Healthful Habits Should Start In Childhood
New Guidelines Outline Ways To Encourage Healthiest Behaviors
When should people start taking the steps necessary to ward off heart disease?
Try childhood.
So says the American Heart Association (AHA), which has just released a comprehensive summary of heart disease prevention guidelines for pediatricians to use with their patients.
"Many studies have shown an association between atherosclerosis and high cholesterol, and high blood pressure and obesity, beginning in children as young as 5 years old," says Dr. Rae-Ellen Kavey, lead author of the guidelines.
Guidelines Underscore Need
But while guidelines have existed for preventive care for adults at risk for heart disease, there were no similar, overall guidelines for children, adds Dr. Kavey, who is chair of cardiology at Children's Memorial Hospital, Northwestern University in Chicago.
"There are pre-existing guidelines for children about cholesterol, blood pressure, and weight, and now we have put all the information together into one place for pediatricians - it is aimed at primary-care providers," Dr. Kavey says.
Preventing heart disease cannot begin too early, she says. The guidelines reflect the latest information that suggests that early intervention in adopting a healthy lifestyle can be enormously effective in delaying the onset of heart disease.
For otherwise healthy children and teens, the guidelines suggest regularly assessing a child's heart health by checking weight, blood pressure, and lipid levels, if necessary.
The guidelines also ask physicians to recommend healthy food choices, such as eating more fruits and vegetables, to restrict intake of saturated fats to less than 10 percent of a child's daily caloric consumption, and to keep sugar intake low.
Prevention Is Key
The guidelines also emphasize the importance of daily physical activity and limiting sedentary activity. For instance, no more than two hours of television or sitting at a computer each day. The dangers of smoking are also discussed.
The second part of the guidelines identifies those children or teens already at high risk for cardiovascular disease. These include children with a Body Mass Index (BMI) above the 85th percentile for their age, height, and weight; a blood pressure reading in the 90th percentile for age, sex, and height; and a cholesterol reading of 170 or higher.
Other factors that put children at higher risk is a family history of heart disease, particularly if male relatives had heart disease before age 55 and female relatives before age 65.
Finally, the guidelines recommend treatments for those children already at risk for heart disease, including dietary changes such as lowering salt intake, losing weight, or prescribing medications if needed.
"Parents have major questions about food, when to start solids, what are good snacks, which kinds of formula, so the doctors are giving advice about diet," she says. "With these guidelines, they have an opportunity to give specific information about low-fat diets at the get-go."
"It's much easier to establish healthy eating and physical activity patterns than to change unhealthy patterns," she adds.
Always consult your child's physician for more information.
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July 2003
Healthful Habits Start With Children
Guidelines Underscore Need
Prevention Is Key
Dealing with Anger, for Health's Sake
Online Resources
Dealing with Anger, for Health's Sake
New findings show that hostile children may end up aggravating their health, researchers report.
The study by University of Pittsburgh and University of Helsinki researchers found children and adolescents who respond with anger to life events have a greater risk of developing metabolic syndrome, a precursor to heart disease.
Indications of metabolic syndrome include high blood pressure, weight gain, insulin resistance, and elevated cholesterol levels.
The researchers examined hostility levels and cardiovascular risk in 134 American children aged 8 to 10 and 15 to 17. They found children who had high scores on hostility tests were more likely to exhibit metabolic syndrome three years later than children who did not have high hostility scores.
Obesity and insulin resistance were the two highest risk factors found in hostile children in the follow-up, the study says.
Unhealthy lifestyles such as physical inactivity, poor diet, and smoking and alcohol use can be a way that hostile children and adolescents cope, behavior that can contribute to development of metabolic syndrome, the authors suggest in the journal Health Psychology.
The authors say the study findings could be used to evaluate youngsters' behavioral risk to developing these potential health problems.
"There is a need for interventions designed to reduce hostility in young people to prevent the precursors to cardiovascular disease, like obesity or type 2 diabetes, which has become a huge health problem in children in the US," says Dr. Karen A. Matthews.
Always consult your child's physician for more information.
Online Resources
(The Medical University of South Carolina is not responsible for the content of Internet sites.)
American Academy of Child & Adolescent Psychiatry
American Academy of Pediatrics
Centers for Disease Control and Prevention (CDC)
National Cancer Institute (NCI) Eat 5 to 9 A Day
National Institute of Child Health and Human Development (NICHD)
National Institute of Mental Health (NIMH)
National Institutes of Health (NIH)
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