January 6, 2022/Pediatrics/Cardiology

Counseling Children and Their Families on Healthy Eating Patterns

Pediatric cardiologist urges families to ‘start with a heart-healthy lifestyle’


More than 20% of children and young adults in the U.S. have obesity — many of them will bring this excess weight with them into adulthood, increasing their risk for obesity-related conditions.


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“As pediatricians and subspecialists, we must closely monitor this in our patients,” says Christina Fink, MD, a pediatric cardiologist at Cleveland Clinic Children’s. “Excessive adiposity increases patients’ risk of metabolic syndrome, which is associated with elevated cholesterol levels, elevated blood pressure and insulin resistance. All of these conditions negatively impact the cardiovascular system over time,” she says.

Dr. Fink recommends working with patients and their families early on to establish good lifestyle habits because “it’s easier to start with a heart-healthy lifestyle than to reverse the negative effects later in life.” She explains, “Younger children are more likely to follow healthy lifestyle changes than adolescents, but it is still worth the effort for the potential benefits.” And making lifestyle changes to improve heart health is beneficial at any time in childhood, emphasizes Dr. Fink.

Diet intervention study compares outcomes of 3 diets

This was also the conclusion of a recent diet intervention study led by Cleveland Clinic researchers. The team prospectively enrolled 96 patients, ages 9 to 18, most with a body mass index > 95% in a year-long trial. Patients were randomly assigned to one of three healthy eating patterns: a plant-based diet, the American Heart Association diet and the Mediterranean diet.

Although there are slight derivations among each, they all emphasize whole foods, fruits, vegetables, whole grains, beans and other legumes and restrict added salt, saturated fatty acids, added sugars, red and processed meats and other processed foods.


Study findings show that all three diets were associated with similarly significant improvements (P < .05 to <.001) in cardiovascular disease risk marker improvements in weight, systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein and myeloperoxidase at four and 52 weeks.

The authors say that their findings support counseling families and patients to choose an eating pattern they like best and can follow most closely. Also, they stress, perfect compliance is not needed to improve outcomes.

Study enrollment skewed younger than older children, and younger children were also less likely to have concerns about the intervention than adolescents. The authors say this aligns with the literature in terms of generally better adherence to family-based diet interventions among younger children.

Be Well Kids Clinic

Cleveland Clinic Children’s Be Well Clinic offers a multidisciplinary team of specialists trained to assist children, ages 2 to 18, with obesity by helping to manage associated issues and work with patients and families to implement healthy lifestyle changes.


Dr. Fink says, “Once a child has been identified as having obesity or excess weight, we want to prevent the development of a metabolic syndrome. The Be Well Clinic is a great option for patients and families who are ready and want to make those lifestyle changes.”

“Every patient and every family is different, but helping families choose approaches that work for them and also counseling them on the factors that contribute to poor cardiovascular health in childhood, and how that impacts adult cardiovascular health, is incredibly important,” she concludes.

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