Improving lifestyles in children aids in preventing cardiovascular deaths, according to an innovative school project in Brazil
Encouraging activity and improving diet in children is crucial to cut deaths from cardiovascular disease and it is the focus of an innovative school project in São Paulo, Brazil. The first results were presented at the Brazilian Congress of Cardiology (SBC 2019).
“Atherosclerosis – clogged arteries – starts in childhood and is more likely with a sedentary lifestyle and unhealthy diet,” said study author Dr Karine Turke, of ABC Medical School, São Paulo. “Exposure to these behaviours throughout life increases the risk of heart attacks and strokes, so prevention should begin in childhood. Yet children are sitting more, eating processed foods, and obesity is becoming the norm.”
Cardiovascular disease is the world’s number one killer, causing 17.9 million deaths a year. The World Health Organization (WHO) estimates that the number of overweight or obese infants and young children rose from 32 million globally in 1990 to 41 million in 2016.2 Around 3.2 million deaths each year are due to insufficient physical activity.
Physical activity is well below the level recommended by the WHO, which is 300 minutes per week for children and adolescents
The School project is set to enlist 3,000 monitors (teachers and students) to receive cardiovascular education. Monitors will then teach 63,000 students aged 6 to 18 from 210 public schools in the state of São Paulo. The first teaching is on School Heart Day, held 25 September 2019, when students will also have baseline measurements of diet and activity. This will be followed by further education and monitoring of diet and activity levels.
Cardiovascular education will address seven risk factors (physical inactivity, obesity, smoking/other drugs, dyslipidaemia, high blood pressure, diabetes, and stress) and two protective factors: healthy eating and regular physical activity. Schools are expected to promote exercise and good eating habits. Input will be provided by numerous disciplines, including cardiologists, nurses, teachers, and psychologists.
Results from the pilot project showed baseline results in the first 433 students. The median age was 13 years and 51% were male. The median time spent doing mild, moderate and vigorous physical activity over one week was 40, 60 and 60 minutes respectively. The median sitting time was 360 minutes per week.
“Physical activity is well below the level recommended by the WHO, which is 300 minutes per week for children and adolescents,” said Dr Turke. “Modern lifestyles promote interaction by mobile phone and video games. There is less security on the streets so children cannot play outside. The programme encourages less sedentary time and finding ways to move around more.”
“Many had eaten processed foods, which are easier for parents to prepare than cooking from fresh ingredients,” said Dr Turke. “Students will learn to classify foods as fresh, minimally processed, processed, and ultra-processed, and to prioritise fresh and minimally processed items.”
Professor Carlos Aguiar, course director of the ESC programme at SBC 2019, said: “Improving lifestyles in children is a collective responsibility. Lawmakers should restrict marketing of junk foods and sugary drinks to children. Schools can provide fresh drinking water and healthy foods in cafeterias and vending machines and hold regular activity breaks. Communities need parks and playgrounds. These efforts and others should go a long way to reducing cardiovascular events in the long run.”
