Tuesday, November 24, 2015

Eight ways to keep kids heart healthy

Frances Zappalla, D.O., a pediatric cardiologist at the Nemours Cardiac Center at the Alfred I. duPont Hospital for Children, offers tips on how to reduce heart disease risk factors for our kids.

Eight ways to keep kids heart healthy


Today’s guest blogger is Frances Zappalla, D.O., a pediatric cardiologist at the Nemours Cardiac Center at the Alfred I. duPont Hospital for Children in Wilmington, De.

We often think of heart disease as an adult condition, but heart disease starts in childhood. Teens, preteens and even little kids have heart-disease risk factors that once only happened to adults.  Autopsies on soldiers from the Korean and Vietnam Wars showed evidence of heart disease in young men in their early 20s. If they had certain risk factors, which included smoking, high blood pressure, high cholesterol, diabetes, there was more plaque in their arteries.  

We know that treating high blood pressure and high cholesterol early in childhood can protect at-risk children from future heart disease.  The first line of treatment is a healthy diet, daily exercise, and maintaining a healthy weight.

Here are my top tips for keeping kids’ hearts healthy:

  1.  All children should have blood pressure done at every doctor visit or at least once a year starting at the age of two years. Healthy blood pressure levels for teens depends on their age, gender and height. For example, healthy blood pressure for a  13-year-old girl of average height is around 109/64 and for a boy, around 110/63.
  2. All children should get a baseline lipid panel or get their cholesterol level by the age of 10 years. The ideal LDL cholesterol level for kids and teens is below 110. They should get tested sooner if they are at high risk for heart disease. High risk factors include:
    a. If there is a family history (especially a parent, aunt, or uncle) with high blood pressure, high cholesterol, or heart disease (stroke, stent, by-pass surgery, or heart attacks before the age of 50 in men or before the age of 60 in women).
    b. Child has diabetes (type 1 or type 2)
    c. Child has a BMI (body mass index) over the 85th percentile
    d. Child has kidney disease
    e. Child has/had cancer
  3. Drinks of choice for all children should be water and milk (one percent or skim after the age of two years).  If you start young infants/toddlers on water instead of apple juice, they will actually enjoy water when they get older instead of developing a sweet tooth.
  4. Juices - even orange and apple juice - should be limited to four ounces per day for toddlers and young children, and six ounces per day for older children and teens. It’s always better to EAT your fruit than drink your fruit.
  5. Soda, sweetened ice tea, lemonade, etc. should all be served sparingly – once or twice a week – not a daily basis.
  6. Children and teens should not consume energy drinks.
  7.  Exercise – at least 60 minutes a day. Activities can be as easy as running, swimming, kicking a soccer ball, or jump rope. When the weather is bad outside, kids can do jumping jacks, sit-ups, push-ups, or workout videos.     
  8. Limit screen time to NO MORE than 2 hours a day. This includes TV, handheld devices, and computer outside of homework. Regarding the Wii and Xbox – only if the child is actually up and moving all extremities (not just thumbs), does it count as exercise.
More coverage
Doctor asks: Are avid exercisers hurting their hearts?
10 lifestyle changes for a healthy heart
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About this blog
Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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