What's in This Booklet?
DID YOU KNOW?
About one-third of pre-teens and teens are overweight or obese. But small changes in what you do and eat may help you stay healthy.As you get older, you are starting to make your own decisions about many things that are important to you. You select what you wear every day, listen to music that you like, and spend time with friends that you choose. Are you also ready to take charge of decisions that affect your health?
This booklet gives you small and doable steps that may help you get healthier. In this booklet, you will find five main sections:
- Know How Your Body Works explains how your body uses the food you eat and how physical activity and other tasks help your body "burn" food.
- Charge Up with Healthy Eating includes tips to help you plan for healthy eating.
- Get Moving gives you some ideas for being physically active in fun ways.
- Take Your Time shares some ideas to help you ease into healthy habits and keep them up for a long time.
- Make It Work for You is a tool to help you plan healthy meals and physical activities that fit into your busy life.
You can also check out the "Did you know?" boxes to learn interesting facts related to your health. Other helpful tips and fun ideas also appear in boxes throughout this booklet. Try flipping through the booklet before you begin reading to get an idea of what you will find on each page.
Know How Your Body Works
Think of food as energy to charge up your battery for the day. Throughout the day, you use energy from the battery to think and move, so you need to eat regularly to keep powered up. This is called "energy balance" because you need to balance food (energy you take in) with activity (energy you spend).
How much energy does your body need?
You may have heard of calories, which measure the amount of energy in a food. There is no "right" number of calories that works for everyone. The number of calories you need depends on whether you are a girl or a boy, how old you are, and how active you are (which may not be the same every day).
Should you diet?
Dieting may not be wise. Many teens try to lose weight by eating very little, cutting out whole groups of foods (like "carbs"), skipping meals, and fasting. These methods can leave out important foods your body needs. In fact, unhealthy dieting may make you gain more weight because it often leads to a cycle of eating very little, then overeating or binge eating because you are hungry. This can also affect your emotions and how you grow.
Other weight-loss tactics like smoking, self-induced vomiting, or using diet pills or laxatives (medicines that help people have bowel movements) can also lead to health problems.
Eating healthy and being physically active may help you . . .
- Do better in school.
- Have more energy for other fun times, like hanging out with your friends.
- Make friends who share your interests in dance, sports, or other activities.
- Tone up and strengthen your muscles.
- Improve your mood.
Charge Up with Healthy Eating
DID YOU KNOW?
Just one super-sized fast food meal can have more calories than you should eat in an entire day. And when people are served more food, they eat more food—even if they don't need it. This may lead to weight gain. When eating fast food, choose small portions or healthy fast food like a veggie wrap or salad.
Take the Portion Distortion Quiz to find out how portion sizes have changed over the last 20 years. See the Resources section for more info.
Healthy eating involves taking control of how much and what types of food you eat. This section has information to help you . . .
- Control your food portions.
- Charge your battery with high-energy foods.
- Avoid pizza, candy, and fast food.
- Stay powered up all day.
Control your food portions
A portion is the amount of one food you eat at one time. Many people eat larger portions than they need, especially when eating away from home. Ready-to-eat meals (from a restaurant, grocery store, or school event) may have larger portions than you need. Follow the tips below to control portions.
When eating away from home,
- Order something small. Try a half-portion or healthy appetizer, like hummus (chickpea spread) with whole-wheat pitas or grilled chicken. If you order a large meal, take half of it home or split it with someone else at the table.
- Limit the amount of fast food you eat. When you do get fast food, say "no thanks" to super-sized or value-sized options, like those that come with fries and soda.
- Choose salad with low-fat dressing, a sandwich with mustard instead of mayo, or other meals that have fruits, veggies, and whole grains.
- Choose grilled options, like chicken, or remove breading from fried items. Avoid meals that use the words creamy, breaded, battered, or buttered.
DID YOU KNOW?
Many teens need more of these nutrients:
Calcium builds strong bones and teeth.
Vitamin D supports bone health.
Potassium helps lower blood pressure.
Dietary fiber may help you to digest your food better and feel full.
Protein helps you grow strong and powers you up.
Iron supports your growth.
When eating at home,
- Take one serving out of a package and eat it off a plate instead of eating straight out of a box or bag. "What do all these numbers mean?" explains where you can find serving sizes.
- 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. Your brain needs about 20 minutes before it gets the message.
Charge your battery with high-energy foods
Eating healthy is not just about the amount of food you eat. You need to make sure you're eating the types of food that charge you up. Strive to eat meals that include fruits, vegetables, whole grains, low-fat protein, and dairy. More information is below, and you can check out the meal planning tool at the end of this guide.
Fruits and Vegetables
Make half of your plate fruits and vegetables. Dark green, red, and orange vegetables, in particular, have high levels of the nutrients you need, such as vitamin C, calcium, and fiber. Adding spinach or romaine lettuce and tomato to your sandwich is an easy way to get more veggies in your meal.
MAINTAIN A HEALTHY WEIGHT
- Try to eat less of foods like cookies and candy. If you do eat dessert, try low-fat frozen yogurt.
- Avoid adding sugar to your food and drinks.
- Drink water, low-fat milk, or fat-free milk, and avoid high-sugar drinks. Soda, energy drinks, and some juices are the main sources of added sugars in our diets.
Grains
Choose whole grains, like whole-wheat bread, brown rice, and oatmeal.
Protein
Power up with lean meats, like turkey on a sandwich, or chicken, seafood, eggs, beans, nuts, tofu, and other protein-rich foods.
Dairy
Build strong bones with fat-free or low-fat milk products. If you cannot digest lactose (the sugar in milk that causes some people stomach pain), choose soy or rice milk and low-fat yogurt.
Avoid pizza, candy, and fast food
You don't have to stop eating these items, but eating less of them may help you maintain a healthy weight. Pizza, candy, fast food, and sodas have lots of added sugar, solid fats, and sodium. A healthy eating plan is low in these items.
Added Sugars
Many foods, especially fruits, are naturally sweet. Other foods, like cookies, snack cakes, and brownies, have added sugars to make them taste better. These sugars add calories but not nutrients.
DID YOU KNOW?
Not all fats are unhealthy! Unsaturated fats can be healthy—as long as you don't eat too much of them. Try eating moderate amounts of these foods, which have unsaturated fats:
- olive, canola, safflower, sunflower, corn, and soybean oils
- nuts like walnuts, almonds, peanuts, and pecans
- fish like tuna, salmon, and trout
Solid Fats
Fat is important. It helps your body grow and develop; it is a source of energy; and it even keeps your skin and hair healthy. But some fats are better for you than others.
Solid fats are fats that are solid at room temperature, like butter, stick margarine, shortening, and lard. These fats often contain saturated and trans fats, which are high in calories and not heart healthy. Take it easy on foods like cakes, cookies, pizza, and fries, which often have a lot of solid fat.
Sodium
Your body needs a small amount of sodium (mostly found in salt). But eating too much sodium can raise your blood pressure, which is unhealthy for your heart and your body in general.
Processed foods, like those that are canned, frozen, or packaged, often have a lot of sodium. Fresh foods do not, but often cost more. If you can afford to, eat fresh foods and prepare your own low-salt meals. If you use packaged foods, check the amount of sodium listed on the Nutrition Facts label. (Read "What do all these numbers mean?".) Rinse canned vegetables to remove excess salt.
Try to eat fewer than 2,300 mg of sodium per day. This equals about one teaspoon and includes salt that is already in prepared food, as well as salt you add when cooking or eating your food.
Your doctor knows more about your specific needs, so don't be afraid to ask her or him how much sodium you should be eating.
What do all these numbers mean?
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 is 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. In most cases, 5% DV or less is low and 20% DV or more is high. For example, this label shows that the food has 20% of the calcium you need to eat in one day. We can consider this food high in calcium. Notice, though, that it is also high in sodium (20%).
Graphic adapted from http://www.fda.gov/Food/ResourcesForYou/Consumers/NFLPM/ucm274593.htm.
SNACK SMART
- fresh apples, berries, or grapes
- a handful of walnuts or almonds
- a small bag of baby carrots
- low-fat or fat-free yogurt
- string cheese
- peanut butter on whole-wheat crackers
Be media smart.
Advertisements, TV shows, the Internet, and other media can affect how you choose to eat and spend your time. Many ads try to persuade you to eat high-fat foods and sugary drinks. Others may try to sell you products, like video games. Be aware of some of the tricks ads use to pressure you:
- An ad may show a group of teens eating a food or using a product to make you think all teens are or should be doing the same. The ad may even use phrases such as "all teens need" or "all teens are."
- Advertisers sometimes show famous athletes using or recommending a product because they think you will want to buy products that your favorite stars use.
- Ads often use cartoon figures to make a food or activity look exciting and teen-friendly.
Stay charged up all day
DID YOU KNOW?
Teens who eat breakfast may do better in school and sports—and have healthier weights. By eating breakfast, you can increase your memory, stay focused, and feel less grouchy and restless.Skipping meals can lead to weight gain. Follow these tips to maintain a healthy weight:
- Eat breakfast every day. It gets your body going. You can even grab something on the go, like a piece of fruit and a slice of whole-grain bread.
- Pack your lunch on school days. If you pack your lunch, you can control the portions and make sure your meal is healthy.
- Eat healthy snacks, and try not to skip meals. See the "Snack smart" ideas above.
- Eat dinner with your family. When you eat with your family, you are more likely to eat a healthy meal, and you can take the time to catch up with each other.
- Be involved in grocery shopping and meal planning at home. If you're involved, you can make sure meals are healthy and taste good.
Get Moving
DID YOU KNOW?
Activity adds up!
Here's one way to
get your 60 minutes:
Walking/biking to a friend's house
+ 30 minutes –
Shooting hoops
+ 20 minutes –
Dancing
= 60 minutes of activity!
Being physically active may help you control your weight, increase flexibility and balance, and improve your mood. You don't have to do boring exercise routines. You can be active through daily activities, like taking the stairs instead of the elevator or escalator.
This section can help you to . . .
- Be active every day.
- Get outside.
- Have fun with your friends.
- Stay active indoors, too.
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. You should be physically active for 60 minutes a day, but you don't have to do it all at once!
Have fun with your friends
Being active can be more fun with friends or family members. You may also find that you make friends when you join active clubs or community activities. Teach each other new games or activities, and keep things interesting by choosing a different activity each day:
- sports
- active games
- other actions that get you moving, like walking around the mall
What if I don't have money for sports equipment?
You don't need money or equipment to stay active. You can dance, walk the dog, or use free community facilities to do your 60 minutes of daily physical activity. If you would like to play a sport or game that requires equipment, check with your neighbors or friends at school to see if you can borrow or share supplies.
Support your friends and challenge them to be healthy with you. You could even take the President's Challenge (see the Resources at the end of this document). Or sign up with your friends for fun, lively events, like charity walks, fun runs, or scavenger hunts.
Get outside
CHOOSE ACTIVITIES YOU LIKE
Being physically active does not mean you have to join a gym or do a team sport. You can walk or bicycle around your neighborhood or even turn up the music and dance. Try some of these ideas:
- Shoot baskets.
- Ride your bike (use a helmet).
- Run.
- Skateboard.
- Jump rope or use a hula hoop.
- Have a dance party with friends.
- Play volleyball or flag football.
- Move with a video game that tracks your motion.
Many teens spend a lot of time indoors on "screen time": watching TV, surfing the web, or playing video games. Too much screen time can lead you to have excess body fat or a higher weight. Instead, be active outdoors to burn calories and get extra vitamin D on a sunny day.
How to cut back your screen time
- Tape your favorite shows and watch them later to keep from zoning out and flipping through channels.
- Replace after-school TV and video-game time with physical activities in your home, school, or community.
- Gradually reduce the time you spend using your phone, computer, or TV. Challenge your friends or family members to join you, and see who can spend the least amount of time in front of a screen each week.
- Set up a text-free time with your friends—a length of time when you can be physically active together and agree not to send or respond to text messages.
- Turn off your cell phone before you go to bed.
Stay active indoors, too
On cold or wet days, screen time is not the only option. Find ways to be active inside:
- Play indoor sports or active games in your building or home, at a local recreation center, or in your school gym.
- Dance to your favorite music by yourself or with friends.
- If you have a gaming system, choose active dance and sports games that track your movement.
Take Your Time
YOU CAN DO IT!
Changing your habits is difficult. Developing new habits takes time. Use the tips here, as well as the tip sheet and checklist at the end of this guide, to stay motivated and meet your goals.- 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 ways you can make your eating and physical activity habits 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 physically active most days of the week? Do you eat when you are stressed?
- Know what's holding you back. 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?
- Set a few realistic goals for yourself. First, try replacing a couple of the sodas you drink with unsweetened beverages. Once you are drinking less soda, try cutting out all soda. Then, set a few more goals, like drinking low-fat or fat-free milk, eating more fruits, or getting more physical activity each day.
- Use the information in this booklet and the following resources to help you. Stay positive and focused by remembering why you want to be healthier—to look, feel, move, and learn better. Accept setbacks—if you don't meet one of your eating or physical activity goals one day, do not give up. Just try again the next day.
- 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.
Make It Work for You
Being healthy sounds like a lot of work, right? It doesn't have to be. This chart will help you plan healthy meals and work healthy habits into your day. Put this on your fridge or in your school locker for quick reminders.
Pick an item from each food category to plan a healthy meal
| Fruits and Veggies | Grains | Protein | Dairy |
|---|---|---|---|
| 1 banana or apple | 1 serving of oatmeal or whole-grain cereal (size of your fist) | 1 scrambled or hard-boiled egg | 1 cup fat-free or low-fat milk (or substitute soy or rice milk) |
| 1 handful fresh berries or raisins | 2 DVD-sized whole-grain waffles or buckwheat pancakes | 1 serving of peanut butter (size of a ping-pong ball) | 6- to 8-ounce yogurt pack (also high in protein!) |
| 1 serving romaine lettuce or spinach (size of your fist) | 2 slices whole-wheat bread | 1 handful of walnuts or almonds | 1 serving low-fat cottage cheese (size of your fist) |
| 1 handful baby carrots, strips of peppers, or celery sticks | 1 whole-grain pita | 1 serving of hummus (size of a ping-pong ball) | 1 slice of Swiss or provolone cheese |
| 1 cup tomato or vegetable juice | 1 whole-wheat tortilla | 1 serving of sliced, lean turkey or ham (size of the palm of your hand) | 1 stick of string cheese |
| 1 snack pack of fruit salad (in natural juices, not syrup) | 1 serving of brown rice (total amount should fit in your cupped hands) | ½ can of tuna with mustard or light mayo | 1 handful shredded low-fat mozzarella cheese |
| 1 serving of tomato-based pasta sauce with vegetables (fits in one cupped hand) | 2 whole-grain taco shells | 1 serving of black beans (size of your fist) | 1 serving of low-fat sour cream (size of a ping-pong ball) |
| 1 serving of steamed broccoli, green beans, or other veggie (fits in one cupped hand) | 1 serving of whole-grain pasta (total amount should fit in your cupped hands) | 1 serving lean beef, grilled chicken, tofu, or baked fish (size of the palm of your hand) | 1 serving non-fat frozen yogurt (size of your fist) |
Sample Meals
Breakfast: one banana, a slice of whole-grain bread with peanut butter, and milk
Lunch: a turkey sandwich with cheese, dark leafy lettuce, tomato, and red peppers on whole-wheat bread
Dinner: two whole-grain taco shells with chicken or black beans, low-fat cheese, and romaine lettuce
For more meal ideas and recipes, go to the "TeensHealth" section of http://kidshealth.org 
or http://www.ChooseMyPlate.gov, where we found some of the ideas for this chart.
Make healthy habits part of your day
Eating healthy and being active can be difficult because you spend much of your day in school and eat meals that are prepared by others. Be a Health Champion by becoming more involved in your meals and school activities. Here's a checklist to help you work healthy habits into your day.
BE A HEALTH CHAMPION!
- Each night, pack a healthy lunch and snacks for the next day.
- Go to bed at a regular time every night to recharge your body and mind. Be sure to turn off your phone, TV, and other devices when you go to bed.
- Eat breakfast.
- Walk or bike to school if you live nearby and can safely do so.
- Drink water throughout the day. Avoid sodas and other high-calorie drinks.
- Between classes, stand up and walk around, even if your next subject is in the same room.
- If a recess is allowed at your school, be sure to take a walk, jump rope, or play an active game with friends.
- Be active in gym classes.
- At lunchtime, eat the lunch you packed. If you have lunch money, spend it on healthy options. Avoid sodas, chips, and candy from the vending machines.
- Stay active after school by joining a sports team or dance group. Walk the dog or jump into a neighborhood pick-up game of basketball, soccer, or softball.
- Be involved in the food choices made in your home. Help make dinner and eat with your family.
- Save screen time for after your activities and limit it to less than 2 hours.
Resources
2008 Physical Activity Guidelines for Americans
These guidelines provide general information on physical activity for teenagers, including how often you should be active and which activities are best
for you.
http://www.health.gov/PAGuidelines
BAM! Body and Mind
This interactive website provides information to help you move more and eat better. It includes games, daily tips, and trivia questions.
http://www.bam.gov
Best Bones Forever!
This bone health campaign encourages girls and their friends to grow stronger together and stay strong forever.
http://www.bestbonesforever.gov
Dietary Guidelines for Americans, 2010
The healthy eating content in Take Charge is based on these guidelines.
http://www.health.gov/dietaryguidelines
Girlshealth.gov
This federal resource provides girls with reliable health information on physical activity, nutrition, stress reduction, and more.
http://www.girlshealth.gov
Let's Move!
This campaign inspires children and teens to get moving. Visit the website to read tips and take action.
http://www.letsmove.gov
Media-Smart Youth
Media-Smart Youth: Eat, Think, and Be Active! is an interactive after-school program that informs young people about the media's influence on food and physical activity choices.
http://www.nichd.nih.gov/msy
MyPlate
MyPlate offers more information, tips, and interactive tools to help you make a plan for moving more and eating better.
http://www.ChooseMyPlate.gov
National Diabetes Education Program (NDEP)
NDEP provides teens with information about diabetes. The website offers publications and resources on how teens can prevent and manage diabetes.
http://www.yourdiabetesinfo.org
Nutrition.gov
This website provides reader-friendly information on a number of topics related to healthy eating.
http://www.nutrition.gov
Portion Distortion Quiz
This quiz on the website of the National Heart, Lung, and Blood Institute shows how portion sizes have changed over time.
http://hp2010.nhlbihin.net/portion
President's Challenge
The President's Challenge encourages you to make physical activity a regular part of life.
http://www.fitness.gov/participate-in-programs/presidents-challenge
Team Nutrition
Team Nutrition focuses on the role nutritious school meals, nutrition education, and a health-promoting school environment play in helping you learn to enjoy healthy eating and physical activity.
http://www.fns.usda.gov/tn
We Can!
We Can! provides information to caregivers and community members so they may help children and teens stay healthy.
http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/index.htm
Inclusion of resources is for information only and does not imply endorsement by NIDDK or WIN.
Why should I participate in clinical trials?
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For more information, visit http://www.clinicaltrials.gov.
The Weight-control Information Network (WIN) is a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). WIN provides the general public, health professionals, and the media with science-based, up-to-date, culturally relevant materials and tips. Topics include healthy eating, barriers to physical activity, portion control, and eating and physical activity myths. Publications produced by WIN are reviewed by both NIDDK scientists and outside experts. This publication was also reviewed by Joshua Kolko, M.D., La Clínica del Pueblo, Washington, D.C. Special thanks also go to the teens who helped with an earlier version of this publication.
This publication is not copyrighted. WIN encourages users of this brochure to copy and share as many copies as desired.
Order FREE publications at http://www.win.niddk.nih.gov/order/index.htm.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 09–4328
Updated May 2012
