Growing Up Healthy: A Complete Guide to Childhood Nutrition, Birth Through Adolescence
Chapter 1: Killer Diseases Begin with Childhood Nutrition
I'm a new mom all over again! And just as excited and in awe of the challenge of parenthood as I was first time around. My new twins Kate and Max share the cover of this book with me because they, along with children everywhere, now have an amazing opportunity to live longer, healthier lives, free of chronic disease. When I was raising Jamie, Lindsay, and Sarah, my three older daughters, I was constantly sifting through books and magazines in search of trustworthy pediatric health news, as I'm sure you are. Throughout my years as cohost on Good Morning America, parenting and the importance of sound childhood nutrition were subjects about which I was always passionate.
Now that my husband Jeff and I have been blessed with our amazing twins, I'm reminded that raising a child into a healthy, happy, and productive adult is one of the most rewarding things a person can do -- and one of the most daunting. So, once again, I found myself searching for the latest findings on how to give a child the healthiest life possible. That's when I was introduced to renowed pediatric nutritionist Dr. Myron Winick, who headed up one of the most important studies in the area of childhood health and nutrition. The three-year task force commissioned by the American Health Foundation produced what just might be the most important medical breakthrough to come along in years: the definitive link between childhood nutrition and chronic illness in later life.
Dr. Winick contacted me to see if I would be interested in helping to get this vitally important news out to other parents. I had first met Dr. Winick in 1984 when I interviewed him on Good Morning America for his earlier book on feeding children, also entitled Growing Up Healthy. Those of us at Good Morning America found him to be such an effective communicator of this type of practical parenting advice that we invited him back on the program regularly. One of our country's leading experts in the field of pediatric nutrition, Dr. Winick later spearheaded the study to examine the significance of our children's diets on chronic illness. The task force findings showed that we as parents have it within our power to help protect our children from disease and very possibly lengthen their lives.
As a concerned parent, I feel privileged to pass along this information to parents everywhere. I think you will agree that it contains some of the most important health and nutritional findings to emerge in decades.
If you're like me, you too love your kids passionately and are eager to learn the secret to possibly lengthening their lives. You want them to be free from the killer diseases plaguing our society; you want them to be happy and blossom into strong, healthy adults; you want them to stay vigorous and fit into their nineties. (Did I say nineties? How about imagining our children as healthy centenarians!) Very simply, you don't want them to get sick! What you do want is to learn how to take control of their nutrition and give them the gift of a life infused with good health.
I know that you work hard, that you're probably pooped out, stressed out, and barraged with the latest information about what you should and shouldn't do for the care and feeding of your children -- and who to trust. Believe me, I know, I'm right there with you. That's why I feel so lucky to have found Dr. Winick's research on nutrition, so as to better understand this link between our children's diets and adult disease. I feel that I'm arming myself with this lifesaving knowledge to help shield my children from illness and to help them grow into strong, fit adults.
Over the past year while I've been working on this book with Dr. Winick, I've had the opportunity to share much of this groundbreaking information with my older girls, Jamie, Lindsay, and Sarah. I can already see what a wonderfully healthy influence it's having on their behaviors. Which reminds me, that just as it's never too early to introduce healthy habits, it's never too late.
Like so many of us, I didn't learn my own personal nutrition lessons until somewhat later in life. While I always understood that my children needed a good foundation for growth and development, quite frankly, I didn't have one myself. It wasn't until I was almost forty that I started paying closer attention to my own fitness and nutrition and launched my own health odyssey. Actually, it was the constant interviews with health experts on the morning show that prompted me to wake up and get serious about my health. And so, I began an exercise program; I changed the way I ate; I lost fifty pounds; and I probably added twenty years to my life. I'd like to see children everywhere add years to their lives, too.
That's why I've come on board to be the voice for this exciting project: I want parents everywhere to become recipients of this most loving gift -- an opportunity to give our children the best shot at growing up healthy and circumventing adult diseases.
This information is critically important for every family. By paying careful attention to the foods we're popping into our children's mouths and making some important alterations in their diets, we can become take-action parents on the front lines of defense against future illness. I look at this as disease intervention.
Training our children to become conscious of their food choices is part of that intervention. I would venture to say that teaching our children sound eating guidelines is equally as important as teaching them about Mesopotamia. Doesn't it seem logical that both history and nutrition are crucial to a complete education?
Our children begin to develop food preferences in early infancy that will remain with them throughout their lives. When we as parents begin to understand this on a gut level, we'll want to maximize their odds by helping them to develop a friendly, positive relationship with healthy foods.
Quite frankly, when I first heard about the direct link between childhood nutrition and adult disease, I was flabbergasted. I began to read as many reports as I could about this important link and found that the implications were staggering. Here are two samples from the U.S. government:
• The U.S. Department of Health and Human Services reports that unhealthy eating and inactivity cause 310,000 to 580,000 deaths every year -- similar to the number of deaths caused by tobacco; thirteen times more than are caused by guns; and twenty times more than by drug use!
• The U.S. Surgeon General's Report on Nutrition and Health tells us that two-thirds of all deaths are related to what we eat. This includes deaths from heart disease, stroke, diabetes, osteoporosis, and cancer. The report highlights that many of the diet-associated chronic diseases of adulthood begin in childhood.
While we should all find these reports alarming, I think it's important that we also view them as motivating. And this is where we, as parents, come in. To understand the necessity of early intervention, let's take a look at how childhood nutrition links to obesity, the development of heart disease and stroke, high blood pressure, Type II diabetes, cancer, and osteoporosis.
Obesity -- Much More Than Just a Weight Problem
We only have to watch kids in school yards (no matter how oversize their pants!), or listen to the nightly news to understand how prevalent obesity has become in our society. Yet, while we're aware of this growing epidemic, much of our focus has been on thinness. Children can be cruel, and none of us want our sons and daughters to be ridiculed because they're fat. But our preoccupation with looking good misses the more serious issue: the link between childhood obesity and chronic adult disease.
We now know that obesity is a definite risk factor for a number of diseases, including heart disease and stroke, high blood pressure, cancer, Type II diabetes, gallbladder disease, and for complications from any type of surgery. Recent studies from researchers highlight the enormity and the seriousness of the obesity epidemic:
• The Centers for Disease Control tells us that obesity is becoming a national health problem with nearly 15 percent -- almost nine million children -- now categorized as seriously overweight, and that number is rising. Instead of seeing heart disease occur when our children reach their fifties and sixties, researchers are predicting that our sons and daughters might be subject to heart disease as early as their twenties and thirties.
• A recent study published in the New England Journal of Medicine showed a direct relationship between excess weight and the risk of death from most cancers -- the more body fat our children carry, the greater their risk.
• Researchers from Duke University report that a staggering number of obese children are developing Type II diabetes earlier in their lives, in some cases, during their teenage years.
What can we do about these findings? We need to prevent our children from becoming obese -- that means ensuring that they eat nutritious foods and exercise regularly. If they have already started down the path to obesity we need to intervene immediately. If we can prevent a child from becoming an obese adult, we will be making a substantial difference in their lives.
Obesity is a vitally important issue, so let's be clear. Many confuse obesity with a few stubborn pounds -- but it's not those extra five pounds everyone wants to lose. According to the National Institute of Health and the Centers for Disease Control and Prevention, individuals are considered obese when their weight is 20 percent or more over the maximum desirable for their height. Obesity is also defined as a BMI (body mass index) over 30. Adults with a BMI between 25 and 29.9 are considered overweight, but not obese. In children, obesity is also defined as a BMI equal to or greater than the 95th percentile on the BMI graph. (To learn how to calculate BMI, turn to The Tools, page 157.)
Stop Heart Disease in its Tracks
Our children may be overeating their way to heart disease. According to the American Heart Association, the increasing epidemic of obesity among children is setting them up for cardiovascular disease later in life. To prevent this from happening, they recommend that we do everything we can to stop our children from becoming obese as early as possible.
Do you know how a heart attack occurs? How about a stroke? Heart attacks occur when coronary arteries clog. Fat, traveling through the arteries, builds up and attaches to the coronary artery walls. The accumulation of fat creates fatty streaks, which change into plaque. Plaque creates clots in the artery that reduce the flow of blood to the heart. A stroke occurs when an artery that goes to the brain becomes clogged, or when a blood vessel in the brain ruptures.
We now know that too much dietary fat -- particularly saturated fat and trans fats -- and too much cholesterol, play a major role in the buildup of those thin, white fatty streaks that ultimately lead to heart attack and stroke. Since our children are now showing evidence of these fatty streaks as young as ten years old, it's essential that we cut down on fat.
Along with too much saturated fat, trans fat, and cholesterol, an iron excess may also prove to be a risk factor for heart disease, particularly for our sons. Our bodies can use only a normal amount of iron. Iron that isn't used is stored as excess. We are now associating such excess iron with an increased risk of heart disease. Unlike our sons, after puberty, the risk for our daughters diminishes: when they begin to menstruate the excess iron is discharged monthly in blood. This may be one reason why coronary artery disease is less common in women (pre-menopausal) than men.
High Blood Pressure/Hypertension -- Bringing Down the Risk
To better understand how high blood pressure develops and leads to hypertension and heart disease you need look no further than salt and its effect on the body. Too much salt causes our kidneys to react. To excrete excess salt, the kidneys increase our body's blood pressure. Continued elevated blood pressure leads to hypertension, which is a major risk factor for coronary artery disease and stroke.
American children are showing increases in both weight and blood pressure levels. Right now, an estimated 10 to 15 percent of school-age children have high blood pressure for their age, and the numbers are rising. These percentages parallel the obesity epidemic and the increased consumption of salty snacks and fast foods in young children around the world.
Children aren't born with a taste for salt. That's right -- it's actually an acquired taste. And the sad fact is that we Americans consume ten times as much salt as we need. It's in our frozen foods, our canned foods, our processed foods, our snack foods, and also on the dinner table. It's everywhere! So why not put those saltshakers away now and help our children avoid high blood pressure and a lifetime on expensive drugs with possible side effects?
Type II Diabetes -- A Threat to All Our Children
Over the past twenty years, Type II diabetes has increased dramatically in both children and adults. That enormous increase has now been linked to childhood obesity. The lack of physical activity isn't helping either. Our kids are spending more than thirty-eight hours a week watching TV, playing video games, downloading music, or chatting with friends on computers -- anything but exercising!
How does childhood obesity link to Type II diabetes? It's all about fat cells. Overweight children are not able to either produce or to utilize all the insulin they need to keep their bodies energized. Insulin must find its way inside all the cells of the body to do its work. Fat cells are the most difficult to penetrate, and an obese child has too many fat cells for insulin to work properly. To compensate, the pancreas begins to produce as much insulin as it can, but eventually the amount needed will remain inadequate and the symptoms of diabetes will appear.
In the past, this disease has typically shown up after the age of thirty. But the 2001 Obesity Statistics from the U.S. government tell us that one in four overweight children is already showing early signs of Type II diabetes, and that 60 percent of these children already have one risk factor for heart disease.
Although these new statistics are distressing, they also clarify what must be done to protect our children. We must help prevent our children from becoming obese! And if they're already obese, let's help them lose the excess fat and reverse the symptoms of Type II diabetes.
Cancer -- A Deadly Disease With Childhood Roots
To all of us, cancer is perhaps the most frightening of diseases. If we thought that lessening our children's risk of developing cancer as adults was within our reach, which of us wouldn't do everything possible to make it happen? Well, we now know that by changing the foods we offer our children, we may be able to lower their risk potential for cancer.
There's no magic bullet, but we do have a fantastic opportunity to give our kids the best protection. The new research tells us that our best chance is an anticancer diet low in total fat, high in dietary fiber and in certain vitamins, all found in fruits and vegetables. In fact, if only one dietary change were to be initiated to reduce the risk of cancer, the best would be to eat a more colorful mix of fruits and vegetables like blueberries, pumpkin, mango, apricots, peaches, oranges, tomatoes, sweet potatoes, carrots, broccoli, spinach, dark leafy greens, and watercress. These foods are low in calories, low in fat (particularly saturated fat), free of cholesterol, high in fiber and in beta-carotene (a form of vitamin A), vitamin C, and natural cancer-fighting compounds.
Osteoporosis -- Bank Enough Bone for a Lifetime
Is there any parent among us who doesn't want to stay physically fit and active throughout our lives? And is there any parent who doesn't long for that same mobility for their children as they age? Of course -- no one wants their children to experience hip or vertebrae fractures in the future.
Childhood is a unique period for preventing osteoporosis. It is the ideal time for building and storing reserves of good bone. From pregnancy to early adult life, more bone is being formed than is being lost. Subsequently, from our early thirties for women and early forties for men, more bone is being lost than deposited.
We've all heard over and over again that calcium is the key to building strong bones. That's why it's imperative that we give our children the maximum amount of calcium to protect them from bone loss as they age and instill in them the importance of exercise in building strong bones. This is especially important for our daughters, who are ten times more likely to suffer osteoporosis later in life than our sons. After menopause, bone loss increases again. If we haven't deposited good bone reserves in childhood, our daughters won't have enough bone to draw on for support and will end up with thin, weak, brittle bones -- the hallmark of osteoporosis.
I hope you now have a clearer picture and a deeper understanding of that critical link between the foods we feed our children and their risk of developing chronic adult diseases.
The challenge doesn't have to be complicated. It's up to all of us to become proactive parents and dedicate ourselves to lowering our children's risk for these diseases. By making the necessary nutritional and lifestyle changes, it can be done.
I strongly believe that whether you're expecting a child, are the parent of a newborn, a toddler, a school-age child, or an adolescent, if they're under your guidance, then you still have the chance to offer them the gift of a healthy, disease-free life.
This is a great place to start!
Copyright © 2004 by Joan Lunden and Myron Winick, MD
A Pediatrician's Passionate Plea to Parents
By Dr. Myron Winick
When I was a young pediatrician, the guiding principle of my profession was to ensure proper growth and development in children. Unlike other medical specialists, however, we pediatricians also had a particular interest in prevention. We made sure that children were vaccinated against smallpox, diphtheria, tetanus, and whooping cough, diseases that had caused misery and death. Over the last thirty years, other vaccines became available, and we were able to prevent diseases like polio, measles, mumps, chickenpox, hepatitis, and others. All of this, in addition to treating sick children. Not much has changed in that area, and this approach is still valid.
Today, however, we look at disease prevention not only as immunizing children against infectious diseases, but also as reducing the risk for certain chronic diseases found almost exclusively in adults. A whole new era in the care of children is beginning, the era of focusing on what researchers call pediatric antecedents of adult disease -- the link between childhood nutrition and chronic illness in later years.
We now know that many of the symptoms of disease associated with adulthood make their first appearance in childhood -- and it is in childhood that steps need to be taken to effectively diagnose, treat, and possibly prevent these diseases.
Our new, groundbreaking research shows that many of the diseases we all associate with old age -- heart disease, stroke, osteoporosis, hypertension, cancer, and diabetes -- actually begin during childhood, and that poor nutrition and the development of unhealthy eating habits take their toll later in life. We now know that early stages of many of these chronic diseases can be detected in children. Decades of painstaking research and testing have shown that the buildup of plaque deposits in arteries, just to cite an example, is apparent in young people who are consuming a typical American diet loaded with fat. Feeding children right in the years when their young bodies are growing and organs and tissues are developing is the best way to shield them from many of the diseases that won't show up as symptoms until much later in life.
How does nutrition in children play a role in preventing some of the most serious chronic diseases seen in adults? If we have learned anything in the last few years, we have learned that the major killer diseases that plague Western society are caused by many factors, and in most of these diseases nutrition is a major factor. Most Americans will die of cardiovascular disease, stroke, or cancer. Millions of Americans will have to learn to live with diabetes, high blood pressure, and osteoporosis. All of these diseases develop at least in part because of poor nutrition -- excesses or deficiencies -- too much of one thing or not enough of another. We now recognize that because of the diets our children consume, some of these diseases may begin in early childhood or infancy -- even in the womb. More importantly, we now know that our intervention can affect the progress of those diseases and perhaps change the course of our children's lives.
Nutrition in infants and children has been my major interest for all of my professional life. For more than thirty years, I've been a pediatrician and a professor of pediatrics and nutrition. My research has focused on nutrition and growth, particularly the growth of the brain, as well as the effects of undernutrition on physical growth and mental development. Over the years, I've maintained my suspicion that a direct link between childhood nutrition and adult disease does exist. Four years ago, I became chairman of a task force for The American Health Foundation, overseeing and compiling studies for a program aimed at preventing adult disease through childhood nutrition. The findings from this literature have validated my suspicion -- and they are nothing short of remarkable.
The discovery of this critical link affects everyone across all socioeconomic lines, from the most affluent of families to the poorest. Affluence does not ensure long life. Even parents in the most privileged circumstances can be unwittingly feeding their children foods that will increase their risk for malnutrition and chronic disease in their adult years.
Prior to the discovery of the link between childhood nutrition and adult disease, most of us had little idea of how important the food we provided our children could be to their future health. Now we know. The foods we place on our children's plates, in their lunch boxes, and in their snacks can make a major difference. Beginning with pregnancy, feeding them the right foods can give them the best shot at living healthier, and very probably longer lives.
To better understand how most of the important diseases that afflict older Americans may begin in childhood, you need look no further than obesity. Obesity is a major factor for high blood pressure and Type II diabetes, each of which by itself is a major risk factor for heart disease and stroke. In addition, obesity increases a person's risk for certain cancers, for gallbladder disease, and for the complications of any type of surgery. So if we could prevent an adult from being obese or prevent a child from becoming an obese adult, we would improve the adult's health greatly.
We now know that a child who is obese at age four has a greater than 80 percent chance of becoming an obese adult if nothing is done to prevent it. Childhood obesity is a very special kind of obesity. Studies have found that it's much more difficult to treat obese adults who were obese as children than obesity that develops after childhood. It stands to reason then that if we wish to prevent the complications of obesity in many adults, we must prevent it from occurring during childhood. And if it hasn't been treated in early childhood, we must take action and begin to treat it immediately.
Not only is obesity striking at an earlier age, but we're also seeing the beginnings of heart disease earlier in children. The sad fact is that more Americans will die of heart disease than any other illness. Heart disease begins when a thin whitish streak of fat is deposited in the arterial wall. These streaks are now showing up in children as young as ten.
We first noticed these fatty streaks in 60 percent of our young soldiers who died of wounds received in the Korean and Vietnam wars. By contrast, almost none of the Korean or Vietnamese soldiers who died of wounds showed these streaks. What we learned from this is that by the time our young sons are in their late teens or early twenties, a majority of them already show signs of coronary heart disease. Why? The American diet contains too much dietary fat, particularly saturated fat, and too much cholesterol, which are all directly related to coronary artery disease.
Iron is a nutrient that further complicates the heart picture. Recent findings demonstrate that large accumulations of iron increase the risk of coronary heart disease, especially in boys. These findings have caused us to reevaluate who should receive iron supplements during later childhood, when, how much, and whether the practice of supplementation should be different for boys and girls. This is something that should be discussed with your doctor.
Another nutrient consumed in excess that contributes to serious heart disease is salt (sodium). When consumed in excess, salt increases our children's risk for high blood pressure, a condition that leads to hypertension and eventually can lead to coronary heart disease. Our children are not born with a taste for salt. It's a learned, acquired taste.
Unlike salt, a liking for the sweet taste of sugar is inborn. Sugar (particularly in a gummy or sticky form) is very dangerous to developing teeth and must be consumed by children in moderation. It is also a source of empty calories. Consuming too much sugar may deprive a child of other important nutrients, nutrients that may lower the risk for cancer and increase the risk factor for serious vitamin and mineral deficiencies.
While we want to avoid an excess of sodium and iron, there are nutrients for which the reverse is true. Calcium is the best example. Here, the adult disease we hope to nip in the bud is osteoporosis. This is a disease in which progressive bone loss, particularly in women after menopause, can result in fractures of the vertebrae, hips, and extremities. Bone growth begins in the womb and continues throughout childhood and, in fact, is active throughout adolescence. Calcium is the key to bone growth. During our children's growth years, calcium must be available in sufficient amounts and in the proper form.
Important changes in our children's diets and eating patterns can also lessen their risk for cancer. We know that certain types of diets offer protection against various cancers and that the longer these diets are consumed the greater the protection. Rather than consuming more or less of a simple nutrient, protection from cancer requires altering our children's dietary patterns.
I believe that it is vitally important for parents to encourage an anticancer food plan for our children. The recommended food plan is low in fat, high in dietary fiber, loaded with vitamins all found in fruits and vegetables, and contains only sufficient calories to maintain ideal weight.
I hope by now you understand that we have it within our power to protect our children from some of the most devastating diseases of old age. And I hope you understand that by feeding our children the right foods and helping them to develop healthy eating patterns, we offer them the most precious of gifts -- the best chance for a long life, free of disease. It does take resolve, but by taking control of our children's future health now, it's not hard to imagine them enjoying life for six, seven, or even eight decades down the road. I call this new resolve, love.
And that is what my passionate plea to parents is all about. I'm asking all of you to take this information seriously. The link between childhood nutrition and adult disease is real, and the findings here are critically important to your entire family.
Finally, of all the writing projects with which I've been involved that deal with nutrition in general and nutrition in children specifically, I am most excited by the information contained in Growing Up Healthy. However, I am quite aware that these critical research findings won't alter the course of our children's lives unless someone who has actually made a difference for parents steps up to share them with you.
For that reason, I teamed up with one of America's most famous and visible working moms, Joan Lunden. A passionate advocate for parents and children over the years, Joan has distinguished herself as a respected and eloquent communicator. During her many years as a host on Good Morning America, she eagerly brought parenting issues into our homes and made them easy to understand. She not only shared important and often intimate information concerning her personal experience as a mother, but also easily assimilated and interpreted new findings from parenting professionals.
I had the good fortune of appearing on Good Morning America with Joan many times -- and it was a pleasure. As she interviewed me on topics regarding children's health, I was impressed with her questions and her facility for demystifying complicated medical issues -- and I still am. Joan does her homework. In this book, she couples her abiding respect for science with her profound love for children -- and she does it using language all parents will understand. We make a great team.
I'm extremely pleased and proud that Joan has partnered with me to share this invaluable, breakthrough guide with you.
Myron Winick, MD
Copyright © 2004 by Joan Lunden and Myron Winick, MD
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Review: Growing Up Healthy: A Complete Guide to Childhood Nutrition, Birth Through AdolescenceUser Review - Traci - Goodreads
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