Teenager heart of the matter
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Transcript of Teenager heart of the matter
TEENAGERS HEART OF THE MATTER
Dr. Vikas Kohli MD FAAP FACCAMERICAN BOARD CERTIFIEDSENIOR CONSULTANT PEDS CARDIOLOGYINDRAPRASTHA APOLLO HOSPITAL
HOW MANY ADULTS IN THIS ROOM ….. WILL NOT HAVE A HEART ATTACK IN THE
NEXT 10 YEARS ?
SIMILARLY, WILL YOUR TEENAGE CHILD OR GRANDCHILD NOT HAVE A HEART ATTACK BEFORE HE/SHE IS 45 YRS OF AGE ?
ARE WE DOING ENOUGH OR HEADING STRAIGHT THERE ?
OBESITY IN CHILDREN
Adolescent Overweight and Future Adult
Coronary Heart Disease
New England Journal of Medicine 2007
OBESE TEENAGERS BECOME OBESE ADULTS Study from California:
Based on statistics and current obesity rates, by 2020:
37% males and 44% females would be obese when they are 35 yrs
This is based on overweight adolescents in 2000 in USA
This would add 19% extra load of heart patients
"Today's adolescents are the young adults of tomorrow -- young adults who would ordinarily be working, raising their families, and not worried about heart disease until they are much older.”
But actually majority of them would be spending a lot of time in hospitalizations and treatment and with medications before they turn 50.
Eighty percent of overweight adolescents become obese adults
Indian Children 13–18 years (n=4700, M:F 2382:2318)
were studied. Body mass index (BMI) was measured. Data on physical activity, food habits, occupation of parents and their economic status, birth weight of the children and age at menarche
prevalence of overweight was 17.8% for boys and 15.8% for girls
Diabetes Research and Clinical Practice
2002
Asia Pac J Clin Nutr 2008
Factors influencing Obesity Birth Weight Life Style Index Diet Parental Obesity Activity Level Time on Computer/TV Snacking
PREVELANCE OF OBESITY childhood obesity varies from over 30%
inUSA Less than 2% in sub- Saharan Africa. 20% in U K and Australia 15.8% in Saudi Arabia 15.6% in Thailand, 10% in Japan 6.2% in Chennai, 7.4% in New Delhi
Hypertension and Obesity Incidence of HTN in Obese kids is 17%
vs in 10% of normal kids
The 10% in a particular study appears very high
HEART PROBLEMS AT YOUNG AGE
How common is fat deposition This study demonstrates that coronary
atherosclerosis begins at a young age and that
lesions are present in 1 of 6 teenagers. These findings suggest the need for intensive efforts at coronary disease prevention in young adults.
What is Fat deposition
General Comments Arteriosclerosis
Thickening and loss of elasticity of arterial walls Hardening of the arteries Greatest morbidity and mortality of all human
diseases viaNarrowingWeakening
18
ATHEROSCLEROTIC PLAQUE
NORMAL ARTERY ATHEROSCLEROTIC PLAQUE
Non-Modifiable Risk Factors
Age A dominant influence Atherosclerosis begins in the young, but
does not precipitate organ injury until later in life
Gender Men more prone than women, but by age 60-
70 about equal frequencyFamily History
Familial cluster of risk factors Genetic differences
Modifiable Risk Factors(potentially controllable)
HyperlipidemiaHypertensionCigarette smokingDiabetes MellitusElevated HomocysteineFactors that affect hemostasis and
thrombosis Infections: Herpes virus; Chlamydia
pneumoniaeObesity, sedentary lifestyle, stress
Normal Artery
Response to Injury
Endothelial Dysfunction
Initiation of Fatty Streak
Fatty Streak
Fibro-fatty Atheroma
Fatty Streak-Aorta
Fatty Streak-Coronary Artery
Normal Artery
Unstable angina with plaque disruption
used with permission from M.J. DaviesAtlas of Coronary Artery Disease 1998Lippincott-Raven Publishers
The plaque cap is torn,projects into the lumen, exposing a mass of thrombus filling the lipid core
WHY THIS IS HAPPENING
Life Style Diet Exercise TV Snacking Computer Lack of urban planning Peer group
ROLE OF FAMILY
Primary Role Estab right dietary habits
Exercise as a part of life
Be a role Model
Decrease In House time: spend time at Sports complexes
ROLE OF SCHOOL
Peer Group & Social Impact This is where they see and decide
complex things in their life They also listen to teachers differently
as compared to parents Exercise and good health a routine
REMOVING ACADEMIC PRESSURE
ROLE OF DOCTOR
GUIDING Main role is to guide
Dietary Implications of Protein VS Carbs Vs. Fat
Early Assessment and Sounding the Alarm
ROLE OF MEDIA
RESPONSIBLE They carry responsibility of not drilling
into heads of kids the great value of Junk Food
They should understand the implications of advertisements
WHAT ARE OTHER COUNTRIES DOING ABOUT IT
LETS MOVE
Active Families: Engage in physical activity each day : a total of 60 minutes for children, 30 minutes for adults.
Active Schools: A variety of opportunities are available for schools to add more physical activity into the school day, including additional physical education classes, before–and afterschool programs, recess, and opening school facilities for student and family recreation in the late afternoon and evening.
Active Communities: Mayors and community leaders can promote physical fitness by working to increase safe routes for kids to walk and ride to school; by revitalizing parks, playgrounds, and community centers; and by providing fun and affordable sports and fitness programs.
Lets Move Healthy Moms
Healthy Communities
Healthy Families
Healthy Schools
WHAT CAN WE
DO IT FOR OUR
KIDS
OURSELVES EDUCATE OURSLEVES MORE ABOUT
DIET AND EXERCISE RELATED ISSUES
AT HOME IMPROVE DIETARY HABITS
INCREASE SPORTS AND ACTIVITY
DECREASE TV AND COMPUTER TIME
DON’T BUY OR ALLOW KIDS TO BUY SNACKS
AT SCHOOL MAKE HEALTHY FOOD AVAILABLE AT
SCHOOL
INCREASE ACTIVITY/SPORTS INVOLVEMENT
DECREASE ACADEMIC PRESSURE
AT COMMUNITY LEVEL INCREASE AVAILABILITY OF SPORTS
COMPLEXES
MAKE MALLS PLACES WHERE MORE PHYSICAL ACTIVITY IS INVOLVED
DIETARY HAZARD FOODS WITH WARNING AND LABEL
WE CAN DO IT
THANK YOU