Eli Rafalovich is 3 years old and just returning from a hike with his mother, Tina. They're no more than in the door of their Falls Church, Va., home when Eli asks if his mom will play ball with him.
"He's a kid who loves balls -- every since he was tiny," Tina Rafalovich said. "We can get all kinds of toys and games. I hope his love of balls and sports continues to be natural."
Whether or not Eli ever becomes an athlete, he's well on his way to a life of fitness. Dr. Michael Cohen, of Boys Town Pediatrics in Omaha, Neb., said developing healthy habits early is the easiest way to have healthy kids who grow into healthy adults.
How can parents inspire it? By living it themselves.
Many parents read to their infants in an effort to show them early how important reading is. Use the same approach with exercise, Cohen said.
"From the earliest days, I encourage (parents of newborns) to take walks with the child in a stroller, and then children are used to having those healthy habits," the doctor said.
Tina Rafalovich said she doesn't give much thought to Eli's exercise regimen, and she doesn't have to. As a stay-at-home mother, Tina and Eli play, sing, bike, swim and chase the family's two dogs through most days. They're getting fit without trying.
"He loves DVDs and watches TV, but he also never sits for long. He'll get up and run around," Tina said.
The Rafalovich approach is just what the American Heart Association recommends.
"Be active with your kids. Experts say that what kids want more than anything else is time with their parents. To give them that, don't just send them out to play -- go play with them," the association writes on its website.
If it's too late to follow the Rafalovich family's example in your house, Cohen suggests four approaches for getting the whole family off the couch and into the world of exercise.
To get moving, start with goals that are easy to attain in a week. Children sometimes can't grasp long-term goals, Cohen said, so break them up into bits.
"'Instead of, 'You're going to start exercising as far as the eye can see' -- sometimes it's too much for them to grasp. Instead, (say) 'Let's start with 10 minutes three times a week.' Then increase each week," Cohen said.
Aim for getting your child's heart rate above 100 beats per minute for 30 minutes.
"I think it's unfair that the parents lecture the children and the parents don't necessarily embrace the lifestyle for themselves. It's so much easier and fun for a child if the parents are involved," he said.
It also helps you multitask, Cohen said, because in a busy life, parents don't need to schedule exercise time separate from family time -- it all happens at once.
Cohen said parents should be very involved in praising their children for trying to become more active. A parent's notice can be the best motivator to keep kids moving.
Whether it is a hug or a phrase, let your children know you notice their efforts.
Food Isn't A Reward
While you should be positive, you shouldn't celebrate goals with a trip to the ice cream store.
"Providing food based on performance or behavior connects food to mood. This practice can encourage children to eat treats even when they are not hungry and can instill lifetime habits of rewarding or comforting themselves with food behaviors associated with unhealthy eating or obesity," according to teaching materials for Chapel Hill-Carrboro City School in North Carolina.
The point of setting diet goals is to change a child's behavior and attitude toward food, so take the reward's focus off food, too.
"Try going to the movies or taking a special outing," Cohen said.
Some families create a chart to map goals, then at certain points along the way the rewards are granted.
"A trip to favorite place ... or something they value but don't get a chance to do often. Be creative," suggests HealthyEatingAdvisor.com.
Rewards could include a day at a water park, a sleepover with friends or something small such as a book, a temporary tattoo, a puzzle or gift certificate to a favorite store.
Exercise Goes Beyond Gym
Don't forget, exercise comes in many forms.
"When most adults think about exercise, they imagine working out in the gym on a treadmill or lifting weights," according to KidsHealth.org. "But for children, exercise means playing and being physically active. Kids exercise when they have gym class at school, soccer practice or dance class. They're also exercising when they're at recess, riding bikes or playing tag."
Cohen said 30 minutes of cardiovascular activity three times a week is a good target for which to aim. And families should keep daily screen time to less than an hour a day on school days, whether that means videogames, TV or non-school-related computer surfing.
While a family can initiate its own fitness program, Cohen recommends seeing a doctor before you start. In his practice, Cohen asks questions to get a complete picture of the family's overall health, and runs screening tests on the children that may pick up hidden problems.
A doctor can help a family tailor its fitness regimen to address any problems. The benefits are substantial and cumulative, and can help increase life expectancy and lower the chance of heart disease.
"Increased physical activity has been associated with an increased life expectancy and decreased risk of cardiovascular disease," according to the American Heart Association. "Physical activity produces overall physical, psychological and social benefits. Inactive children are likely to become inactive adults. And physical activity helps with controlling weight, reducing blood pressure, raising HDL ("good") cholesterol and reducing the risk of diabetes and some kinds of cancer."