In contrast to adults, chest pain in kids is rarely of cardiac origin. A new article in Pediatrics reassures us that an aching chest in kids, although a common complaint, was only rarely due to abnormalities of the heart.
But is the growing epidemic of childhood obesity threatening to change that? Could obesity in childhood result in heart attacks and other cardiovascular events when those children hit their 20s and 30s and even when they’re still teens?
Dr. David Katz’s piece in Childhood Obesity last year starts with a scary prediction, a prediction he hopes will never come true.
Katz, an internist and leading authority on nutrition, weight management and the prevention of chronic disease, director and founder of Yale University's Prevention Research Center, warns that heart disease might become a routine pediatric condition. Heart disease can follow the path of type 2 diabetes, – previously called “adult onset” diabetes because it was an affliction of adults – which is spreading among kids like an epidemic and is diagnosed more frequently in obese kids under the age of 10 years.
Dr. Katz tells us that in adults, guidelines for healthcare providers suggest that any patient with diabetes should be treated as if they have some degree of heart disease, because diabetes is such a strong risk factor for coronary artery disease.
Can we assume the same for kids? Kids who’ve had diabetes for 10 years have been exposed to the damages this disease causes to blood vessels, and Katz suspects we’re going to see more and more kids in their late teens with chest pain and heart attacks. He’s personally encountered a 25-year-old who’s had coronary angioplasty and a 17-year-old who’s had a triple bypass.
Stack a sandbag today
Katz is announcing this grim prediction so that action will be taken to prevent it from materializing.
We know what causes childhood obesity. Overconsumption of all the wrong foods and lack of physical activity are now the default way of life for so many of our kids. We live in an obesogenic environment, which is going to deluge us with disease. To prepare for the rising tide and to block its toxic water we need, Katz suggests, any sandbag we can find:
“Programs that provide routine physical activity throughout the school day are a sandbag. Nutrition education is a sandbag. Cafeteria make- overs are a sandbag. Adding sidewalks to a neighborhood is a sandbag. Nutrition information on menu boards is a sandbag. Worksite wellness programs are a sandbag. Reliable nutrition guidance systems in the supermarket are a sandbag. Recognizing that neither children nor adults will get healthy unless both do, together, is a sandbag.
The flood waters are both menacing and high. Stacking sandbags to raise a levee is hard work—but it’s not complicated. So seize the moment; embrace the opportunity in this crisis. Stack a sandbag today. The child you save from our new-age plague might be your own.”
Whenever a solution is proposed critics are quick to scrutinize and announce, quite correctly, that it will not solve the obesity crisis. But if we can’t stop the flood and dam a mighty river should we dismiss sandbags? I completely agree with Katz: the sandbags needn’t be perfect, but we do need many of them and a joint effort to stack them up real high.
More from David Katz here.