WebMD Medical News
Louise Chang, MD
Jan 4, 2011 -- Encouraging children to make healthy lifestyle changes before they reach adulthood, including regular exercise and not smoking, can help lower the children’s blood cholesterol levels and potentially reverse their risk of developing heart disease as they age.
Growing numbers of U.S. children have high levels of cholesterol and other blood fats called triglycerides, which are considered major risk factors for heart disease, but these numbers are not set in stone, according to a new study in the January issue of the Archives of Pediatrics & Adolescent Medicine.
There may be a window of opportunity to change unhealthy habits in children, reverse risk factors such as high cholesterol in children, and stave off heart disease, conclude study researchers who were led by Costan C. Magnussen, PhD, of the Menzies Research Institute in Tasmania, Hobart, Australia.
In the study, 539 young adults had their cholesterol and triglyderides levels measured when they were 9, 12, or 15 in 1985. These measurements served as the baseline. Participants had their cholesterol and triglyceride levels tested again after an average of 20 years of follow-up. Researchers also measured their height, weight, waist circumference, saturated fat intake, skin-fold thickness, smoking status, cardiorespiratory fitness, and socioeconomic factors at both time points.
High-risk cholesterol levels were defined as total cholesterol levels of 240 milligrams per deciliter of blood (mg/dL) or higher, an LDL “bad” cholesterol level of 160 mg/dL or higher, an HDL “good” cholesterol level of less than 40 mg/dL, and a triglyceride level of 200 mg/dL or higher.
Many children who were “high risk” at baseline were not high risk at follow-up when they reached adulthood, the study showed.
Those children who were overweight or obese and who began or continued smoking were among the most likely to maintain their high blood cholesterol and elevated risk status throughout the study.
Among those children who were initially considered low risk, those who gained weight, become less physically fit between the surveys, and did not show improvement in their socioeconomic status were more likely to become high risk as adults, when compared with their counterparts who remained low risk.
Those who did remain high risk throughout the study gained more body fat and were more likely to begin or continue smoking during the follow-up period, the study showed.
“Unhealthy lifestyle changes that occur between youth and adulthood affect whether an individual maintains, loses, or develops high-risk blood lipid and lipoprotein levels in adulthood,” the researchers write. “Prevention and intervention programs designed to promote weight control in the first instance, but also physical activity, not smoking, and improvements in socioeconomic circumstances in the time between youth and adulthood, are important for youth with and without high-risk lipid and lipoprotein levels.”
“I love this study,” says Suzanne Steinbaum, MD, a preventive cardiologist at Lenox Hill Hospital in New York City and a spokeswoman for the American Heart Association.
The new study results are “extraordinarily empowering,” she says. “There are many diseases that we have no control over, and here we are saying, ‘if you make lifestyle changes, don’t smoke, and watch your weight you can prevent heart disease.’”
The onus is on parents, educators, and public health advocates to buck these trends -- and the new study shows their efforts can make a difference.
“Kids learn by example, so parents need to be good role models and show their children how to eat healthfully,” she says.
“We need healthy lunches in school and to stock vending machines with water instead of soda,” Steinbaum says. “We have an obligation to give our children healthy choices, and if we don’t do that, we are setting them up for disaster.”
Many adult diseases begin in childhood, often early childhood, says Scott Kahan, MD, MPH, a preventive medicine specialist at the George Washington University Weight Management Program in Washington, D.C.
“Heart disease, in particular, has been shown to begin quite early in life in many cases,” he tells WebMD in an email. “Many children have blood pressures and cholesterol levels high enough to warrant treatment with adult medications; and rates of childhood obesity, which drive heart disease and heart disease risk factors, are spiraling upwards.”
This study adds further data to the commonsense notion that prevention is the best medicine, he says.
“It suggests that we should initiate prevention efforts in children [and that] in particular, promoting healthful eating and physical activity, preventing the initiation of tobacco use, and ensuring access to high-quality education is likely to benefit children in many ways, including preventing high cholesterol levels and ultimately perhaps heart disease,” he says. “We need to continue studying this issue to confirm and extend their results.”
SOURCES:Suzanne Steinbaum, MD, preventive cardiologist, Lenox Hill Hospital, New York City.Scott Kahan, MD, MPH, preventive medicine specialist, George Washington University Weight Management Program, Washington, D.C.Magnussen, C.G. Archives of Pediatrics & Adolescent Medicine 2011; vol 165: pp 68-76.
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