If you ask pediatrician Dr. Jolene Meis whether she sees overweight and obese children during her regular child checks, her answer is simple.
"I do," Meis said. "A see a lot of kids who tend to be overweight or obese or at risk for that."
Floyd Valley Hospital leaders and other health officials in Plymouth County are honing in on childhood obesity this year.
The problem of childhood obesity doesn't end with childhood, Meis said.
Being obese as a child can have lifelong negative effects -- including a higher risk of adult obesity.
In Plymouth County, the rate of adult obesity is slightly higher than average in Iowa.
About 31 percent of adults in the county are obese, while 29 percent of Iowans fall in that category.
These statistics come from the County Health Rankings and Roadmaps website, a collaboration between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. The website defines obesity based on a body mass index greater than 30.
What can parents do?
Loretta Myers, director of patient care at Floyd Valley Hospital, in Le Mars, shared some ideas at a recent meeting with a group of Plymouth County adults and teens who focus on health issues in the county.
She suggested trying to remember four numbers: 5-2-1-0.
5: Five servings of fruits and vegetables a day.
2: Cut "screen time" to two hours or less each day. That includes everything from TVs, game systems and computer screens to iPads and mobile phones.
1: One hour of moderate to vigorous physical activity daily.
0: Aim for zero servings of soda or sugar-sweetened sports drinks or fruit drinks
Meis also touched on several parts of the 5-2-1-0 list in her suggestions for parents.
"Soda and Gatorade are the first thing I look for," Meis said. "I think the soft drink companies have done a fantastic job of marketing their products, particularly sports drinks, as healthy and something a child needs when they exercise. But in my opinion, there are very, very few children who exercise to the extent that they need that many calories replaced."
Most children aren't vigorously exercising for two or three hours, the pediatrician said.
"So probably what they need most is water," Meis said. "The only thing that would change that is excessive heat. In the summer when they're swimming a lot, they might need some electrolyte replacement. But still the calories in those are excessive."
As for "screen time," Meis said the American Academy of Pediatrics states that children should not exceed more than two hours each day.
"We have an epidemic of screen time going on for kids after school and before school," she said. "They're sitting all the time."
Meis suggested that children have 45 minutes to an hour of activity at least five days a week.
"That's good activity where their heart rate is getting up and their breathing rate increases and they're actually burning some calories," she said. "That would be swimming, jump rope, bicycling, walking briskly, running, any type of sport like basketball or football."
She suggested checking on opportunities for children to be involved in organized sports activities offered in the community.
During Myers' talk with the hospital-hosted health committee, she noted that some schools already offers ways to encourage activity for students.
Gehlen Catholic School in Le Mars invites students to walk around the track before or after school to earn points toward a class party, Myers said.
But she suggested adults take a lead role in showing children how to get off the couch.
"We've been encouraging parents with children to role model exercise along with providing healthy meals," Myers said. "Parents role model that activity and encourage their children to be active."
Plymouth County has a higher rate of physical inactivity than the state average, she said.
According to County Health Rankings and Roadmaps, about 30 percent of people in Plymouth County are physically inactive, while about 25 percent of Iowans are.
These statistics were based on the percentage of adults age 20 and older who reported no leisure time activity.
"We're trying to decrease the overall county rate of obesity below the state of Iowa average," Myers said.
One goal of local health officials is to increase the participation in the Live Healthy Iowa program to 10 percent.
That would be about 2,490 people in Plymouth County.
With registration still ongoing, so far only 110 Plymouth County residents have signed up to participate in Live Healthy Iowa.
For more information on Live Healthy Le Mars, people can go online to livehealthyiowa.org. People can also seek further information from Kari Daale at Floyd Valley Hospital, Todd Lancaster at the Le Mars YMCA, or Carol Schneider at the Plymouth County Iowa State University Extension office.
But families don't have to be part of a formal program to help their children live healthily, Myers said.
People can visit with their physician or a YMCA representative about getting active, she said.
"Get out and play and have some fun with your kids," Myers said. "Encourage the five servings of fruits and vegetables, which school menus are very much in line with, and do it as a family. Just get moving."