Nutrition research shows that optimal health and health habits – or the lack thereof – originate early in life. Conditions such as osteoporosis, hypertension, cardiovascular disease, type 2 diabetes and obesity – all traditionally associated with adulthood – are “down aging,” appearing in early childhood and adolescence.
Research connecting lifestyle and diet to future chronic disease risk, and outlining ways that health professionals can intervene and facilitate health-promoting habits early in life are an absolute necessity if we are going to help the younger generations. Such action is critical if we are to avoid a potential medical meltdown of health care resources as chronic diseases take their toll earlier in life.
Within the context of setting the stage for risk of chronic disease, the conventional wisdom that pregnant women eat for two takes on additional meaning. For example:
– Maternal calcium intake has been linked to lower blood pressure in children, potentially helping to prevent hypertension in the next generation.
– Twin offspring of mothers supplemented with calcium had lower cardiovascular risk factors (triacylglycerol, total cholesterol and LDL cholesterol) at age 9 years than other children.
– Calcium’s (and vitamin D’s) role in bone health and the development of osteoporosis later in life is well known. Optimizing bone deposition before age 18 is especially important in females.
– Maternal overweight and obesity not only contribute to complications during pregnancy, but also increase the risk of obesity in infants. Research on children born to overweight mothers showed that by age 4, weight, body mass index (BMI) and lean body mass were significantly greater and by age 6, weight and fat mass were greater than those born to lean mothers.
Over the past 30 years, the prevalence of obesity has more than doubled for preschool-aged children and adolescents aged 12-19, and it has more than tripled for children aged 6-11. This evolving childhood obesity epidemic is linked to increased risk of type 2 diabetes. In the past referred to as “adult-onset,” type 2 diabetes now commonly occurs in the adolescent and teen years; cases in children as young as 4 have even occurred. One study found that for each adolescent diagnosed with type 2 diabetes, there were 10 others with impaired fasting glucose. Researchers expect pre-pubescent type 2 diabetes rates to soar as the population becomes increasingly overweight. African American, Hispanic/Latino and American Indian children who are obese and have a family history of type 2 diabetes are at especially high risk.
Blood pressure has increased steadily in children over the past decade, across all age and race/ethnic groups and in both genders. Clinical guidelines for ranges in blood pressure in children now include a “pre-hypertensive” range mirroring the revised categories for hypertension in adults. Diets rich in fruits and vegetables and low-fat dairy products such as the Dietary Approaches to Stop Hypertension (DASH) diet have had positive effects on blood pressure in adults – and research indicates a beneficial effect during childhood. Children who ate 4 or more daily servings of fruits and vegetables or 2 or more daily servings of dairy products during preschool years had smaller yearly.
The down-aging of chronic diseases and the identification of “pre-conditions” are relatively new phenomena. The impact on children, their family’s quality of life, and on our health care system is still to be felt. As health professionals we need to take a more proactive approach through early screening, intervention and referral when necessary to other disciplines to prevent these consequences.
What we have to promote is healthy food in appropriate portions coupled with appropriate levels of physical activity? We had hoped research would find a magic bullet but we aren’t even close to manipulating our basic genetic and metabolic mechanisms. The only way to achieve energy balance is through appropriate food choices and activity. We must make changes in our communities, worksites and schools to enable us to get in energy balance, but we cannot afford to wait for all the needed changes to take place.