When teenagers feel good about themselves and their lives, it may also do their hearts good in the long run, a new study suggests.
Researchers found that teenagers who generally felt happy, optimistic and loved went on to show better cardiovascular health in their 20s and 30s, versus kids who lacked that level of mental well-being.
Overall, they were more likely to maintain a healthy weight, as well as normal blood pressure, blood sugar and cholesterol levels. And having such positive feelings appeared particularly important for Black teenagers' future health.
The idea that kids' well-being can affect their health well into adulthood is not new. Studies have shown that childhood obesity, for example, is tied to increased risks of various health conditions — including type 2 diabetes and heart disease — later in life.
And the links go beyond physical factors: Adults who went through childhood hardships like abuse and neglect are at heightened risk of heart disease and other ills, as well.
Experts said the new study asked a different question: Are there positive psychological "assets" that might help protect kids' physical health in the long run?
"One thing I'm struck by is, we really don't have a handle on the 'good things' that kids need to support their cardiometabolic health," said lead researcher Farah Qureshi, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, in Baltimore.
To dig into the question, her team examined data from a national health study that enrolled nearly 3,500 U.S. high school students in the 1990s and followed them for more than two decades.
At the outset, the students answered questions that gauged five psychological assets: happiness; hopefulness about the future; high self-esteem; feeling socially accepted; feeling loved and wanted.
The bad news: More than half of kids — 55% — had none or only one of those positive feelings.
But when they had four or five of those assets, they were about 69% more likely to maintain good cardiovascular health into their 30s, compared with their peers. That was with a range of other factors — like family income, parents' education and kids' body weight — taken into account.
What's more, those positive feelings seemed especially critical for Black teens. When they did not have them, they were highly unlikely to be in good cardiovascular health 20 years later: Only 6% were.
As for why, Qureshi said the way kids feel about themselves and their lives can affect their health behaviors.
It's generally tough to exercise and eat healthfully on a regular basis, she noted. But if you feel good about yourself and the future, that's a good motivator.
Adrienne Kovacs, a volunteer expert with the American Heart Association, agreed.
"When we're optimistic, for example, we expect that we're going to be able to handle a situation, so we behave accordingly," said Kovacs, a clinical and health psychologist with Equilibria Psychological Health in Toronto.
That could be the difference between believing, or not believing, that you can change an unhealthy habit, Kovacs said.
Beyond that, both experts said, psychological factors like chronic stress can have direct physiological effects on the body.
Kovacs said the new study is a reminder that "we need to broaden our conceptualization of cardiovascular risk factors." And that has to begin early in life, she noted.
In line with past research, this study found that an unfortunately small number of participants maintained good cardiovascular health into their late 30s: just 12% overall.
But having psychological assets in adolescence strengthened those odds. Meanwhile, a lack of those positive feelings seemed particularly detrimental to Black teens: In the study group with one or no psychological assets, only 6% of Black kids were in good cardiovascular health in adulthood, versus 12% of their white counterparts.
That implies that supporting teenagers' mental well-being is a matter of health equity, too, both experts said.
Qureshi said that for Black teenagers, who face the chronic stress of structural racism, having a strong sense of self-esteem, belonging and feeling loved may be particularly critical.
Parents can, of course, support those feelings, Qureshi and Kovacs said. But so can any adult in a child's life, as well as schools, community programs and society at large. As an example, Kovacs pointed to the health care system, which could do a better job of "creating an environment where everyone feels they belong."
For families, Qureshi said, supporting kids' mental well-being "can be as simple as sitting down together at dinner and asking them how they're doing — those things we can take for granted."
The study was published online Jan. 11 in the Journal of the American Heart Association.
The American Heart Association has advice on maintaining lifelong good health.
SOURCES: Farah Qureshi, ScD, MHS, assistant professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Adrienne Kovacs, PhD, volunteer expert, American Heart Association, Dallas, and clinical and health psychologist, Equilibria Psychological Health, Toronto; Journal of the American Heart Association, Jan. 11, 2023, online