Start early, stay consistent: the blueprint for lifelong heart health

Building heart health is not a midlife correction; it's an early investment. The dietary habits established in childhood, from the first solid foods through adolescence, play a defining role in shaping long-term cardiovascular outcomes. According to Andrew Souza, DO, a pediatric cardiologist at Loma Linda University Children's Hospital, consistency, not complexity, matters most.

Rather than focusing on restrictive diets or short-term fixes, Souza emphasizes a steady, balanced approach to nutrition that children can sustain as they grow. Meals centered on fruits and vegetables, lean proteins, and appropriate portions of carbohydrates create a framework not only for healthy development, but for lifelong disease prevention.

In an era where processed foods and sedentary habits are increasingly common, the opportunity and responsibility fall on families to establish these patterns early. The payoff is significant: lower risk of heart disease, better overall health, and a generation equipped with the habits to sustain both.

In an interview, Souza spoke about some key things parents can do to maximize heart health for their families when it comes to nutrition.

What does a heart-healthy plate look like for children at different ages?

I like to be consistent with young children (2+) through to adulthood. Every plate should contain about ½ fruits and vegetables, ¼ starch, and ¼ lean proteins. The sooner these things are offered, the more consistently kids will eat them as they get older. Toddlers usually require smaller meals and more frequent snacks.

How do nutritional needs for heart health differ between toddlers, school-aged kids, and teens?

Toddlers usually have a higher fat requirement for their development. I don't generally feel that the needs differ significantly between age groups. I focus on providing early exposure to a balanced diet that kids can maintain as they grow.

What are the most important nutrients for building and maintaining a healthy heart in childhood?

Balanced intake of unsaturated fats for optimized cholesterol, lean proteins, and fiber.

Which foods best support cardiovascular development in children?

We are primarily looking at a balanced diet, rather than specific foods. Different cultures will have their own dietary norms. Every child will have different preferences and tastes.

What foods contribute most to early heart disease risk in children?

We really want to minimize sugar-sweetened drinks, processed snacks, processed meats, and fried foods. These lead to obesity, metabolic disorders, and early coronary artery narrowing. Adults with chronic exposure to a poor diet/lifestyle would be at higher risk for cardiac disease in their 40s or earlier. Kids are unlikely to develop outward signs of a heart problem unless they have another genetic issue. However, an early, consistent healthy lifestyle is always our goal.

Should parents avoid processed snacks entirely, or is moderation okay?

Moderation is preferred. Total elimination can increase cravings. 80-90% of intake should be nutrient-dense foods with a predictable treat.

What are simple things families can do to improve heart health?

Eat meals together to model good eating habits. Shop for food together. Kids will be more likely to eat the things they choose. Focus on shopping for fruits, vegetables, dairy, lean proteins, rather than processed foods. Replace sugar-sweetened beverages with water or milk. Focus on eating your calories, rather than drinking them. Find an activity the child likes and provide an opportunity to do it regularly, even at home, for 60 minutes or more a day, 6 days a week. Keep screen time in check and prioritize sleep.

How can parents encourage picky eaters to choose heart-healthy foods?

Repeat exposures, a lot. Pair new foods with old. Let the kids pick foods and cook them. Minimize the pressure, encourage them to take one bite, and leave it at that.

At what age should parents start thinking about cholesterol levels?

Cholesterol screening should occur between the ages of 9 and 11. Any child with a family history of early sudden cardiac death, including stroke, heart attack, bypass surgery, or stents in coronary arteries in males younger than 55 or females younger than 65, should ask their pediatrician if they need earlier evaluation.

While children may not show immediate signs of heart disease, the habits formed in early life can influence long-term health. By prioritizing balanced meals, encouraging physical activity, and modeling healthy choices, families can set children up for a lifetime of strong heart health. Small, consistent changes can make a meaningful difference.

Loma Linda University Children's Hospital has been ranked among the Best Children's Hospitals by U.S. News & World Report for 2025-2026 - 8th in California and 9th in the Pacific Region, with Pediatric Cardiology & Heart Surgery ranked No. 18 nationally.

Visit online for more information on cardiology & heart surgery at Children's Hospital.