For National Heart Month, five Seattle Children’s providers share their tips for helping kids and teens build strong, healthy hearts. Make a heart-healthy resolution for your family this month:

1. Protect young athletes with pre-sport heart screenings

“We’ve all heard stories in the news – the sudden death of a young, competitive athlete due to undetected cardiovascular disease,” says Jack Salerno, MD, director of electrophysiology and pacing services at Seattle Children’s. “It’s every parent’s worst nightmare. One minute your seemingly healthy child is on top of the world competing in a sport they love. The next minute their heart suddenly stops.”

Salerno says parents can help protect their young athletes from sudden cardiac arrest by learning about potential “red flags” before their kids begin competing in sports. “It’s important for student athletes and their parents to work hand-in-hand with physicians to detect any potential risks before the sports season begins.”

The American Heart Association recommends that kids and teens be screened against a 12-point checklist that includes a review of the athlete’s personal and family medical history, and a physical exam by a doctor. The medical history review looks for risk factors like chest pain, elevated blood pressure and unexplained fainting, as well as any family history of heart disease. “A positive response to one or more items on the checklist could trigger further testing, including an electrocardiogram,” Salerno says.

Salerno is on the medical board for the Nick of Time Foundation, which provides free heart screenings at schools in western Washington. The foundation was started by the family of a 16-year-old football player who died of sudden cardiac arrest in 2004.

2. Help kids eat a heart-healthy diet

Elevated cholesterol is one of many risk factors for heart disease, but sifting through all the information and recommendations can be overwhelming.

Aaron Owens, clinical pediatric dietitian at Seattle Children’s, says now is the time for parents to help their kids develop heart-healthy habits when it comes to food. The trick, she says, is knowing how to read a nutrition label:

  • Know your cholesterols. Only animal products, like meat, egg yolks and dairy products, contain cholesterol. LDL, or low-density lipoprotein cholesterol, is known as “bad” cholesterol. High levels of LDL increase the risk of heart disease. HDL, or high-density lipoprotein cholesterol, is the good kind, and can help protect against heart disease. Just remember, “Low you want low” and “high you want high.”
  • Substitute unsaturated fats for saturated fats. Saturated fats are primarily found in meat and dairy products, as well as tropical oils like coconut and palm oils. Saturated fats can increase LDL, so limit them in your kids’ diets. Unsaturated fats, on the other hand, can help increase HDL, so use them in place of saturated fats when you can. Unsaturated fats are found in nuts, avocados and oils like olive and canola.
  • Limit processed foods. Processed foods, like crackers and doughnuts, contain hydrogenated oils and are high in trans fats that can increase LDL. Trans fats are especially bad for hearts, and should be avoided when possible.
  • Add fiber-rich foods. Fiber is a must-have for heart-healthy diets. Soluble fiber binds to LDL cholesterol and helps flush it out of the body. You can add oats, beans and lentils to your kids’ diets to help increase their fiber levels.

“A heart-healthy diet includes lean meats, fruits, vegetables, low-fat dairy products and whole grains,” Owens says. “If a food has a label, check to make sure that any fats are the unsaturated kind.”

3. Encourage ‘active play every day’

“Anything that gets the heart rate up – even a little bit – is good for the heart!” says Mollie Grow, MD, MPH, a pediatrician at Seattle Children’s, and the daughter of a cardiologist. “My motto for young children is ‘active play every day.’ Kids naturally love to play and we can teach them from a young age how to enjoy being active.”

Being active on a regular basis helps strengthen our hearts, Grow explains. Stronger hearts pump blood more efficiently, which can help lower blood pressure.

Grow offers five simple tips parents can use to help their kids develop a love of activity:

  1. Be your kid’s playmate. Kids are more active if they have people to be active with, so plan family activities like walking to the park, bike riding, playing tag, or dancing. Simple games are often the most fun, Grow says.
  2. Get outdoors. Outdoor activity is a great way for kids to stay active, and most kids don’t get enough outdoor playtime on a regular basis. Make it your goal to get outside once a day, and don’t let cold weather deter you. Grow suggests searching used clothing stores for rain suits and boots so the whole family can be comfortable outside.
  3. Add to your indoor repertoire. Create a list of go-to indoor activities, like dancing or tossing a ball, to keep your kids engaged. Brainstorm with other parents or browse local parenting blogs and magazines for indoor play areas. For instance, says Grow, many community centers offer open gyms and toddler play zones.
  4. Plan for it. Set aside dedicated time for play in the evenings and on weekends when families are together. Sign up for structured activities that your kids enjoy, like swim or karate lessons.
  5. Look for “activity opportunities.” Grow suggests building in “little bits of activity” throughout the day, whether it’s taking the stairs at the mall, walking your kids to school, or taking an evening walk to the grocery store rather than driving. “It’s so true that when it comes to activity, everything counts,” Grow says.

4. Talk to your teens about the dangers of smoking

The health risks associated with tobacco – including heart disease – are well documented. The good news for parents is that teens’ tobacco use has decreased significantly in recent years, from a high of 39 percent of U.S. teens smoking cigarettes in 1976, to a low of 19 percent in 2012. However, parents still need to make sure their teens are aware of the dangers of smoking, says Leslie Walker, MD, chief of Seattle Children’s adolescent medicine division.

Walker says one concerning trend is the increased use of hookahs, or water pipes, for smoking tobacco. In fact, it’s the only type of tobacco use that’s increased in recent years among teens. “Teens may perceive this as a healthier, tastier and more social way to ingest tobacco,” says Walker. “But hookahs still deliver the same addictive nicotine and toxins as cigarettes, and there is no regulation or quality control of what is actually being smoked.”

In addition to increased risks for cancer and other infectious diseases, the Centers for Disease Control and Prevention warn that hookah smokers may take in higher concentrations of the toxins found in cigarette smoke – toxins that are known to clog arteries and cause heart disease.

If you know or suspect your teen is smoking, Walker recommends beginning by asking questions, listening, and sharing basic facts about tobacco. She also encourages parents to set family rules about drug and alcohol use, and make sure teens are aware of expectations and consequences.

“It’s essential for parents to keep lines of communication open with their children throughout the teen years,” Walker says. “Parents are the primary influence on teenagers’ behavior, even if it doesn’t seem that way.”

5. Express your love and gratitude

Valentine’s Day is a great opportunity for parents to write a love note to their kids, says Cora Breuner, MD, MPH, of Seattle Children’s orthopedics and sports medicine and adolescent medicine divisions. For a different kind of heart health, parents can model an attitude of gratitude in their family.

“Valentine’s Day is a reminder that we have hearts, which can be filled with tenderness and love, especially for our children,” Breuner says. She encourages parents to use Valentine’s Day to start a practice of intentionally expressing love and gratitude to their kids. It doesn’t need to be a big gesture; a simple sentiment can mean a lot to a child, she says.

“I like to write ten ‘gratitudes’ to my kids,” Breuner says. For instance, “You like my cooking despite the fact that it usually involves pasta and pesto. You empty the dishwasher even when I don’t ask you. You like to snuggle with our dog. You have a wonderful smile.”

Parenting can be a challenge, and Breuner says it’s important for parents to let their kids know they’re proud of them.

“When we take pen to paper or even fingers to text, we take a feeling and put it into words,” Breuner says. “When we write them down, feelings become real and tangible, thoughtful and strong. And sometimes sharp anger can change to soft love, resentment to forgiveness and bitterness to compassion.”

Additional resources for parents:

To learn more about health issues from Seattle Children's, visit On the Pulse.