Andraea Van Hulst

By Christina Kozakiewicz, Ingram School of Nursing

February is Heart Month, a time to bring attention to the importance of cardiovascular health, and what we can do to reduce our risk of heart disease—also known as cardiovascular disease—which is an umbrella term for a group of conditions that affect the structure and functions of the heart. While some forms of heart disease are congenital (present at birth), the vast majority develop with age. According to Health Canada, cardiovascular disease affects approximately 2.4 million Canadian adults, and is the second leading cause of death in the country.

While children and teens are not usually diagnosed with clinical heart disease, they may present risk factors for the illness. These include high blood pressure, abnormal cholesterol levels, diabetes and being overweight. Right now, an estimated 27% of Canadian children and teens are overweight, and of them, 13% are considered obese, making excess weight and obesity the most common pediatric risk factors for heart disease. Moreover, studies show that obese children and teens are more likely to develop compounded risk factors, and to remain obese as adults, leaving them more at risk for developing heart disease into adulthood.

The good news: many forms of heart disease can be prevented by living an active, healthy lifestyle, and McGill Nursing professor and researcher Andraea Van Hulst would argue that targeting childhood obesity is one of the best ways to prevent the development of this illness.

Professor Van Hulst began her career as an ER nurse in a hospital with many patients seeking care for conditions related to heart disease. “While I loved the challenges and the pace of the ER, I soon realized I was not focusing my efforts where they were most needed,” says Van Hulst. “At the end of a shift, I felt good about contributing to saving the life of a patient who suffered a heart attack or stroke, but I felt that I needed to stop people from falling into the river instead of pulling them out of the water as they were drowning,” she says.

Van Hulst went from the ER to pursue graduate studies in public health, to now, where her program of research includes identifying the social and environmental factors and conditions that can lead to poor lifestyle behaviours and obesity in childhood. “Eating is part of everyday life, and how a child eats depends largely on how their family and friends eat, and on their access to different types of food,” says Van Hulst.

What’s more, according to Van Hulst, it’s not just what we eat, it’s where we eat.

“Where we live and work affects us, and children are no different,” says Van Hulst. “Environments in which children live, learn and play influence their health. Living in low-income neighbourhoods often means less access to health promoting opportunities such as proximity to stores selling healthy foods, or parks that are safe and appealing to children for play,” she says. “We hope our research can identify targets for the prevention of obesity both at the individual and at the population levels.”

Having recently joined the Ingram School of Nursing’s faculty, Van Hulst is putting together a team and developing a program of research, which will include focusing on preventing risk factors for heart disease in children and teens, and incorporating nursing expertise into the development of health-promotion and obesity-management strategies.

“Family-based approaches are recommended for treating childhood obesity, and nurses have an expertise and a longstanding background in using whole-family approaches in their practice,” says Van Hulst. “One of my goals is to develop a nurse-led multidisciplinary approach to obesity prevention and treatment.”

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February 20, 2018