Yes, we worry about our children’s safety while they play outside. Did they do all their homework? Did they finish dinner? The bottom line is that being a parent is tough work. I know because, over the years, my wife and I have fretted plenty over our two sons. And now that we have a grandson, we’ll start watching out for him, too.

Now, I want you to ask yourself something more serious. Do you ever think of how they are aging on the inside? Are our children growing plaque in their arteries?

Several scientific articles have startled me in recent years. The first was a study published in the prestigious New England Journal of Medicine showing that today’s children are projected to have a shorter lifespan than my own generation and even my parents’ generation. The second article from a research group in Los Angeles showed that when arterial plaque was measured in obese adolescents, the average child had an arterial plaque score of someone in their mid-40s and several other studies have shown similar findings. This means that overweight children had mostly doubled their arterial plaque age and some, long before they were old enough to vote.

As a concerned parent, physician, and nutritionist, I conducted my own study to see if I got similar results. I used an ultrasound device (carotid IMT testing as I do on most adults in my clinic) to measure the arterial plaque score of adolescents (ages 15-21) I have seen over time as patients. Of these children who were obese by height and weight criteria, the average child had the arterial plaque of a 42-year-old adult. This means these children have aged their arteries at more than twice the normal rate. To me, this shows that unhealthy aspects of our culture are potentially killing our children.

Because it’s unrealistic for all parents to have this type of artery ultrasound testing, in our clinic, we have identified lifestyle factors that predict arterial plaque age and arterial plaque growth. So, how can you predict if your children are plaque free, or plaque producing?

Your answers to the following four questions will give you a good idea of how they’re faring:

• Is your child active? To be active, children need at least one hour of moderate to intense activity daily, the equivalent of walking fast for at least 3-5 miles. The bottom line for them is, “Do you huff, puff, and sweat for an hour every day?” Well, they should!
• Does your child get enough fiber? Use the fiber table tools online, http://pediatrics.about.com/od/nutrition/a/0806_high_fiber.htm or with the table in The 30-Day Heart Tune-Up, to calculate fiber content in the food they eat every day. The usual recommendation from the Academy of Pediatrics is that kids should eat about 14 grams (g) of fiber for every 1,000 calories they consume. So older kids who need more calories should also get more fiber in their diets.

Some general guidelines for fiber recommendations for kids include:

• 1 to 3-year-olds should get about 19 g of fiber each day
• 4 to 8-year-olds should get about 25 g of fiber each day
• 9- to 13-year-olds should get about 25-30 g of fiber each day
• Over 13, 30+ g of fiber each day (just like adults)

3. Does your child eat enough vegetables and fruits? Of the fiber eaten, at least half should come from fruits and vegetables (but potatoes don’t count).
4. Is your child at an appropriate weight? Typically, when your child gets a check-up, the doctor measures height and weight and calculates a body-mass index (BMI) score. Anything above the 75^th percentile for BMI is likely overweight. Many medical groups allow up to the 85^th percentile, which is generous in today’s world. For a tool to calculate your child’s BMI percentile, please visit: http://pediatrics.about.com/cs/usefultools/l/bl_bmi_calc.htm

Our clinical experience shows that if your children are active, get enough fiber (including their quota of vegetables and fruits), and are at an appropriate weight, their arterial plaque score should be totally normal. If not, ensure they receive the activity, fiber (especially from eating vegetables, fruits, beans, and nuts), and nutrients they need. If they are overweight, be sure to cut out all the sugar in their diet (sugar, not fat, is the number one cause for heart disease). Not only will making these changes help to ensure a healthy heart for you and your children, but they will likely help to correct any weight issues as well.

Lastly, during the month of February, Heart Month, please check out the recipes in The 30-Day Heart Tune-Up. The recipes are created for families—they are delicious, easy-to-prepare with ingredients you can find in your local grocery store and are designed with nutrients that will nourish your heart and soul.

I wish you and your family the very best of health!

Steven Masley, MD, FAHA, FACN, FAAFP

References:

1. Davis PH, Dawson JD, Mahoney Lt, Lauer Rm. Increased Carotid Intimal-Medial Thickness And Coronary Calcification Are Related In Young And Middle-Aged Adults. The Muscatine Study. Circulation 1999; 100: 838–842.
2. Tuzcu EM, Kapadia SR, Tutar E, Ziada KM, Hobbs RE, McCarthy Pm, Young JB, Nissen SE. High Prevalence Of Coronary Atherosclerosis In Asymptomatic Teenagers And Young Adults: Evidence From Intravascular Ultrasound. Circulation 2001; 103: 2705–2710.
3. Homma S, Hirose N, Ishida H, Ishii T, Araki G. Carotid Plaque And Intima-Media Thickness Assessed By B-Mode Ultrasonography In Subjects Ranging From Young Adults To Centenarians. Stroke 2001; 32: 830–835.
4. Oren A, Vos LE, Uiterwaal CSPM, Gorissen WHM, Grobbee DE, and BotsML. Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: The Atherosclerosis Risk in Young Adults study. International Journal of Obesity (2003) 27, 1383–1390.
5. Iannuzzi A, Licenziati MR, Acampora C, Salvatore V, Auriemma L, Romano ML, Panico S, Rubba P, Trevisan M. Increased Carotid Intima-Media Thickness and Stiffness in Obese Children. Diabetes Care 2004: 27: 2504-06.