Raising heart-smart kids takes a coordinated family effort

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By Jane Meredith Adams

(WebMD) -- When one of the first words to come out of my daughter's mouth was "chips," I began to wonder what kind of eating habits we were teaching her. I already knew, of course, that American kids were growing increasingly tubby and that many weren't getting enough exercise. Then I read that the Surgeon General had declared childhood obesity an epidemic and that researchers had found clogged arteries in boys as young as 15. And I started getting a little worried.

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I began to imagine my 2-year-old twins (one girl and one boy) as teenagers, lolling around on the couch as they watched television and scarfed down tortilla chips. And I realized that if we wanted our children to be "heart-healthy," now was the time for us to model the kinds of habits and activities that would point them in the right direction.

Dr. Henry McGill agrees. "The early stages of heart disease begin in childhood," McGill said. And he's helped prove it. A pathologist at the Southwest Foundation for Biomedical Research in San Antonio, Texas, McGill was the lead author on a rather distressing new study published in the July 25, 2000 issue of the journal Circulation.

While reviewing autopsies of 760 young men and women, McGill and his colleagues found arterial blockage in 2 percent of the 15- to 19-year-old boys, according to their report. Although this percentage was tiny, the researchers were surprised to see any blockages at all in people of that age group.

Even worse, about 20 percent of the men aged 20 to 34 had similar blockages. Teenage girls and women in the study fared much better, backing up to some degree the notion that women are at lower risk of heart disease until menopause.

Gender differences aside, McGill's big message is that parents need to help their children lower their risk of future heart attacks and strokes. And he emphasized what I already knew: that eating a low-fat diet and getting regular exercise are the best ways to do this -- for children as well as adults.

We decided it was time to get our family on the right track and to try to be a heart-healthy family for a week. As for diet, this meant taking a look at what we were eating and choosing lower-fat alternatives. On the exercise front, it meant a major change in our lifestyle because we didn't have a consistent exercise program, either individually or as a family.

My kids being only 2 years old, I hadn't considered that it might be time for them to cut down on fat, but apparently it was. Before the age of 2, kids do need to get more of their calories -- about 40 percent -- from fat, says Jeff Hampl, Ph.D., R.D., a spokesman for the American Dietetic Association and assistant professor of nutrition at Arizona State University. That quantity of fat is essential for the rapid growth and brain development that occurs during this early phase of life, he says.

But once they hit 2 -- and for the rest of their lives -- their fat-bingeing days should be behind them. At that point, Hampl says, "there should be a gradual reduction in fat until it's (only) 30 percent of the diet."

The first step was to figure out healthy meals that a 2-year-old would actually eat. I logged onto the American Heart Association (AHA) web site [--link: www.americanheart.org--] and clicked on the "Heart-healthy recipe" section. At the recommendation of a friend, I also picked up a copy of "Moosewood Restaurant Low-Fat Favorites" edited by Pam Krauss. I was going to have to give up our frozen-food dinners and start cooking.

In looking at healthier recipes, I noticed easy substitutions that lowered both fat and calories. When adding toppings to a store-bought pizza crust, for example, I switched to mozzarella cheese made from skim milk instead of whole. The kids ate it up. Simple!

The kids and I were both unwilling to give up our morning fried eggs, but I figured we could cut some fat and calories by cooking them in a nonstick pan with a low-calorie cooking spray rather than using oil or butter. Taste did not suffer. Fat-free cream cheese was also a marvelous discovery: zero fat, 30 calories and 5 grams of protein for 2 tablespoons. I started using it on toast instead of butter. Unfortunately, the kids spat it out in displeasure.

We all enjoy a tuna sandwich for lunch two or three times a week. Although worth a shot, I found fat-free mayonnaise unsatisfying. As a compromise, I squeezed lemon juice on the tuna and used smaller amounts of real mayonnaise: not ideal as far as the fat content, but better than nothing.

I found a hot-and-sour soup recipe on the AHA web site, and it turned out to be delicious; my spouse had two bowls for dinner, but it was too spicy for the kids. And the "Moosewood Restaurant Low-Fat Favorites" cookbook was a treasure. I whipped up the white bean and roasted pepper dip and served it to the kids with carrot sticks. "More!" said my son.

My spouse was looking forward to frozen fish sticks for dinner but was chagrined to learn that they were actually fried and had 11 grams of fat per serving. A better idea: Dip fresh fish filets in egg whites, roll them in cornflake crumbs and bake.

With food choices mastered, we faced the next step: Exercise.

To help our family get going, I joined the AHA "Choose to move" plan -- a program that encourages you to make exercise a part of everyday life. I had been swimming twice a week at the pool for a long time, but I wanted to add an activity that would get my spouse moving and would include the kids.

We found a park where we could push the strollers while walking briskly and did that three days in a row for 45 minutes -- an activity that swiftly showed us how out of shape we were. The problem was being consistent. The next week we walked only twice; the following week we walked once and took the kids to the pool once.

The number one reason people stop exercising, according to the AHA, is that they start with a program that's too ambitious. So we scaled back. Instead of feeling defeated when we didn't exercise every day, we were content to exercise as a family twice a week. My spouse pointed out that gardening counted as exercise, and that was something the kids loved to do, too.

We're on our way now, and I really think we're going to keep it up. The kids don't notice the difference between life before and after we made these simple changes. They'll grow up knowing this is how we live. And most important, they'll grow up with healthy bodies -- and hearts.

© 2000 Healtheon/WebMD. All rights reserved.

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