The road to health is one better paved very early on in our lives, suggests a new study published in the Journal of the American College of Cardiology. They found that preschool-aged children who are taught about a healthy lifestyle may take those lessons to heart even years later.

The researchers recruited over 2,000 preschoolers, ages 3 to 5, from Madrid, Spain, across 24 different public schools, to take part in a grand experiment.

Half the children were taught their standard curriculum, while the other half was enrolled in the SI! (Salud Integral, or Integral Health in English) Program, an intervention created to "instill and develop healthy behaviors in relation to diet, physical activity, and understanding how the human body and heart work," for a period of up to three years, depending on how old they were when the program began. And it was taught by a school faculty member who volunteered for an extensive 30-hour training seminar.

The authors kept track of these children for three years, annually measuring their physical fitness as well as their scores on a test designed to track their knowledge, attitudes, and habits (KAH) surrounding health. Though perhaps relatively small, the authors did notice significant differences between the two groups.

“After three years of follow-up, the overall KAH score was 4.9 percent higher in children in the intervention group compared with the control group, the authors concluded. “A peak effect was observed at the second year (improvement 7.1 percent higher than in the control group).” Overall, the prevalence of obesity was lower in the SI group (1.1 percent vs 1.3 percent), and overweightness (7 percent vs 7.4 percent). Furthermore, it was those who had been in the SI program for the full three years that fared best, especially when it came to measures of physical activity and body fat content, though there didn’t appear to be a significant effect on the latter measure for those who had only taken part in SI for two years or less.

"There is a need for a complete change in the timing of when we deliver care," said senior author Dr. Valentin Fuster in a statement released by the American College of Cardiology. "Until now, the clinical community has focused on cardiovascular disease, which typically manifests in the later stages of life. Now, we need to focus our care in the opposite stage of life — we need to start promoting health at the earliest years, as early as 3 to 5 years old, in order to prevent cardiovascular disease."

As Fuster explains in an accompanying audio commentary, the study’s findings are also bolstered by a similar 2012 study conducted in 14 preschool faculties across Bogota, Colombia. In that study, more than 1,000 children were enrolled in a five-month educational program and their KAH scores were evaluated at the end of the program and a year afterward. “A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children,” they similarly concluded.

Though these early results are encouraging, Fuster and his colleagues acknowledge that the true measure of their program’s success will come later. “What about these children in 15 years from now? This is the real project,” he said. “We certainly are following all the studied children from Bogota and the studied children from Spain, and we’ll see if the hypothesis is correct — that they will maintain their healthy habits for years to come.”