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We owe a lot to the small community of Bogalusa, Louisiana, and a physician whose work has greatly advanced our knowledge about the progression of heart disease. For three decades, renowned cardiologist Gerald Berenson and his team of researchers have conducted the longest, most detailed study of children in the world; in the process, the Bogalusa Heart Study has provided invaluable insights into the natural history of coronary heart disease and hypertension.
“We have an unprecedented wealth of knowledge about the lifestyle, dietary habits, and cardiovascular risk factors of this population,” noted Dr. Berenson, director of the Tulane Center for cardiovascular health and founder of the study. “Very clearly, adult heart disease, hypertension, diabetes [type 2] and obesity begin in childhood. We know how to study risk factors in children, and we have an understanding that lifestyles begin in childhood. Most of all, we’ve learned the importance of prevention. As the majority of the population grows older, study of the aging process and longevity becomes increasingly important from a public- health perspective.”
Since 1972, the research team has tracked health histories of over 14,000 children and young adults--analyzing blood samples, measuring blood pressure, assessing height and weight, and interviewing the children and parents about food and lifestyle choices--yielding a vast treasure of data that have been included in over 700 publications and numerous books.
Dr. Berenson’s findings prove even more relevant in light of the recent dramatic increase in obesity among youth and adults. While many adults may believe that overweight children are simply passing through a harmless phase and will eventually outgrow youthful obesity, research demonstrates a much different conclusion. Bogalusa researchers have found evidence of coronary heart disease and arteriosclerosis in children as young as five years old. Unfortunately, early patterns tend to persist throughout life.
“Looking at height and weight, overweight children are going to be obese in adulthood,” Dr. Berenson told NHW. “The message from Bogalusa is: our population
has an epidemic of obesity, an epidemic of coronary artery
disease.”
The ongoing study also shows that health risk factors often emerge in groups, leading to more serious chronic diseases later in life.
“Multiple risk factors tend to cluster and reinforce themselves,” Berenson notes. “High LDL (bad) cholesterol levels, high triglycerides, low HDL (good) cholesterol, and obesity are risk factors that we
have found elevated in the youth population.”
A longtime advocate for early intervention and prevention, Dr. Berenson’s research underscores the role that lifestyle and behavior, such as poor diet and inactivity, play in disease. Adopted within a child’s first few years of life, choices dramatically influence cardiovascular risk later on. His team developed an innovative program called Health Ahead/Heart Smart to help teach healthy behaviors to youth.
“The best way to approach prevention is through health education,” says Berenson. “Health Ahead/Heart Smart is a comprehensive initiative. We address the entire school environment--lifestyle changes for teachers, changes in the cafeteria, and increasing physical activity for all kids on the school grounds. The program includes 75 noncompetitive exercises. We also have a program to get parents and the community involved with newsletters and health fairs. For example, we have fun runs across the country, celebrating areas of historic interest. Along the way, students can talk about the geography of special areas, and we integrate mathematics with heart and pulse rates. The thrust of the program is behavioral orientation, starting in kindergarten.”
To learn more about Health Ahead/Heart Smart, write The Tulane Center for Cardiovascular Health, SL29 1430 Tulane Avenue, New Orleans, LA 70112-2699 or e-mail Dr. Berenson at berenson@tulane.edu.
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