Protecting Kids From Heart Disease

Video: Is Your Child Overweight?

Gray area. Drugs are clearly necessary for kids with type 2 diabetes and for those with an inherited form of high cholesterol in which LDL levels soar well above 200 mg/dL. But Spiotta thinks the right course of action for an overweight child with somewhat elevated cholesterol and blood sugar levels falls into a "gray area" requiring a talk involving parents, physician, and kid. The wisest move—changing the diet and exercise habits of the entire family—is often the hardest to implement.

For kids who barely tip the scales, simple solutions—like a daily walk or hour of outdoor play and a switch to low-fat dairy products—might do the trick. The easiest calorie saver? Substitute water for sugary sodas and fruit juices, which a June Pediatrics study found accounts for an average of 270 calories a day in kids ages 2 to 19. Establishing set meal times and periodic healthful snacks may also help your child avoid endless dips into the cookie jar. The government's food pyramid guidelines recommend offering kids a variety of fruits, vegetables, low-sugar cereals, and low-fat dairy products with a daily serving or two of meat or beans. They also suggest eating as a family, and using those times to get kids to sample new foods.

Those with hard-to-manage weight problems, like Kenderick Scorza, may require professional nutrition counseling to learn healthful eating strategies. Pediatrician Lawrence Rosen, vice chair of the AAP's section on complementary and integrative medicine, says psychological counseling may be needed, too. He teaches patients who overeat when they're stressed to find other ways to deal: a daily bike ride, prayer or meditation, listening to their favorite music, kid-friendly yoga classes. "These techniques also teach them to be more mindful about what and how much they're eating," Rosen explains. Pediatric obesity clinics, found in many large teaching hospitals, can provide a coordinated team of specialists—pediatrician specializing in weight issues, nutritionist, psychologist, exercise physiologist—to combine lifestyle changes with medication if necessary. Finding the right strategy may yield lifesaving payoffs for kids who have the beginnings of diabetes or vascular disease. "These conditions can be reversible if the right steps are taken," says Lavie.