or the number of different food group’s people eats over the time given. Studies done in the past have indicated that sleep duration is associated positively with fruits and vegetables intake while the consumption of sweet and snack food items including junk food would lead to lesser sleep duration. Also, short sleep duration and poor sleep were associated with an increase in BMI and fat mass. Another study indicate that poor sleep quality predict obesity and high body fat mass among adults. Several studies have argued that excessive introduction of food, which leads to an increased risk of obesity in people with short term sleep, is associated with changes in hormones responsible for hunger and appetite control especially leptin and ghrelin. Adults and children that sleep less, have an increase in obesity and overweight risk with dysfunctional eating behaviors, decreased physical activity and metabolic changes. The review aims to see how the sleep quality is associated with BMI and dietary diversity in different age group people.

The menopause transition: a critical stage for cardiovascular disease risk acceleration in women.

The menopause transition is a critical period for cardiovascular health. During this stage, women experience adverse changes in multiple components that are key for optimal cardiovascular health. Additionally, women struggle to maintain ideal health behaviors, which if adopted collectively, have been shown in observational studies to prevent more than 70% of coronary heart disease cases. Significant efforts should be directed toward increasing awareness among women and healthcare professionals about the menopause transition as a stage of cardiovascular disease risk acceleration that is amenable to reduction with positive lifestyle measures.

What's the ideal World Health Organization (WHO)?

The World Health Organization (WHO) is tasked with the 'attainment by all peoples of the highest possible level of health', yet, it is widely struggling to meet this mandate, and COVID-19 has revealed significant limitations of the organisation. Despite clear guidance provided by the institution as to how best to respond to the pathogen, many governments departed from WHO's guidance in their response efforts. Is this a new crisis for WHO? Does WHO need to restore its legitimacy in the eyes of the global community? As renewed calls for changes to WHO emerge, in this perspective we lay out the obstacles WHO face to become the WHO 'we' need. The assumption is that UN member states need an empowered and well-funded organisation. Yet, many years of discussion of reform of WHO have failed to lead to meaningful change, and glaring challenges remain in its financing, governance and politics, which are considered in turn. The reality may be that we have the WHO that UN member states need - one that can provide guidance and advice, but also take criticism for health governance failures when states want to avoid blame or responsibility. We discuss this, by analysing three key areas of WHO'S challenges: mandate and scope; structure, governance and money and domestic vs international.

Transforming Public Health Data Systems to Advance the Population's Health.

Policy Points Accurate and reliable data systems are critical for delivering the essential services and foundational capabilities of public health for a 21st -century public health infrastructure. Chronic underfunding, workforce shortages, and operational silos limit the effectiveness of America's public health data systems, with the country's anemic response to COVID-19 highlighting the results of long-standing infrastructure gaps. As the public health sector begins an unprecedented data modernization effort, scholars and policymakers should ensure ongoing reforms are aligned with the five components of an ideal public health data system: outcomes and equity oriented, actionable, interoperable, collaborative, and grounded in a robust public health system.

Association between ideal cardiovascular health and multiple disabilities among US adults, BRFSS 2017–2019

ObjectivesCardiovascular health is the leading cause of death and disability in the United States. Our objective was to estimate the association between ideal cardiovascular health (ICVH) and multiple disabilities among US adults stratified into the three age groups of young (18–44 years), midlife (45–64 years), and older adults (≥65 years). Study designWe conducted a cross-sectional analysis using data pooled from the 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS). MethodsUsing American Heart Association's seven-component (four ideal behaviors and three ideal health factors) scoring tool, we identified ICVH as a composite score ≥5 and also computed the ideal behavioral (score ≥3) and ideal health factors (score = 3) submetrics. The outcome, single vs multiple disabilities indicator, was defined using US Census's disability domains and analyzed using multinomial regression. ResultsFor all three groups, the prevalence of multiple disabilities was significantly lower among those meeting ICVH, ideal behavioral, and ideal health factors compared with those that did not. After controlling for covariates, ICVH score ≥5 was associated with lower relative risk of multiple disabilities in all groups. Although both ideal health and ideal behavioral factors were associated with lower relative risk of multiple disabilities among all groups, the reduction in risk was the highest for multiple disabilities and ideal behavioral factors among midlife (relative risk ratio: 0.30, 95% confidence interval: 0.25, 0.36) and older adults (relative risk ratio: 0.40, 95% confidence interval: 0.33, 0.48). ConclusionAdults with less-than-ideal cardiovascular health had a higher relative risk of multiple disabilities. Addressing the risk of multiple disabilities of US adults will require effective promotion of ICVH.

Critical thinking in musicians' health education. Findings from four workshops with experts (Part I).

Health education encompasses building health knowledge, but also training skills such as critical thinking, that guide individuals' ability to access, understand and use health information to take care of their own health (WHO, 1998). This study aimed to document expert discussions on the content of an ideal health education curriculum for higher music education (HME) students in the UK, integrating critical thinking. Four interdisciplinary workshops were conducted, where 67 experts in relevant fields discussed the content of four lists created based on literature reviews (cognitive biases, logical fallacies, critical appraisal tools and health topics). Notes taken during the discussions were thematically analysed. Most of the participants thought that the topics and tools were relevant. Two of four identified themes are reported in this paper, which represents the first of a two-part series: (1) critical thinking applied to health; and (2) misconceptions. This is the first attempt to document conversations aimed at using the applied knowledge of key stakeholders to discuss the content of an ideal health education curriculum integrating critical thinking, for conservatoire students.

Development of indicators to measure quality of life for pregnant women (QOL-PW).

Ideal health assessment includes physical, mental, and social health measures that measure a person's quality of life. This study aims to develop indicators to measure the quality of life of pregnant women.The design of this study was development research with a cross-sectional data collection. The study sites were in six PHC in Ngawi district and Blitar city, East Java Province, Indonesia. The sample size is 800 pregnant women. Data analysis used the second-order Convincatory Factor Analysis (CFA) method.The indicators to measure the quality of life of pregnant women were all 46, consist of 21 indicators for functional and physical health factors, 6 indicators for mental health and functional factors, and 19 indicators for the social functional and environmental factors. Health factors and physical functions consist of 21 indicators, which are divided into seven aspects. Health factors and mental functions consist of 6 indicators divided into three aspects. The social and environmental function factor consists of 19 indicators divided into six aspects.The indicators of quality of life for pregnant women that are developed can represent most of the conditions of pregnant women, and if they have been validated, they are expected to be applied easily. Indicators of quality of life for pregnant women have provided a sufficient but straight forward way of calculating and cutting off points to categorize the quality of life status of pregnant women.

Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age

We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (< 40 years of age). In the prognostic group (n = 894, followed for 13 years until aged 40–50 years at follow-up), the primary outcome was presence of carotid plaque measured by carotid ultrasound at follow-up. Of these 894 participants, 86 (9.6%) had unilateral, and 23 participants (2.6%) had bilateral, carotid plaques at follow-up. The baseline FBS was predictive of carotid plaque at follow-up [odds ratio OR = 0.86 (95% CI 0.77–0.96) per 1-SD increase in FBS], similar to prediction from Pooled Cohort Equation [PCE, OR = 0.72 (0.61–0.85) per 1-SD decrease in PCE]. Risk scores at baseline predicted outcomes more strongly than those at follow-up, and did so independently of any changes over 13 years of follow-up. Similar discrimination for predicting carotid plaque after 13 years was found for both baseline FBS [C-statistic = 0.68 (95% CI 0.62–0.74)] and PCE [C-statistic = 0.69 (95% CI 0.63–0.75)]. Application of this FBS prognostic information to a contemporary cohort of 1763 young adults anticipates the future development of plaque in 305 (17.3%), especially in the 1494 participants (85%) with ≤ 2 metrics of ideal health. In conclusions, FBS measured in young adulthood predicted atherosclerosis 13 years later in middle age, independent of score changes over the follow-up period, emphasizing the importance of early damage to vascular health. FBS may be a simple and feasible risk score for engaging low-risk young people with reduction of future cardiovascular risk.

Mobile-phone text messaging to promote ideal cardiovascular health in women

ObjectiveIdeal cardiovascular health (CVH) was developed to promote CVH as a key component of primordial prevention. Mobile short message service (SMS) is useful for improving health behaviours. We aim to...

Health education in conservatoires: what should it consist of? Findings from workshops with experts (Part II).

Although health education programmes have been implemented in higher music education (HME) and their evaluations published in peer-reviewed journals, guidelines as to what ought to be included in these programmes are still missing. This study aimed to document expert discussions on the content of an ideal health education curriculum for HME students in the UK, integrating critical thinking. Four interdisciplinary workshops were conducted, where 67 experts in relevant fields took part, and were asked to discuss four lists of topics and concepts created based on literature reviews (cognitive biases, logical fallacies, critical appraisal tools and health topics). Only the list on health topics is relevant here. Notes taken by the participants and ourselves were thematically analysed. Four themes were identified, two of which are reported in this paper: (i) The health education curriculum and (ii) A settings-based approach to health. Part I of this project (published elsewhere) is focussed on the critical thinking content of health education for conservatoire students. The present paper focusses on the ideal health education curriculum and its implications for the wider context of health promotion.

Reigniting tobacco control: returning Australia to the front of the pack.

Australia has long been heralded as a leader in tobacco control, but more than 10 years have passed since the country implemented the world's first tobacco plain packaging reforms. In late 2022, the Australian Federal Government announced it would be "reigniting the fight against tobacco addiction". The forthcoming reforms package will help modernise and re-energise Australian tobacco control. The Government has signalled that preliminary reforms will include updating graphic health warnings, standardising tobacco pack sizes and filters, and banning menthol and flavours. The recently endorsed National Tobacco Strategy 2023-2030 also opens the door to further supply-side reforms. Ten years ago, when Australia fought multiple legal challenges from the tobacco industry and established plain packaging as a best practice standard, e-cigarette or vaping products were a fringe issue with little presence in Australia. Today, vaping product use by young Australians has dramatically and rapidly increased. Easy access and marketing of cheap, flavoured, disposable, nicotine-containing vaping products are driving use. Recognising that the current approach to e-cigarette regulation is not achieving its aim of preventing children and adolescents from accessing vaping products, the Australian Therapeutic Goods Administration (TGA) launched a consultation on possible reforms in late 2022. Currently, vaping importers and retailers are exploiting an exemption for non-nicotine products in regulations, and nicotine-containing products are masquerading as non-nicotine products. The ideal public health solution would see the elimination of all vaping product sales, nicotine and non-nicotine alike, that fall outside of the TGA prescription-only access pathway. After 10 years of minimal action, it is invigorating to have three key initiatives in play to fully "reignite" tobacco control - the tobacco legislation renewal and update, the imminent national strategy release, and the TGA consultation on vaping products. Re-establishing Australia as a tobacco control leader is welcome news for public health.

Evaluation of Types of Traumatic Events and Comorbid Mental and Physical Diseases in Adults with Posttraumatic Stress Disorder: A Retrospective Study.

In this study, mental and physical illnesses, types of traumatic events, frequency of recurrence and sociodemographic characteristics of patients with Posttraumatic Stress Disorder (PTSD) were examined. The study included the files of 179 patients over the age of 18 who were admitted to the psychiatry outpatient clinic between 01.12.2010 and 31.01.2023 and diagnosed with PTSD. The data was obtained from the hospital automation system and national database. Of the 44 patients diagnosed with a single comorbid mental illness, 45.5% had mixed anxiety and depressive disorder and 36.4% had a depressive disorder. The rate of patients with comorbid mental illness in PTSD was 51.4%, and chronic physical illness was observed in 59.8%. In our study, sexual trauma and domestic violence had the highest recurrence rates among traumatic events (80%). Comorbid mental and physical illnesses are common in PTSD. The lack of adequate examination time and an appropriate therapeutic environment causes this diagnosis to be missed by clinicians and prevents patients from getting an ideal health service. In order to prevent recurrences of sexual traumas and domestic violence, the competent authorities must make practices of protecting socially disadvantaged groups more effective and act in accordance with international conventions.

The joint effect between fetal growth and health behaviors on the risk of cardiovascular diseases in young adulthood

To investigate the individual and the joint effect of impaired fetal growth and adult health behaviors on the risk of cardiovascular diseases (CVDs). A total of 15,618 individuals were included from three sub-cohorts of the Stockholm Public Health Cohort. Data on participants' birthweight and gestational age were retrieved from the Medical Birth Register. Data on the diagnoses of CVDs were extracted from the Swedish National Patient Register and the Cause of Death Register. Data on health behaviors were identified from self-reported questionnaires, and health behavioral profile was defined based on the recommendations of the American Health Association. The associations of fetal growth and health behaviors with the risk of CVDs were analyzed using Cox proportional hazard model. Individuals born small for gestational age (SGA) had a higher risk of CVDs than those born appropriate for gestational age (AGA), and the adjusted hazard ratio (HR) and 95% confidence interval (CI) was 1.88 (1.44, 2.47). Participants born SGA and having poor health behavioral profile in adulthood had a higher risk of CVDs than those born AGA and having ideal health behaviors with adjusted HR (95% CI) being 3.58 (1.95, 6.56). Impaired fetal growth was associated with an increased risk of CVDs in adulthood, and the risk was highest in individuals with both impaired fetal growth and poor health behaviors in adulthood.

Clarify the Concept of Healthcare Quality

Public confidence is shaken by declining health care quality indicators. Healthcare quality is still conceptually and practically undefined, despite improvements in hospital safety and quality of care. So, the purpose of this analysis is to define the term "healthcare quality." The framework was based on the concept analysis technique developed by Walker and Avant, which is frequently cited in nursing literature. We looked through five academic literature databases, public domain websites, general and medical dictionaries, and dictionaries. Healthcare and quality were search terms, as well as terms related to health care. From 2004 to 2016, peer-reviewed papers and official reports that were published in English were included. Gray literature, discussions of the need for high-quality healthcare, related concepts, and conference proceedings were all excluded. During analysis, similar characteristics were categorized into themes. After removing duplicates and articles that weren't eligible, 42 pertinent articles were examined. Four defining characteristics were found after thematic analysis: (1) effective, (2) safe, (3) culture of excellence, and (4) desired outcomes. Based on these characteristics, the definition of high-quality healthcare is the evaluation and delivery of safe, effective care that is reflected in an excellence-centered culture and leads to the achievement of ideal or desired health. This analysis offers a conceptualization of healthcare quality that clarifies its underlying assumptions and may enhance the delivery of high-quality care. Theoretical and practical implications are provided to support a more thorough and consistent understanding of the elements required to enhance healthcare delivery and maintain public confidence.

Risk and protective factors for dementia: epidemiological evidence and windows of opportunity

AbstractBackgroundMost people with dementia already live in low‐ to middle‐income countries (LMIC). However, most evidence regarding dementia prevention comes from high‐income countries that have different socioeconomic status (SES) and risk factors prevalence than LMIC. In this session, we will present results on risk and protective factors for dementia from the Longitudinal Study of Adult Health (ELSA‐Brasil), the Brazilian Longitudinal Study of Aging (ELSI‐Brazil), and the Brazilian Biobank for Aging Studies (BAS).MethodThe ELSA‐Brasil follows 15,105 public servants since 2008‐10. The ELSI‐Brazil is a nationally representative study with 9,412 adults aged 50 years and older, who were enrolled in 2015‐16. The BAS is a neuropathology study that started in 2004 and is the largest brain bank in Latin America with a collection of 1,441 brains. The focus of this presentation will be on the associations of education, SES, and cardiovascular factors with dementia using data from these three studies.ResultIn the BAS, 77% of the sample has less than 5 years of education and 56% unskilled occupations. Compared to the group without education, those with formal education had better cognitive performance (1‐4 years: 𝛽 = ‐0.99, 95%CI = –1.85; –0.14, p = 0.02; ≥5 years: = –1.42, 95% CI = –2.47; –0.38, p = 0.008). On the other hand, occupation complexity and demands were unrelated to cognition. Similarly, we showed that education and early‐life SES were the main contributors to cognitive performance in the ELSA‐Brasil, while later SES had a lower influence on cognitive scores. Cardiovascular factors are also important contributors to brain health. Ideal vascular health was related to better cognitive function in the ELSA‐Brasil. Participants with intermediate (β = 0.064, 95%CI = 0.033; 0.096) and optimal health (β = 0.108, 95%CI = 0.052; 0.164) had better cognitive z‐scores. Moreover, carotid artery atherosclerosis evaluated by morphometric measurements was related to cognitive impairment in BAS and with cognitive decline in the ELSA‐Brasil after 8 years of follow‐up (β = ‐0.028, 95%CI = ‐0.036; ‐0.020, p&lt;0.001). Finally, hypertension was related to worse cognition (β = ‐0.09; 95%CI = ‐0.15, ‐0.04; p = 0.001) in ELSI‐Brazil, mainly in non‐frail participants.ConclusionStudies from LMIC regarding dementia risk factors are essential to implement tailored public policies for dementia primary prevention.

Peruvian children toothbrushing during the COVID-19 pandemic.

Background: Toothbrushing is a convenient, inexpensive, widespread and culturally accepted method, resulting in an ideal public health outcome. This study aimed to determine the impact of the COVID-19 pandemic on toothbrushing in Peruvian children. Methods: This was a cross-sectional study conducted using a database of children aged 0 to 11 years, with a final sample of 39,124 participants, 15,974 in 2019 (62.03%) and 7088 in 2020 (55.54%). General toothbrushing, daily toothbrushing and minimum frequency of two times a day were dependent variables; the year was considered as the independent variable. In addition, other covariates such as geographical landscape, area of residence, place of residence, altitude, wealth index, health insurance cover, sex and age. Descriptive, bivariate and multivariate statistical analyses were applied. Results: General toothbrushing was 96.19% (n=51 013), daily toothbrushing was 87.47% (n=42 246) and minimum toothbrushing two times a day was 84.53% (n=33 957). In multivariate form, the year presented a negative association with daily toothbrushing (RPa: 0.97; CI95%: 0.96-0.98; p<0.001) and minimum toothbrushing two times a day (RPa: 0.97; CI95%: 0.95-0.98; p<0.001), adjusted for the previously associated co-variables. Conclusions: The year 2020 of the COVID-19 pandemic negatively impacted daily toothbrushing and minimum twice-daily toothbrushing of Peruvian children.

What Young People Want from Clinicians: Youth-Informed Clinical Practice in Mental Health Care

Evidence from around the world consistently indicates young people experience high rates of mental ill-health, but frequently have limited engagement with treatment. One powerful influence on young people’s engagement with mental health care is their relationships with treatment providers. A strong relationship with clinicians may be key to sustaining engagement, reducing dropout rates, and improving outcomes from treatment. However, research into young people’s perspectives on qualities they value in their clinicians has often been limited by traditional methodologies which explore young people’s attitudes to clinicians they have already worked with. This limits young people’s responses and, therefore, our understanding of who an effective ‘youth mental health clinician’ could be. In this study, 94 young people from New Zealand participated in innovative research workshops in which they described their ideal mental health clinician. Thematic analysis identified five themes which summarized these young peoples’ priorities for an ideal mental health clinician: Someone Like Me, Someone I Connect With, Someone Who Protects My Space, Someone Who Treats Me as an Equal, and Someone Who Works in the Right Way for Me. The presence and demonstration of these qualities may support both initial and sustained engagement with treatment, with the potential to improve outcomes for young people. Importantly, the connections between these themes highlight that young people are less likely to value ‘relatability’ as an isolated quality in their clinicians and most desire to work with clinicians who balance a warm and comfortable personal style with professional expertise and boundaries. These findings provide guidance for clinicians from a range of orientations who wish to work effectively with young people as to how they can adapt their approaches and seek feedback to improve their work with young people.

Desenlaces con el uso de rituximab en pacientes con nefritis lúpica refractaria en una cohorte colombiana

Introduction/ObjectiveTo describe the safety and response to treatment with rituximab (RTX), estimating its impact on the health state utility (HSU) of patients with refractory lupus nephritis (LN) treated in referral centres in several cities in Colombia. Materials and methodsA registry-based follow-up study. Patients aged between 16 and 75years, who were refractory to first-line management and had ISN/RPS class III-IV (±V) LN, were included. Our primary outcome was total or partial response to treatment; secondary outcomes were HSU measured with the EQ-5D-3L, and safety of treatment with RTX. The impact analysis of response to RTX on HSU were performed by mean difference estimated by robust regression. ResultsForty-six patients (44 women) were included, with a median age of 34years (IQR=13), the median SDI was1 (IQR=1) and the median activity measured by SLEDAI was 4.5 (IQR=5.9). Response to RTX was observed in 27 (58.7%) patients. Adjusted for SLEDAI and co-interventions, the patients who responded to RTX obtained a higher mean HSU by 0.162 (95%CI: 0.006-0.317). Which is equivalent to 1.9 (95%CI: 0.2-3.8) more months lived in ideal health conditions for each year with refractory LN. In 54.3% of the patients, RTX had adequate safety. ConclusionFrom the patient's perspective, the response to treatment with RTX in patients with refractory LN implies a significant impact on their quality of life.

Actualización en tabaquismo, abordaje desde la farmacia comunitaria y tratamientos farmacológicos de elección

Smoking is a chronic addictive disease with a pandemic character and, therefore, requires the development of prevention and treatment strategies. The relationship of smoking with obesity and genetics has been studied in recent years, as well as its approach in adolescents, the main objective of the tobacco industry. The implications of second-hand smoke (passive smoking), third-hand smoke (toxics in the smoker’s environment) and fourth-hand smoke (environmental pollution from tobacco) are well known, as is the fact that there is no safe level of smoking, as numerous studies show. The community pharmacist, due to his basic training and accessibility, is an ideal health professional to act in the prevention of smoking and its treatment, developing a professional smoking service in his pharmacy, for which specific training and a adequate physical structure of the pharmacy are required. The treatment of tobacco addiction must be, fundamentally, a combination of pharmacological treatment with cognitive-behavioral treatment. The drugs of first choice for its treatment are Nicotine Replacement Therapy (NRT) combined (patches together with oral form) and varenicline. The kinetics of nicotine in NRT and its agonist effect on alpha 4 beta 2 receptors and the agonist-antagonist effect of varenicline on them, explain its mechanism of action and effectiveness. Cytisine, an alkaloid from which varenicline is derived, and with a similar mechanism of action, is a drug recently marketed in Spain, although it has been used in eastern countries for many years. It has demonstrated its effectiveness and safety, and with the experience of its use in our setting, it is expected to be included in the first line of pharmacological treatment of smoking.

Cardiovascular health behavior and cardiorespiratory fitness in adolescents: a longitudinal study.

Cardiorespiratory fitness has been substantially associated with health status. However, longitudinal studies on cardiorespiratory fitness and ideal cardiovascular health behavior (ICHB) in adolescents are scarce. The aim of this study was to evaluate the longitudinal association between ICHB (at baseline) and cardiorespiratory fitness (at follow-up). This is a 2-year prospective analysis of 445 adolescents (232 girls) aged 12–18 years. The ICHB was developed by the American Heart Association as meeting the ideal health behaviors for a healthy diet, physical activity, smoking status, and body mass index. ANCOVAS adjusted by age, sex, pubertal stage, socioeconomic status, and cardiorespiratory fitness showed that the higher the number of ICHB metrics accumulated at baseline (from 1 to 4), the higher the cardiorespiratory fitness levels over a 2-year period (p = 0.038). In logistic regressions, after adjusting for potential confounders, the odds ratios for having high cardiorespiratory fitness at follow-up was 4.9 (95% CI, 1.2–20.1, p = 0.02) for those who accumulated all four metrics of ICHB, when compared to those with 1 or less metrics of ICHB. In addition, the higher the number of ICHB metrics accumulated, the higher the likelihood of having a high cardiorespiratory fitness level over a 2-year period (p for trend = 0.01).Conclusion: We identified a significant association between ICBH and cardiorespiratory fitness in adolescents. Therefore, improving ICBH in adolescence is likely to benefit the cardiorespiratory fitness. What is Known:• Smoking status, body mass index, physical activity, and diet are associated to cardiorespiratory fitness in adulthood.• Lifestyle behaviors such as physical activity, smoking, body weight, and healthy diet are individually linked with cardiorespiratory fitness and, however, have not been examined jointly, as combined health behaviors.What is New:• Accumulation of cardiovascular health behavior metrics was positively associated with cardiorespiratory fitness at a 2-year follow-up, in adolescents.• Meeting all the four metrics of ideal cardiovascular health behavior seems important for healthy cardiorespiratory fitness during adolescence.