The strategy of trying to prevent heart disease risk in childhood has been described as radical, but is the concept really so radical? What truly would be radical would be to adopt this concept and actually do something about our #1 killer epidemic. “The alternative is to continue indefinitely to rely upon the late and incompletely effective strategies, with their recognized costs, for detecting and treating already established risk factors” like high cholesterol levels that may have been causing progression of the disease their whole lives. As I discuss in my video Heart Disease May Start in the Womb, “a failure to diagnose and treat risk factors in youth may miss an opportunity to prevent the long-term consequences of [heart] disease,” the leading cause of disability and death in the United States for both men and women.
We could prevent 90 percent of heart attacks. Such a claim would have seemed outrageous 50 years ago, but now we know stopping this epidemic is achievable. There are two ways we can do this. The first is the clinical medicine approach, in which physicians identify kids at risk and vigorously advocate lifestyle changes or drug them. However, “[t]his model can, at best, be applied to only a few individuals, because physician effort is limited”—we have 15-minute doctor visits—“preventive care is not reimbursed, and interventions directed toward individuals are often ineffective because they are not supported by the surrounding culture.” To stop the disease process completely, one may have to go to an almost exclusively plant-based diet, something that hasn’t been officially recommended for fear of “discouraging” the public. But our job as physicians is to tell the truth and let the public decide.
That’s why, to prevent atherosclerosis, we need broad social and cultural changes that pervade the entire population. The evidence justifies igniting a veritable social movement that eventually will be supported officially by the powers that be. “The goal of eliminating 90% of [coronary heart disease] is feasible,” but the “cultural and societal changes necessary to achieve this goal won’t be easy, and they won’t happen soon, but it’s time to start.”
So, it may be that the newest Academy of Pediatrics-approved guidelines for universal cholesterol screening of all children, starting around age nine, might actually be too conservative. How about starting at age two? That’s “when parents are generally engaged and vigilant about well-child checkups and when there are additional opportunities for provider-parent education about the importance of diet, exercise, and a healthy lifestyle,” not only for their kids but for themselves as well, because atherosclerosis can start even before birth and depend on what our moms ate.
Fatty streak formation occurs in human fetal arteries and is worsened greatly by how high the pregnant mother’s cholesterol is. In one study, arteries were obtained from spontaneous miscarriages and premature newborns who died within 12 hours of birth around the end of the second trimester. They looked at the arteries of fetuses from mothers with normal cholesterol levels and from pregnant moms with high cholesterol, and fetal arteries from mothers with high cholesterol contained significantly greater lesions.
This suggests not only that heart disease may start much earlier than we had previously assumed, but that it also depends on maternal cholesterol levels. So, atherosclerosis might not just start out as a nutritional disease of childhood, but also as a nutritional disease of pregnancy.
More on healthy pregnancies in:
- The Wrong Way to Detox
- Why Do Vegan Women Have 5x Fewer Twins?
- Preventing Childhood Allergies
- Meat Fumes: Dietary Secondhand Smoke
- How Long to Detox from Fish Before Pregnancy?
- Bacon, Eggs, and Gestational Diabetes During Pregnancy
- Garlic and Raisins to Prevent Premature Birth
- Diet Soda and Preterm Birth
- Caution: Anti-Inflammatory Foods in the Third Trimester
- Maternal Mercury Levels
- Peanuts in Pregnancy
- Should Pregnant and Breastfeeding Women Take DHA?
Some of my videos on raising healthy kids include:
- How to Prevent Prediabetes in Children
- Childhood Constipation and Cow’s Milk
- Infectobesity: Adenovirus 36 and Childhood Obesity
- Formula for Childhood Obesity
- Flame Retardant Pollutants and Child Development
- Treating Infant Colic by Changing Mom’s Diet
- Tricks to Get Kids to Eat Healthier at Home
- Tricks to Get Kids to Eat Healthier at School
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:
- 2012: Uprooting the Leading Causes of Death
- 2013: More Than an Apple a Day
- 2014: From Table to Able: Combating Disabling Diseases with Food
- 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet
- 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers