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DOI: 10.5935/abc.20190099 Cardiovascular disease (CVD) remains the leading cause of death globally, however, 80% of premature heart disease, stroke and diabetes can be prevented.1 Atherosclerotic cardiovascular disease (ASCVD) can begin in youth, exacerbated by exposure to factors associated with increased cardiovascular risk.2 There are interventions to prevent risk factors onset (primordial prevention), to identify and treat risk factors in childhood and adolescence (primary prevention) and to address the risk of additional events in those who already have ASCVD or other CVDs (secondary prevention) at a young age.3 Adolescence presents a prime opportunity to assess risk factors for CVD and to intervene to prevent its development. The manuscript by Scherr et al.4 highlights the importance of a school-based program including physical activity (PA) and healthy eating patterns in adolescence for the prevention of cardiovascular risk factors.