Want your kids to shine? Shoot for 5-2-1-0-9.

By Angela Lennon, M.D., pediatric endocrinologist, and Becky McCarver, M.S., R.D., CDE, pediatric diabetes educator and dietitian, Providence Pediatric Endocrinology

We all want our children to be happy and healthy. We understand, in general, that encouraging kids to eat well, play actively and get plenty of sleep will help them do and feel their best. But when it comes to the specifics – Eat what? Play how much? Sleep how long? – things tend to get complicated.

So let’s keep it simple. There are five daily health essentials that every family can focus on to reduce the risks of childhood obesity and disease and to give kids a healthy start in life. All you have to remember is:

Rise and Shine with 5-2-1-0-9

If your family is already doing well in several of these areas, pick one or two where you’re not quite hitting the mark, and work on those. Improving in just one of these areas can make a big difference in a child’s health, weight, mood and/or performance in school. As one recent patient’s experience shows, when kids – and parents, too – are hitting all five of the 5-2-1-0-9, they really shine. 

5 or more fruits and vegetables 

When families focus on eating five or more fruits and vegetables every day, nearly all the other dietary advice falls into place. Fruits and vegetables are rich in flavor, vitamins, minerals and fiber. Fresh is ideal, but frozen and dried are good, too. To cover all the nutrients, encourage kids to “eat the rainbow,” including a variety of different-colored fruits and vegetables every day.

Here are five tips to help your kids eat five a day:

  • Include a fruit or vegetable in every meal and snack. 
  • Add fruit to every breakfast: top cereal with bananas or berries, or make fruit and yogurt parfaits.
  • Dip it: Let kids dip colorful vegetable sticks into healthy bean- or yogurt-based dips for fun lunches and snacks, or try nut butters as dips for apples and bananas.
  • Serve a salad with dinner, and let kids pick out fruits and veggies to toss into the bowl.
  • Try offering vegetables in a variety of ways: raw, grilled, roasted, baked, etc. Don’t force it, but do encourage one “just try it” bite. Add veggies to pasta sauces and soups. For more ideas, read "12 ways to turn your kids into vegetable lovers."  

Find recipes at www.fruitsandveggiesmorematters.org and www.foodhero.org.

2 hours max of recreational screen time

Limiting the time kids spend on screens – whether they’re gaming or watching TV – gives them more time and energy for healthier activities. It also helps them sleep better. Here are some screen-time do’s and don’ts:

  • Don’t allow screens in the bedroom – they disrupt sleep.
  • Don’t allow screen time until chores, homework and physical activity are done.
  • Do allow exceptions for screen time that is educational or physical – for example, Wii dance games are a fun way to get some physical activity on dark, rainy days. 
  • Learn more here.

1 hour or more of physical activity

Kids need an hour of active play, every day, and that doesn't mean Nintendo. It means getting up, getting out, walking, running, shooting hoops, jumping, hopping, skipping — anything to get moving. Why? For just about every reason: physical activity lifts mood, improves sleep, prevents disease, builds strength, controls weight, helps kids be social and is just plain fun. If you’re having trouble getting your kids moving, here are some ideas:

  • Activity doesn’t have to be “exercise” – it can be fun (hopscotch) or productive (chores) or both (leaf-raking contests).
  • The best activity is the kind that’s built into your child’s day, such as walking or biking to school.
  • Encourage outdoor play: give kids fewer video games and more jump ropes, hula hoops and lawn games. 
  • Find ways to increase activity for the whole family, such as taking walks before or after dinner and exploring new hiking trails on weekends. 
  • When the weather is bad, encourage kids to sign up for an indoor sport, take them swimming at a public pool, or get a mini trampoline they can jump on while they listen to music.
  • Here are more tips for parents.

0 sugar-sweetened drinks

Sodas, sports drinks, coffee-shop drinks, juice boxes — they’re all low in nutrients and high in calories, and kids shouldn’t be drinking empty calories (neither should adults). Some drinks also have caffeine in them, which affects kids’ behavior and sleep. Even 100 percent fruit juice isn’t recommended anymore. Focus your kids’ drink options on the only two their bodies need: milk and water. That may be a tough sell, so it will definitely require parental involvement. Here are some tips to ease the transition:

  • Don’t keep tempting drinks in the house.
  • Let each member of the family pick out his or her own, personal water bottle.
  • Make water more interesting by adding fruit slices, cucumber, mint leaves or herbal tea.
  • Try sparkling water for kids who like fizzy drinks, with fruit or a small splash of juice added (a little bit on occasion is OK). 
  • Set a good example – what you do speaks louder than what you say.
  • Learn more about why and how to rethink your drinks.

9 hours or more of sleep 

Adults might get by on 7 or 8 hours of sleep per night, but kids need more than that. Short-changing sleep can affect a child’s moods, behavior, attention span, academic performance, brain development and overall health. Sometimes, just reprioritizing sleep can make a noticeable difference in a child who has been acting out or struggling in school. Here are some guidelines to help kids get the sleep they need:

  • Kids from the ages of 6-12 need 9-12 hours of sleep each night. 
  • Teenagers need 8-10 hours of sleep. 
  • Set a consistent sleep schedule, with the same bedtime and waking time (within an hour) every day. 
  • Stop naps after age 5 – they will only keep kids awake at night.
  • Unwind and unplug as bedtime approaches. A calming routine – such as switching from overhead lights to lamps, and from electronics to books – signals kids’ brains and bodies that it’s time to get ready to sleep. 
  • Learn more about pediatric sleep recommendations for optimal health.

One patient’s success story

Recently, a 17-year-old patient came to us struggling with obesity, depression and severe sleep problems. A home-schooled student, she had no clear structure to her days, no regular meal schedule and a wildly erratic sleep schedule. She ate few fruits or vegetables and drank a lot of juice. She spent hours on screens and almost no time outdoors, and got very little physical activity. 

As we talked about how food, sleep, activity and mood are all interrelated, this bright young girl took it all in. Even in the midst of deep depression and sleep deprivation, she was determined to make changes to improve her life. Together, we set four goals to help her get closer to 5-2-1-0-9: to eat every four hours, to get outside at least once a day, to regulate her sleep schedule and to see a therapist for her depression.

At her return visit two months later, she proudly announced that she had met all of her goals, and then some. She was now on a regular eating schedule and was more in touch with her feelings of hunger and fullness. She had started walking twice a day and now regularly walks 90 minutes a day. She had stopped napping and started going to bed at the same time every night. And she had traded in juice for water and tea. As a result of her efforts, she had lost 23 pounds – a remarkable achievement. Her diabetes risk markers also had dropped impressively. And her mood was vastly improved – she felt very, very proud of herself, and rightly so.

Incidentally, when the patient’s mother started walking with her, the mother lost weight, too. Which just goes to show that when we set health goals for our kids, and we work on them together, as a family, it’s not just the kids who benefit. We all do.  


Resources to help children and families: