One of Cutty's favorite times of the year is here. February is a romantic time of Valentine's, International Friendship month, Black History month and the American Heart Association's HEART MONTH.
Heart Month is a time to learn more about your heart, it is the most important muscle in your body. Unfortunately we cannot see our heart, but we are lucky that the "Cookin' with Cutty" television show teaches us that the best way to take care of our heart is through proper nutrition, physical activities and to avoid all tobacco products.
The American Heart Association recently released a scientific statement, AHA Guidelines for Primary Prevention of Atherosclerotic Cardiovascular Disease Beginning in Childhood, that can help parents and health professionals identify and manage risk factors children can have that will increase their risk of having heart disease as an adult.
Although there is not a lot of new information in these guidelines, it puts all previous recommendations in one place, including health promotion goals and recommendations to meet these goals, guidelines to identify kids at risk for cardiovascular disease and how to reduce their risk.
Health Promotion Goals
The guideline's health promotion goals for diet, smoking and physical activity are likely to be the most useful for parents. These goals include having a healthy diet, appropriate body weight, not smoking, and being physically active each day.
Among the specific recommendations to meet these goals include:
- eating a variety of fruits, vegetables, whole grains, dairy products, fish, legumes, poultry and lean meat
- limiting high fat foods once a child is two years old, including limiting foods high in saturated fats to less than 10% of calories each day, cholesterol to less than 300mg a day, and trans-fatty acids.
- limiting salt intake to less than 6g a day
- limiting the intake of sugar
- strongly advises kids to not begin smoking, stop smoking if they have already started, and avoiding second hand smoke
- being physically active each day, with at least 60 minutes of moderate to vigorous fun physical activities each day, and limiting sedentary time watching TV, playing video games, talking on the phone, etc. to less than 2 hours a day
Identifying High Risk Children
One of the best ways to identify kids at risk for cardiovascular disease is to look for risk factors in other family members, especially parents, grandparents, aunts and uncles. These risk factors include being overweight, having high blood pressure, high cholesterol, diabetes, or cardiovascular disease before age 55 for men or 65 for women. Having family members that smoke is another risk factor.
Children that have a family history of high cholesterol or early heart disease should have testing of fasting lipids after age 2. Those kids with other risk factors should have a lipid and lipoprotein analysis.
One of the other health promotion goals of this guideline is for children to have a 'desirable lipid profile', which would include having blood tests below the following values:
- Total cholesterol > 170 mg/dl (borderline), >200 mg/dl (elevated)
- LDL > 110 mg/dl (borderline), >130 mg/dl (elevated)
- HDL < 35 mg/dl
- Triglycerides > 150 mg/dl (elevated)
If the average results of three lipid profiles are above these cutoff values, interventions should be made to lower them.
Treatment of High Risk Children
The initial treatments for high risk children include dietary and lifestyle changes with the help of a trained dietician. Children with an LDL above 190 mg/dl or 160 mg/dl and other risk factors might need medications to help lower their cholesterol.
Other interventions include maintaining a normal blood pressure, a healthy weight, and helping both parents and children stop smoking.
The Role of your Pediatrician
The other big part of these guidelines are the emphasis for Pediatricians to target and learn to identify the risk factors that lead to cardiovascular disease.
This includes:
- assessing a child's diet at each visit
- questioning tobacco use by parents at each visit
- questioning tobacco use by children at every visit starting at age 10
- assessing physical activity at each visit
- asking about family history risk factors
- assessing height, weight and BMI at each visit
- measuring blood pressure at each visit after age 3
- performing lipid and lipoprotein analysis when necessary
If your child is overweight or has other risk factors for cardiovascular disease, be sure to ask your Pediatrician to review these things with you and your child.
Cutty and Lisa have been active volunteers for the American Heart Association and know that a healthy heart is a happy heart. To learn more check out the website for the American Heart Association at: www.americanheart.org. HAPPY HEART MONTH!
