Kids and Healthy Hearts


Children who don’t have heart problems as kids may develop them as adults, due to risk factors like obesity and hereditary factors, says Dr. Linda E. Muhonen, a pediatric cardiologist at CHOC. Risk factors that contribute to coronary artery disease and other cardiovascular diseases include smoking, poor diet that can lead to dyslipidemias, high blood pressure and a lack of exercise.

These often take root at an early age. “An obese child has an 80 percent chance of being an obese adult, and obesity can contribute to the onset of multiple illnesses including diabetes and hypertension,” says Dr. Muhonen.


“Parents should avoid bringing unhealthy foods into the home, such as soda or sugar-sweetened drinks,” says Dr. Muhonen. “The only drinks most kids should have are water and fat-free milk. Kids should eat three meals a day with snacks of fruits and vegetables in between. Many children skip meals, creating an environment of overeating at the next meal; skipping meals can lead to lowering your metabolic rate. We encourage children to bring their lunch to school so they can pack something healthy like a turkey sandwich on whole wheat bread, a piece of fruit and some pretzels or string cheese.”


“I like to see families have some healthy family time before dinner, like going for a family walk or going to the park before they sit down to eat,” says Dr. Muhonen. “This gets the kids to move. One of the rules in our Lipid Clinic, where we help kids at risk for developing heart disease, is that children cannot watch TV or have screen time until they have been outside for an hour doing a physical activity. The American Heart Association recommends that children have an hour a day of moderate to vigorous physical activity. It doesn’t have to be all at one time,” she says.


Children are considered overweight if their Body Mass Index (BMI) falls in the 85-94th percentile. They are considered obese if their BMI falls in the 95th percentile or above, says Dr. Muhonen. Parents can ask their pediatrician to help make this determination.


  • Approximate number of children ages 12-17 who are already smokers: 4.5 Million
  • Percentage of obese children who will become obese adults: 80%
  • Approximate percentage of children and adolescents (ages 6-19) who were overweight or obese in 2010: 33%

Meet Dr. Muhonen - CHOC Cardiologist

Dr. Linda Muhonen helps patients with the full spectrum of heart conditions, with special emphasis in preventive cardiology. She also directs the Children’s Cholesterol (Lipid) Clinic at CHOC. Dr. Muhonen served her Pediatric Cardiology fellowship at the University of Iowa Hospital in Iowa City and she completed her internship and residency at Loma Linda University Medical Center. Part of her practice focuses on helping children avoid heart problems related to genetics and/or obesity later in life. She is the leading physician at CHOC’s Lipid Clinic, which treats these “at risk” children.

Dr. Muhonen’s philosophy of care: “I focus on the family as a whole when treating children with heart and obesity related problems. You can’t just focus on the child because a child is a product of genetics and their environment.”

Oral Roberts School of Medicine – Tulsa, Oklahoma

Pediatric Cardiology

Dr. Linda Muhonen

A Healthy Heart Starts Early

Did you know the seeds for a healthy heart in adulthood are often planted during childhood? Children with poor diets and inadequate exercise can develop a range of heart-related diseases later in life.

Parents and other caregivers can set children on a path to a healthy heart, says Dr. Linda Muhonen, a pediatric cardiologist at CHOC who also leads CHOC’s Lipid Clinic.

Young boy eating an apple

Tips for a Healthy Heart

CHOC Clinical Dietitian, Joanne DeMarchi

CHOC Clinical Dietitian, Joanne DeMarchi offers helpful tips to CHOC Radio listeners for promoting cardiovascular health. She stresses the importance of evaluating the family’s entire diet to ensure a wide variety of foods, especially fruits, vegetables and whole grains.

How ECMO Can Save a Child’s Life

Children who are hospitalized with critical cardiac or pulmonary disease and don’t respond to current medical treatments might be candidates for a life-saving device called extracorporeal membrane oxygenation (ECMO).

ECMO (also known as extracorporeal life support) is a heart and lung bypass machine that can be used to rest a failing heart or lungs, providing complete support for a few days, or even weeks, until the heart and lungs recover.

Dr. Michele Domico, medical director, CHOC ECMO service

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