Prevention Research for Cardiovascular Disease
Obesity and Heart Disease
About 30 years ago, the weight of children and adolescents began to increase. We were aware of this at The Hope Heart Institute and started our research on how to treat the adult obesity epidemic and expanded our research into childhood obesity. Today we not only have obese children, but many are super obese. In the period of 2015 – 2016, of children 2 to 5 years old, 15% were obese and 2% severely obese: of Children 6 – 11 years old, 18% were obese and 5% severely obese: of Adolescents 12 – 19 years old, 21% were obese and 8% severely obese. Long term, childhood obesity is associated with increased cardiovascular disease, hip and knee osteoarthritis and multiple cancers.
Any extra pounds usually add up to health problems. In adults, overweight and obesity are linked to increased body inflammation which results in heart disease, high cholesterol, high blood pressure, diabetes, many cancers, osteoarthritis, depression, sleep problems, and many other conditions.
For children, being overweight starts “body inflammation” earlier in life. This can result in the same disorders found in adults: High cholesterol, high blood pressure and Type 2 Diabetes. A generation ago, Type 2 Diabetes in children was unheard of. Now physicians are treating this disease in kids as young as four years old. Overweight children are also more likely to become overweight or obese adults about 80% of the time.
A person’s weight is the result of many things working together – genes, microbiomes, activity level, behavior, and environment to name just a few.
Changes in our environment that are making it harder to engage in healthy behavior have a lot to do with our overall increase in weight over the past few decades. For example:• We’re an in-the-car and sit-behind-a-desk society. For many of us – parents and children alike – daily life doesn’t involve a lot of physical activity. So we need fewer calories than the previous generation. If we want to be active, we have to make an effort.• Food is everywhere, along with messages telling us to eat, drink and feel good. We can get something to eat in places where it was never available before – like the gas station. Going out to eat or buying carryout is easy. The foods we consume away from home are high in calories, saturated fat and salt. Today over 50% of meals are eaten away from home and another 15% - 20% are meals that are prepared in restaurants and carried home to the family.• Food portions at restaurants, and at home, are bigger than they used to be. Restaurants don’t want us to go away hungry so they serve two to three times the amount our bodies need.
In the 1980s we started researching how to successfully treat the overweight/obese epidemic and continue today with programs like 20/20 LifeStyles, which has added the review of patient’s genetics to further personalize their program. For the last several years, we have been studying gut microbiomes to determine their relationship to weight gain, diseases and disorders like Type 2 Diabetes.
We also created a children’s program called Committed to Kids which had great long term weight maintenance results of more than 75% after three years. The program saw the most success when parents were engaged in their child’s weight loss program since parents play a key role in their children’s choices and behaviors. We have found that some parents, who do not engage, are in denial regarding their child’s unhealthy lifestyle behaviors, such as poor diet and lack of exercise. Our psychology team is searching for the right message to overcome this resistance. We hope that the addition of genetic screening and the ability to review the child’s genetic profile will aid in parental participation.
Aiming for a Healthy Weight
Eat Well (ENERGY IN) Move More (ENERGY OUT)
- Drink water before a meal.
- Share dessert, or choose fruit instead.
- Serve food portions no larger than your fist.
- Eat off smaller plates.
- Don't eat late at night.
- Skip buffets.
- Grill, steam, or bake instead of frying.
- Share an entree with a family member or friend.
- Eat before grocery shopping.
- Choose a checkout line without a candy display.
- Make a grocery list before you shop.
- Serve water or low-fat milk at meals instead of soda or sugary drinks.
- Flavor foods with herbs, spices, and low-fat seasonings.
- Keep to a regular eating schedule. Eat together as a family most days of the week.
- Eat before you get too hungry.
- Ensure your family eats breakfast everyday.
- Stop eating when you are full.
- Provide plenty of fruits and vegetables for snacks.
- Provide sliced apples or bananas for your family to top their favorite cereal.
- Serve several whole grain foods daily.
- If entrees are large, choose an appetizer or side dish.
- Ask for salad dressing "on the side."
- Don't serve seconds.
- Try a green salad instead of fries.
- Walk your children to school.
- Do sit-ups in front of the TV. Challenge your children to see who can do the most sit-ups in one minute.
- Walk instead of drive whenever you can.
- Take a family walk after dinner.
- Join an exercise group and enroll your children in community sports teams or lessons.
- Replace a Sunday drive with a Sunday walk.
- Do yard work. Get your children to help rake, weed, or plant.
- Get off the bus a stop early and walk.
- Work around the house. Ask your children for help doing active chores.
- Take the dog to the park.
- Go for a half-hour walk instead of watching TV.
- Wash the car by hand.
- Pace the sidelines at kids' athletic games.
- Choose an activity that fits into your daily life. Being physically active with your family is a great way to spend time together.
- Park farther from the store and walk.
- Use an exercise video if the weather is bad.
- Perform gardening or home repair activities.
- Avoid labor-saving devices, such as a remote control or electric mixers.
- Play with your kids 30 minutes a day.
- Dance to music. Play your favorite dance music for your children and have them play their favorites for you.
- Make a Saturday morning walk a family habit.
- Walk briskly in the mall.
- Choose activities you enjoy—you'll be more likely to stick with them. Ask children what activities they want to do.
Body Mass Index (BMI)
For children and teens, overweight is defined differently than it is for adults. Because children are still growing, and boys and girls develop at different rates, BMIs for children 2 to 20 years old are determined by comparing their weight and height against growth charts that take their age and gender into account.
A child's "BMI-for-age" shows how his or her BMI compares with other boys or girls of the same age. A child or teen who is between the 85th and 95th percentile on the growth chart is considered at risk of overweight. A child or teen who is at the 95th percentile or above is considered overweight.
Ask your family doctor, pediatrician, or other health care provider about your child's BMI-for-age. Click here for more information about BMI-for-age and growth charts for children.
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