By Peter Laird, MD
America aggressively addressed our high rates of cardiovascular disease beginning in earnest with the Framingham Study that derived many of the known cardiac risk factors. Aggressive control of these risk factors has lowered the prevailing rates of heart disease through dietary moderation, smoke cessation, cholesterol lowering, exercise and reducing diabetes complications. However, there are several areas of concern for the teenagers of today who are already beginning to show the signs of early cardiovascular disease.
Childhood obesity and adult onset diabetes during the teen years are now commonplace. Children today lack the daily exercise from play as was common in the past nor are they eating diets from fresh vegetables and produce. Sedentary lifestyles and processed foods are to blame for many of these findings. The NEJM published a recent report on the obesity epidemic among the young and predict that these characteristics can be reversed:
Overweight or obese children who were obese as adults had increased risks of type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks of these outcomes among overweight or obese children who became nonobese by adulthood were similar to those among persons who were never obese. (Funded by the Academy of Finland and others.)
Despite the fact that reversal of adiposity early in life can also reverse the cardiovascular risk, there is little evidence that the interventions designed to combat childhood obesity have had any positive effects:
Today's Teens Will Die Younger of Heart Disease, Study Finds
"Cardiovascular disease is a lifelong process," Lloyd-Jones said. "The plaques that kill us in our 40s and 50s start to form in adolescence and young adulthood. These risk factors really matter."
"After four decades of declining deaths from heart disease, we are starting to lose the battle again," Lloyd-Jones added.
The American Heart Association (AHA) defines ideal cardiovascular health as having optimum levels of seven well-established cardiovascular risk factors, noted lead study author Christina Shay, who did the research while she was a postdoctoral fellow in preventive medicine at Northwestern's Feinberg School. Shay now is an assistant professor of epidemiology at the University of Oklahoma Health Sciences Center.
"What was most alarming about the findings of this study is that zero children or adolescents surveyed met the criteria for ideal cardiovascular health," Shay said. "These data indicate ideal cardiovascular health is being lost as early as, if not earlier than the teenage years."
Dealing with heart disease in the 30's and 40's is fortunately rather rare today, but will become the new norm in decades to come. Sadly, the ability to counteract this growing epidemic is readily at hand by promoting healthy eating habits, exercise and weight loss. In many ways, the older generations are now more physically fit than their children and grandchildren who spend many of their waking hours with electronic toys and devices. Lack of cardiovascular health will not only cost America precious lives, but will also tax the health care system with the younger generations chronic health conditions at the very time that the majority of the baby boomers face their own health issues.
The financial crises that is generated by this medical calamity will leave few untouched. It is time for parents to take account of physicial activity as one of our most important national treasures for our children. It is time for individuals to reverse this legacy and simply do what is right. The solutions are at hand, if only we have the will.
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