Northwestern University researchers found that while most of the nearly 9,000 children they studied had healthy blood pressure levels, 40 percent did not have good cholesterol levels, almost none ate a healthy diet regularly and 30 percent were overweight or obese.

These findings may mean more children will face a future that will include heart disease if nothing changes, said Dr. Sarah Samaan, a cardiologist at Legacy Heart Center in Plano, Texas.

"Childhood sets the stage for life. If a child starts off with a healthy diet and active lifestyle, he or she is far less likely to develop chronic, expensive diseases that can take years off of a productive life," said Samaan, who was not involved with the study.

"Obese kids and adults are far more likely to develop high blood pressure, diabetes, arthritis and heart disease, so we should not accept this as the 'new normal,'" she added.

The healthy diet score was one of four items used to assess the heart health of American children, aged 2 to 11, from national surveys conducted between 2003 and 2010. The other measures included blood pressure, total cholesterol and body mass index (BMI), a ratio of a person's height to weight used to measure body fat.

According to the American Heart Association, a healthy diet meant at least four of the following five components: at least 4.5 cups of fruits and vegetables daily; at least two 3.5-ounce servings of fish a week; at least three 1-ounce servings of fiber-rich whole grains daily; less than 1,500 milligrams of daily sodium; and no more than 450 calories from sugar-sweetened beverages per week.

Fewer than 1 percent of the children over age 5 ate a healthy diet, and less than 20 percent met two or three of the components. Children were least likely to get the whole grain requirement, the study authors said.

More than 90 percent of children got too much daily sodium and too little fish or fruits and vegetables, according to the report. More than half drank too many sugary beverages.

About 90 percent of the children had a healthy blood pressure, but only 60 percent of children had good total cholesterol levels, the investigators found.

Healthy BMIs were more common: 67 percent of the 2- to 5-year-olds and 77 percent of the 6- to 11-year-olds had a healthy BMI. But 15 percent of all the children were overweight, and about the same percentage were obese.

The findings were published March 17 in the journal Circulation: Cardiovascular Quality and Outcomes.

"Parents need to set better examples with their own diet and exercise habits to demonstrate healthy behaviors to their children," said Dr. Danelle Fisher, a pediatrician at Providence Saint John's Health Center in Santa Monica, Calif.

"Discussions about food, cooking at home, limiting sugary beverages, and including children in food shopping and meal preparation are some things parents can do to introduce these concepts to children from a young age," Fisher suggested.

Dr. Carlo Reyes, a pediatrician at Los Robles Hospital in Thousand Oaks, Calif., pointed out that the biggest concern about these findings is that children's eating habits may be setting in by age 12.

"This is a difficult problem, probably having its roots in both societal and cultural constructs," Reyes said. "Educating parents on healthy options is a start, but not nearly enough to turn this trend. Helping parents will likely involve the effort of a community of leaders composed of pediatricians, family practitioners and educators."

Schools can also help support children's heart health, said study co-author Dr. Donald Lloyd-Jones, a professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine in Chicago.

"From providing healthy meals as the default to assuring students have physical education every day, they can play a key role in the health of children and are an important link to families as well," Lloyd-Jones said. "The takeaway for parents, and for our society as a whole, is that we must make every effort to preserve heart health by establishing healthy habits in our kids right from the start."

These habits should include regular physical activity and a healthy diet high in fruits, vegetables and lean proteins, and with limited processed foods and starches, he and Samaan said.

"Many adults grew up in households where healthy, fresh food was not part of the everyday routine, so it may take a little effort and education to learn how to help a child thrive," Samaan said. "The effort is worth it. When a child is not given a healthy start in life, a healthy adulthood is far more difficult to attain."