Heart disease begins early in life
Gerald Berenson, M.D., professor of cardiology at LSU Health New Orleans School of Medicine, passed away in November. He was 96. Berenson is best known for the Bogalusa Heart Study, a multi-decade study of the development of heart disease, diabetes and metabolic syndrome.
A primary finding of the Bogalusa Heart Study, which began in 1972, is that the major causes of adult heart diseases begin in childhood – including atherosclerosis, coronary artery disease, hypertension, type 2 diabetes and obesity.
“The impact of the Bogalusa Heart Study cannot be overstated,” noted Dr. Frank Smart, LSU Health New Orleans chief of cardiology, in the LSU Health obituary. “The study was landmark research because it established a link between diet, exercise, and genetics and the development of coronary heart disease.”
In fact, Berenson believed that schoolchildren should be routinely tested for blood pressure, cholesterol and body mass. “This internationally acclaimed research project is the foundation for diet and lifestyle interventions that are commonly employed today,” Smart was quoted as saying.
The pediatrician
Gerald S Berenson, MD, Photo Courtesy of LSU Health
One of the greatest risk factors for heart disease among children today is obesity, notes Christopher Snyder, M.D., FAAP, University Hospitals, Cleveland, and chair of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery.
“Obesity is dangerous, it limits kids’ lives, and it’s a public health issue which we have to recognize,” he says.
Obesity is more common among adolescents today than in years past, says Snyder. And even though overweight or obesity may not be the reason a child visits the pediatrician, “it’s what we see. If we want to move the needle and help people live longer, we have to attack it.”
That’s a tall order, given popular culture, which still prizes tasty but unhealthy food, as well as today’s more sedentary lifestyles.
In 2011, the American Academy of Pediatrics endorsed guidelines by the National Heart, Lung and Blood Institute (NHLBI), part of the National Institutes of Health, which recommended universal cholesterol screening at ages 9-11 and 17-21 years, and selective cholesterol screening in children ages 2-21 years with risk factors.
But long-term change calls for: 1) willingness on the part of the child and his/her parents to adopt a healthy lifestyle, and 2) help from professionals, such as dieticians and fitness experts, says Snyder.
“The doctor has to make time to talk to the child and the parents,” he says. Obesity is usually a family affair; that is to say, pediatricians seldom see an obese child with two parents of healthy weight. “You can’t just walk into the exam room, tell the child and his parents that he’s obese, and then leave. You have to help them set goals and continue working toward them.”
Again, that is often more easily said than done, he says. Some families can’t afford the price of healthy food, and so opt for cheaper junk food instead. Some live in unsafe neighborhoods, where kids are unable to play outside with friends.
“Obesity is an epidemic,” says Snyder. “We cannot ignore it, even though it can be really difficult.
“Pediatricians have to make the time to talk to families about how obesity can affect life expectancy, high blood pressure and diabetes. If we don’t do it, who will?”