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The question: If there is a history of heart disease in my family, what can I do to protect my children (they're 4 and 6)? Is it too early in life to start thinking about heart disease?

The answer: Many of us remember moments in our childhood when our parents asked us to play outside instead of sitting in front of the TV, or encouraged us to choose the broccoli over chips or junk food. While these moments may have made us groan as kids, they helped to build awareness of healthy lifestyle habits. We can all appreciate that how we live now will affect our potential risk of developing health problems in the future. Keeping this in mind, it's never too early to think about your children and guide them to build healthy lifestyle habits as they grow. The earlier you instill healthy habits in your kids, the better. Even at the young ages of 4 or 6, it becomes very difficult to suggest change once they become teenagers.

Certainly a family history of heart disease is a concern – specifically if it's a first-degree male relative under 55 or a first-degree female relative who has suffered from a heart attack or angina. Being aware of your family history is important, but because we can't change it, we need to focus on the risk factors that are within our control. The good news is that 80 per cent of heart disease is preventable by decreasing modifiable risk factors such as high blood pressure, smoking, high cholesterol and diabetes. All these risk factors increase when we eat diets high in sodium, fats and processed foods; when we're sedentary; and when we choose habits such as smoking.

Before we get to your children, let's start by doing an inventory of your own health habits. Modelling healthy behaviours can have a powerful effect on your children, so be aware of your actions.. If you smoke, consider seeking support to quit or cut back. According to Health Canada, children of smokers are almost twice as likely to smoke as children with parents who never smoked.

With the rise in childhood obesity (along with school exercise programs being cut back), it is vital to encourage physical activity at home. According to Active Healthy Kids Canada, children and youth get an average of 7 hours and 48 minutes of screen time per day. In relation to this number, it's not surprising that they also found that only 7 per cent of Canadian kids are getting the recommended 60 minutes of activity per day. While it can be easy to turn on the television or throw in a video game, this can encourage sedentary habits that continues into adulthood.

As a bonus, exercise can reduce stress and improve sleep quality – factors that can benefit your kid's school performance and physical well-being. An excellent resource with recommended times and activity ideas for kids (broken down by age) can be found at the Canadian Society for Exercise Physiology.

In addition to exercise, inspire your kids to make smart food choices. Take your kids grocery shopping to teach them about healthy foods. Let them choose a healthy fruit or vegetable when you're shopping and ask for their input with meal planning. Equally important is what's left out of your child's diet – you should avoid any junk food in the home. Kids who develop a taste for easy – but fatty – foods at a young age will reach for them over healthier options if they're available. Try eatrightontario.ca for fun recipes for kids and tips for easy, fun and convenient meal options.

Because heart disease is significant in your family, educate your kids about this history so that when they reach their 20s or 30s, they can see their doctor to be screened early for high cholesterol and diabetes and keep their blood pressure monitored. Hopefully, with the healthy lifestyle that you've instilled from a young age, they will be able to focus on maintaining these habits into their adulthood and decrease their risk of heart disease as a result.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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