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For Kids, Ideal Heart Health Explained in New Statement

August 18, 2016

From American Heart Association News

The road to cardiovascular disease begins in childhood, and it’s a road many American children are on, based on a new report that indicates very few kids meet all the criteria for ideal heart health.

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Many are overweight or obese. Others don’t get enough exercise or have picked up smoking. But the biggest disqualifying factor was diet: Less than 1 percent of children ages 2 to 19 meet the criteria for an ideal diet, according to federal data from 2007 to 2008.

That troubling reality led the American Heart Association to issue Thursday’s scientific statement that provides the first detailed look at ideal heart health for kids: no tobacco use, a healthy weight, at least 60 minutes of physical activity a day, a healthy diet score and normal blood pressure, total cholesterol and blood sugar.

Pediatric cardiologist Thomas R. Kimball, M.D., was “shocked” when he heard so few U.S. children meet all seven criteria for ideal heart health.

“As pediatric cardiologists and parents and primary care providers, we have to think about the fact that disease is beginning in childhood,” said Kimball, medical director of the Heart Institute at Cincinnati Children’s Hospital Medical Center in Ohio. Kimball was not involved in the statement.

And there’s no one thing to blame, said Julia Steinberger, M.D., who chaired the writing group of the new statement. “Kids sit around a big part of the day,” she said. “Much of this is screen time, whether it’s TV, computers, phones, etc.” Kimball calls it “physical activity for the thumbs.”

Among the data compiled in the statement, about 91 percent of children have poor diets, with most calories coming from simple carbohydrates such as sugary desserts and drinks. Among 6- to 11-year-olds, only half of boys and about one-third of girls got at least one hour of exercise each day. Even fewer teens got enough exercise.

The seven-item checklist brings all the pieces together for doctors and families, said Steinberger, director of Pediatric Cardiology at the University of Minnesota in Minneapolis. But she suggests starting by moving children from poor to intermediate health, while striving for ideal health in all.

Kimball advises his overweight patients to start by adding one serving of fruit a day and avoiding full-sugar soda and energy drinks.

Although healthy eating and exercise starts at home, it shouldn’t end there, Steinberger said. Schools should offer physical education classes and other programs that keep kids active, she said.

To improve kids’ long-term health, the statement calls for better nationwide tracking of cardiovascular health among children and research to find out to what degree intervening during childhood helps prevent health problems later in life. Steinberger supports the development of mobile apps for kids to help doctors collect health data and provide real-time feedback to their young patients.

The new breakdown for ideal heart health in children is meant to supplement a similar set of AHA health measures for adults issued in 2010.

“Since 2010, as should happen, researchers and policymakers and clinicians have dug in on those definitions, and pushed and prodded at them,” said Donald Lloyd-Jones, M.D., chair of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago, who was involved in both the 2010 recommendations and the current measures for children. “It was time to make recommendations about how to refine and better represent cardiovascular health in kids.”

The time has also come, Lloyd-Jones said, for people to realize that decisions made early in life can have a big impact later on. “Hopefully this will be a wake-up call that cardiovascular health is a life course phenomenon.”