You are what you eat
Children’s diet proving to be important in prevention of disease later in life
If toward the end of the 20th century a professor asked a student in medical school what plans they had for a future career in medicine, and the student answered, “I want to specialize in lifestyle medicine,” the professor would have looked at the student as if he or she had two heads.
Today, lifestyle medicine is a legitimate career and one can get accreditation in this field from the American College of Lifestyle Medicine.
Certainly, if a doctor works long enough, he or she can recognize the importance of prevention. Some wonder if young adult-onset cardiovascular disease can be prevented if we start reducing risks as early as childhood? The answer appears to be a solid yes.
Finland is in the enviable position where long-term studies can be conducted more easily than in bigger and demographically more diverse countries. The University of Turku in Finland is known for its high-quality research over the years. In a recent article in Pediatrics, the official journal of the American Academy of Pediatrics (April 2020), researchers published data of a prospective, randomized, controlled trial where they followed children from infancy until young adulthood.
The association of dietary fat distribution with markers of subclinical atherosclerosis during early life was unknown prior to the study. The authors hypothesized that early and personalized dietary counselling, given biannually to healthy children from infancy to young adulthood, may
make a difference. The counselling was based on Nordic Nutrition Recommendations which favour unsaturated fats and eating real food as opposed to processed foods. Measurements on the aorta and carotid arteries took place at ages 11, 13, 15, 17 and 19 years.
The study, respected for its prospective and longitudinal design, suggested that over the long term, it led to healthier blood vessels. Prevention did pay off, at least until young adulthood, setting the stage for healthier healthspans later. (Many experts in the field of lifestyle medicine have replaced “lifespan” with “healthspan.”)
Ideal cardiovascular health (CVH) consists of seven metrics: optimal levels of cholesterol, blood pressure and fasting glucose, non-smoking, normal BMI, adequate physical activity and a healthful diet.
Currently, less than one per cent of adults who are 20 years or older have optimal levels of all seven metrics. In the U.S., 45 to 50 per cent of adolescents have at least five of the seven metrics and 39 per cent of eight- to 11-year olds have ideal levels of diet, BMI, cholesterol and blood pressure.
African-american and Hispanic youth exhibit fewer metrics
ideal for CVH. The NIH currently is sponsoring a project named ECHO (Environmental Influences on Child Health Outcomes). This project will study at least 50,000 children from the prenatal period to adolescence and the cohort will include children from diverse backgrounds.
Clearly, if pediatricians do a good job of helping families set the stage at the onset of adulthood to maintain ideal CVH, the question is if those behaviours will stick or not.
I have noticed full page newspaper ads with cute pictures of a physically active child. The organization that sponsors the ad wants us to believe that if a child has good role models it automatically means they will imitate their parents. That, of course, remains to be seen and skeptics may argue that is simply delusional thinking.
In the same edition of Pediatrics, authors from Australia, the U.K., Finland and the U.S. pooled their data and asked if the current recommendations of universal screening of young children’s cholesterol, as recommended by the National Heart, Lung and Blood Institute, is backed up by evidence. They conclude it is not and would like to see the recommendation changed to screening cholesterol at a later age such as around age 15.
But what if a child is raised in a family where seven out of seven markers for CVH are in place for as long as possible, the child then leaves home and eats badly at university or in their twenties and thirties, gains weight in their forties and end up with a massive paunch at age 50? Obviously, it is bad news at a time of a viral pandemic as we have seen lately.
Obesity, hypertension and heart disease are risk factors for death due to a virulent organism that hobbled the economy and led to a federal deficit in Canada of close to $265 billion — an almost 10 times higher deficit than ever before, somehow to be paid for by future taxation.
The short answer is that it is never too late to reverse heart disease and hypertension via seeing a plantician rather than a traditional MD. A plantician is a physician who promotes plantbased eating as a new lifestyle and a way to reverse disease.