Nov. 12, 2003 (ORLANDO, Fla.) -- When it comes to preventing heart disease in obese children, there are some fun alternatives. Researchers say a simple exercise program can reverse some ominous changes that can signal heart disease in youngsters.
"This is the first study in at-risk children to show that the progression of [heart disease] that begins early on can be reversed," says Daniel Green, PhD, of the University of Western Australia in Nedlands.
Heart disease from clogged heart arteries was once largely an adult problem. But with more and more children packing on the pounds from lack of exercise and bad diet, some kids are showing signs of heart disease before they even start kindergarten.
The good news, doctors said here at the annual meeting of American Heart Association, is that the process can be stopped in its tracks -- even turned on its deadly head.
Fun and Games
Green studied 35 obese children aged 6 years to 16 years. All the youngsters were given a test to check the function of the inside of the blood vessels -- an early sign that clogged arteries and heart disease is in their future.
Without intervention, a child who shows signs of impaired function will develop visible signs and symptoms of heart disease 30 to 40 years later, Green says.
The teens were put on a program of weight-resistance exercises, three times a week, for eight weeks.
While their total body weight didn't change, the teens shed an average of 3 pounds of body fat -- fat that was replaced with lean muscle mass, Green says. Lean muscle mass can also help to protect against the development of diabetes, Green says.
In the younger children "it was a little bit trickier because they don't want to push weights in a gym. They want to run around in a field," Green says. So that's what they did, he says. "It was essentially fun and games."
By the end of the eight-week program, blood vessel function had improved in both groups of children, he reports.
More Remarkable Results
So what happens when they stopped?
By two months later, "all the improvements had reverted back," Green says. "You have to keep on doing it."
Albert Wiegman, MD, a pediatrician at the Academic Medical Center in Amsterdam, The Netherlands, says all children at risk of heart disease later in life should be on a program of diet and exercise.
In a second study, Wiegman followed 211 children with an inherited susceptibility to very high cholesterol. The condition, called familial hypercholesterolemia, affects one in 400 children. Ultrasound tests showed that the youngsters had already begun to show signs of thickening of their blood vessel walls -- this can lead to clogged arteries.
Without intervention, the kids face an ominous future, Wiegman says: Their affected parents with the disorder died before they turned 40 years, on average.
By the end of the two-year trial, cholesterol levels had dropped an average of 25% in the group that took the statin, while staying stable in those who took the placebo. Ultrasound measurements showed that arteries had opened up in the kids who took the statin. In those on placebo, however, arterial thickening had worsened.
There were no side effects, Wiegman says. Children more than 14 years old took an adult dose, while younger kids were given half doses.
Vinay Nadkarni, MD, associate professor of anesthesia and pediatrics at the University of Pennsylvania in Philadelphia, says the findings are "remarkable."
"Intervention in highly motivated kids can not only halt the progression of plaque, but reverse it," says Nadkarni, who moderated a discussion of the findings.
So how to get young kids to take their medicine?
That's easy, Wiegman says. "Explain to them that just like they have to brush their teeth at night to keep their teeth clean and prevent decay, they have to take this pill to brush out their arteries.
"Kids are smart, they'll get it."