'Baby' fat of the land

Poor diet, exercise habits feed cardiovascular disease in American kids

By Debra Melani, Rocky Mountain News

August 26, 2003

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For years, Jan Bingham has watched excess weight take a toll on her son. His peers can be brutal, sometimes breaking the boy's spirit with taunts and jeers. It's heart-wrenching for mother and son.

But last year, when her boy's weight reached its highest point yet, spurring Bingham to seek medical help, she learned that his heart faced a bigger threat. At age 14, Bingham's son has high cholesterol.

"I thought, 'Man, he's so young' and, 'This is serious,' " said Bingham, a nurse who knows elevated blood fat levels promote plaque buildup and could result in heart disease early in her son's life. "Cholesterol is not something you can hope will go away with age."

As the rate of childhood obesity in the nation rises, Bingham's boy is one of a growing number of kids showing early signs of heart disease, some as young as 5. Nearly 9 million American youth ages 6 to 19 are overweight, increasing their risk of high blood pressure and cholesterol.

Now, as parents find themselves once again immersed in the time-crunched school year, experts have some advice: Before giving in to convenience foods and sedentary habits, think of those little hearts.

"It's going to be bad," said Dr. Susan Spoerke, a Denver pediatrician, referring to the nation's future health status. "It's going to be expensive, and without some major societal changes in attitude, this next generation is not going to have the same longevity as their parent generation."

Cardiovascular disease is already the No. 1 killer in this country, claiming nearly 2,600 lives a day - more than from all cancers combined.

The National Institutes of Health recently recommended routine cholesterol screenings for obese children beginning at age 2. Blood pressure checks for all kids should begin at age 3.

Doctors turn first to diet and exercise when advising parents on lowering heart-disease risk in kids. All parents can help protect their children's hearts by heeding the advice, they say.

Exercise builds strong hearts

Bingham is placing her biggest bet on football. "I have real high expectations," Bingham said of the effect she hopes her son's newfound sport will have on his health. In just three weeks, he has noticed his pants fit better, she said.

"He's also going to be riding his bike to school, which is about two miles away," his mom said. "We're really trying to work in more physical activity."

Boosting exercise is crucial in today's electronics-focused generation, especially for kids with cholesterol problems, doctors say.

Studies have found that, even in people who remain overweight, physical activity can help improve total cholesterol levels, mostly by boosting "good" cholesterol, said Dr. Nancy Krebs, a pediatrician with Children's Hospital.

Parents need to zap the TV and Nintendo from daily routines, Krebs said. Kids under 2 should watch no television at all, she said.

Such sedentary activities should take less than two hours of an older kid's day, and if parents are directing their children toward televisions and computer games for their personal convenience, they need to consider the consequences, said Dr. Michelle Booth, a pediatrician with Littleton Adventist Hospital.

"Because the kids are quiet and doing something, we let them (TVs and electronic games) be our baby-sitters," she said.

Bingham's son, a high school student who is about 60 pounds overweight and asked that his name not be used, said he knows football is going to improve his health, but that's not his primary focus.

"My big goal is to look better," said the freshman. He doesn't hesitate when asked about the hardest part of being overweight: the blow to his self-esteem. He also wants to be faster, he said.

"Like when I do running drills in football and stuff, I'm like bigger than most of the kids, so it's harder for me to do, and I don't go as fast. It's getting easier and easier every time," he said.

Parents facing high cholesterol in their children should focus on things that inspire them, not the long-term health threat, Krebs said. "I don't think trying to scare kids is the right way to motivate them. And it's hard for kids to identify with this."

Bingham's high expectations for football are driven by her son's enthusiasm. He works hard because he's looking forward to the games, she said, adding that the coach and players are very supportive.

Bingham learned through a Children's Hospital program called Shapedown, which she took with her son, that little changes can go a long way. His cholesterol has begun to drop within just a few months. Shapedown emphasizes that lifestyle changes must be a family affair, especially when it comes to the second part of the equation: diet.

Diet can make or break a heart

"If you look around our house, you won't find anything that's fattening," Bingham's son said. "We have low-fat cheese, low-fat crackers."

Watching what foods are brought into the home is critical to changing the diet, said Laura Brieser-Smith, a registered dietitian who teaches the American Heart Association's Slim for Life classes.

Focusing on fat is key to heart health, and in recent years, another type has joined saturated fat on the limited list. Transfat, which is formed when oils are hydrogenated, or exposed to hydrogen to make them solid, has such a bad reputation that the Food and Drug Administration this year required that it be listed on all food labels by 2006.

"There is some research that shows it may be even worse for us than saturated fat," Brieser-Smith said, referring to transfat's effect on cholesterol levels.

Transfat lurks in pre-packaged foods, which busy parents often choose, and most manufacturers probably will not heed labeling requirements until the last minute, she said. Until then, consumers can do some math.

Product labels generally list total, saturated and unsaturated fat levels. If the individual-fat percentages don't add up to the total-fat content, then the difference is probably transfat, Brieser-Smith said.

Parents also can check ingredients, she said. "If hydrogenated fat is the second item on the list, it's probably not a very good choice."

No official recommendation has been made on how much transfat should be allowed in a diet. But Brieser-Smith suggests that consumers, particularly those concerned about cholesterol, limit saturated fats and transfats combined to less than 10 percent of their total daily calories.

For math-phobic parents, Booth offers an easier way to assure a heart-healthy diet: Stock up on foods on the outside aisles at the grocery store - yogurt, cheese, milk, whole-grain bread, lean meat and fresh fruit and vegetables. Spend less time in the inside aisles, where packaged products prevail.

Low-fat dairy products generally are the best choice, except for children under 2. Their fat levels should never be restricted without a doctor's supervision because of developing brains and nervous systems, experts say.

"But that doesn't mean you should be feeding them french fries cooked in lard every day," Spoerke said.

Parents build kids' eating habits, beginning in the toddler stage. Many parents fail because of a common practice of bribing or rewarding kids with food, Booth said.

"A lot of parents carry around crackers and cookies, and they keep feeding their kids constantly throughout the day."

The practice can lead to emotional eating, prompting weight issues later in life. Bingham admits making that mistake when her son was younger, and now he eats when he's upset, she said. His most dramatic weight gain happened last year, after the family moved to Arvada.

Although too much snacking can lead to weight gain, eating five or six small meals or healthy snacks throughout the day might help keep kids' blood-fat levels stable, some research suggests.

"Plus, they won't feel famished and overeat," Krebs said.

Diets heavy in processed foods also can trigger high blood pressure, especially in those with a genetic risk, such as Booth's patient, Kurt Nevergold. The Highlands Ranch resident recently had to be placed on medication to lower high blood pressure - at age 17.

At 6 feet 4 inches and 160 pounds, Nevergold is not overweight and has always been active in sports, but his diet often included things like chips and canned ravioli, and his father has high blood pressure. Even without obesity, American habits are hastening heart-disease risks in people prone to them, Spoerke said.

"The doctor was surprised, for my age, that I had it," Nevergold said, adding that his diet changes were tough at first but easier now. "I have a cardiologist who really stresses that I need to eat right, because the medication itself won't do the job."

His mother, Penny Nevergold, says her advice to parents is to be sure their children are screened for high blood pressure, which Booth said isn't done routinely.

Nevergold said she didn't connect her son's periodic headaches and nausea with a serious health problem until the recent diagnosis. "Ask the doctor questions," she said. "And listen to your kids when they tell you they don't feel well."

melanid~RockyMountainNews.com or 303-892-2301