A simple equation for good children's health

It was lunchtime at the office, and my partner was looking thoughtful as he munched on his brown-bag selection of sandwich, grapes and yogurt. He'd been evaluating various approaches to healthy-lifestyle counseling over the summer physical season, and wondered how the rest of us felt about using the straightforward 5-2-1-0 goals as teaching tools for our pediatric patients.

We all chimed in with our own individual methods of addressing obesity prevention, but agreed that this numeric system was a simple way to pass health and fitness recommendations on to children and their parents.

Armed with my catchy sound bite, I entered the exam room to meet with an elementary school student and her mother for an annual checkup. As always, the session included more than height, weight, blood pressure and physical exam. We spent time discussing her school experience over the past year, talked about sports-related injuries, recorded new medications, and also, last but certainly not least, evaluated her eating habits.

Well, the young lady was doing just fine in school and was quite the little athlete, but her diet left much to be desired. The gymnast easily hit her physical fitness goals, but with her foods of choice limited to carbs, dairy products and the occasional carrot, she was nowhere near the five-a-day fruit and vegetable minimum, and was light years away from the preferred nine daily servings of these food groups.

I couldn't come down too hard on a child who was an exemplary patient in so many ways, and I realized that I was not going to change her diet in one office visit. Instead, I gave the girl her first homework assignment of the school year: pick one new fruit and one new vegetable to add to her menu. I also stressed the "5-2-1-0" system, complimenting my patient on what she'd already accomplished, and giving the whole family four easy-to-remember goals to work toward in the coming year.

While many of the kids I see during summer sports physicals are slim, well-conditioned athletes, it's important to remember that childhood obesity is considered a major epidemic in the U.S. The American Academy of Pediatrics notes that obesity prevalence in children jumped from 5 percent in the 1960s to 17 percent over the last decade. Rates are found to be even higher among certain racial/ethnic groups, in particular, black girls (24 percent) and Mexican-American boys (22 percent).

The "Five, two, one and none" goals were adopted in 2006 by the Maine Youth Overweight Collaborative and have been promoted by the AAP, as well as other health organizations, in an effort to combat this rising tide of obesity.

A quick breakdown of the daily 5-2-1-0 goals includes: a minimum of five servings of fruit and vegetables, no more than two hours of screen time (that means TV, computer, and video games), at least one hour of moderate to vigorous exercise, and no sugary drinks. The Maine Youth Overweight Collaborative is willing to cut parents a little slack on the drink issue, but not much. Fruit juice should be kept to four ounces or less per day, with fat-free milk served at mealtimes and water offered between meals.

An alternate version of these goals is 9-5-2-1-0, with a lead number "nine" inserted to stress the importance of getting about nine hours of quality sleep each night (though the exact sleep requirement will vary with the age of the child).

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.