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‘The new aha’: Connecting childhood obesity to heart disease

Our children's heart health is affected by what we feed them and how much they exercise. The good news is that obesity is preventable and reversible. Pictured, Allison Collins, MD, right, prepares a healthy snack with Nathan Vidal, 13, left, and his mother, Lorena Vidal, in a Healthy Eating, Active Living class in Cupertino.

When it comes to preventing heart disease, the earlier the better.

And this now applies to children as young as toddlers. Research shows that what we feed our children, even in infancy, and how much they exercise makes a difference in their lifespan.

“We now know obesity can start as early as infancy. That is the new ‘aha,’” said Kaiser Permanente Pediatric Cardiologist Kavin Desai, MD, chair of chiefs of Pediatric Cardiology in Northern California. “The thought then is that obesity therefore predisposes you to have heart disease later in life.”

The rates of childhood obesity grew from 14% in 2016 of all U.S. children to nearly 20%, or 14.7 million kids, in 2020.

Nathan Vidal, left, and his sister, Emily, learn to scan labels for trans-fat and other unhealthy additives to peanut butter during the Healthy Eating, Active Living class.
Nathan Vidal, left, and his sister, Emily, learn to scan labels for trans fat and other unhealthy additives during the Healthy Eating, Active Living class.

“Studies show that even toddlers and younger children with obesity can show early signs of the dangerous plaque buildup in coronary arteries that is often seen later in life,” Dr. Desai said. “Unhealthy lifestyle choices make that more likely to happen at an earlier age.”

Heavier children and adults have a second risk that is aimed directly at the heart itself, not just to the arteries that supply blood to it, said Dr. Desai.

“The heart is a muscle and being obese places a higher demand on it at rest and during exercise,” he said. “If that heart has to pump enough blood to support a 150-pound person, it has to pump twice as much to support a 300-pound person, which means it’s going to deteriorate more quickly.”

The good news is that parents have control, especially in the early years. Clinicians are now treating obesity very early on and showing parents it is preventable and reversible with Lifestyle Medicine interventions, like diet, exercise, proper sleep, and stress management.

“We’re now focusing more on parents of toddlers because they have more control at that age,” said Allison Collins, MD, director of Lifestyle and Culinary Medicine at Kaiser Permanente Santa Clara Medical Center. “The foundation for a healthy lifestyle should be set early by parents and caregivers who model healthy habits.”

Donna Petersen, a Kaiser Permanente senior physical therapist, shows Nathan Vidal, left background, and his sister, Emily, how to stretch to activate muscles for exercise.
Donna Petersen, foreground, a Kaiser Permanente senior physical therapist, shows Nathan Vidal and his sister, Emily, how to stretch to activate muscles for exercise.

Unhealthy habits formed early on are harder for children to change as time goes on, she added.

Dr. Collins started the Healthy Eating, Active Living program for children in the Santa Clara area in 2011. Her team includes a pediatric physical therapist, pediatric nutritionist, pediatric psychologist, and a clinical health educator who see kids and families in a 12-month intensive lifestyle program. It is now available in Fresno and South San Francisco.

There are online offerings, too. Dr. Collins also started Cook for Health virtual cooking classes for kids and families. In addition, there are various healthy eating classes online and in person for families across Kaiser Permanente Northern California.

Healthy eating habits begin in infancy

“One healthy tip I give is promoting eating vegetables early on and first introducing the ones that are not that sweet,” said Dr. Collins. “This trains baby to enjoy these flavors from the beginning. But parents should also eat the same food, because the babies learn by watching family and peers.”

Lorena Vidal of Sunnyvale, her husband, and 2 teenagers are enrolled in the Santa Clara Healthy Eating Active Living program. There are child and teen exercise sessions, parent support groups, family nutrition and cooking sessions, coaching calls with health educators, and check-ins with the physician. 

The health benefits of the class for Vidal and her son have been significant, she added. Her blood sugar levels are down to a healthy range, and her son reduced his liver inflammation by 50%. Liver inflammation is associated with obesity and can cause cirrhosis and liver cancer.

Parents who learn about childhood obesity and how it affects the longevity of their children are doing them a great service, said Dr. Desai.

“We want our kids to have wonderful lives when they grow up,” he said. “We don’t want to throw a wrench into that. My vision is that we are just raising awareness that there are health consequences, and you should make that effort for your child.”


childhood obesityheart diseaselifestyle medicine

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