Diabetes, heart problems, depression - you know why childhood obesity is bad. Here's how you can fight it.

Obesity in children can lead to a host of health problems, including Type 2 diabetes, a condition that normally strikes older, overweight adults but is now appearing more often in adolescents. Diabetes is a condition in which the body either does not make enough insulin (Type 1) or its cells cannot respond to the insulin (Type 2). Without insulin, your child cannot use his body's supply of glucose, or sugar, to give him energy.

"If you keep your child's weight in check, you can lower his risk of fatty liver disease, metabolic syndrome and Type 2 diabetes," said Phil Zeitler, MD, Pediatric Endocrinologist at The Children's Hospital and Professor of Pediatrics at the University of Colorado Denver School of Medicine. "If you prevent obesity, you prevent Type 2 diabetes. It's as simple as that."

What's not simple is changing lifestyle patterns. Dr. Zeitler, lead researcher in a nationwide study concerning Type 2 diabetes among youth, said the team is learning there are big challenges to eating healthier diets and becoming more active, thanks to higher-calorie foods, increased portion sizes and couch-potato lifestyles. Fortunately, you can take some very practical steps now to help prevent your child from falling into the obesity trap.

Get Food Smart

When it comes to fighting obesity, an ounce of prevention is worth a pound of cure.

"Early prevention is key and you can start as early as infancy," said Stephen Daniels, MD, PhD, Pediatrician-in-Chief at Children's and Professor and Chair of the Department of Pediatrics at University of Colorado Denver School of Medicine. "Obesity prevention should begin with breastfeeding. Children who are breastfed have a lower risk of obesity later in life."

As babies start eating solid food, begin giving them healthy foods in correct serving sizes.

"Kids don't realize, and neither do parents, what an actual serving size looks like," said Marilyn Day, MS, RD, Co-director of Preventive Programs at The Children's Hospital Heart Institute and Coordinator of the SHAPEDOWN Clinic. "Serving sizes are much smaller than what some would suspect."

Want a correct serving size of fruits, veggies or grains? Your fist is a good reference for the proper amount. Likewise, your child's fist provides the right reference for a child-sized portion. And when it comes to protein, for adults or older children, a deck of cards looks like one serving of meat, fish or poultry. However, a toddler only needs approximately 2-3 ounces of protein per day, which is about 1/3 of an adult or older child's needs.

Pack those servings with foods from each food group that your child likes. Get kids involved in choosing the foods they enjoy by having them go to the store with you and putting their favorite healthy foods on the grocery list. Remember that behavioral changes can work - and last. It is much easier for people to adopt and maintain lifestyle modifications successfully as children than when they become older.

Move It or Gain It

Kids also need at least 30 to 60 minutes of physical activity and no more than two hours of "screen time" each day to keep obesity at bay. Unfortunately, computers, video games and television have replaced basketball, football and other forms of physical play.

"Parents may find obstacles to helping their child exercise," Dr. Zeitler said. "For example, financial challenges can keep kids from participating in activities like sports, but there are other options."

Teach your kids that physical fitness can be a fun family activity. Here are a few ideas to get you going:

• Go for family walks after mealtimes.
• Plan cycling and hiking trips on ?safe trails.
• Enter a "bike-a-thon" or "fun run/walk," then train for it.
• "Virtually" walk, run or cycle across Colorado. Look at a map and find out how many miles need to be traveled. Journal how many miles you travel every day (2,000 steps equal one mile on a pedometer). Mark your progress on the map weekly.

How to Talk to Your Child

If your child is overweight, it is important to be supportive when talking with her about it. Since it is common for overweight children to be teased at school, make sure you approach your daughter with compassion when discussing her weight. Small children especially won't understand long-term health complications, so instead address simple changes. For example, if your child makes a healthy food choice, say "good job," and don't say anything if she makes an unhealthy selection.

You can also try saying:

If you keep riding your bike and playing outside, you'll start getting into shape, and we may have to go buy you new clothes.

Or

If you start eating more fruits and vegetables and keep practicing, you'll be able to play soccer without getting so tired.

When parents keep a variety of healthy foods in the house, children have an easier time making these choices. Make sure your child knows she is not alone in changing her habits and be there to guide and encourage her along the way.

If you have questions or concerns about your child's weight or body mass index, ask your pediatrician or family doctor how to schedule an appointment with an expert at The Children's Hospital.

The Children's Hospital North Campus gives kids the specialized pediatric care they deserve, closer to home including around-the-clock Urgent Care, Specialist Care by appointment, advanced diagnostics and imaging and a brand new service: Observation Care. Observation care is designed as an alternative to hospitalization for simpler health issues. The North campus is located on Highway 7 in Broomfield, 1/2 mile west of I-25.