What parents can do to protect children from heart disease

vgajic/E+ via Getty Images
(vgajic/E+ via Getty Images)

The consequences of heart disease often only become apparent in adulthood. Why should busy parents think about this with their kids?

“Because it’s probably a lot easier to prevent cardiac risk factors from developing than trying to get rid of them once they’ve developed,” said Dr. Sarah de Ferranti, a pediatric cardiologist at Boston Children’s Hospital. “Prevention is really the key.”

Most people don’t think about risk factors during childhood, said de Ferranti, who is also an associate professor of pediatrics at Harvard Medical School. “But I think it’s actually important that we all start with it.”

According to a recent study published in the American Heart Association’s journal Circulation, only 2.2% of 2- to 19-year-olds had “optimal” scores on a rating system that included diet, physical activity, and body mass index. And while almost 57% of 2- to 5-year-olds scored high, only 14% of 11- to 19-year-olds did.

Protecting a child’s heart health can begin with a focus on a mother’s health during or even before pregnancy, said Dr. Amanda Marma Perak, senior author of the Circulation study and pediatric cardiologist at Ann and Robert H. Lurie Children’s Hospital of Chicago. But if you have a child and you haven’t thought about their heart health, “now is the time to start,” she said.

Perak and de Ferranti offered this advice.

It starts with the food

Healthy eating habits are critical to heart health. They can also be difficult to figure out.

“I think first you have to understand what healthy eating is?” said Perak, who is also an assistant professor of pediatrics and preventive medicine at Northwestern University. She recently contributed to an update to the AHA heart health rating system, now known as Life’s Essential 8. It weighs eight factors that contribute to heart health in children and adults: diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids (cholesterol and other fats), blood sugar, and blood pressure.

To help families understand what constitutes a healthy diet, Perak uses the Department of Agriculture’s MyPlate methodology. It proposes a diet in which half the diet consists of vegetables and fruits, one quarter lean protein and one quarter whole grains with a side of dairy products.

Be patient

For picky eaters, a light touch can pay off, de Ferranti said. She’s found that serving fruits and vegetables first, when kids are hungriest, “as opposed to a big fight” to eat a certain amount is effective.

It’s a long game that may require exposing children to healthy foods many times, de Ferranti said. “Try, try, try. Try again. Be persistent.”

Keep them moving

Exercise can start young, Perak said. “Even with a baby, you can think about making it active when lying on its stomach and not confining it to the carrier and high chair for long periods of time.”

Whether it’s through a formal class or just playing in a park, physical activity should be built into a family’s schedule, de Ferranti said. But the activity should be age appropriate and match the child’s interests.

Perak has patients who enjoy dancing or just doing simple exercises at home. Organized sports can be “super helpful,” Perak said. But if they are put under too much stress, they can also cause stress and decrease sleep time.

Sleep on it

A sleepy child may be less physically active or craving unhealthy foods in search of an energy boost. For example, poor sleep has been linked to childhood obesity.

According to the AHA, the daily amount of sleep a child needs to promote healing, improve brain function, and reduce risk of chronic disease varies by age: 12 to 16 hours (including naps) at ages 4 to 12 months ; 11 to 14 hours for 1 to 2 years; 10 to 13 hours for 3 to 5 year olds; 9 to 12 hours for 6 to 12 year olds; and 8 to 10 hours for 13 to 18 year olds.

Establish a bedtime routine that leaves time for calming activities. “There is definitely research showing that consistent bedtime is associated with adequate sleep in children,” Perak said.

Children can also have high blood pressure

It’s important to know your child’s blood pressure readings, but measuring them in children is difficult, de Ferranti said. Hypertension figures vary by age, height, and gender.

“Your pediatrician should be your go-to person for this,” she said.

Understand the importance of mental health

Mental health is important to heart health, de Ferranti said. Stressful events in childhood have been linked to unhealthy behavior and cardiovascular problems later in life.

In the last two years of the pandemic, de Ferranti has seen the effects of stress in real time. “I have seen many young people with high blood pressure or other symptomatic complaints such as chest pain, palpitations or dizziness in my pediatric cardiology practice.”

Parents should monitor their children for these and other signs of stress and seek help if needed, according to a 2021 report by the Surgeon General on Adolescent Mental Health, which offers advice for young people, parents, professionals and educators.

Be ready for change

As with anything parenting-related, parents need to remain vigilant, de Ferranti said.

A decade ago, for example, the health hazards of vaping were unknown. Now, scientific evidence suggests that e-cigarette use can be harmful to cardiovascular health.

“We need to be agile,” she said, “because the world is always changing.”

Don’t be too hard on yourself

“Think of it as a long game,” stressed de Ferranti. “There’s always another day to try to eat healthier or get more sleep or get out and get physically active.”

She said, “Overall, it’s about being pretty good in general — not perfect.”

If you have any questions or comments about this American Heart Association News story, please email [email protected].

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