DC Child Accident & Safety Blog

Are you sitting down? A study of teenagers showed that sedentary behavior increased as they aged, and at the expense of physical activity. The culprit is the allure of an electronic screen.

As interpreted by the American College of Sports Medicine, (ACSM) cardiorespiratory fitness (CRF) levels could improve in childhood if kids spent less time in front of a screen. The study was published in the official journal of the ACSM, Medicine & Science in Sports & Exercise.

Researchers assessed more than 2,000 children ages 11 to 13 in their relationship between sedentary time spent in front of a screen and changes in CRF. Boys and girls living in a single city in England were studied. Intervals of screen time were broken into segments of 10-19, 20-29 and more than 30 minutes.

As the children grew older, they generally grew more sedentary. By the time they were 16, on average, they spent 121 percent more time sitting in front of a screen for longer than 30 minutes than at the beginning of the study.

Those who reported more screen time were able to complete fewer running laps. The association was strongest for the children who started with mid-to-high CRF levels, and was independent of physical activity levels.

It isn’t exactly rocket science to conclude that the popularity of electronic media can be a threat to cardiovascular development, whether you’re playing “Call of Duty: Modern Warfare,” updating your Facebook page or texting your homework assignments to your bff. And that if sedentary habits of kids become the sedentary habits of adults, that’s an invitation to all the disorders that can reflect poor cardio fitness—heart disease, diabetes and obesity.

“[S] pending too much time sitting is hazardous to children’s health,” the study’s lead author said. To co-opt the words of Romantic-era poet William Wordsworth, “The Child is father of the Man.”

Childhood is generally the time when we begin establishing the bad habits—eating poorly, overeating, being sedentary—that later come back to haunt us in the form of diabetes, heart disease and a higher risk of cancer.

But the American Academy of Pediatrics (AAP) has determined that for youngsters, it’s almost never too early to be screened for high blood pressure.

A large—no pun intended—-part of the concern is that one-third of children and teenagers are overweight or obese. The forecast is grim—as much as half the population, researchers say, could be obese by 2030.

As noted above, obesity invites myriad health problems, including high blood pressure. According to a story on NPR, pediatricians are seeing the roots of these diseases in kids as young as 3.

Diagnosing hypertension (or high blood pressure) in kids is more complicated than for adults. The numbers rendered when the nurse applies the cuff to an adult arm are pretty clear—if they’re higher than 140 over 90, you’re at risk. But those values vary for children according to their age, gender and height.

So doctors must not only measure a child’s blood pressure, but compare it to standards of normalcy for children with the same traits as the patient. What’s normal for an 8-year-old girl isn’t what’s normal for a 15-year-old boy.

Sometimes pediatricians neglect to measure their patients’ blood pressure. The NPR story noted that among children eventually diagnosed with high blood pressure, only about 1 in 4 had it recorded in his or her chart. As a parent, you should insist on this simple, painless procedure.

And even if the notation is made, if the doctor fails to consult the varying standards, a high reading might not be recognized. So after the reading is taken on your child, ask what is deemed normal for a kid like yours. Don’t accept a response such as “he’s fine,” or “there’s nothing to worry about here.” Get the values and ask how they will change as your child grows. This not only reinforces your participation in your children’s care, it models how they should manage their health care as adults.

The risk of not diagnosing high blood pressure early is setting up a child for premature problems. We recently reported about the wisdom of testing children for high cholesterol for the same reasons. People as young as 20 or 30 can suffer a stroke that results from hypertension that might have been recognized sooner.

One estimate counts 2,000 children and teens among people who suffer strokes every year as a result of high blood pressure.

But unlike many adults, children don’t necessarily require medication to control hypertension. Simple lifestyle changes generally bring positive change in their health profile. As usual, reducing high-fat foods and high-sugar drinks, and increasing activity make a big difference. And, because kids have higher metabolism, they’re better at losing weight.

Most high blood pressure in children is found during routine medical exams. According to the AAP, these symptoms also can indicate hypertension:

• headache;


• dizziness;


• shortness of breath;


• visual disturbances;


• fatigue.



Posted by Patrick A. Malone | Permalink | Email This Post

Posted In: Heart

Happily for most parents, heart trouble is pretty well off their child-care radar. When a child succumbs to cardiac arrest, often it’s a shock and a surprise.

But by some estimates, according to a recent story on MedPage Today, there might be warning signs in as many as half of all cases of sudden cardiac arrest in children. Awareness by clinicians of these signs and a thorough understand of family history by both parents and pediatricians can prevent sudden cardiac arrest in youngsters, says the American Academy of Pediatrics in the journal Pediatrics.

A primary point in the academy’s statement was that some symptoms of cardiac problems in children commonly are associated with other, less dire disorders. Pediatricians must remain not only vigilant in observing them, but open-minded about their cause because pediatric sudden cardiac arrest can be lethal within minutes if it goes unrecognized and untreated.

Approximately 2,000 such deaths are estimated to occur annually in the United States.

Symptoms can include chest pain, dizziness, exercise-induced syncope (temporary loss of consciousness) and dyspnea (difficult or labored breathing). Any or several of these symptoms might have been disregarded by the patient and family, the article notes.

A detailed family history that yields knowledge of a sudden, unexplained death of a young relative also warrants scrutiny of any child exhibiting symptoms of what can easily be ascribed to getting tackled on a Pop Warner football game, or too many rides on the Tilt-a-Whirl.

The most common underlying causes of sudden cardiac arrest among children are:

• structural or functional disorders such as hypertrophic cardiomyopathy, a heart defect in which the muscle wall is so strong that it can’t relax enough to allow sufficient blood flow;


• coronary artery anomalies, or congenitally malformed heart vessels;


• primary cardiac electrical disorders, when the heart’s electrical system malfunctions.

An afflicted child most frequently experiences ventricular tachyarrhythmia, which is an abnormal heart rhythm that is rapid and regular. It originates in the lower chamber, or ventricle, of the heart. Sometimes arrhythmias are of short duration, and resemble seizures.

If a doctor or parent believes a child is having a seizure, he or she probably will be referred to a neurologist. If the real problem, however, is heart-related, the delayed diagnosis can be disastrous.

Similarly, if a child experiences breathing trouble, someone might believe he or she has a respiratory problem, and send to a pulmonary specialist.

If your child has experienced any of the symptoms above, was diagnosed and treated for a problem other than a heart issue and has not responded, see a pediatric cardiologist immediately.

The academy advises use of these risk-assessment tools, which haven’t been validated or assessed for sensitivity or specificity; nevertheless, experts emphasize that if any of the following have occurred, the patient should get a cardiac assessment as soon as possible:

• a history of fainting or having a seizure, especially during exercise;


• past episodes of chest pain or shortness of breath with exercise; and/or


• a family member with unexpected sudden death or a condition such as hypertrophic cardiomyopathy or Brugada syndrome (a certain kind of heart rhythm disorder heart rhythm disorder characterized by a specific abnormal heartbeat and detected by an electrocardiogram test).

Although heart screenings have long been overused, in the case of young athletes, the academy advised against following earlier American Heart Association guidelines that did not endorse widespread use of ECG tests. (The AHA rightfully cited the possibility of false-positive and false-negative results, additional cost and associated problems.) The academy advised screening young athletes before they participate in sports.

The academy also recommended that automated external defibrillators be widely available in schools, as well as cardiopulmonary resuscitation training of staff and others. Parents should determine if these tools are present in their child’s school, and lobby for them if they are not.