Heart disease prevention starts in childhood

Health services should step up efforts to reduce future heart disease risks in childhood by tackling factors such as obesity and inactivity, experts say today.

The European Association of Preventive Cardiology and the European Childhood Obesity Group publish a joint scientific statement today in European Journal of Preventive Cardiology.

They point out that childhood obesity is on the rise, bringing the associated problems of high blood pressure, high blood lipids and blood glucose.

First author Professor Henner Hanssen of the University of Basel, Switzerland, and colleagues explain that having more than one risk factor “compounds the likelihood of cardiovascular disease in adulthood”.

They state that, compared to children with a low body mass index, those with a high BMI are 40% more likely to suffer from cardiovascular disease in midlife.

Professor Hanssen believes childhood is a “window of opportunity” to tackle obesity before the damage it causes is irreversible.

“The global rise in childhood obesity, to a large extent driven by more physical inactivity, has been linked with an increased prevalence of high blood pressure, blood lipids and blood glucose in childhood,” said Professor Hanssen.

“This combination of factors is in turn linked with damage to the arteries and heart, which can be reversed with exercise in children but much less so in adults.”

He recommends that school-age young people should do at least 60 minutes per day of moderate to vigorous aerobic physical activity, plus muscle strengthening activities at least three times per week.

The team call on policymakers to promote physical activity, reduce sedentary time, encourage healthy eating habits, and provide diet counselling and psychological support for behaviour change.

“If there are no spaces to enjoy being active and nutritious food is unavailable or unaffordable, it is very difficult to change behaviour,” Professor Hanssen said.

Hanssen, H. et al. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood. European Journal of Preventive Cardiology 26 July 2023; doi: 10.1093/eurjpc/zwad152

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