We’ve all heard it before, “Coronary heart disease is the number one cause of death in the United States,” and “Everyone should exercise on a regular basis,” and “Watch what you eat and don’t smoke!” And yet, despite the fact that these long-standing pronouncements are a part of virtually every school’s health curriculum, according to the American Heart Association’s, Heart Disease and Stroke Statistics-2004 Update

minimal improvement has occurred in terms of America’s overall heart health. In fact, while the death rates from cardiovascular disease declined 9.2 percent between 1991 and 2001, the actual number of deaths increased 0.9 percent during that same period of time. Additionally, the American Heart Association has estimated that in 2004 the direct and indirect cost of cardiovascular disease in the U.S. will be $368.4 billion.

So what’s going on?

Can anything really be done about heart disease? What if you are born with heart problems? Or if your parents or grandparents have heart disease? How can we help our students understand that heart health is a “package deal,” and that if the heart is healthy then there will be benefits for the entire body?

We know that there are uncontrollable and controllable risk factors for heart disease. Uncontrollable factors include genetics/family history and age. A physician can monitor the health of those with a positive family history of heart disease through regular check-ups, and can also make recommendations regarding diet and physical activity. Controllable risk factors are those that are primarily a result of lifestyle choices such as diet, exercise, and smoking. We also know that those individuals with heart disease may be at a greater risk for high blood pressure, stroke and diabetes. And for those who smoke, respiratory illnesses are a major concern as well. Again, the family physician can monitor the individual’s health, and can make recommendations for changes that will have the maximum benefit. However, an individual may need to see the personal relevance of these changes since heart disease can be symptom-free for years.

Andrea Wallis Petho
Health & Fitness Section Editor

Some ideas on how we can incorporate not just the information, but effect a positive change, to decrease the likelihood that our students will engage in negative lifestyle choices, and consequently enjoy better heart health.

1. Physical Activity: We’ve heard it before and it bears repeating – children should participate in age appropriate physical (aerobic) activity on a regular basis. The CDC (MMWR June 2002) cites that 51.7 percent of high school students were enrolled in physical education classes in 2001, but only 32.2 percent attended P.E. classes on a daily basis – compared to 42% in 1991. The National Association for Sport and Physical Education (NASPE) issued a statement on December 30, 2003, which recommends increasing the amount of time that children should engage in physical activity. Healthy hearts need regular exercise.
2. Diet and Nutrition: As we know, kids don’t always make wise food choices. They may eat what their friends are eating, what’s in front of them, or what just plain tastes good. Childhood obesity is on the rise and should be addressed in our health curriculums as well as in our school cafeterias. Take a look at this lesson plan, Menu Madness, by Kimberly Emanuel on the Education World website. School-age children often eat fast foods, and don’t always equate the negative impact that high fat/high sodium foods can have on their heart and overall health. This lesson plan incorporates recommended daily allowances and allows students to compare the nutritive value of fast foods based on the RDA.
   
   This site: provides an online presentation by Dr. Gary English (New York Statewide Center for Healthy Schools) on “The Top Ten Reasons to Address Physical Activity and Healthy Eating in Schools.” It provides information (including statistics on obesity) you can share with fellow educators and parents.
3. Smoking: The good news - According to the World Health Organization (WHO), 1 year after quitting smoking, the risk of coronary heart disease (CHD) decreases by 50 percent. Within 15 years of quitting, the risk of CHD in the ex-smoker is close to that of a lifetime non-smoker. The not-so-good news – According to the American Heart Association, approximately 1.7 million Americans began smoking cigarettes daily in 1998. More than half of these were younger than 18 years of age. This equates to more than 4,000 new smokers per day, 2,000 of which are youths. A survey by the CDC in 2001 showed that the greatest prevalence of smoking in youths is among Non-Hispanic Whites (both male and female).
   
   Take a look at this interactive/ interdisciplinary website for teachers, students and parents: It includes activities, games and puzzles (as well as information) about heart health. The site (under the parent section) includes information on the effects of smoking, as well as resources to contact for assistance in quitting.
4. Chronic Disease Prevention:The CDC’s website called, “Healthy Youth: An Investment in Our Nation’s Future” provides information, site links and resources regarding the health of our youth. Online printable publications are also available (PDF format).
   
   “Children are our most valuable resource, and schools represent an opportunity to provide our children with valuable health skills." (US Senate Appropriations Committee Senate Report 107-84, 2002) Here’s another lesson plan, from Kirsten Rooks, on the Discovery School website. It’s called, “ Here’s to Your Healthy Heart!” and has information, as well as activity handouts, forms and questionnaires. It’s written for grades 6-8, but can easily be adapted for older students.
5. Role Models: As physical education and health educators, do we have a responsibility to be positive role models for our students? If we expect our students to incorporate the behaviors necessary for good heart health, should we emulate those behaviors as well? As hard as it may be, even a small change can result in significant benefits.
   

A fun website to share with your students regarding how risk factors can impact longevity. Included on the site is a calculator which figures an individual’s approximate life expectancy based on the answers to twenty-three questions related to lifestyle choices and family medical history. Consider having your students take the survey a second time after changing two or three of the answers to reflect positive changes, and then see how their life expectancy is recalculated. (An interesting side note is that according to the CDC, life expectancy in the US would rise by nearly seven years if all forms of major cardiovascular disease were eliminated.)

Food Facts: Here are some interesting facts to add to your lessons when considering appropriate nutrition for healthy hearts:

• A man weighing 150 pounds will need to eat approximately 50 tons of food during his lifetime, just to maintain his weight.
  
• Each day in the US people consume:
  
• 50 million pounds of sugar
  
• 3 million pounds of butter
  
• 47 million hot dogs
  
• 363 thousand square yards of pizza
  
• About 65% of the sugar Americans consume is in processed foods.
  
• Removing one tablespoon of fat from the daily diet can help most people lose up to 10 lbs. per year.
  
• Most 12 oz. cans of (non-decaffeinated) cola contain water, caffeine, carbonation, and about 9 teaspoons of sugar
  

(from, Rizzo-Toner, P. and Milliken, M., The Health Teacher’s Book of Lists: The Center for Applied Research in Education, 1999)