Heart disease and children are two terms often not closely associated in everyday life. Heart disease is an adult disease after all, right?
Wrong. Just like adult onset diabetes has become increasingly common in children, so too has heart disease. Although we typically feel that young age is a time of good health, a 'free from disease' era if you please, children as young as thirteen years old have died from heart disease.
As always, prevention is key and starts from day one. Fortunately the American Academy of Paediatrics (AAP) have identified some simple steps you can take with your children to reduce both their and your risk of heart disease today. The following are the list of their strong recommendations (that is, those where the supporting evidence is excellent):
1. Breastfeed exclusively until 6 months
Then continue breastfeeding until at least 12 months of age while gradually adding solids. There is no mistake about it – breast milk is the ideal food for your baby. Other than having the ideal mix of proteins, fat and carbohydrate, breast milk is full of other healthful nutrients and protective antibodies. On average breastfed babies have fewer infections in early life (including chest and ear infections), are less likely to develop eczema and more importantly for reducing their heart disease risk : are less likely to be obese and develop type 2 diabetes later on in life.
2. Use reduced-fat unflavoured milk
Many families will transition to cow's milk while weening off the breast. At 12 months old, the AAP recommend transitioning to either reduced-fat or fat-free milk (unflavoured of course). This is because most of the fat in full-cream cow's milk is saturated fat – the kind that's unkind to your arteries. To ensure your child is able to get all the benefits of cow's milk namely calcium and vitamin D, without the excess saturated fat, make the switch. If you miss the creaminess of full-fat cow's milk why not try a plant-based milk like almond milk or soy milk instead?
3. Encourage water and minimise sugary drinks
Encouraging water exclusively not only limits the excess calories from sugar-sweetened beverages, but also can help prevent obesity – another plus! Childhood habits are often carried into adulthood, so start young. If you can make water one of your child's solid habits, you're setting them up for good health.
4. Limit fat intake, particularly saturated fat
Fat is the most concentrated source of energy, providing 9 calories of energy per gram of fat. Subsequently the fat you eat is the fat you wear. Limit the fat you eat from animal foods (e.g. milk, butter, cheese, meat), fried foods and desserts (e.g. cakes, biscuits) to limit your heart disease risk. Instead focus on eating whole food plant sources of fat e.g. nuts, seeds, and avocados. Not only are these fats healthier (did you know you can get all your omega-3 fatty acids in only 2 teaspoons of flaxseeds?), they're also bundled with many other healthful phytonutrients known to reduce heart disease risk, cancer and diabetes.
5. Limit cholesterol to less than 300mg a day
This recommendation means nothing unless you can visualise what 300mg of cholesterol looks like. [3,4]
One large egg contains up to 200mg of cholesterol.
One cup of full-cream milk = 35mg cholesterol
3 slices of cheese: 100mg cholesterol
1 drumstick with skin: 115mg cholesterol
2 slices of roast lamb: 70mg cholesterol
You can see how easily these numbers add up, particularly with an adolescent appetite! Contrary to popular belief, you can never eat too little cholesterol. Your body is set up to make all the cholesterol it needs in your liver, so whatever you eat on top of that is in excess.
6. Encourage high fibre foods
Fibre is found exclusively in plant foods like fruits, vegetables, grains and legumes. Not only do they make you feel full faster (thereby reducing the amount of calories you eat), they also help reduce your blood cholesterol and keep your digestive system in tip-top shape.
7. Stop smoking before and during pregnancy
Both smoking and passive smoking are unequivocally associated with heart disease and stroke. I will add that if your children see you smoking, they're more likely to pick up the habit themselves. Need some encouragement to quit smoking? If you quit today, your increased risk of heart disease will halve within a year, and after 15 years you'll have a risk that's similar to a non-smoker. The earlier you quit the better – so take the plunge today. If you need some help, check this site out.
8. Eat lots of plant-based foods
This sort of goes hand-in-hand with #6, so I'll simply add: Try fruit smoothies to boost your fruit intake, and hiding vegetables in your meals so your kids don't realise how healthily they're really eating. If you're really keen, why not try going vegetarian for one day a week? Check out this site for some recipe ideas. If you want to take it one step further, eat vegan for one or two meals a week. Check out this site for some great ideas of vegan recipe books to buy to get you started.
9. Limit watching television and playing video games
We've all heard of them – kids who die from fatal blood clots developed while playing computer/video games. Watching TV and playing computer and video games are some of the most common sedentary activities. Ditch the excessive sedentary time indoors means for some quality time outside working up a sweat, soaking in your vitamin D and developing social skills by interacting with other children/parents.
10. Encourage daily moderate physical activity
Physical activity helps to reduce the risk of heart disease. It can reduce blood pressure, improve your good HDL cholesterol and reduce your triglycerides. If you're a smoker, exercise can help you quit when it's combined with cognitive behavioural programs. Last, but not least, regular exercising helps prevent osteoporosis, cancer, obesity, depression and type-2 diabetes.[6, 7] It may also reduce your risk of colds – who doesn't want that?
In addition to these measures, the AAP recommend doctors screen for heart disease in children (as young as 11 years of age). What does this involve? Checking your child's blood pressure, cholesterol, weight (usually with BMI measurements) and general health –remember, knowing your own numbers is just as important.
I know the above list of steps can be daunting if you try to tackle them all at once. Try to take small steps in the right direction each week, picking one or two goals to focus on for the week. Any change is better than no change, and if all you do is increase fruit in you and your child's diet to one apple a day – you really are making a difference.
 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report, American Academy of Paediatrics
 NHS Choices, Breastfeeding: Health Benefits for your Baby
 USDA Nutrient Database
 Calorie King
 QuitNow, Reasons to Quit
 HealthBites 5 reasons to exercise
 Mayo Clinic, Depression and Anxiety: Exercise eases symptoms