5-2-1-0 AAP Diet Plan -John Roth MD

A few simple numbers to help solve the very complicated and growing problem of obesity.

According to data from the Centers for Disease Control and Prevention, Louisville ranks eighth as the fattest city in the United States.

Thirty-nine percent of Kentucky children are overweight led by greater than 50 percent of the urban and rural poor. These numbers foreshadow significant health problems for these children in the future with heart disease, liver disease, diabetes, gallstones and joint breakdown most likely. Besides the personal suffering this entails, our society will have the burden of increased healthcare costs and an unhealthy workforce.

The time has come when individuals, families, the medical [field], government, schools and the business community are coming together to try to solve the problem. Most recently, Medicare has announced that it will pay for screenings and preventative services to help curb obesity and its associated conditions. Schools are finding ways to improve school lunches, curb access to soft drinks and junk foods, and increase physical activity. Business leaders now recognize and are promoting wellness programs for their employees. Physicians are taking an increasing role in screening and helping patients improve their lifestyle and condition.

Because it is always better and perhaps easier to prevent obesity than to treat it, programs such as 5-2-1-0 are coming to the forefront and are being implemented nationwide. Following these simple rules will help children and adults live a healthier life.

5 or more servings of fruits and vegetables a day

Besides providing essential vitamins and minerals, vegetables enhance the immune system and are associated with lower rates of heart disease, stroke, high blood pressure and possibly cancer. Eating these foods also helps prevent weight gain and can help in sustaining weight loss.

  • Choose fruits and vegetables for snack.
  • Keep a bowl of fruit handy for snacks.
  • Start dinner with salad or raw vegetables.
  • Parents should set a good example.
  • Eat dinners as a family.
  • Involve the family in food preparation.

2 hours or less of screen time

The American Academy of Pediatrics found that the average child watches five to six hours of television a day. In addition many children spend hours on video games, phones and computers. Too much television increases obesity and attention problems. The Academy recommended that children under two should not watch any television, older children be limited to two hours per day and there should not be a television or computer in the room where the child sleeps.

  • Power down TVs, video games, computers and electronic devices.
  • Encourage family games and activities.
  • Encourage outdoor play. Go to the park. Go to the gym.
  • Have board games, books and puzzles readily available for rainy days.

1 hour or more of physical activity

Physical activity helps maintain weight and is vital in preventing chronic diseases and osteoporosis. Adolescents in particular have sharp reduction in physical activity unless involved in sports. Children in families who have an active life style are more likely to remain active as adults.

  • Give children the time and space to play.
  • Choose fun family activities like biking, hiking and skating.
  • Introduce children to the basics of sports such as throwing, jumping and running.
  • Set an example as active parents.
  • Walk wherever you can, such as to the store.
  • Involve the children in active household chores like vacuuming, raking leaves, washing the car or walking the dog.

0 sugar-sweetened drinks

The dramatic increase in the consumption of sugar-sweetened drinks over the past 25 years is directly associated with the increase in overweight and obese children and adults. These drinks, whether sodas or juices, have replaced water and milk in our diets.  They offer calories without good nutrition and thus have little value, but great detriment.

  • Children should not drink sodas, fruit punches or diluted fruit juices. Limit these to very occasional treats if you must.
  • Offer children water throughout the day.
  • Offer milk as a healthier drink and use lower fat milks for children over three.
  • Children should not be drinking sport, caffeine or energy drinks.

We all need to make more healthy choices and set good examples for our families. These simple numbers will give us a good start in making all of us healthier.

Resources

Visit the web site at http://www.healthynh.com/fhc/initiatives/ch_obesity/5210.php# for educational handouts for parents and families with information on:

  • Fruits and vegetables
  • Healthy snacks
  • Family style physical activity
  • Decreasing screen time
  • Increasing water and milk consumption
  • Non-food reward ideas
  • Goal trackers

By John Roth, M.D., Kaplan Barron Pediatrics