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Today’s Woman Goes Red for heart each year to raise awareness of how heart disease impacts women in our community. In many cases, heart disease doesn’t just pop up when a woman is in her 40s, 50s, and beyond. The habits we develop as children are the foundations that can either lead to heart disease or prevent heart disease when we are adults. Going red is really something that needs to begin in childhood.
The incidence of preventable heart disease has increased over the past decade or so due in large part to an increase in obesity. Dr. Lucinda Wright, director of fetal cardiology at Norton Children’s Hospital, says, “The increase in childhood obesity is of significant concern because of the known association between obesity and the development of elevated blood pressure, elevated cholesterol, and type II diabetes mellitus. These are all known to be associated with early cardiovascular disease.”
Parents are often confused about how best to feed their children, particularly when busy lifestyles make it increasingly difficult to sit everyone in the family down to a home-cooked, nutritious meal. There is often a need for convenience foods for on-the-go lives. Many parents (myself included) wonder how to work in nutritious meals when they can and healthy-ish convenience foods when they need them.
Laura Walsh, a local registered dietitian and licensed nutritionist, says the Kentucky Department for Public Health has a program called 5-2-1-0: Healthy Numbers for Kentucky Families. This program informs parents about ways to improve children’s health by remembering to eat five servings of fruits and vegetables a day, getting two or fewer hours of screen time a day, having one hour of physical activity per day, and drinking no sugary drinks.
Dr. Wright says it is critical that parents lead by example as much as possible. “Children learn what they see at home, and parents should model the healthy lifestyle they want their kids to live,” she says. Taking a family walk or bike ride or making dinner together are ways to begin this modeling process. Cutting out sugary drinks from the grocery budget for all family members is another idea. “Parents should avoid waiting too long to teach healthy habits and thus avoid making healthy habits feel like a punishment for a child when a health problem develops, and change is needed,” she says.
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Of course, sometimes it feels like an impossible task to find the time to go for a walk or fix dinner. Fixing a snack of salsa with pretzels instead of potato chips may be the best you can do some days. Working in exercise some evenings may be as simple as challenging your kids to see who can run up and down the steps five times the fastest, which can be done as a way to get their wiggles out before bed.
Parents may wonder how to know whether their children are in the danger zone for developing childhood heart disease. Dr. Wright says most pediatricians feel comfortable talking to parents about heart disease risk during yearly wellness visits. While body mass index (BMI) is the standard measure of obesity in both adults and children, Dr. Wright says, “We look at percentiles in children.”
Children naturally go through growth stages when they may be a little more skinny or a little more pudgy, and these tend to be normal fluctuations in weight. The percentile range for normal BMI for children is anywhere between 5-85 percent, which is pretty wide and accounts for natural growth progression. Dr. Wright says when a child reaches 85-95 percent BMI, he or she is considered overweight. A BMI in the 95th percentile is considered obese.
If a child is in the overweight or obese percentile or has elevated blood pressure at doctor visits, his or her pediatrician may recommend additional blood testing to check lipid or glucose levels. Depending on the results of testing, a family may be referred to a pediatric cardiologist or endocrinologist, which is often the trigger that gets families to take the problem seriously. “When families are referred to a specialist, it kind of sinks in that this is a real problem,” Dr. Wright says.
Sometimes families whose children are between 7-13 years old with a BMI in the 95th percentile or greater are referred to the YMCA’s Healthy Weight and Your Child pilot program. Ime Okpokho, associate director of community integrated health, says the program duration is 25 weeks and includes both an educational and a physical activity component. A parent or guardian must attend every session with the child. The cost is determined by annual household income and family size and includes not only the program and materials, but also a family YMCA membership during those 25 weeks.
While most doctors would be hesitant to make medication usage their first order of business for children, if a family has a strong history of heart disease it might be prudent to be aggressive in treating the condition. A child with a long and strong family history of hypertension might legitimately benefit from lifestyle changes along with medication.
Fortunately, children have time on their sides when it comes to heart disease. “When we change habits at a young age, we can change the risk outcome,” Dr. Wright says.
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