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Helping kids live healthy has never been more important


A child runs up stone steps on a grassy hill

Pediatricians encourage parents to use the 5-2-1-0 approach to help children build daily health habits. Here’s why.

Pediatricians are seeing alarming trends in children’s health and they’re taking steps to help parents and kids turn things around with a new lifestyle training tool.

Doctors at PeaceHealth are leading vital efforts to leverage the 5-2-1-0 program, a national approach endorsed by the American Pediatric Association, to proactively promote children’s good health for a lifetime.

Serena Black, MD, a pediatrician and the medical director of Pediatrics at PeaceHealth, and Misty Carlson, MD, a pediatric cardiologist in Springfield, Oregon, provide insights into why it’s important to take decisive action now.

What unhealthy trends?

“As never before, we’re seeing increasingly higher rates of diabetes, prediabetes, hypertension and hyperlipidemia in children,” said Dr. Black. “The direction and rate at which those trends are going is frankly a bit worrisome.”

Dr. Carlson noted, “What’s worse is that these are all risk factors that can eventually lead to developing much more serious health challenges later in life, including cardiovascular disease and stroke.”

Consider the following facts on childhood metabolic health:

  • 22% of children and adolescents have abnormal lipid levels (blood cholesterol).
  • 15% of children and adolescents have hypertension (elevated blood pressure).
  • 28% of adolescents have prediabetes, as of 2018—more than double since 1999.
  • 17% of adolescents have evidence of non-alcoholic fatty liver disease—the number one cause of liver disease in children.

All these conditions were—until recent years—relatively rare in children. And all are due largely to unhealthy lifestyles prevalent in the U.S., according to the physicians.

What unhealthy lifestyles?

“The rapid rise in all of these areas point to the fact that something needs to be done—and soon—to reverse the trends,” said Dr. Black.

Consider these facts on just a few unhealthy choices:

  • 67% of total daily food intake in children comes from ultra-processed foods.
  • 89% of children aged 12–19 years have a poor diet, eating fewer than 2 of the 5 servings recommended by the American Heart Association for a healthy diet.
  • 44% of adolescents get less than the recommended physical activity of 60 minutes of moderate to vigorous activity per day.
  • 21% of adolescents report no physical activity.

Some children score lower than adults when it comes to getting enough exercise and eating a healthy diet, according to the AHA 2022 cardiovascular risk assessment of behaviors and factors that affect heart health.

So what can be done to turn things around?

Fortunately, some of the most significant actions are neatly summed up in 5-2-1-0.

What is 5-2-1-0?

Each number represents a key to promoting good health:

5 = Eat 5 vegetables and fruit per day

2 = Spend 2 hours or fewer per day in front of a screen

1 = Spend 1 hour per day moving

0 = Drink no sugar-sweetened beverages

“These are the basics intended to help kids—and the rest of their family—eat well and move more,” said Dr. Carlson. “It’s a quick reminder for kids and parents on how to start adopting new meaningful habits that will help them all feel their best.”

Make it a family affair.

One overarching piece not specifically called out in the numbers but rather woven into the approach is the importance of doing it together. Social support is crucial. Playing with friends or cooking and eating meals with the family are part of building healthy habits.

And Dr. Black emphasized that the program isn’t just for kids. “This is really geared to help the whole family learn or reinforce healthy habits together. As parents, we model for our little ones how to care for ourselves. We’re teaching them to follow our example by what we say and do.”

Get started today!

The sooner you and the kids in your life start to make healthy changes, the sooner you’ll see results that can keep your family going strong for the long-term.

For younger children, download the 5-2-1-0 flashcards. Spend a few minutes with your little ones coloring the cards and talking about which tips you want to start trying.

For tweens and teens in your household, bring up the topic in ways that are positive and encouraging.

Consider sharing posts on social media that show how your family uses the #5210plan. This can help start conversations and build momentum for the movement with other families.

Talk with your child’s pediatrician at the next office visit about strategies for making step-by-step changes that will stick.

This article is the first in a series about the 5-2-1-0 program. Watch for the next post with more detail and ideas about adopting the first guideline—eating five veggies and fruit per day.