How to Raise a Heart-Healthy Child: Tips from Pediatric Cardiologists

It's never too early to start developing healthy habits. Supporting good heart health early in your child’s development will help lower the risk for heart disease, stroke and other major health problems later in life. Our experts from Lurie Children's Preventive Cardiology Program, Dr. Amanda Marma Perak, Dr. Kendra Ward, and Dr. Guilherme Baptista De Faria, offer tips for parents on how to improve your child’s heart health today, tomorrow and throughout adulthod.

Why Heart Health Matters for Kids

Heart disease might seem like an adult concern, but the foundation for cardiovascular health is built during childhood. The habits your child develops now can have an impact on their heart health in the future. Research shows that risk factors for heart disease, such as high blood pressure, high cholesterol and obesity, can begin in childhood and continue in adulthood. 
 
Children today face unique challenges. Increased screen time, more processed foods in the diet and less physical activity have contributed to a rise in childhood obesity and related heart health concerns. By prioritizing heart-healthy habits now, you're giving your child the best possible start for a long, healthy life. 
 
The good news is that children are incredibly adaptable. When healthy habits are introduced early and made part of the family routine, they become second nature. Your child's heart is growing and developing, and the choices you make together today can strengthen their cardiovascular system and reduce their risk of developing serious health problems later in life.

Encourage a balanced diet

Our bodies need a balance of healthy foods to stay strong. Because parents provide the menu, you can help shape your child’s choices by stocking the kitchen with nutritious foods. You can also teach by example – show your children how you put together and enjoy balanced, healthy meals for yourself. Here are some examples of foods for the whole family to enjoy and limit:  

Foods to Enjoy	Foods to Limit
Vegetables Fruits Whole grains Beans, legumes and nuts Plant-based proteins Lean animal proteins like skinless chicken or turkey breast Fish and seafood Low-fat, unsweetened dairy	Sweetened drinks (soda, juice, sweet tea, flavored milk) Red and processed meats Refined carbohydrates and added sugars Most white breads, pastries, cakes and crackers Processed, packaged, and fast foods Chips, sweets, packaged soups, chicken nuggets, hotdogs and fries Full-fat dairy products

Getting enough fruits and vegetables can be challenging. Extend your budget and limit waste by freezing extra fruits and veggies before they go bad, buying frozen and canned versions that can last longer, and skipping the more expensive organic produce. To manage picky eating, stock the vegetables you know your child tolerates (so they actually do eat a vegetable at every lunch and dinner!), but also encourage them to try other vegetables so that they can add variety over time.   
 
Parents can also teach their children how to listen to their body’s needs. Oftentimes we eat out of stress or boredom or for taste instead of real hunger. Offer meals and snacks around the same time every day and let nutritious vegetables, fruits and lean proteins make up the base of your child’s diet – this will help regulate your child’s internal hunger and fullness cues. Then teach your child how to check in with their belly when deciding when to eat and how much is enough, and listen to them when they tell you how their belly feels. Sometimes they really need that extra serving of protein when they’re very active or going through a growth spurt, and other times their bodies don’t need as much. 

Simple Swaps for Heart Health

Making heart-healthy choices doesn't have to be complicated or require a complete diet overhaul. Small, simple swaps can make a big difference in your child's nutrition. Here are some easy substitutions that can improve heart health without sacrificing taste: 

Breakfast Swaps:

• Swap sugary cereals for whole-grain oatmeal topped with fresh berries
• Replace white toast with whole-grain bread or English muffins
• Choose water or low-fat milk instead of juice or flavored milk

Lunch and Dinner Swaps:

• Use whole-wheat pasta, brown rice or quinoa instead of white pasta or white rice
• Replace ground beef with lean ground turkey or plant-based protein in dishes
• Swap fried chicken nuggets for baked chicken breast strips
• Choose baked sweet potato fries instead of regular French fries

Snack Swaps:

• Replace chips with air-popped popcorn, veggie sticks with hummus, or a handful of nuts
• Swap cookies or candy or fresh fruit or a homemade trail mix of unsalted nuts and dried fruit (no added sugar)
• Choose water, sparkling water with a splash of fruit juice or unsweetened herbal tea instead of soda or sports drinks

Cooking Method Swaps:

• Bake, grill or steam foods instead of frying
• Use olive oil or avocado oil instead of butter when cooking
• Season foods with herbs and spices instead of salt

Dairy Swaps:

• Choose low-fat or skim milk instead of whole milk
• Select low-fat yogurt and add your own fresh fruit instead of buying pre-sweetened varieties
• Use low-fat cheese or reduce the amount of cheese in recipes

These simple swaps can help reduce saturated fat, sodium, and added sugars in your child's diet while increasing their intake of whole grains, fruits, vegetables, and healthy fats. Remember, you don't need to make all these changes at once. Start with one or two swaps that seem easiest for your family and build from there. We don’t have to eat perfectly all the time, and it’s great to enjoy our favorite treats occasionally. But a healthy, balanced diet will help your child stay nourished and well. Find more healthy eating tips and resource here. 

Prioritize good sleep

Our bodies and brains need sleep. While we sleep, our muscles and bones grow and become stronger, and our immune systems go to work. Our brains sort through and store information, replace chemicals and even solve problems while we snooze.

Getting a good night’s sleep every night is also vital to heart health. Too little sleep increases stress hormones in the body and can lead to higher blood pressure and obesity in kids. Sleep needs depend on age: teens need about 8-10 hours per night, while elementary school-aged children need 9-12 hours. Younger kids and babies need even more.

But with today'stechnology and busy schedules, it can be even more difficult to get a good night’s sleep. Here are a few tips to help encourage healthy sleep for your child:

• Stick to a regular bedtime, and don’t let it vary much on the weekends.
• Turn off all screens at least 1 hour before bedtime.
• Encourage a daily bedtime routine that is calming, such as taking a warm bath, reading (an actual book, not a screen!), journaling, drawing or other pleasurable activities.
• Provide a quiet, cool, dark space for your child to sleep, and remove all electronics from their bedroom or sleep space.
• Avoid letting your child be overscheduled – think carefully about evening or early morning commitments. Encourage sports, clubs and other activities that don’t interfere with a good night’s sleep.
• Recognize sleep problems, such as heavy snoring, restless sleep, or daytime sleepiness, and talk to your child’s doctor to get to the bottom of it. 

Find out more information about healthy sleep by age here. 

Get moving 

Physical activity is central to a healthy, strong body. Regular exercise can prevent heart disease in the future and reduce the risk of chronic diseases like obesity and high blood pressure. Physical activity also releases hormones that make you feel good, keeping the brain and body happy.  

Kids and teens need at least 60 minutes of physical activity every day to keep them healthy. The 60 minutes can be broken up throughout the day, for example 20 minutes of activity three times per day. Most of this will be heart-pumping aerobic exercise, like running around or playing basketball. Older kids and teens also need to include bone and muscle strengthening activities (such as climbing, push-ups, or weight training) at least 3 days per week.  

Encourage your kids to find activities they enjoy so movement becomes a normal part of their day. For some kids, this means playing with friends at the park, riding bikes or kicking a ball around the yard. Others enjoy more structured activities such as team sports, going to the gym or doing fitness videos at home. Parents can get involved by taking the whole family on a short (or long!) daily walk or letting your kids see how you like to get your physical activity in. Lurie Children’s Early Childhood Physical Activity Toolkit is full of creative ways to encourage movement from a young age.

Parents can also encourage kids to be more active by limiting recreational and especially passive screen time (like watching videos, as opposed to creating something). Screen time should never get in the way of healthy sleep or staying active. For more tips and information, check out Digital Wellness Lab's guides for parents and caregivers on raising kids in the digital age.

Heart Health Risk Factors in Children

While we often think of heart disease as an adult condition, certain risk factors can develop during childhood and significantly impact long-term cardiovascular health. Understanding these risk factors can help parents take proactive steps to protect their child's heart. Here are some common risk factors to monitor: 

• Family History: If you have a family history of early heart disease, high cholesterol, high blood pressure or stroke, your child may be at increased risk. 
• High Blood Pressure: Also known as hypertension, high blood pressure in children is becoming more common, often related to obesity and lack of physical activity. Regular blood pressure checks during well-child visits are important for early detection.
• High Cholesterol: Children can have elevated cholesterol levels, which may be genetic or related to diet and lifestyle. 
• A Child with Overweight BMI: Excess weight puts strain on the heart and increases the risk of developing high blood pressure, high cholesterol and type 2 diabetes. These conditions can damage blood vessels and the heart over time.
• Type 2 Diabetes: Once rare in children, type 2 diabetes is increasingly diagnosed in young people, particularly those who are overweight or obese. This condition can damage blood vessels and significantly increase heart disease risk.
• Lack of Physical Activity: Sedentary lifestyles contribute to obesity, weak muscles (including the heart) and poor cardiovascular fitness. Children who are inactive are more likely to develop heart-related health problems.
• Poor Diet: Diets high in saturated fats and added sugars and low in nutrient-rich foods (fruits, vegetables, whole grains) can contribute to obesity, high cholesterol and high blood pressure, all of which are risk factors for heart disease.
• Secondhand Smoke Exposure: Children exposed to secondhand smoke have an increased risk of developing heart disease later in life. 
• Certain Medical Conditions: Some children are born with congenital heart defects or develop conditions like Kawasaki disease that can affect heart health. Others may have underlying conditions like kidney disease that increase cardiovascular risk.

If your child has one or more risk factors, don't panic. Many of these risk factors can be improved through healthy lifestyle changes. Work with your child's doctor to develop a plan that addresses specific concerns while promoting overall health and wellbeing. Early intervention can make a significant difference in your child's long-term heart health. 

When to Talk to a Doctor

While promoting healthy habits at home is essential, there are times when you should consult with your child's healthcare provider about heart health concerns. Seek immediate medical attention if your child:

• Has Severe Chest Pain: Especially if accompanied by difficulty breathing, dizziness, fainting or pain that radiates to the arms, neck or jaw.
• Faints or Loses Consciousness: Particularly during or immediately after physical activity, as this could indicate a heart rhythm problem.
• Has Extreme Shortness of Breath: Difficulty breathing that is severe, sudden or not related to asthma or other known conditions.
• Shows an Irregular Heartbeat: If you notice your child's heart is racing, skipping beats or beating irregularly, especially if accompanied by other symptoms like dizziness or weakness.
• Experiences Unexplained Swelling: Swelling in the legs, ankles or around the eyes can sometimes indicate heart problems.
• Has Unusual Fatigue: Extreme tiredness that interferes with normal activities, especially if combined with other symptoms.

Remember, your child's doctor is your partner in promoting lifelong heart health. Regular well-child visits provide opportunities to monitor growth, screen for risk factors and address any concerns. Most pediatricians check blood pressure starting around age 3 and may recommend cholesterol screening based on family history and other risk factors. 

By maintaining open communication with your healthcare provider and staying proactive about your child's health, you can catch potential issues early and set your child on the path to a healthy heart.

Learn more about Lurie Children’s Heart Center 

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