Take Charge of Your Health

A Guide for Teenagers

• Introduction
• Healthy Eating
• Physical Activity
• Making It Work
• Change Occurs Slowly
• Other Resources

Introduction

Does your life move at a hectic pace?

You may feel stressed from school, after-school activities, peer pressure, and family relationships. Your busy schedule may lead you to skip breakfast, buy lunch from vending machines, and grab whatever is in the refrigerator for dinner when you get home.

Where is the time to think about your health?

Yet healthy behaviors, like nutritious eating and regular physical activity, may help you meet the challenges of your life. In fact, healthy eating and regular exercise may help you feel energized, learn better, and stay alert in class. These healthy habits may also lower your risk for diseases such as diabetes, asthma, heart disease, and some forms of cancer.

Did you know?

• From 2003 to 2004, approximately 17.4 percent of U.S. teens between the ages of 12 and 19 were overweight.
• Overweight children and teens are at high risk for developing serious diseases. Type 2 diabetes and heart disease were considered adult diseases, but they are now being reported in children and teens.

Dieting is not the answer.

The best way to lose weight is to eat healthfully and be physically active. It is a good idea to talk with your health care provider if you want to lose weight.

Many teens turn to unhealthy dieting methods to lose weight, including eating very little, cutting out whole groups of foods (like grain products), skipping meals, and fasting. These methods can leave out important foods you need to grow. Other weight-loss tactics such as smoking, self-induced vomiting, or using diet pills or laxatives can lead to health problems.

In fact, unhealthy dieting can actually cause you to gain more weight because it often leads to a cycle of eating very little, then overeating or binge eating. Also, unhealthy dieting can put you at greater risk for growth and emotional problems.

Take Charge.

What You Can Do

This booklet is designed to help you take small and simple steps to keep a healthy weight. It gives you basic facts about nutrition and physical activity, and offers practical tools that you can use in your everyday life, from reading food labels and selecting how much and what foods to eat, to replacing TV time with physical activities.

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Healthy Eating

Eating healthfully means getting the right balance of nutrients your body needs to perform every day. You can find out more about your nutritional needs by checking out the 2005 Dietary Guidelines for Americans. Published by the U.S. Government, this publication explains how much of each type of food you should eat, along with great information on nutrition and physical activity. The guidelines suggest the number of calories you should eat daily based on your gender, age, and activity level.

According to the guidelines, a healthy eating plan includes:

• fruits and vegetables
• fat-free or low-fat milk and milk products
• lean meats, poultry, fish, beans, eggs, and nuts
• whole grains

In addition, a healthy diet is low in saturated and trans fats, cholesterol, salt, and added sugars.

When it comes to food portions, the Dietary Guidelines use the word "servings" to describe a standard amount of food. Serving sizes are measured as “ounce-” or “cup-equivalents.” Listed below are some tips based on the guidelines that can help you develop healthy eating habits for a lifetime.

Eat fruits and vegetables every day.

When consumed as part of a well-balanced and nutritious eating plan, fruits and vegetables can help keep you healthy.

You may get your servings from fresh, frozen, dried, and canned fruits and vegetables. Teenagers who are consuming 2,000 calories per day should aim for 2 cups of fruit and 2 1/2 cups of vegetables every day. You may need fewer or more servings depending on your individual calorie needs, which your health care provider can help you determine.

Count your calcium.

Calcium helps strengthen bones and teeth. This nutrient is very important, since getting enough calcium now can reduce the risk for broken bones later in life. Yet most teens get less than the recommended 1,200 mg of calcium per day. Aim for at least three 1 cup-equivalents of low-fat or fat-free calcium-rich foods and beverages each day.

Power up with protein.

Protein builds and repairs body tissue like muscles and organs. Eating enough protein can help you grow strong and sustain your energy levels. Teens need five and one-half 1 ounce-equivalents of protein-rich foods each day.

Go whole grain.

Grain foods help give you energy. Whole-grain foods like whole-wheat bread, brown rice, and oatmeal usually have more nutrients than refined grain products. They give you a feeling of fullness and add bulk to your diet.

Try to get six 1 ounce-equivalents of grains every day, with at least three 1 ounce-equivalents coming from whole-grain sources.

Know your fats.

Fat is also an important nutrient. It helps your body grow and develop, and it is a source of energy as well—it even keeps your skin and hair healthy. But be aware that some fats are better for you than others. Limit your fat intake to 25 to 35 percent of your total calories each day.

Unsaturated fat can be part of a healthy diet—as long as you do not eat too much since it is still high in calories. Good sources include:

• olive, canola, safflower, sunflower,corn, and soybean oils
• fish like salmon, trout, tuna, and whitefish
• nuts like walnuts, almonds, peanuts, and cashews

Limit saturated fat, which can clog your arteries and raise your risk for heart disease. Saturated fat is found primarily in animal products and in a few plant oils like:

• butter
• full-fat cheese
• whole milk
• fatty meats
• coconut, palm, and palm kernel oils

Limit trans fat, which is also bad for your heart. Trans fat is often found in:

• baked goods like cookies, muffins, and doughnuts
• snack foods like crackers and chips
• vegetable shortening
• stick margarine
• fried foods

Look for words like “shortening,” “partially hydrogenated vegetable oil,” or “hydrogenated vegetable oil” in the list of ingredients. These ingredients tell you that the food contains trans fat. Packaged food products are required to list trans fat on their Nutrition Facts.

Replenish your body with iron.

Teen boys need iron to support their rapid growth—most boys double their lean body mass between the ages of 10 and 17. Teen girls also need iron to support growth and replace blood lost during menstruation.

To get the iron you need, try eating these foods:

• fish and shellfish
• lean beef
• iron-fortified cereals
• enriched and whole-grain breads
• cooked dried beans and peas like black beans, kidney beans, black-eyed peas, and chickpeas/garbanzo beans
• spinach

Control your food portions.

The portion sizes that you get away from home at a restaurant, grocery store, or school event may contain more food than you need to eat in one sitting. Research shows that when people are served more food, they eat more food. So, how can you control your food portions? Try these tips:

• When eating out, share your meal, order a half-portion, or order an appetizer as a main meal. Be aware that some appetizers are larger than others and can have as many calories as an entree.
• Take at least half of your meal home.
• When eating at home, take one serving out of a package (read the Nutrition Facts to find out how big a serving is) and eat it off a plate instead of eating straight out of a box or bag.
• Avoid eating in front of the TV or while you are busy with other activities. It is easy to lose track of how much you are eating if you eat while doing other things.
• Eat slowly so your brain can get the message that your stomach is full.
• Do not skip meals. Skipping meals may lead you to eat more high-calorie, high-fat foods at your next meal or snack. Eat breakfast every day.

Read food labels.

When you read a food label, pay special attention to:

• Serving Size. Check the amount of food in a serving. Do you eat more or less? The "servings per container" line tells you the number of servings in the food package.
• Calories and Other Nutrients. Remember, the number of calories and other listed nutrients are for one serving only. Food packages often contain more than one serving.
• Percent Daily Value. Look at how much of the recommended daily amount of a nutrient (% DV) is in one serving of food—5-percent DV or less is low and 20-percent DV or more is high. For example, if your breakfast cereal has 25-percent DV for iron, it is high in iron.

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Plan meals and snacks.

You and your family have busy schedules, which can make eating healthfully a challenge. Planning ahead can help. Think about the meals and snacks you would like for the week—including bag lunches to take to school—and help your family make a shopping list. You may even want to go grocery shopping and cook together.

Jumpstart your day with breakfast.

Did you know that eating breakfast can help you do better in school? By eating breakfast you can increase your attention span and memory, have more energy, and feel less irritable and restless. A breakfast that is part of a healthy diet can also help you maintain an appropriate weight now and in the future.

Bag it! Pack your lunch.

Whether you eat lunch from school or pack your own, this meal should provide you with one-third of the day's nutritional needs. A lunch of chips, cookies, candy, or soda just gives you lots of calories, but not many nutrients. Instead of buying snacks from vending machines at school, bring food from home. Try packing your lunch with a lean turkey sandwich on whole-grain bread, healthy foods like fruits, vegetables, low-fat yogurt, and nuts.

Snack smart.

A healthy snack can contribute to a healthy eating plan and give you the energy boost you need to get through the day. Try these snack ideas, but keep in mind that most of these foods should be eaten in small amounts:

• fruit—any kind—fresh, canned, dried, or frozen
• peanut butter on rice cakes or whole-wheat crackers
• baked potato chips or tortilla chips with salsa
• veggies with low-fat dip
• string cheese, low-fat cottage cheese, or low-fat yogurt
• frozen fruit bars, fruit sorbet, or low-fat frozen yogurt
• vanilla wafers, graham crackers, animal crackers, or fig bars
• popcorn (air popped or low-fat microwave)

Eat dinner with your family.

For many teens, dinner consists of eating on the run, snacking in front of the TV, or nonstop munching from after school to bedtime. Try to eat dinner as a family instead. Believe it or not, when you eat with your family you are more likely to get more fruits, vegetables, and other foods with the vitamins and minerals your body needs. Family meals also help you reconnect after a busy day. Talk to your family about fitting in at least a few meals together throughout the week.

Limit fast food and choose wisely.

Like many teens, you may eat at fast food restaurants often. If so, you are probably taking in a lot of extra calories from added sugar and fat. Just one value-sized fast food meal of a sandwich, fries, and sweetened soda can have more calories, fat, and added sugar than anyone should eat in an entire day.

The best approach is to limit the amount of fast food you eat. If you do order fast food, try these tips:

• Skip "value-sized" or "super-sized" meals.
• Choose a grilled chicken sandwich or a plain, small burger.
• Use mustard instead of mayonnaise.
• Limit fried foods or remove breading from fried chicken, which can cut half the fat.
• Order garden or grilled chicken salads with light or reduced-calorie dressings.
• Choose water, fat-free, or low-fat milk instead of sweetened soda.

Rethink your drinks.

Soda and other sugary drinks have replaced milk and water as the drinks of choice for teens and adults alike. Yet these drinks are actually more like desserts because they are high in added sugar and calories. In fact, soda and sugar-laden drinks may contribute to weight problems in kids and teens. Try sticking to water, low-fat milk, or fat-free milk.

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Physical Activity

Like eating well, physical activity may help you feel good. Being physically active may:

• Help you control your weight, build lean muscle, and reduce your body fat.
• Strengthen your bones.
• Increase flexibility and balance.
• Reduce your risk for chronic diseases like type 2 diabetes, heart disease, and high blood pressure.

Physical activity also has possible emotional and social benefits, including:

• Improving your self-esteem and mood.
• Decreasing feelings of anxiety and depression.
• Helping you do better in school.
• Improving your teamwork skills through sports.

Be active every day.

Physical activity should be part of your daily life, whether you play sports, take P.E. or other exercise classes, or even get from place to place by walking or bicycling. Teens should be physically active for 60 minutes or more on most, preferably all, days of the week.

Turn off the TV and get moving!

Can too much TV contribute to weight problems? Several research studies say yes. In fact, one study noted that boys and girls who watched the most TV had more body fat than those who watched TV less than 2 hours a day.

Try to cut back on your TV, computer, and video game time and get moving instead. Here are some tips to help you break the TV habit.

• Tape your favorite shows and watch them later. This cuts down on TV time because you plan to watch specific shows instead of zoning out and flipping through the channels indefinitely.
• Replace after-school TV watching and video game use with physical activities. Get involved with activities at your school or in your community.

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Making It Work

Look for chances to move more and eat better at home, at school, and in the community.

It is not easy to maintain a healthy weight in today's environment. Fast food restaurants on every corner, vending machines at schools, and not enough safe places for physical activity can make it difficult to eat healthfully and be active. Busy schedules may also keep families from fixing and eating dinners together.

Understanding your home, school, and community is an important step in changing your eating and activity habits. Your answers to the questions on this checklist can help you identify barriers and ways to change your behavior to support your success.

Home

1. Is the kitchen stocked with fruits, vegetables, low-fat or fat-free milk and milk products, whole-grain items, and other foods you need to eat healthy?
2. Can you get water and low-fat or fat-free milk instead of soda, sweetened tea, and sugary fruit drinks?
3. Do you pack healthy lunches to take to school?
4. Does your family eat dinner together a few times per week?
5. Do you have sports or exercise equipment at home, including balls, bikes, and jump ropes?
6. Do you limit the hours you spend watching TV or playing video or computer games?

School

1. Does the cafeteria offer healthy foods such as salads and fruit?
2. Are there vending machines in school where you can buy snacks and drinks like baked chips, fig bars, and bottled water?
3. Do you take gym class on a regular basis?
4. Are there after-school sports or other physical activities available aside from gym class?

Community (Where You Live)

1. Are there bike paths, hiking trails, swimming pools, parks, or open fields that are safe to use?
2. Is there a community center, church, or other place that offers classes such as dance, self-defense, or other physical activities?
3. Are there grocery stores that offer fruits, vegetables, and other healthy foods?
4. Do the streets have sidewalks so you can walk safely?

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Change Occurs Slowly

Old habits are hard to break and new ones, especially those related to eating and physical activity, can take months to develop and stick with. Here are some tips to help you in the process:

• Make changes slowly. Do not expect to change your eating or activity habits overnight. Changing too much too fast can hurt your chances of success.
• Look at your current eating and physical activity habits and at ways you can make them healthier. Use a food and activity journal for 4 or 5 days, and write down everything you eat, your activities, and your emotions. Review your journal to get a picture of your habits. Do you skip breakfast? Are you eating fruits and vegetables every day? Are you physically active most days of the week? Do you eat when you are stressed? Can you substitute physical activity for eating at these times? For tips on keeping a food and activity diary, check out the website of the American Academy of Family Physicians at http://www.familydoctor.org . You can also buy inexpensive journals at grocery stores, discount stores, or online bookstores.
• Set a few realistic goals for yourself. First, try cutting back the number of sweetened sodas you drink by replacing a couple of them with unsweetened beverages. Once you have reduced your sweetened soda intake, try eliminating these drinks from your diet. Then set a few more goals, like drinking low-fat or fat-free milk, eating more fruits, or getting more physical activity each day.
• Identify your barriers. Are there unhealthy snack foods at home that are too tempting? Is the food at your cafeteria too high in fat and added sugars? Do you find it hard to resist drinking several sweetened sodas a day because your friends do it? Use the tips above to identify changes you can make.
• Get a buddy at school or someone at home to support your new habits. Ask a friend, sibling, parent, or guardian to help you make changes and stick with your new habits.
• Know that you can do it! Use the information in this booklet and the resources listed at the end to help you. Stay positive and focused by remembering why you wanted to be healthier—to look, feel, move, and learn better. Accept relapses—if you fail at one of your nutrition or physical activity goals one day, do not give up. Just try again the next day. Also, share this information with your family. They can support you in adopting healthier behaviors.

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Other Resources

Websites

http://www.mypyramid.gov is your access point for the U.S. Department of Agriculture's (USDA) food guidance system. This website contains general guidance on food and healthy eating, with tips and suggestions for making smart dietary choices. The site also features interactive tools that can customize food and calorie recommendations according to your age, gender, and physical activity level.

http://www.health.gov/PAGuidelines is where you can learn about the benefits of physical activity. The 2008 Physical Activity Guidelines for Americans, from the U.S. Department of Health and Human Services, provides general information on physical activity for teenagers, including how often you should be active and which activities are best for you.

http://www.fitness.gov, run by The President's Council on Physical Fitness and Sports, provides regular updates on the Council's activities as well as resources on how to get involved in its programs.

http://www.girlshealth.gov, developed by the Office on Women's Health, provides girls with reliable health information on physical activity, nutrition, stress reduction, and more.

http://www.fns.usda.gov/tn is the USDA's Team Nutrition website, which focuses on the role nutritious school meals, nutrition education, and a health-promoting school environment play in helping students learn to enjoy healthy eating and physical activity.

http://www.nichd.nih.gov/msy is the National Institute of Child Health and Development's Media-Smart Youth: Eat, Think, and Be Active! program. This interactive after-school program is designed to help young people become aware of the media's influence on their food and physical activity choices.

http://www.bestbonesforever.gov is a bone health campaign sponsored by the Office of Women’s Health for girls and their friends to grow stronger together and stay strong forever.

http://ndep.nih.gov/teens/index.aspx, from the National Diabetes Education Program, provides teens with information about diabetes. The website offers publications and resources on how teens can prevent and manage diabetes.

http://hin.nhlbi.nih.gov/portion/keep.htm is a quiz from the National Heart, Lung, and Blood Institute that tests your knowledge of how food portion sizes have changed during the last 20 years.

http://www.cdc.gov/nccdphp/dnpa/physical/index.htm, a site sponsored by the CDC's Division of Nutrition and Physical Activity, addresses the importance of physical activity and provides recommendations on how to get started on a fitness program. It includes links to websites that offer health information for teenagers.

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Weight-control Information Network

1 WIN Way
Bethesda, MD 20892–3665
Phone: (202) 828–1025
Toll-free number: 1–877–946–4627
Fax: (202) 828–1028
Email: win@info.niddk.nih.gov
Internet: http://www.win.niddk.nih.gov

The Weight-control Information Network (WIN) is a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health, which is the Federal Government's lead agency responsible for biomedical research on nutrition and obesity. Authorized by Congress (Public Law 103-43), WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues. Publications provided by WIN are reviewed by both NIDDK scientists and outside experts.

Special thanks to the teens who helped with this publication.

This publication is not copyrighted. WIN encourages users of this brochure to duplicate and distribute as many copies as desired.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health

NIH Publication No. 09-4328
August 2009