Preschoolers Take Heart

This is the way we feel our hearts, feel our hearts, feel our hearts.

This is the way we feel our hearts, morning, noon and night time.

This is the way we ride our trikes, ride our trikes, ride our trikes.

This is the way we ride our trikes to make our hearts grow stronger.

--from an American Heart Assn. song for children Nearly half of all deaths in the United States are caused by cardiovascular disease, according to Marilyn Cowan, a community programs specialist with the Los Angeles chapter of the American Heart Assn. And although there is much about the disease that is not understood, it is certain that there are particular risk factors.

Many of these factors--life style, exercise, dietary habits, smoking--are developed early in life. And if very young children had better control over them, it could potentially extend their lives as adults.

That’s the theory behind the Heart Treasure Chest program, a colorful package of activities developed by the heart association. The treasure chest is designed to increase the awareness of preschoolers aged 3 to 5, encouraging them to develop heart-healthy attitudes that will carry them through adulthood.

Based on the idea that it is easier to acquire good habits as a child than to change bad ones as an adult, the kit focuses on the importance of getting enough rest and exercise, not smoking and eating foods that are wholesome--discouraging items like candy, chips and soda--all presented in a fashion that’s familiar to the young child, and with an emphasis on fun.

“It is not ‘do this or you’ll die,’ ” said Lucy Riccio, RN and health coordinator for ABC Child Development Center, a Head Start site currently working with the AHA treasure chest. “It (the program) instills healthy habits in young children in a positive way so they can make choices in the form of prevention now, rather than teaching what to do when you’re having a heart attack (later).”

Available at a cost of $35 to licensed day-care centers and preschools nationwide, the little package of activities comes in a bright gold box shaped like a treasure chest. It appears to be very well received by the youngsters. They have not only raised their own understanding about what is healthy and what isn’t, but they also are passing along some of their concerns to their parents--in some cases down-right refusing to eat cake even on special occasions and forbidding their parents to smoke in the house, teachers said.

Of the children at this particular center, 95% speak Spanish only, yet their enthusiasm for the activities in the chest teaches them to understand and to speak many words of English, the teachers at the center said. Ideally, the program will touch parents through their children, teaching the adults that they can cook the foods that are familiar to them in a healthful way.

The bulletin board at this East Los Angeles center is covered with clippings of good-for-you foods from magazines. In one corner, there’s the “Downey Road Clinica Medica,” a home for injured dolls where the children role-play in hospital garb made by teachers and parent volunteers, listening to one another’s heartbeat, feeling for one another’s pulse.

Another wall prominently displays body charts and a life-size mannequin (fondly named Michael on the day of our visit). Each of these helps the youngsters learn about the parts of their bodies and their various functions.

Graduating to Good Health

The day of our visit was a special one at the center. After weeks of studying about the heart, the children were about to graduate. Their commencement activities included: making a heart-healthy vegetable soup, the recipe for which is included in the treasure chest on a colorful wall chart showing amounts of vegetables in easy-to-understand pictures; a demonstration of the songs they’ve learned, which teach about giving the heart sufficient rest and exercise, and finally, a rather graphic hands-on experiment--comparing a cow’s heart to that of a chicken--which the children found astounding and just a tiny bit gross.

Over the past few weeks the children have been involved in activities such as listening to one another’s hearts with a stethoscope provided in the kit, examining the way blood flows through the veins by squeezing red-tinted water through an oversized bulb syringe, coloring photocopied pictures of the heart, playing a board game that teaches which foods are good and studying the role that the heart plays in their daily existence, as well as some of the consequences of not taking care of the heart.

The kids have learned that obesity and smoking are the leading contributors to coronary disease and that excessive dietary fat and lack of exercise are the main causes of obesity. They now understand that although heart attacks and strokes generally are suffered by adults, there are some early warning signs that can be found in children who have the potential for developing the disease.

The Heart Treasure Chest contains a curriculum guide for teachers with instructions on how to convey key concepts that might be difficult for young people to understand. It suggests activities and questions teachers might ask the children and instructs through familiar tunes, finger plays and stories.

“How do we hear our heart?” asked teacher Ruth Delgadillo.

“Stethoscope,” the children replied in unison.

“How do we feel our hearts?” she queried.

“El pulso,” the children giggled.

Another useful teaching tool is a brightly colored board game. Here children roll the die to determine the number of spaces they may move their markers. If they land on a sad face--soda, too tired, too many sweets, too much salt--they must move back one space. If they land on a happy face--juice, milk, jumping rope, cereal, resting, brown bread, don’t smoke, water or baked chicken--they get to stay where they are.

Other features of the kit include a “Hear Your Heart” book by Paul Showers; a simple, illustrated description of what happens in the doctor’s office; an explanation of how the stethoscope is used; information about the heart, arteries and finding your pulse; oversized physical activity and rest cards that use bright illustrations to exhibit these two types of behavior; a life-size poster of the Heart Child, a body with veins and arteries and a heart shown in proportion to a child’s; a large color chart of the inside of your heart; a wall recipe chart for crock-pot vegetable soup; the bulb syringe; stethoscope, filmstrips and a video.

The notion that fat children become fat adults is a valid concern when assessing the potential risk for heart disease. Children today are fatter--more so than their parents were and more so than their grandparents. Research by the Harvard School of Public Health has proven that the prevalence of obesity in children today has increased by more than half in the last 10 to 20 years.

Prudent Diet Modification

As a result, a great controversy continues to brew over what constitutes a safe diet for children. On one hand, it should provide a child with sufficient nutrients and calories for growth and to carry them through the activities of their day, yet it should be reasonable and consider the AHA guidelines regarding fat and cholesterol consumption.

Until a ruling is made, researchers suggest that parents pursue prudent modification of the diet of healthy young children and encourage sensible eating practices without eliminating the dairy products, meats, eggs and other foods that adults are omitting from their diets in order to keep their fat intake at or below 30% of total calories--a figure that is currently considered too severe for a growing child.

To further plead the case of a healthy heart, the AHA is developing four similar programs geared toward children of varying age groups: lower elementary school level students (grades one through three), upper elementary (grades four to six), middle school age (for grades seven through eight) and senior high.

By bringing nutrition information to the child in a format designed for his or her individual stage of development, the AHA hopes to reduce the number of children who may have already adopted unhealthy eating habits, are already overweight, don’t exercise properly or who are likely to begin smoking at a very early age. These elementary and upper level programs are still in the testing stage and are as yet unavailable.

Meantime, some suggestions for achieving these goals at home: Offer kids healthy snacks between meals, directing them toward fresh fruit, easy-open individual cans of fruit packed in juice, snack-size sandwiches made with tuna, chicken and turkey, soups, raw vegetables and fruit shakes; participate in regular exercise with your child to set a positive role model, and don’t smoke.

The following recipes, from the “American Heart Assn. Cookbook” (David McKay Company Inc.: $15.95, hardcover, 542 pp., non-illustrated) are healthful snacks and desserts that young children will enjoy between or after meals.

Oatmeal-Carrot Cookies are made with whole grain products: wheat flour, oatmeal and wheat germ; raisins, vanilla and brown sugar contribute the sweetness kids crave. Lemon Fluff Pudding is a whipped-milk treat that will provide a boost of calcium and serve as an after-school refresher.

Puree fresh bananas, orange juice, milk and yogurt for a variation of supermarket soft frozen yogurt in push-up containers. Freeze the mixture in paper cups sporting your child’s favorite cartoon character to add to the fun.

Crunchy Cereal, a mix of oats, nuts, wheat germ and flavorings, is suitable as a quick breakfast cereal, or with raisins and other dried fruits added, for tasty granola--great for out-of-hand eating.

OATMEAL-CARROT

BARS

1/2 cup brown sugar, packed

1/3 cup margarine, melted

1 egg

1/2 teaspoon vanilla

3/4 cup shredded carrots

1 cup whole-wheat flour

1 teaspoon baking powder

1/2 cup oats

1/4 cup wheat germ

1/2 cup raisins

Cream together brown sugar, margarine, egg and vanilla in small bowl until light and fluffy. Add carrots and mix well.

In another bowl, thoroughly stir together flour, baking powder, oats and wheat germ. Stir dry ingredients into creamed mixture. Fold in raisins and pour mixture into 9-inch square pan sprayed with non-stick coating spray. Bake at 350 degrees 30 minutes. Let cool. Cut into bars or squares. Makes 24 bars.

BANANA-ORANGE

FROZEN PUSH-UPS

2 ripe bananas

1 (6-ounce) can frozen orange juice, thawed

1/2 cup instant nonfat dry milk powder

1/2 cup water

1 cup plain low-fat yogurt

Peel bananas and slice into blender or food processor. Add orange juice, milk, water and yogurt, cover and blend until foamy. Pour into small paper cups and freeze. To eat, squeeze bottom of cup. Makes 6 servings.

WHOLE-WHEAT

APPLESAUCE

CUPCAKES

1/2 cup oil

3/4 cup brown sugar, packed

1 cup applesauce

1 teaspoon baking soda

1 1/2 cups whole-wheat flour

1 teaspoon ground cinnamon

Beat oil and brown sugar together until well mixed. Beat in applesauce and baking soda. Fold in flour and cinnamon, blending thoroughly. Pour batter into muffin tins sprayed with non-stick coating spray. Bake at 375 degrees 20 minutes. Makes 12 cupcakes.

CRUNCHY CEREAL

2 1/2 cups old-fashioned oats

1/2 cup coarsely chopped peanuts

1/2 cup sesame seeds

1/2 cup sunflower seeds

1/2 cup nonfat dry milk

1/2 cup wheat germ

1/4 cup brown sugar, packed

1/4 cup oil

2 teaspoons ground cinnamon

2 teaspoons vanilla

Combine oats, nuts, seeds, dry milk and wheat germ in large bowl. Combine brown sugar, cinnamon and oil, stirring until smooth. Mix with dry ingredients and spread mixture on baking sheet. Bake at 300 degrees 1 hour, stirring every 10 minutes.

Remove from oven, sprinkle with vanilla and allow to cool. Mixture keeps well if stored in airtight container. Makes 16 (1/3 cup) servings.

Note: Dried fruits such as apricots, apples and raisins may be added to cooled mixture.

LEMON FLUFF

PUDDING

1 tablespoon unflavored gelatin

1/2 cup sugar

1 cup boiling water

1/2 cup lemon juice

1/2 cup nonfat dry milk

1/2 cup ice water

1 teaspoon grated lemon zest

Soften gelatin in 1 tablespoon cold water, then add boiling water and stir to dissolve. Add sugar, 1/2 cup cold water, lemon juice and zest and chill until nearly firm.

Chill a deep mixing bowl and beaters. In bowl, mix powdered nonfat milk with 1/2 cup ice water. Beat until fluffy. Chill.

Break up frozen lemon mixture with fork and add to whipped milk. Beat well with mixer until pudding is fluffy, but not too soft. Chill again until firm. Makes 6 servings.