Childhood obesity is quite a touchy subject. None of us, myself included, love to talk about our weight. However, when it’s our kid’s midlines, it’s even more sensitive. Studies show that parents often underestimate their own child’s weight issues.

Sometimes, it’s difficult to see the issue when you are so close to the situation. Some parents love and reward their children with food. Others may over-indulge their child due to guilt about working too much. Others have difficulty setting limits and don’t want to be the “bad parent,” so they give in to pleas for unhealthy snacks.

One in three children is overweight and a third of those children are obese. According to the Centers for Disease Control (CDC), there are currently 12.7 million children who are obese in America. This generation of children are projected to have shorter life spans than their parents due to obesity-related issues. Obesity is linked to high blood pressure, cardiovascular issues, sleep apnea, respiratory ailments, and joint problems.

It’s a serious and multi-factorial issue and one that’s not easily solved. Talk to your pediatric provider about your child’s Body Mass Index percentile (BMI%): less than five percentile is underweight, between the fifth and the eighty-fifth percentile is normal, above the eighty-fifth percentile is overweight, and above the ninety-fifth percentile is obese.

Still, we as parents can make small, consistent changes which are helpful:

• Encourage 9-10 hours of sleep each night. Children who are well-rested tend not to overeat as much as children who are sleep deprived. This makes perfect sense as we all may eat to keep going when we are tired.

• Increase the amount of fresh fruits and vegetables in your child’s diet. Often when I ask children, they can’t name the last time they had a fruit or vegetable. Strive for five fresh fruits and vegetables each day. Try a banana with some Greek yogurt for breakfast. Add carrots and an apple to a packed lunch. Include a salad and melon to your dinner. It’s easy to include five daily fruits and vegetables with some planning.

• Limit your child’s screen time to fewer than two hours each day. This includes computer, TV, video games, and phone screens. Children on their screens tend to be less active.

• Include one hour of vigorous exercise daily. Physical education at school doesn’t count in this hour. Many children don’t get PE daily and sometimes PE isn’t very vigorous. Children need to run and play.

• Avoid sweetened drinks including juice. Most kids don’t drink enough water. Substitute water (or flavored water) for soda. Give an apple instead of apple juice. Try lemonade or iced-tea sweetened with Splenda rather than sugar. Kids need water and milk. If your child is over age two, low-fat or skim milk is recommended. From 12 months to 2 years whole milk is recommended.

• Increase the fiber in your family’s diet. Whole wheat bread and pasta are an easy switch. Popcorn is a high-fiber snack, but choose a low-calorie product or pop your own!

• Choose plant-based fats (olive oil, avocado) over animal fats (butter, bacon). Plant-based fats tend to be “healthier” fats. It’s just as easy (and healthier) to cook with olive oil rather than butter or lard. Avoid fried foods.

• Prepare lean meats and fish more often. Salmon is a delightful choice. Try frozen previously cooked shrimp for a quick stir fry with brown rice and veggies. Choose poultry products without the skin.

• Eat at home with the TV off. Studies find that those who eat in front of the TV consume 30 percent more than those who don’t. Rediscover the family dinner table. Make it a device-free zone. Talk about the day. Take turns sharing the high and low points of your day. Talk to your kids.

• Feel free to set limits about seconds at dinner and snacks. Don’t be overly controlling, but don’t be overly indulgent either. Encourage healthy snacks such as fruits. Limit eating to the table. Set a limit to snacking (no snacks after 8 p.m. or only fruit after dinner).

With a few consistent changes, children can improve their weight and their health. Your health may improve as well. After all, children learn what they see us do. Let’s model the behavior that we wish to see in our kids.