Dr. Eduardo Joutteaux | Pediatrics

Cardiovascular disease (ECV) in childhood

For a long time, we have been working on the primary prevention of ECV, that is, when there are risk factors that are avoided in order to prevent the progression of ECV. This may have been the right thing to do, but the rates of illness and death continue to rise, which means that these factors have not been controlled and that they have been installed.

You can have the genetic load (AHF) positive, with familiar branches of obese, with metabolic, endocrine alterations, HTA) that predisposes you to make alterations and most likely ends in the same

But the EPIGENETICA which are series of processes derived from an intake of toxic substances in poor diet, which modify by different processes (eg methylation) DNA messages.

It can be concluded that an individual is the product of their genetics, of their epigenetics in which this influence of environmental behavior is high in their diet.

Today we talk about PRIMORDIAL prevention, which is to act early, before symptoms of these alterations appear.

When should you act?

The intervention must be very early, it could be in prenatal stage, pre birth, in the pregnant mother. But much better in the PREGESTATIONAL stage, the woman must prepare herself to be a mother long before pregnancy, avoiding the entry of toxic elements into her body, smoking (including passive or involuntary), hypercaloric foods, with chemical preservatives, salt, saturated fats , etc.

Here obstetrician gynecologists are very valuable in prevention because they can insist with pregnant mothers on their recommendations on food, avoid contact with smoking and encourage physical activity.

When the child is born the pediatric intervention is very important, it must be avoided that it has a disorderly, chaotic growth, with exaggerated weight gains.

The pediatric controls during the first year of life serve for the pediatrician to monitor, regulate, advise and strengthen in the mother criteria of adequate nutrition and satisfactory growth.

That a fat kid does not mean he’s healthy.

That overweight or obesity cause SYSTEMATIC INFLAMMATION and that it is stored as information for your whole life and that you can REACT it in the future if the conditions of excess food exist.

Growth curves and weight gains help a lot, they should be used and respected.

WHAT ARE THE MOST EFFECTIVE PEDIATRIC INTERVENTIONS?  
1- BREASTFEEDING

It is the first and the most successful.

It must be secured for at least the first 6 months of the child’s life, ideal 12 months.

Weight gains from breastfeeding are temporary and regressive.

They do not leave damage or memory to suffer obesity.

There is no obesity due to breastfeeding.

Breastfeeding is the first vaccine for obesity.

The misfortune is the early return of nursing mothers to their work activities.

2- MONITORING AND CONTROL OF WEIGHT GAIN IN THE FIRST YEAR:

Advice and training of healthy eating habits.

3- ADVICE, FOLLOW-UP AND CONTROL:
what the child eats at different ages, it should be done in each consultation and not only in the first year.

4- INSIST AND REPEAT WHAT YOU MUST AND WHAT YOU SHOULD NOT EAT:

In school, suggest in a lunch box with healthy foods.

Excess intake of sodium and packaged and packaged carbohydrates.

There are high loads of proteins and fats, especially in milk formulas (cow’s milk).

Increased sodium intake is well documented with high blood pressure.

Likewise, high carbohydrate intake is related and documented with diabetes. It is shown that the degree of obesity and insulin resistance, the pro-inflammatory state and a tendency to lower plasma adiponectin, a cardiovascular protective factor, is associated.

The prevalence of DM2 in the pediatric age is parallel to the increase in obesity. DM2 evolves asymptomatically in most cases and is required for its diagnosis increased insulinemia as C peptide. There is a relationship between obesity in children and adolescents and the state of insulin resistance, dyslipidemia and hypertension in young adults.

It is shown that children fed with these hyperproteic formulas will be the ones who fatten and probably the future obese.

The industry of some milk formulas made believe that these hiperproteicas and hipercaloricas formulas allowed a better development, the terms were confused with fattening.

There are long-term studies that analyze eating behaviors and lifestyles with low intakes of Na, CH and proteins and achieve a reduction in metabolic alterations and consequently obesity and arterial hypertension.

Children who have had genetic and epigenetic risks of suffering from CVD have also been studied, at first they found fatty streaks and after 3 years they had atheromas.

Ultrasound of high resolution, detects early structural changes, such as thickening at the level of the carotid arteries, is a predictor for coronary heart disease and myocardial infarction in early adulthood.

The thickness of the intima media of the carotid artery in young adults who presented multiple risk factors from childhood is indicative of an accumulation of atheromatous fats or plaques in the coronary or cerebral arteries.

5- PROMOTION OF PHYSICAL ACTIVITIES:

“play sweating, it is always the best”

Recreation in the parks is always good. Preferable in family.

It must (fight, insist) for more physical activities in schools.

6-STIMULATING FAMILY FOOD:

Respect for meal times, integration and solidarity (everyone should eat the same).