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Richard Termine
Dr. Valentin Fuster of Mount Sinai Hospital with “Dr. Valentin Ruster,” his Muppet counterpart on “Sesame Street” in Spain.
THE SPECIALIST: Dr. Valentin Fuster
As the director of Mount Sinai Heart at Mount Sinai Hospital, Dr. Valentin Fuster is a cardiologist who specializes in the prevention and treatment of heart disease. He also oversees programs around the world helping to promote a heart-healthy lifestyle for children.
WHO’S AT RISK
Since 2006, Mount Sinai cardiologist Dr. Valentin Fuster has teamed up with “Sesame Street” to use characters like Elmo to introduce heart-healthy ideas and actions to young kids — “Sesame Street” in Spain even has named a Muppet physician “Dr. Valentin Ruster.” (Fuster is a native of Barcelona.)
“What we’re discovering is that a lot depends on what children learn about health from age 3 to 6,” says Fuster. “Programs around the world are working with ‘Sesame Street’ to advance two goals: one is to prevent children from becoming obese, and the other is to teach children how to take health seriously.”
At this point, 1 in 3 American children is overweight or obese. “What weight counts as obese depends on the age of the child, but the most common situation is that parents know their child is overweight or obese,” says Fuster. “The great problem is what do we do about it?”
Medical research has found that 50% of all adult obesity started in childhood. “There are two main categories of risk factors for childhood obesity: the environment that the children live in — what habits the family has about nutrition and exercise — and genetics,” says Fuster. “What is really remarkable is how much children as young as 3 or 4 can learn about good habits in terms of nutrition, exercise and knowing your body, which is very positive for their health as adults.”
There’s a direct correlation between childhood obesity and adult health problems like heart attack and stroke. “Obesity itself is a risk factor and the root of three other heart disease risk factors: high blood pressure, diabetes and alterations of cholesterol levels,” says Fuster. Smoking and not exercising are the other primary risk factors for cardiovascular disease.
SIGNS AND SYMPTOMS
While adulthood obesity can often be measured simply by BMI — body mass index — it’s more complicated for children.
“It’s not so much a question of numbers, because the BMI guidelines for children change depending on their age,” says Fuster. “For instance, the amount of body fat that is considered in the healthy range changes with age, and the amount of body fat that is normal in boys is different than the level in girls.”
Most parents are good judges of whether their child’s weight is healthy or excessive. Fuster says, “The good news for parents is that we are increasingly aware of how we can help children to promote their own health in ways that will benefit them for the rest of their lives.”
TRADITIONAL TREATMENT
Any adult who has tried to lose weight or stop smoking knows that changing habits is very hard, but it’s much easier for children.
“Once children learn core concepts about nutrition and exercise, they can actually observe and quite quickly act to change their own habits,” says Fuster. “What we’re learning from our study and others is that adults need the support of other adults to make changes — sort of like AA, but in terms of general health, whether it is weight loss, or lack of exercise, or tobacco use, or blood pressure.”
Programs around the world are taking a new, hands-on approach to teaching children about how to stay healthy. “One of the programs we run spent 40 hours over six months teaching children ages 3 to 6 four key concepts: how their body works, what to eat to avoid being overweight, how to get enough physical exercise, and how to control their emotions — how to say no to something they might otherwise want to eat,” says Fuster. “Our priority is the promotion of health, and it’s wonderful to see how little 3- or 4-year-old children can really get that.”
One of the challenges in helping children get healthy is ensuring the adults who surround them are on board. “There’s still the attitude in some communities that the more a child eats, the healthier it is,” says Fuster. “What we’re trying to drive home to parents and caregivers is just how damaging it is for children to be overweight at a younger age. Childhood is the time to turn this around.”
RESEARCH BREAKTHROUGHS
After decades of studying cardiovascular disease, doctors are taking a new tack. “The move is from thinking in terms of disease to health — treating disease is expensive, but promoting health is much cheaper,” says Fuster. “One of the toughest questions is how do we change lifestyle? We are looking for a methodology that helps us do this.”
At the American Heart Association’s Scientific Sessions next week in Dallas, Fuster and his team will present the three-year results of their pilot study using “Sesame Street” to educate preschoolers in Colombia.
QUESTIONS FOR YOUR DOCTOR
A question all parents should ask is, “What’s a healthy weight range for my child?” Don’t be afraid to ask, “Is my child overweight?” and “What resources do you have to help me break unhealthy habits in the home?”
“Making lifestyle changes is hard, but it will probably be easier for your kids than for you,” says Fuster. “Don’t put it off or give up. Helping kids form healthy habits is a gift that will benefit them for the rest of their lives.”
WHAT YOU CAN DO
Get informed. Government at the federal and local levels is working to help kids live healthy lives. For example, “Let’s Move!” (letsmove.gov) gives “simple steps to success,” and NYC.gov has brochures with “proven tips for parents.”
Know the big six risk factors. Ninety percent of heart attacks and strokes are due to the root causes of obesity, diabetes, high blood pressure, high cholesterol, smoking and a sedentary lifestyle. Childhood obesity puts kids at risk of four of these factors.
Switch your brain. “Your brain must decide to either take care of yourself and be healthy or not,” says Fuster. Talk to your doctor if you need help breaking old habits — both for you and your kids.
