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Are the Health Behaviors of Preschoolers Really a Factor in Future Disease Risk?

February is American Heart Month and a good time to set some family-based health goals. Over 15% of children between the ages of 2 to 9 years already have 2 or more risk factors for cardiovascular disease, with the prevalence increasing with age and higher BMIs. According to Marie Roth, registered dietitian for Blythedale Children’s Hospital and Kohl’s Eat Well, Be Well Nutrition Outreach Program, "The associations between health behaviors and cardiovascular risk appear early in life. Eating and health behaviors are also established at very young age. So, the bottom-line is that if we want our children to prefer and select nutrient-rich foods and engage in healthy behaviors- they need lots of early, positive and repeated experiences with those foods and health-promoting behaviors.” She shares some of her recommendations:

Remember the Roles of Responsibility in Feeding
Parents and caregivers are responsible for "What”, "Where”, and "When” or in other words routinely providing healthy food options for meals and snacks, while children are responsible for determining "If” they will eat, "How Much” they will eat, and the "Pace” at which they eat. Allowing children to use internal cues to determine these things helps them develop a healthy relationship with food. (For more information on this topic, feeding expert Ellyn Satter, has written numerous books)

Nix the Children’s Menu Mentality
A diet high in saturated fat, sodium and sugar and low in vital nutrients—think, the typical children’s fare of hotdogs, fries, pizza, macaroni and cheese, fast food and sugar sweetened beverages, sets the stage for developing obesity, high cholesterol, high blood pressure, diabetes and so on. The U.S. is the only country in the world that thinks children need a different selection of foods than adults. In every other culture, kids are taught from the beginning to eat the foods inherent to their family and ethnicity. If you offer healthy options, they will eat them. But, it may take multiple exposures before they accept new foods.

Check and Manage Cholesterol Levels
Experts agree that managing cholesterol levels early in life through lifestyle factors, and maintaining high levels of high-density lipoproteins (HDL) , the "good” guys, offers great potential in reducing the rates of heart disease as well as diseases such as Alzheimer’s, breast cancer, colorectal cancer and other inflammatory conditions. Current research shows strong associations between low HDL levels and sustained inflammation. It appears that HDL not only helps transport excess cholesterol out of the bloodstream, but plays a role in counteracting and regulating inflammatory reactions in the body.

Keep Your Kids Moving
Exercise is well known to reduce the risk of heart disease. A 2013 report published in BMC Medicine highlights the amount of exercise children age 10 and younger need to reduce the risk of developing heart disease later in life. According to the study, girls showed decreased risk factors with 60 minutes of daily physical activity, while boys under age 6 needed 70 minutes and boys older than 6 needed approximately 85 minutes of movement daily. In addition, at least 20 of those minutes needed to be from vigorous activity for all groups. In contrast, recent studies suggest that preschool-aged children are quite inactive- spending less than 5% of their day in moderate-to-vigorous physical activity and more than three-fourths of their waking hours in sedentary activities.

How To Increase HDL Levels:

  • Get More Soluble Fiber - Include more dried beans or legumes, apples, pears, oats, barley and carrots.
  • Choose Healthy Fats (Monounsaturated & Omega 3 fats) - Eat more avocados, olive oil, fish, nuts, seeds, green veggies & omega-3 eggs.
  • Eliminate Trans Fatty Acids - Avoid all foods containing "partially hydrogenated oils”- such as fast foods, commercially prepared baked goods, cake & pancake mixes and margarine.
  • Limit Added Sugars - The American Heart Association recommends no more than 3-4 teaspoons or (12-16 grams) of added sugar per day for young children.
Specific HDL-boosting Foods:
  • Berries
  • Kale/ Kale juice 
  • 100% cranberry juice
  • Dark chocolate (70-85% cocoa)
Other Important Factors:
  • Keep Your Children Active. Young children should not be inactive for more than an hour at a time, except when sleeping.
  • Avoid Second-hand Smoke. Children exposed to secondhand smoke tend to have lower HDL levels. The impact on HDL levels seems to be more significant in females.
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