One in three children in North Carolina is overweight -- and overweight kids are more likely than their normal-weight peers to suffer from health problems and social isolation.

Pediatricians Sarah Armstrong, MD, and Michelle Bailey, MD, say Duke’s Healthy Lifestyles Program helps kids and families find opportunities to be healthy and active, using their strategy of 5-3-2-1-almost none.

Eat at Least Five Fruits and Vegetables Every Day

• Fresh fruits and veggies can be expensive, but frozen or canned foods are healthful alternatives that still have nutritional value.

• Fruit packed in juice or (better yet) water is much lower in sugar than the fruit packed in syrup.

• The Healthy Lifestyles program encourages five different kinds of fruits and vegetables every day, but the portion size depends on how old you are and how active you are. In general:

A five-year-old boy needs:
One and a half cups of fruit and one and a half cups of veggies

A 10-year-old girl needs:
One and a half cups of fruit and two and a half cups of veggies

A 15-year-old boy needs:
Two cups of fruit and three and a half cups of veggies

An adult needs:
Two cups of fruit and four cups of veggies

Eat Three Structured Meals Every Day

• Eat together as a family as much as possible. Kids who eat meals with their families tend to eat more healthy overall, do better in school, and communicate better with their parents.

• Serve food on plates instead of family-style, and cancel the “clean plate club” -- so that children can learn to eat when hungry and stop when satisfied.

• When eating out, avoid all-you-can-eat buffets and combo meals, both of which almost always mean oversized portions.

Keep "Screen Time" to Two Hours a Day or Less

• Children who eat while watching TV typically take in 400 to 600 more calories a day than children in families that do not eat with the TV on.

• Get and keep the TV and computers out of the bedrooms, including your own -- they lead to more screen time and less sleep.

• Don’t keep the TV on as background noise. Make a schedule and help your kids prioritize what they watch.

• Treat TV and computer game time as a treat. Have your kids “earn” time for playing video games by doing their chores, their homework, or other positive things around the house.

Be Active for One Hour Every Day

• Set a good example by exercising yourself.

• Be active together as a family. Assign active chores like raking leaves, washing the car, or vacuuming.

• Remember that activities don’t have to be team sports, and they don’t have to include expensive equipment. Walking, hiking, jump rope, Frisbee -- the options are endless.

• Use TV time as an opportunity to get moving. Try jumping rope or doing jumping jacks during commercial breaks!

Almost None: Avoid Sweetened Drinks and Foods

• Make water the go-to beverage for the whole family.

• Juice has a lot of calories and sugar -- one cup a day is enough for anyone, no matter what the age, and kids under six should have no more than six ounces.

• Sweetened beverages should be for special occasions only -- and watch the refills at restaurants.