Encouraging a healthy weight for a healthy heart

A healthy weight is the key to a healthy heart, and yet an estimated 1 out of 3 children is either overweight or obese in the U.S. During a special symposium Oct. 27 at the American Academy of Pediatrics National Conference and Exhibition in Orlando, pediatricians discussed obesity and cardiovascular risk factors, public health policy, and how physicians can partner with families to improve children's weight.

"Overweight children are more likely to become overweight adults," said Stephen Daniels, MD, FAAP, who will speak about cardiovascular health during the symposium, "Heavy Challenges for Healthy Hearts."

Obesity in childhood and adulthood is associated with many health risks, including Type 2 diabetes, obstructive sleep apnea, high blood pressure, lipid abnormalities and high cholesterol. Left untreated, these conditions can lead to heart disease and other chronic health conditions, Dr. Daniels said. The AAP has endorsed guidelines from the National Heart, Lung and Blood Institute which recommend all children undergo cholesterol screening once between the ages of 9 and 11, and again between the ages of 17 and 21.

The guidelines are based on research showing that early atherosclerosis exists in young patients with elevated cholesterol. In addition, lipid disorders are common in children and linked to childhood obesity. The testing is helping pediatricians to monitor and intervene to minimize the effects of weight and an unhealthy lifestyle on overall health.

"If you have a child with obesity, you should know what his or her blood pressure and cholesterol levels are," said Dr. Daniels, a cardiologist and chair of the AAP Committee on Nutrition. "If you ask why there are so many kids who are overweight and obese, it has to do with behaviors and how our environment influences these behaviors. We have more attractive, high-calorie drinks and foods, and lots of things that keep kids from being active. How do we change the environment or how do we improve behaviors in spite of our environment?"

Stephen Pont, MD, FAAP, chair of the AAP Section on Obesity, urged pediatricians to partner with overweight and obese children to improve their eating, lifestyle and overall health habits.

"We must create a safe, guilt-free environment for our patients, if we are going to be most effective in empowering our patients to make healthy changes," Dr. Pont said. "Placing more guilt and blame on our patients and their families only makes them feel worse, it doesn't help their motivation. There are big forces at work that make being healthy difficult for many of our patients, and so if we are to best empower our patients we must take an empathetic, patient-centered approach, which is most effective in dealing with weight and other sensitive issues."