Children live in the present, so telling them what they can do now to prevent heart disease in their adulthood is a futile mission, right? Maybe not.

Childhood obesity is a public health epidemic in the United States with one in five children considered obese, according to the CDC. Childhood obesity is associated with developing a range of chronic conditions in adulthood including type 2 diabetes, certain cancers and cardiovascular diseases and events like heart attacks.

Kids learned about heart-healthy behaviors from a heart-shaped character named Cardio and a Muppet-based character, along with flash cards and an interactive board game.

Overweight and childhood obesity are more common among Latin, Black and poorer communities, the result of structural inequalities that keep healthy foods out of lower income neighborhoods, resulting in food deserts.

Because lower income parents are more likely to work longer hours, they also more often turn to fast food to feed their families. A host of other factors plays into childhood obesity, too; but it is certain that a child’s weight is more a function of their environment than of their personal will.

Because poor cardiovascular health in childhood — often the result of a poor diet and a lack of exercise — can lead to heart problems in adulthood, scientists and educators are looking for ways to teach kids early the basics of healthy eating.

Researchers weren’t sure whether a school-based intervention would make a difference for such young children, much less make a difference in their adult cardiovascular health. But that’s exactly what a new study by researchers at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) in Barcelona, Spain indicates.

Their program, called the the “SI!” or Salud Integral Program, was tailored with different styles and levels of content for each age group.

“The SI! Program breaks down cardiovascular health into four components,” lead author, Gloria Santos-Beneit of Icahn School of Medicine at Mount Sinai and CNIC, explained. “Through the first two components, children are learning how a well-balanced diet and physically active life are directly connected to a healthy heart. Next, they learn about emotion management, which seeks to instill behavior mechanisms against substance abuse — mainly smoking — and dietary decisions later in life. Finally, the children are taught about how the human body works and how it is affected by behavior and lifestyle.”

The youngest students, aged four to five years, were introduced to a heart-shaped character named Cardio and a Muppet-based character to teach them about heart-healthy behaviors. Other materials included an interactive board game, flash cards and an accompanying teacher's manual to help guide instruction and integration of the intervention into the curriculum.

Children taking part in 75 percent or more of the program were found to have significant changes in attitudes, beliefs and behaviors around cardiovascular exercise, especially compared to those who only were exposed to 50 percent or less of the program.

Children from the U.S., Spain and Colombia were all included in the study, with study materials chosen to reflect foods common to each place and the cultural norms around food and mealtimes.

There are many challenges to putting a program like this into place, as the researchers point out. Changing a child’s diet is often a matter of modifying the way a whole family system eats, and this is more challenging than targeting the health behavior of, say, a single adult. How effective an intervention like “SI!” is also depends in large part upon how well it is taught, a factor which can vary widely from place to place.

But there's plenty any parent or caregiver concerned about preventing or addressing overweight or obesity in their children can do. Consider integrating more cardiovascular exercise like running into your playtime. Talk to your children about the benefits of exercise and eating a healthy diet. Teach you kids about what good nutrition is and why it and physical activity are important for heart health now and in the future. It may not just fall on deaf ears, after all.

The study is published in the Journal of the American College of Cardiology.