Children as young as age 2 can and should, with the help of their parents, get a jump start on eating behavior that's healthy for the heart, according to new dietary recommendations released by the American Heart Association (AHA) and endorsed by the American Academy of Pediatrics.

The new dietary recommendations for infants, children and adolescents update guidelines issued in 1982 on the same topic. Why now? According to the AHA, significant changes have occurred in the prevalence of heart risk factors and nutrition behaviors in children.

Since the early 80s, America's youth have become heavier, less active, and eat less nutritious food, setting the table for heart trouble, according to AHA.

Because there is now ample evidence that the process of heart disease begins at a young age, the new guidelines encourage parents and pediatricians to take a "primordial prevention" approach -- taking steps in a child's infancy to prevent heart disease risk factors from developing.

Previous dietary recommendations from AHA were not intended for children under age 2, who need a higher percentage of fat in their diet to support growth. The new guidelines, published online in the American Heart Association's journal Circulation, for the first time provide guidance for the under-2 set.

They suggest feeding infants breast milk exclusively for the first four to six months continuing through the first year.

As solids are introduced, the AHA recommends that well-meaning parents not overfeed infants; introduce healthy foods repeatedly even if they are initially refused; skip calorie-packed, low-nutrient foods; and delay introducing juice until at least 6 months of age and limit juice to 4 to 6 ounces daily.

"Foods given to babies are less nutritious than 10 or 20 years ago," Dr. Samuel S. Gidding who helped write the guidelines notes in an AHA statement. "By 19 months of age, on any given day, one-third of toddlers eat no fruit, and french fries are the most commonly consumed vegetables. These practices are providing poor nutrition and causing kids to be overweight at their 2-year-old checkups."

Gidding reminds parents that it is important to model healthy behaviors for their children by exercising regularly, eating healthy foods during family meals and not smoking.

"Parents can have more impact with a 'do-as-I-do' rather than 'do-as-I-say' approach," Gidding said, noting that children are much more responsive to actions than to words.

Among the key recommendations for children age 2 and older:

-- Balance dietary calories with physical activity to maintain normal growth.

-- Get one hour of moderate to vigorous physical activity each day.

-- Eat nutrient-rich foods daily such as lean meats and low-mercury fish such as salmon and tuna that is baked or broiled. "Serving fried fish sticks can negate the whole benefit of having fish," Gidding said.

-- Eat plenty of vegetables and fruits and whole grains and drink fat-free milk.

-- Use vegetable oils and soft margarine low in saturated fat instead of butter.

-- Reduce the intake of sugar-sweetened drinks and foods.

-- Go easy on the salt, including salt from processed foods.

For more on the revised dietary recommendations for infants, children and adolescents, visit the AHA's website at www.americanheart.org.

SOURCE: Circulation, September 26, 2005.