March 21, 2004 Dr. Mark Nelson MD, FACC, MPH Capital Cardiology Associates Preventive Cardiology Preventing Childhood Obesity, Diabetes and Heart Disease: The Vegetarian Alternative Childhood obesity is the most serious and prevalent nutritional disorder in the United States. Over 22% of preschool children (aged 2-5) are overweight and over 10% are obese. Over 33% of our young people aged 6-19 years of age are overweight and 15% of them are obese. The number of overweight and obese children has doubled in the last two decades. Nine million American children are currently overweight or obese. The probability of childhood obesity persisting into adulthood is estimated to increase from approximately 20% at four years to 80% by adolescence. The metabolic disorders caused by obesity include hypertension, high cholesterol, inflammation, the metabolic syndrome (a constellation of these disorders) and type 2 diabetes. These metabolic disorders, as well as smoking and sedentary lifestyle are all potent risk factors for coronary heart disease (CHD). The metabolic syndrome (a precursor to diabetes) and diabetes mellitus are especially worrisome because 80% of diabetics die of cardiovascular disease. Because of the obesity epidemic, we are now witnessing growing epidemics of hypertension, high cholesterol, the metabolic syndrome and type 2 diabetes in our children and teenagers. 95% of all diabetics have type 2 diabetes for which obesity is overwhelmingly responsible. As a result of the obesity epidemic, the Centers for Disease Control (CDC) predicts that one in three children born in the U.S. in the year 2000 and one in two Hispanic females born in the U.S. in the year 2000 will develop diabetes! Recent studies indicate that approximately one third of all overweight adolescents in America have the metabolic syndrome. Many of these young people will go on to develop type 2 diabetes and coronary heart disease. If we do not interrupt this cycle of disease, the outlook for this new generation of Americans will be bleak indeed. Because of our unhealthy lifestyle to which our children are not immune, Americans adults and children are growing vascular disease. In America, coronary heart disease starts when we are 5, not 50 years old. One third of 20 year olds and one sixth of teenagers in America already have coronary heart disease. The obesity epidemic and its associated cardiovascular disease (CVD) risk factors is accelerating the epidemic of CVD (heart disease, heart attacks and strokes) already the greatest killer and women and men in America. There are currently 60 million obese Americans; by 2009 the CDC predicts that 68 million Americans will be obese. The obesity epidemic resulted in 400,000 preventable deaths in America in the year 2000; an increase of 33% from 1990, at a cost of $120 billion. The health and economic consequences of obesity will soon make the carnage from cigarette smoking look like an anthill. Our lifestyle is responsible for the vast majority of cardiovascular disease. 70% of U.S. adults and 50% of U.S. youth (aged 12-21 years) are sedentary. In a recent study, 56% of black and 31% of white teenage girls reported no habitual physical activity in their leisure time! In a recent international school based survey of 30,000 teenagers, U.S. teens were the most obese and the most likely to eat fast food, snacks and drink soda and more likely to be driven to school and other activities. Upon graduation the average U.S. high school senior will have spent 12,000 hours in the classroom and over 15,000 hours watching TV! In the face of this sedentary epidemic athletic activities are being stripped from our school curricula, and winning by the few is awarded more resources and recognition than ensuring the health of many. 80% of adult smokers start smoking before 18 years of age. The American diet is a recipe for coronary heart disease. Typical school lunches and snacks are laden with calorie dense foods, saturated fat and trans fat all of which contribute to obesity, diabetes and an atherogenic lipid profile (raising LDL, the "bad cholesterol" and lowering HDL, the "good cholesterol." This atherogenic diet is one of the major reasons for the growing epidemics of disease in our young people. Our children deserve more, they deserve to have a choice, the opportunity, to learn about the eat vegetarian. A vegetarian choice in our school could very well, over time, have a profound influence in stemming the tide of obesity and diabetes that increasingly afflicts our children. Rather than being cultural centers for health and learning our schools have become markets for corporate America. In over 12,000 schools across America school children are required to watch a 12 minute television program every day with two minutes of commercials from companies like McDonald's, Hershey, Pepsi, Coca-Cola, KFC, Frito-Lay, Domino's and 7Up. In many schools across America school administrators and school boards are bartering the health of our children for corporate funding. Pouring rights contracts open school doors to Coca Cola, Pepsi, Mcdonalds and others to sell their wares to a captive and helpless population; our children. This is, of course, a unique marketing opportunity allowing these corporate giants to hook young Americans on their artery clogging products for years to come. In exchange, schools request corporate donations for school projects and in so doing sacrifice the health our future generations for money. This is not a question of whether we call the football field the Pepsi Field. It is about whether our children's bodies and their futures will be healthy or diseased. Obesity and the diseases it causes are preventable and reversible. Coronary heart disease is preventable and reversible. It is time we set an example by how we live. It is time that our schools become centers of learning and centers of health and healing. It is time we give our children a healthy choice; eating vegetarian is such a choice. We owe it to ourselves, we owe it to our children.