Current research shows that the primary risk factors for cardiovascular disease (e.g. high cholesterol, high blood pressure, diabetes, lack of physical activity, overweight and obesity, and smoking) are occurring in alarmingly increasing rates among children and adolescents.  These findings, combined with evidence of the presence of fatty streaks (the precursors to atherosclerotic lesions) in the arteries of children as young as three, have led researchers to believe that the time to begin preventing cardiovascular disease is in childhood.

The American Heart Association (AHA) has published a set of guidelines for the prevention of cardiovascular disease in children and adolescents.  Behavior patterns adopted in childhood such as dietary habits, level of physical activity and tobacco use have a large impact on the number of cardiovascular risk factors children carry with them into adulthood.

The AHA guidelines are broken down into two categories.  The first set lists general recommendations directed at promoting cardiovascular health in all children, adolescents and young adults.  The second category is designed to help doctors and parents manage those children who have been identified as being at the highest risk of developing cardiovascular disease.  The following is a listing of the strategies that you can use to promote cardiovascular health in your children.

Guidelines for Cardiovascular Health in All Children and Adolescents:

• Encourage a healthful diet (emphasizing consumption of fresh fruits and vegetables, whole grains, non-fat & low-fat dairy products, fish, beans, poultry and lean meat).
• Encourage your child to maintain an appropriate body weight.  Your pediatrician or family physician can help you determine if your child is of a healthy weight by utilizing clinical growth charts or a BMI-for-Age chart.  (BMI – body mass index)
• Talk to your child about the importance of maintaining a desirable total cholesterol level through healthy eating.
• Talk to your child about the importance of maintaining a desirable blood pressure through healthy eating and daily exercise.
• After age two, limit consumption of high fat foods, cholesterol and trans-fatty acids.
• Limit salt and sugar intake.
• Talk to your child about not smoking and set a good example yourself.
• Actively work to limit your child’s exposure to environmental (“second-hand”) tobacco smoke.
• If your child already smokes, help him/her quit.
• Encourage your child to be physically active every day.
• Limit the amount of time your child participates in sedentary activities (e.g. watching television, on the computer or telephone and playing video games).

Guidelines for Cardiovascular Risk Reduction in At Risk Children and Adolescents

If your child’s doctor has determined that your child may be at risk for developing cardiovascular disease later in life, it is important that you work as a team to help your child reduce their risks. 

• Monitor your child’s blood cholesterol.  Targets: LDL-cholesterol (“bad” cholesterol) of less than 130 –160 mg/dl; in children who have diabetes this should be less than 100 mg/dl.
• Monitor your child’s other lipid levels.  Targets: fasting triglycerides of less than 150 mg/dl; HDL-cholesterol (“good” cholesterol) of more than 35 mg/dl.
• Manage you child’s blood pressure.  A child’s blood pressure will change as they age.
• Manage your child’s weight by helping them achieve a BMI less than 95^th percentile for his or her age and gender.
• If your child is diabetic, work with them to manage the disease.  This means teaching your child the importance of closely monitoring blood glucose levels.
• If your child doesn’t smoke, talk to them about the importance of not starting.  If your child does smoke, work with them to kick the habit.

Central Baptist Hospital’s Community Education and Fitness Express Fitness and Wellness Center have programs and services available to help you and your family develop and maintain a heart healthy lifestyle.  For more information call 859-260-6457.

Sources: American Heart Association, http://www.americanheart.org; American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in children.  AHA Position Statement.  Circulation, 107:1562-1566, 2003.