Academician Leyla Namazova-Baranova: Only by ensuring a healthy childhood can one achieve healthy longevity
Leyla Namazova-Baranova: You said - from the cradle. Forced to fix. Problems arise before diapers. Therefore, you need to know the main thing. With proper preparation of parents, both of them, for a planned pregnancy, with the conscious entry of a married couple into parenthood, with timely registration and adequate observation by obstetrician-gynecologists, a newborn has every chance to be born into this world absolutely healthy.
Visits to the antenatal clinic, to the obstetrician-gynecologist in order to make sure everything is in order with the unborn child, screenings for the most dangerous congenital diseases, vaccination of pregnant women in order to prevent the negative impact of the infection on the health of the unborn baby - the alphabet, which is simply dangerous to ignore.
But you will not deny that a very difficult moment is the birth itself?
Leyla Namazova-Baranova: How can there be denial? Childbirth is a test for both the child and the mother. That is why it is so important to be at this moment in an institution of the right level. If the pregnancy is complicated and problems are expected - in the perinatal center. If the pregnant woman and her baby are healthy, you can go to the maternity hospital of the first or second level.
Of course, much in the obstetric service depends on the qualifications of our colleagues in the maternity unit. According to the data of the World Health Organization, various birth injuries occur on average in every tenth baby, and microdamages can occur in almost 75%. In the structure of diseases that occur in newborns, if something still goes wrong, diseases of the respiratory organs, the nervous system, and congenital anomalies of development dominate.
And what about the deaths of children at birth or in the first 28 days?
Leyla Namazova-Baranova: These are most often premature or complicated births, infections, congenital malformations or lack of qualified medical care.
Suppose mom was lucky: the birth was physiological, the maternity hospital was right, the person was born safely. What's next?
Leyla Namazova-Baranova: The health of a newborn, and indeed the health of a person throughout life, depends very much on how it all starts. According to the paradigm of modern medicine "1000 days of programming", all human health is laid in the first 270 days of intrauterine and two years (730 days) of extrauterine life. Although pediatricians know, the "programming window" opens much earlier. For example, taking folic acid to prevent malformations of the child's nervous system is three times more effective if it is started six months before the planned pregnancy. And not from the first days after the conception.
I repeat, all diseases come from childhood. Everything that the child manages to get sick with will remain with him forever or pave the way for the early manifestation of severe chronic diseases in the near future. For example, if a child in infancy had been ill with rotavirus gastroenteritis - the so-called "stomach flu", then he will "toil with his stomach" all his life. By the way, such children suffer from diabetes more often. If you have had pneumococcal pneumonia, you will be left with lung problems and so on.
And this is the so-called "programming window"?
Leyla Namazova-Baranova: Yes! And it seems to me that it not only opens a year or two before conception, but also remains open until school or even until adolescence. That is why it is so important for parents to do everything so that the child is conceived, born healthy and remains so at least all childhood years. Then, having become an adult, he will be able to fully realize the ability of a modern person to live up to 100 years.
Is this the practical implementation of the modern concept of healthy aging or healthy longevity?
Leyla Namazova-Baranova: Exactly! Only by ensuring a healthy childhood, you can achieve healthy longevity!
And you do not find that "healthy longevity" - from the category of dreams?
Leyla Namazova-Baranova: And it is not forbidden to dream! You just have to strive to make dreams come true.
Are you sure you're talking about children's screenings? Then tell me what their health problems are most common. And what is at the root of these problems? And most importantly, how to fix them?
Leyla Namazova-Baranova: There is a clear irony in your question about medical examinations. But in vain! The preventive orientation or the preventive component of Russian health care has always been at its best. Was - I say not by chance. Much has been lost in this area. But for all that, I want to say that the medical examinations that we have been accustomed to since childhood, or, as they say now, preventive examinations of children of different ages, have served and continue to serve as the platform that gives a direct idea of the state of children's health. The coverage (I don’t like this word myself, but ...) by professional examinations remains quite high: up to 80-85% of children visit pediatricians and other specialists every year for preventive purposes: they take tests, undergo instrumental examinations (ECG, ultrasound, etc.). ). However, there is clearly a need to improve the schemes of professional examinations.Parents need to know: the programming window for children's health remains open until school or even adolescence.
For example, conducting regular large-scale studies in various federal districts of the Russian Federation, we see an increase in children with overweight and obesity, impaired vision, altered posture, headaches, problems with the skin and gastrointestinal tract, and psychological disorders. Probably, it is necessary to think about improving the examination scheme itself and to choose the right preventive or therapeutic interventions if any changes are detected during examinations. And, of course, it is necessary to conduct medical examinations for children who have had a new coronavirus infection.
Leila Seymurovna, do parents now make sure that their children pass medical examinations on time? Or does it need to be constantly reminded of? Who should be active: parents or doctors?
Leyla Namazova-Baranova: The answer is obvious: both. We are accustomed to operating with numbers "by negotiability": that is, if a patient has applied to a doctor under the CHI system, he will be displayed in the statistics. If not, it will "fall out". That is, there will be some kind of underestimation. However, there is also the opposite problem. Many people think that they have health problems, although in reality they may not be. It's sort of like a "recap". So it turns out that we need large-scale population studies in order to have objective data with verified diagnoses.
Let me explain with an example. Fifteen years ago, we conducted a scientific study in Moscow and Tomsk, trying to answer the question about the prevalence of allergies among adolescents living in the European and Siberian parts of the Russian Federation. Initially, letters with questionnaires were sent out. Then they collected official statistics by region. Some of the respondents were called for examination to confirm or exclude the diagnosis. It turned out to be a classic picture. Approximately 20% of children thought they had asthma. But according to official data, no more than 1% of teenagers had it. And in real life, the disease was confirmed in about 5%. Moreover, both among those who considered themselves asthmatic, and among those who believed that he was healthy.
Collecting data on self-reporting (self-assessment) always leads to inflated data. And the statistics "by negotiability" gives obviously underestimated figures. That is why population studies and individual data on the health status of each child are so important.Leyla Namazova-Baranova: Healthy childhood is the key to healthy longevity. Photo: From the personal archive of the author
Without going into the wilds of research, the more often do modern children fall ill?
Leyla Namazova-Baranova: If we turn to official statistics, the vast majority of children are assigned to the first and second health groups - conditionally healthy or those who have some functional abnormalities. Of course it isn't. Only a few percent of children are completely healthy. The rest have some kind of disease. The question is that the plasticity of the child's body is incredibly high. And many problems can be leveled, or at least seriously restore impaired health, which is impossible to do in adulthood.
Are diseases of the cardiovascular, respiratory, endocrine systems and obesity among children also common, as in adults?
Leyla Namazova-Baranova: According to the already mentioned studies of children in the regions, diseases of the cardiovascular system were diagnosed in 10% of today's schoolchildren. Analysis of body mass index (BMI) revealed the presence of increased nutrition/obesity in one third of the examined children. At the same time, another 15-18% of children had a lack of body weight or reduced nutrition. According to anamnestic data on the presence of diseases of the endocrine system, less than 2% of the examined adolescents were aware before the examination. At the same time, an ultrasound examination of the thyroid gland revealed a number of changes in a third of them.
In addition, the era of the COVID-19 pandemic (the term for the simultaneous burden of the novel coronavirus pandemic and the inextricably linked epidemic of noncommunicable diseases) has seen an explosive increase in the incidence of newly diagnosed cases of diabetes, psychiatric conditions and other diseases. Including in children.
What can parents do in this situation?
Leyla Namazova-Baranova: Much, if not all, actually depends on parents. Parents can instill in their child the habit of starting the morning with exercises. They can teach you to eat a little, but correctly. They can teach you to use gadgets wisely. This will create an opportunity to preserve the health with which the child was born, strengthen it and create the basis for healthy longevity. But they may not. Then there will be neither health nor longevity.
And once again about family habits. If in a family all education boils down to putting a gadget with a cartoon on the table while the baby is eating ... If there is no desire to read books with the child, teach them how to behave at the table, learn how to comb their hair neatly ... In short, how to help the child acquire good habits for health?
Leila Namazova-Baranova: The simplest, most banal, but always, at all times, relevant recipe: to be parents who set the right example for their children.Russian newspaper - Capital issue: No. 239 (8887)
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