A Pediatrician's Passionate Plea to Parents

Growing Up Healthy
by Joan Lunden, Myron Winick, M.D.

(Page 3 of 3)

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

About the Author

Joan Lunden was co-host of ABC's Good Morning America for nearly twenty years. A bestselling author, she hosts A&E's Behind Closed Doors and the Newborn Channel's Parenting Minutes. She lives in Connecticut.

Is the Williams Professor of Nutrition and Pediatrics (emeritus) at Columbia University and for more than fifteen years serves as Director of the Institute of Human Nutrition at Columbia's Collage of Physicians and Surgeons. Chairman of the Task Force for the Study of Pediatric Antecedents of Adult Diseases of the Institute for Cancer Prevention (formerly the American Health Foundation), Dr. Winick lives in New York City.