About one in five U.S. high school students has a high cardiovascular health score, according to a CDC report in the Oct. 15 issue of the Morbidity and Mortality Weekly Report. The Centers for Disease Control and Prevention scored 20.7% of students as high, 61.3% as moderate and 18.0% as low.
How the CDC Scored Teen Heart Health
The report, published in the MMWR Supplement and led by CDC scientist Izraelle McKinnon, uses answers from the 2025 national Youth Risk Behavior Survey. The authors scored five measures from the American Heart Association’s Life’s Essential 8 framework: diet, physical activity, nicotine exposure, sleep and body mass index. Each measure runs from 0 to 100, and the overall score is the average of the five.
A score of 80 to 100 counts as high, 50 to 79 as moderate and 0 to 49 as low. The average overall score was 65.3. Body mass index scored best at 85.4, and nicotine exposure followed at 80.5. Physical activity averaged 62.0 and sleep 59.1. Diet scored lowest at 39.3.
Adding the low and moderate groups shows that 79.3% of students fell below the high category. That is a calculation from the CDC’s figures. The authors reached a similar conclusion, writing that about four in five students had a low or moderate overall score.
Why Diet Scores So Low
The diet score comes from fruit, vegetable and sugary drink intake. According to the report, a student earns full points for fruit by eating it at least twice a day, for vegetables at least three times a day and for sugar-sweetened drinks by drinking none. The point totals for the three items are averaged and multiplied by 10.
A companion report in the same supplement shows how few students reach those marks. In the dietary and physical activity report, 28.1% of students ate fruit twice a day and 16.2% ate vegetables three times a day. Soda was avoided by 30.4% and sports drinks by 50.8%. Those low rates fit the 39.3 diet average.
The same companion report found some gains since 2023. Daily fruit eating rose from 32.9% to 38.9%, and daily vegetable eating rose from 57.5% to 62.5%. Daily gym class attendance went the other way, falling from 27.4% to 19.8%, a drop of 7.6 percentage points.
Scores Fall between Grade 9 and Grade 12
Heart health scores drop with each year of high school. The average overall score was 68.3 in ninth grade, 65.9 in 10th, 63.7 in 11th and 62.7 in 12th. The share of students with a high score fell from 27.6% in ninth grade to 15.3% in 12th grade.
That is a decline of 12.3 percentage points, or about 45% of the ninth-grade share, by the same calculation method. The CDC authors wrote that “less favorable CVH is evident as early as grade 10.” The abbreviation stands for cardiovascular health. Nicotine exposure shows part of the pattern. The nicotine score averaged 88.8 in ninth grade and 72.6 in 12th grade, where a lower score means more use. The authors also reported lower physical activity and sleep scores among older students and female students.
By sex, female students averaged 64.2 and male students 66.2. A high score went to 18.1% of female students and 23.0% of male students. Female students averaged 56.5 on physical activity against 66.9 for male students. Their sleep averages were 56.4 and 61.5.
Gaps by Race and Ethnicity
The report shows wide differences among racial and ethnic groups. Average overall scores were 70.2 for Asian students, 69.8 for Middle Eastern or North African students, 66.8 for White students, 65.8 for multiracial students, 62.5 for Hispanic students and 60.2 for Black students. The average for American Indian or Alaska Native students was 62.3.
The share with a high score was 37.2% for Middle Eastern or North African students, 24.3% for White students, 21.0% for multiracial students, 14.9% for Hispanic students and 11.2% for Black students. The text does not give high-score shares for Asian or American Indian or Alaska Native students. Estimates for Native Hawaiian or Pacific Islander students were suppressed because too few students answered.
The high-score share for Middle Eastern or North African students is 3.3 times the share for Black students, and the White share is 2.2 times the Black share, calculations from the CDC figures. The authors wrote that Black and Hispanic students had lower overall scores than Asian, Middle Eastern or North African, White and multiracial students.
They said the comparatively high Middle Eastern or North African result warrants further examination and called for cautious reading because of its wide confidence interval. Black students averaged 53.4 on physical activity and 51.8 on sleep, the lowest sleep average in the group table the authors provided. For the sleep score, the authors used the recommended 8 to 10 hours per night for adolescents. Eight or more hours earns 100, seven hours earns 70 and six hours earns 40.
What Limits the Findings
The scores rest on a smaller group than the full survey. Of 10,710 students who took the 2025 survey, 5,192 answered all five measures. That is 48.5%, a calculation from the two figures. The authors said missing answers came mostly from the diet and nicotine questions and that White students were overrepresented in the analysis group.
All data are self-reported, including height and weight, which the authors said may lead to an underestimate of body mass index. The report could not score blood pressure, cholesterol, blood sugar or secondhand smoke. The overall score also came out lower than a national health exam survey’s score for ages 16 to 19, 65.3 against 73.2, and the authors said measurement differences may explain it.
The survey itself had its lowest response rate on record. The overview report put the 2025 overall response rate at 30.6%, with 108 of 230 selected schools taking part and 65.2% of sampled students responding. The CDC called it the lowest in the survey’s history.
What the Authors Recommend
The authors wrote that school and community policies on nutrition, physical activity, sleep and tobacco prevention could help. They named policies that support adequate sleep, including later school start times. The dietary report also pointed to the CDC’s Healthy Schools Program and Comprehensive School Physical Activity Programs.
For parents, the numbers point to three things the survey measured: how many hours teenagers sleep, how often they eat fruit and vegetables and how many days they get 60 minutes of hard activity. Only 25.0% of students met the activity mark on all seven days in the week before the survey.
