When you think of someone with cardiovascular problems, a preschooler isn’t the image that’s likely to spring to mind. Indeed, according to the Centers for Disease Control and Prevention, 28.1 million U.S. adults have been diagnosed with heart disease. But every one of those 28.1 million adults was once a toddler, when the habits that contribute to heart disease begin to take root. Mount Sinai Medical System kicked off its Familia program in 2015 with the aim of reaching kids (and their caregivers) at this critical stage and teaching them to make healthy choices, setting them up for a heart-healthy lifestyle that will reduce their chances of developing cardiovascular problems when they are adults. We spoke with Dr. Valentin Fuster, director of Mount Sinai Heart and physician-in-chief of the Mount Sinai Hospital, who pioneered similar successful programs in Colombia and Spain.
Why did you decide to target children and their caretakers in Harlem?
Basically, we have good data, successful data in addressing children between age 3 to 6. [We spend] 70 hours over a six-month period with these children, teaching them how the body works, exercise, the right nutrition, and how to control emotions. How to say no when they're confronted in the future with alcohol, tobacco, and so forth. There is good data that whatever goes on between 3 and 6 really models the behavior of when we are adults. Adults usually do not listen, or we do not really take care of ourselves, unless we work on a community basis.
Familia was modeled after similar programs you led in Spain and Colombia. What were the outcomes of these programs?
The results were fantastic. What we measured there was knowledge, attitude and habits in Colombia. We surveilled these children three years after intervention [to see] what their knowledge was about risk factors leading to cardiovascular disease. We analyzed the attitude and whether they were already having habits in favor of health. It was very positive.
Then we went to Spain with 2,000 more children. There, we had weight and exercise in addition to knowledge, attitude and habits. In three years of follow up, 2,000 children, 1,000 randomized into the intervention approach of 70 hours was quite successful.
What benefits do you see in their caretakers?
The children listen, and you have a tremendous impact spending many hours really teaching health. And in the adults, we prove it's the community work. The adults need community, other people to really get engaged and to be motivated.
Do you plan to expand the program?
To the five boroughs of New York; from there, to the world. The government of Mexico and the government of Peru now wants to rush to get there and do the same thing. It's how you deal with children, how you deal with the adults, and how you deal with the family. And this concept, if it works — we hope it will — will then be expanded like an umbrella.