A Toolkit for Healthy Teens & Strong FamiliesFOR TEENSEat Right Move More Feel Great

BodyWorks For Teens is a publication of the Office on Women’sHealth (OWH) in the U.S. Department of Health and Human Services.Learn more about OWH and its programs at more information on girls’ health, please visit the OWH

Thinking About…Page 2Why Healthy Foods?Page 4What’s InsideWhy Physical Activity?Page 24Get ReadyPage 30Take ActionPage 38Look Around YouPage 5 2

Thinking About…Healthy eating and exerciseHave you ever thought about your eating and exercisehabits? Did you ever wonder if you could change somethings in your daily life to be a little healthier? If so,BodyWorks For Teens is for you.2

Why BodyWorks “For Teens”?Feeling good, looking your best, and having lots ofenergy are just some of the pluses of eating healthyfoods and exercising. You’ll learn more about thesetopics by reading BodyWorks For Teens. It’s not aboutbeing perfect, or changing every habit right away.Small changes make a big difference, and BodyWorksFor Teens can tell you how.3

Why Healthy Foods?4

1Eating healthy foods can helpyou feel good, look good, andget energized to do all thethings you want to do.5

How to Eat HealthyBalancing CaloriesEnjoy your food, but eat less.Avoid oversized portions.Foods to IncreaseMake half of your plate fruits and vegetables.Make whole grains at least half of all your grains.Switch to fat-free or low-fat (1%) milk.Foods to ReduceCompare sodium in foods like soup, bread, and frozenmeals and choose the foods with lower numbers.Drink water instead of sugary drinks (like sodas,juices, sports drinks, flavored milks, specialty coffees,and more).6

What it all means:A Healthy Eating PlanTeen girls need to eat a good mix of foods each day.These everyday foods are:Fruits. Add more fruits each day.Vegetables. Eat a variety, especially dark-green, red,and orange vegetables, as well as beans and peas.Low-fat or fat-free dairy foods, such as milk, yogurt,and cheese.Whole-grain foods, like oatmeal, whole-grain breads,and brown rice.Protein foods, such as lean meats, poultry, seafood,beans, and tofu.Some foods and drinks are treats to have only from timeto time, because they are high in solid fats, added sugars,and salt (sodium), which add calories you don’t need.Examples include:CandyCookiesChipsOnion ringsFrench friesSugar-sweetened sodas7

What Do You Need to Eat Each Day?Starting around age 14 you need about 1,800 calories a day — more if you arevery active. Get your personal daily calorie limit at www.choosemyplate.govand keep that number in mind when deciding what to eat.Food groupServingsteen girlsneedWhat counts as 1 servingFruits4 servings(2 cups)1 medium apple, banana, pear, orange½ cup of chopped, cooked, or canned fruit,fruit salad, berries½ cup of 100% fruit juiceVegetables5 servings(2½ cups)½ cup cooked or raw peas, carrots,green beans, sweet potatoes, corn,broccoli1 cup raw, leafy vegetable (spinach,collard greens, salad greens)½ cup of vegetable juice¼ cup of cooked, dry legumes(such as lentils, black beans,kidney beans, chickpeas)GrainsWhole-wheat orother kinds of breads,crackers, tortillas,cereal or pasta, brownrice, bulgur, couscous,popcorn, and oatmeal9–11servings(6 ounces)At least 3ounces (oz.)should bewhole grain.1 slice of bread1 cup of cold cereal½ cup of oatmeal or other cooked cereal½ cup of cooked pasta, brown rice,bulgur, couscousDairy FoodsLow-fat or fat-free milk,yogurt, and cheese3 servings(3 cups)1 cup of milk or yogurt1½ ounces of natural cheese(such as cheddar)2 ounces of processed cheese(such as American cheese)Protein FoodsLean meats, chickenand turkey, seafood,beans and peas, eggs,soy products, andunsalted nuts and seeds2 servings(5 oz.)3 ounces of cooked lean meat,poultry, or seafood1 tablespoon of peanut butter¼ cup of cooked, dry beans(such as lentils, black beans,kidney beans, chickpeas)1 egg½ cup of tofu or a 2½ ounce soy burger¹/ ³ cup of nuts8

What Size is a Serving?Fruit: 1 medium fruit, aboutthe size of a baseball=Vegetables: 1 ⁄2 cup, about the sizeof a small computer mouse=Cheese (low-fat or fat-free):1 1 ⁄2 ounces, about the size ofsix dice=Pasta (cooked): 1 ⁄2 cup,about the size of a smallcomputer mouse=Seafood or lean meat:2–3 ounces, about the sizeof a deck of cards=You can get more information at U.S. Department of Agriculture and U.S. Department of Health and Human Services.Dietary Guidelines for Americans, 2010. 7th Edition, Washington, D.C.: U.S. Government Printing Office.December 2010.9

Power FoodsNUTRIENT BENEFITS SOME FOOD SOURCESVITAMIN A Good visionHealthy skin and hairHelps you growVITAMIN C Healthy bones, skin,blood cells, gumsand teethVITAMIN D Reduces risk of bonefracture and preventssoftening of bones(rickets)Helps body absorbcalcium from foodVITAMIN E Protects the body’scellsFortified instant cereals (cerealsthat have Vitamin A added to them)Liver, dairy, and fishDark-green, leafy vegetables likespinach, collards, and kaleCarrots, sweet potatoes, pumpkin,and winter squashStrawberries, grapefruits, oranges,melons, mangoes, and tomatoesBroccoli, red sweet peppers,cauliflower, and sweet potatoesSalmon, herring, mackerel, tuna,and egg yolksFortified foods, such as breakfastcereal, milk, and some yogurtsSunlight on the skin enables thebody to make Vitamin D. Ten to 15minutes of sunshine three timesa week is enough to produce thebody’s requirement for many people.Nuts (almonds, hazelnuts, andpeanuts)Sunflower seeds and pine nutsVegetable oilsCALCIUM Strong bonesand teethLow-fat or fat-free milk, yogurt,and cheeseCalcium-fortified cereals, juices,soy beverages, and tofuCanned sardines and salmon(bones included)MAGNESIUM Helps contract andrelax musclesReady-to-eat 100% bran cerealsSpinachAlmonds, cashews, and pine nutsHalibut and haddock10

Foods contain nutrients that help you look and feelyour best and grow healthy and strong.NUTRIENT BENEFITS SOME FOOD SOURCESFOLATE(also calledfolic acid)Helps your bodymake red blood cellsBeans and peasPeanutsOranges and orange juiceDark-green, leafy vegetables,like spinachFortified cerealsEnriched grain productsFIBER May help reduce riskfor coronary heartdiseaseHelps make you feelfull and have regularbowel movementsBeans and peasReady-to-eat 100% bran cerealsSweet potatoes and baked potatoeswith skinPears and apples with skinIRON Helps red bloodcells carry oxygen todifferent parts of thebody to help produceenergyLack of iron in redblood cells (calledanemia) can make youfeel weak and tiredLean meat and poultryClams, oysters, shrimp, andcanned sardinesSpinachBeans (white, navy, and kidney),lentils, and roasted pumpkin andsquash seedsIron-fortified cerealsPOTASSIUMHelps muscles work Baked white or sweet potatoesTomato productsReduces risk ofhigh blood pressureand strokeSquash (pumpkin, butternut,and acorn)Bananas and plantainsDried peaches, prunes, and apricotsOranges and orange juiceCantaloupe and honeydewLow-fat or fat-free yogurt11

Check The FactsWhat you need to know about the Nutrition Facts label123Start hereCheck caloriesLimit thesenutrients4% DailyValue:4Get enough ofthese nutrients5% or lessis low20% or moreis high12

How to Read theNutrition Facts LabelsServing Size: Always look at the serving size (this exampleis 1 cup) on the label. If you double the servings you eat,you also double the calories and nutrients. Notice that thiscontainer has two servings.Calories: Decide if this food is worth eating, based on thenumber of calories and the amount of nutrients you are getting.More than 400 calories per serving is high for a single food item.Fat, Cholesterol, and Sodium: To reduce the risk of heartdisease, limit your intake of fat, saturated fat, and cholesteroland reduce your intake of sodium. Keep trans fat as lowas possible.Percent Daily Value (%DV): The %DV tells you if a servingof food is high or low in a nutrient, and provides informationon how a serving of the food fits overall into a healthy diet.5% DV or less is low and 20% DV or more is high. Limityour intake of fat, saturated fat, and cholesterol and reduceyour intake of sodium. Keep trans fat as low as possible.Throughout the day, remember to eat foods that are high indietary fiber, vitamins A and C, calcium, and iron. Accomplishthis goal by eating foods from the various food groups.Read the ingredients on the label. Check to see if sugarsare listed as the first few ingredients. If so, this food or drinkmay not be very healthy. There are many different kinds ofsugars, so look for ingredients such as brown sugar, cornsweetener, high-fructose corn syrup, dextrose, fructose, fruitjuice concentrate, maltose, dextrose, sucrose, honey, andmaple syrup.13

Understanding Food Labels:What Does it Mean?CaloriesWHAT DOESIT MEAN?A measure of the energycontent of food. Caloriesact as fuel for your body.Starting around age 14teen girls need about1,800 calories a day —more if you are veryactive.WHERE DOES ITCOME FROM?Most foods have calories.FatYour body needs somefat both for energy andto keep your hair, organs,and blood system healthy.Too much fat can causeweight gain and increasethe risk of health problemslike heart disease.Eat more of these fats:vegetable oils (or oilsfrom plants like olive,sunflower, etc.), nuts, andseafood.Eat less of these fats: fattymeats, butter, and friedfoods. Keep trans fat aslow as possible.14

CholesterolWHAT DOESIT MEAN?A waxy substance. Toomuch can build up in yourblood vessels and blockblood flow to your heart.WHERE DOES ITCOME FROM?Meat, whole milk, eggs,poultry, and seafood.SodiumDietary FiberSugarsAnother word for salt.Most teen girls needless than one teaspoonof salt a day.Helps digestion andmay help prevent heartdisease.A source of energy.Natural sugars comefrom foods that also bringvitamins and mineralsthat you need. Addedsugar in sodas, candy,and other sweets giveyou empty calorieswithout added nutrients.Many prepared andprocessed foods like delimeats, bacon, and somecanned soups containhigh levels of sodium(salt). Fast food is usuallyvery high in salt.Fruits, vegetables, beans,whole-grain foods, andhigh-fiber foods.Natural sources of sugarinclude fruits and milkproducts (lactose). Addedsugars come from cornsyrup or white, brown, orpowdered sugar.CarbohydratesA source of energy.There are two types:simple carbohydrates(sugars, as shownabove) and complexcarbohydrates that comefrom starchy foods.Starchy foods includepasta, rice, bread, cereals,potatoes, and starchyvegetables (corn, sweetpotatoes, peas, lentils).15

Circle your answers.Test Your Nutrition Smarts1 True or False: Kids who eat a healthybreakfast tend to do better in schoolthan those who skip it and don’t eatuntil lunch.2 True or False: Teen girls need morecalories than teen boys.3 About how much sugar is in a12-ounce can of cola?A Three teaspoonsB Five teaspoonsC Seven teaspoonsD Nine teaspoons4 What counts as a serving (1 ounce)of bread?A One sliceB Two slicesC Four slicesD One loaf5 True or False: Skipping meals, fasting,and not eating whole groups of foods(like grains) are not healthy ways tolose weight.Answers1 True 2 False 3 D 4 A 5 True16

Calcium Word FindFind and circle the terms listed below in the word bank. All these foodsare good sources of calcium, which helps build strong bones and teeth.C I L O C C O R BH A E D A T L M EE W E U F O T C SB M A T U R U E EO E D F U T N R NK A N G F I O E OC L O M I L K A MH Y M R U L E L LO S L L M A N S AY S A R D I N E SA P U U D T N G SE O R D A E R B AL S O Y M I L K BWord bank: Milk, (fortified) bread, soy milk (fortified beverage),yogurt, tortilla, broccoli, bok choy, almond, waffles, (fortified)cereals, (canned) sardines, (canned) salmon, tofu.Check food labels. Find out how much calcium is in different foods.Look for “Percent Daily Value” (written as %DV or % Daily Value).If it has 5% or less, that’s low. If it has 20% or more, that’s high.17

How Does Nutrition ReallyAffect Your Health?Find out the answersto common questionsabout food and eatinghabits.Q Does eating pizza or chocolate give you pimples?A Generally, food is not what causes acne or bad skin. However,it’s always a good idea to drink plenty of water, eat lots of fruitsand vegetables, and limit excess fat.Q How does caffeine affect your energy level?A You can find caffeine in drinks like soda, tea, and coffee.Caffeine makes everything in your body speed up. Your heartbeats faster and you can feel more “awake.” Once it wears off,you may feel like you have even less energy than before. Toboost your energy level, get enough sleep and skip the caffeine.18

Q Are there foods that make you feel lazy?A The main reason for feeling sluggish after a meal is the amountyou eat. One trick to avoid eating too much is to eat slowly. Ittakes your brain some time to register that you’ve eaten and tellyour body to take a break.QADo I need to drink eight glasses of water a day?It’s important to drink plenty of fluids during the day. Exactlyhow much you need depends on a lot of things. If it is hot oryou’re exercising and sweating a lot, you can drink more. If youeat a lot of fruits and vegetables (water-rich foods), you’ll needto drink less.QAIs it true that you shouldn’t eat after 8 p.m.?There is no magic time to stop eating. If your life is too busy toeat dinner before 8 p.m., it’s okay to eat after that time. Or, ifyou’re hungry because you haven’t eaten enough that day, graba healthy snack like a glass of low-fat or fat-free milk or yogurt.Sometimes we crave food when we’re tired and want to stayawake. In that case, head for bed and leave eating for the morning.— Answers provided by Jessica Donze-Black, R.D., M.P.H. 19

What is a Healthy Weight?Teen girls’ bodies are constantlygrowing and changing. Beforethe age of 11 or 12, girls maystart to get taller and heavierand have more fat around theirhips, waist, and breasts. This isa normal part of growing up.Talk to a doctor, school nurse,or other health professionalif you’re worried about yourweight. They can help you findthe best way to reach and keepa weight that is healthy for you.To reach and keepa healthy weightEat foods from different foodgroups (fruits, vegetables,dairy, grains, and proteins) inthe right amounts. Eat seafoodtwice a week as your protein.Make half of your plate fruitsand vegetables.Drink water instead of sugarydrinks.Be physically active for anhour every day.20

Dieting is Not the AnswerDon’t Do ThisSkip mealsStarve yourselfLeave out a whole foodgroup or just eat foodsfrom a few food groupsMake yourself vomitBecause...Missing meals often leads toovereating at later meals.It’s not likely you’ll keep weightoff in the long term. Also, you’llmiss out on important nutrientsyour body needs for growth.You need a balance of differentfood groups to make sure youget all the nutrients you need.Vomiting can keep your bodyfrom absorbing the nutrientsyou need for good health. Inparticular, your body can’t takein electrolytes, which affect thefunctioning of your heart.21

A Healthy Diet and Dieting –They Don’t Mean the Same ThingA healthy diet means getting the right balance of foods andnutrients that your body needs every day.Dieting means limiting how much food (or the kinds of food)you eat to help lose weight. Teens should not diet unlessthey are under a doctor’s care. They should not miss out onimportant nutrients.The best way to make sure you look and feel your best isto take steps to keep a healthy diet and maintain a healthyweight. Here’s how:Start with breakfast. This will help you have more energy,increase your attention span and memory, and feel lessgrouchy or restless.Plan ahead. Think about what kind of meals and snacks youwould like to eat during the week. Help your family makea shopping list — you may even want to help with theshopping and cooking.Pack your lunch. Snacks and sodas froma vending machine will give you plenty ofcalories, but not many nutrients. Bringyour own lunch. Create your ownsandwich, and add healthy foods anddrinks like fruits, unsalted nuts, lowfatyogurt, vegetables, water, and100% fruit juice.22

Eat dinner with your family. Familymeals help you reconnect after a busyday, and they are more likely to includemore fruits, vegetables, and grains. Helpyour family make healthy dinner choices.Make smart choices. Skip “Super Size”fast-food portions.Think about what you drink. Try sticking to water and lowfator fat-free milk instead of sodas, sports drinks, energydrinks, and other sugary drinks. There are about 10 packetsof sugar in a 12-ounce can of soda.Keep a journal. Use an online food and activity journal such smart snacks. Here are some ideas:Fresh or dried fruitPeanut butter on rice cakes, whole-wheat crackers,celery sticksBaked potato chips or tortilla chips with salsaVeggies with low-fat dipLow-fat cheese or low-fat yogurtGraham crackers, vanilla wafers, animal crackers,fig barsAir-popped or low-fat microwave popcorn23

Why Physical Activity?24

2Swimming, dancing, skating,playing soccer, and riding a bikeare all examples of physicalactivity. In other words, it’s anactivity that gets your bodymoving and uses up energy.25

Physical Activity is Fun and isSomething You Can Do with FriendsIt can also help you to…Build and keep healthybones, muscles, and joints.Strengthen your heart,lungs, and blood vessels.Get your mind readyfor learning.Feel less stressed.Boost your self confidence.“Having a goal to be physically activeevery day is very important forkids, and it can be achieved throughactivities as simple as doing jumpingjacks. No one needs fancy equipment,specific clothing or a gym membershipto get out and exercise.”— Dominique Dawes, Co-Chair,President’s Council on Fitness,Sports & Nutrition, on May 4, 201126

How Physically Active Am I?1 What physical activities do you do now? (Check all that apply).Team sports (example: volleyball, soccer, basketball)Biking Dancing School P.E. ClassWalking Gymnastics Martial artsRollerblading Skating HikingSwimming Yoga Running (jogging)Other(fill in one or more activities)2 How many days do you do physical activity during a typical week?Every day 5–6 days 3–4 days1–2 days 0 days3 On a typical day, how much time do you spend doingphysical activities?About 60 minutes30–60 minutes20–30 minutes Less than 20 minutes0 minutesIt All Adds Up!1 The key is to pick one or two physical activities that you like to do.Remember that you do not have to be competitive to be active.2 Aim to do 60 minutes of physical activity each day. You shoulddo a mix of activities (aerobic, muscle-strengthening, and bonestrengthening)and include both moderate and vigorous activity.3 If you’re not physically active for 60 minutes nonstop, it’s okayto do physical activity for 10 or 20 minutes at a time throughoutthe day.27

Work ItPhysical Activity IdeasTry to get 60 minutes of moderate and vigorous physical activity every day. Findactivities you enjoy. Try new activities with friends or a parent.Activity LevelLightNot sweatingNot breathing hardModerateBreaking a sweatCan talk, but can’t singWhat is it?Slow walking, some types of yoga,ping-pong, bowlingRollerblading, swimming, walkingfast, biking, mowing the lawnVigorousSweatingBreathing hardCan’t talk or singJogging, playing basketball, bikinguphill, swimming laps, martial arts,tennis, field hockeyAlso Try Fitting In…Type What is it? Why do it?28Musclestrengthening3 days a week,as part of your60 minutesBonestrengthening3 days a week,as part of your60 minutesGymnastics, yoga, pushupsand sit-ups, usingweight machines andresistance bandsWalking, running, hiking,dancing, jumping rope,soccer, and other weightbearingactivities thatwork bones and musclesagainst gravityIncreases strengthBuilds muscleMakes bonesstronger

Word ScrambleWhat do all these words have in common? They are allphysical activities you can do.1 bduleo uhdtc2 cuhot bloftlao3 ghetiw riinangt4 iaeuttml seibfre5 saals nagincd6 igsink7 gedslndi8 botlasflAnswers1 double dutch 2 touch football 3 weight training 4 ultimatefrisbee 5 salsa dancing 6 skiing 7 sledding 8 softball29

Get Ready30

3Making small changes to eathealthy foods or be physicallyactive is a great way to help youfeel good and have more energy.31

Start SmallJust start with a few small changesyou’re most willing to do. The listbelow can help. Check off the smallchanges or goals that appeal toyou. Each goal you set is a smallstep toward a larger goal of living ahealthier lifestyle.Increase the number of fruits andvegetables you eat each day.Build up to one hour of physicalactivity each day.Eat fewer sweets.Turn off the TV when eatingmeals and snacks.Drink less soda.Drink low-fat or fat-free milk.Drink more water.Eat low-fat or fat-free yogurtor cheese.Eat breakfast most days ofthe week.Eat more whole-grain foods(such as whole-wheat bread,whole-grain pasta, or whole-graincrackers; oatmeal; or brown rice).Other(fill in the blank)32

Now Take Action. Put it in Writing.Pick your top two goals from your list and answer the questionsbelow for each.1 Pick two goals from the previous page and make them specific to you!Example: Drink milk instead of soda after school.2 Why did you choose these goals?3 Who can help you reach y our goal? (Choose one or more options)FriendsFamilyOther(fill in the blank)4 How will you get started?5 How will you reward yourself when you reach your goal?6 When will you get started?(month and day)Sample answers1 What is your goal?To eat fewer sweets.2 Why did you choose this goal?Because I eat at least twochocolate bars every day.3 Who will help you reach yourgoal?FamilyFriends4 How will you get started?Pack a lunch from home so Iwon’t eat chocolate from theschool vending machine.5 How will you reward yourselfwhen you reach your goal?Go to a movie with my friends.6 When will you get started?Monday, January 31.33

Keeping a Food andExercise DiaryWriting in a diary is a good way to get to know your eating andexercise habits. It can also help with the small changes you may wantto make.The next page has a sample to get you started. This is a page fromthe Best Journal Ever! in the BodyWorks toolkit. You can also use anonline food diary, such as are some tips:Write things down as soon as possible.Write down everything you eat, even if it’s just one cookie.Be honest. A journal is meant to help you, not judge you.Include drinks.Write down how you were feeling. It can help you figure out if youate because you were hungry or for other reasons.34

October 5 October 11EXERCISE SNACKDINNERLUNCHBREAKFAST10/5Sun:_________Waffles with slicedbananas on topCup of fat-freeYogurtOrange Juice3 3Sleepy!Mood Mood MoodMood Mood MoodMood Mood MoodMood Mood Moodtotal exerciseMon:_________Tue:_________calcium vitamin D calcium vitamin D calcium vitamin Dgrilled cheese sandwichon whole-wheat breadbaby carrotschocolate milk3 3boredcalcium vitamin D calcium vitamin D calcium vitamin Dwhole-wheat quesadillawith chickenbroccoli and cheese3 3calcium vitamin D calcium vitamin D calcium vitamin Dhappysliced apples dipped inpeanut buttercalcium vitamin D calcium vitamin D calcium vitamin Drelaxed and a little sleepypracticed danceroutine30went for a walk 4575 mins35

What’s Stopping You?ExercisingWhat’s getting in the way?Rather watch TV or beon the computer.Healthy ideas“ Exercise with a group of peopleso it’s easier…It’s fun and youmake close friends.”— Annie, age 15Too tired, no energy.“ Once you start exercising, yourenergy level goes up so you won’thave that problem anymore.”— Yolanda, age 14No time.“ It’s important to be a balanced,healthy person. Try to balanceschool and exercise so you canmake the time.”— Emily, age 1536

Eating healthy foodsWhat’s getting in the way?Some foods don’ttaste good.Healthy ideas“Celery with peanut butter tastesreally good and it’s healthy.”— Kathleen, age 14Takes too much timeto make.“You can eat raisins and peanutsinstead of potato chips. Thatdoesn’t take long.”— Yolanda, age 14There’s junk food in thehouse, so it’s easy to eat.“If you have a healthy balanceof foods, you can have thattreat once in a while.”— Deliah, age 1537

Take Action38

4You’re ready to start makingsmall changes for your health.Begin with your meals.39

Breakfast BoostEating breakfast gives you energy to start the day.Breakfast ideasBowl of instant oatmeal or whole-grain cereal withlow-fat milk. Add berries, banana slices, or raisins.Whole-wheat pita or sandwich bread stuffed withscrambled eggs, topped with a dab of ketchup or hotsauce. Wash it down with a glass of calcium-fortifiedorange juice.Toasted, frozen whole-grain waffles topped withpeanut butter and a sliced banana. Add a glass oflow-fat milk or low-fat yogurt smoothie.Why eat breakfast?“You should always eat breakfast — it keeps you fromfalling asleep in class.”— Ashley, age 12How do you make the time?“Wake up early every morning and eat. If you don’thave an alarm clock, ask your mom to wake you up.”— Ashley, age 1340“Make it your responsibility as a preteen or teen to goto bed early so you can wake up to eat breakfast.”— Jessica, age 11

Try a Bag LunchLong cafeteria lines, food you’re not crazy about, and shortlunch periods. These are some of the reasons teens say theyskip lunch or grab snacks from the vending machine. If this soundsfamiliar, think about packing a bag lunch and buying a carton oflow-fat milk.Lunch ideasTurkey sandwich on whole-wheat bread with mustard, baked potatochips, a pear, red pepper slices, and fat-free milk.Tuna salad on whole-wheat bread with lettuce, tomato,cucumber, and low-fat mayonnaise plus a fruit cup, pretzels,fig bars, and low-fat milk.Salad with mixtures of fruits and vegetables. A vegetable saladwith corn, avocado pieces, and mandarin oranges. A chickensalad with tomatoes, lettuce, cucumbers, and pieces of grilledchicken. Try adding grated carrots, raisins, or dried cranberriesto a vegetable salad. Use low-fat dressing. Add a glass of lowfatmilk, whole-wheat crackers, low-fat string cheese, and somelow-fat pudding.Peanut butter and banana sandwich on whole-wheat bread withcarrot sticks, apple sauce, an oatmeal raisin cookie, and fat-freechocolate milk.Snack smart ideasFruitVeggies with low-fat or fat-free dipLow-fat yogurtLow-fat string cheeseBaked potato chipsBaked tortilla chips with salsaFlavored rice cakes (caramel or apple cinnamon)Popcorn (air popped or low-fat microwave)41

Are Family Meals Healthy?Did you know that kids who eatmeals with their families eatmore fruits, vegetables, and otherhealthy foods? Yet these days,many families are busy and don’teat together much.Monet Griffin, age 15, often eatsmeals with her family. Monettalked to her mom, ElviraRobinson, about family meals andhow girls can get their families toeat together more.QWhy do you think families should eat together?AWe have a high regard for family. We make it our business toset aside meal time and come together to share our thoughts. Wetalk about what happened during our day, and anything that may begoing on in our lives.42

QA lot of families don’t eat together these days.Why do you think that is?AI think it’s because people have lost the sense of family and howimportant it is for families to be closely knitted.QDid you eat together with your family when youwere my age?AYes I did, but it was a little different. My parents had a settime for meals that applied to everybody. Our parents alwayssaid that eating together helped to build family ties.QAWhat could a girl my age do to help her family try toeat together sometimes?A girl your age could surprise her family one evening bymaking a meal (something simple), setting the table, and gettingeveryone seated and enjoying a meal together. She might besurprised at the response.43

Fast FoodTipsOrder garden or grilled chickensalads with low-fat dressings.Limit fried foods (french fries,onion rings, or fried chickenor fish).Choose grilled chicken, butskip or go light on the sauceor mayo.Order a plain burger withoutcheese and bacon.Buy the smallest sandwich onthe menu.Use mustard, ketchup, orlow-fat mayonnaise.Order low-fat or fat-free milk,or just have water.Pick vegetable toppings foryour pizza, such as peppers,mushrooms, onions, andtomatoes.44Many restaurants now includenutritional information ontheir menus or websites.Check out the stats of yourfavorite restaurant meals tohelp make healthy choiceswhen you eat out!

Pick the Low-Fat Choices1 Grilled chicken sandwich,light on the sauce.orFried fish fillet sandwich2 Bacon cheeseburger orsandwichLean roast beefsandwich3 Turkey sub with mustard or Tuna salad sub4 French fries or Baked potatoAnswers1 Grilled chicken sandwich. Fast food fish fillet sandwiches tendto be fried so they’re higher in fat, calories, and salt.2 Lean roast beef sandwich. The bacon and cheese add extra fat,salt, and calories. If you go with the burger, try it plain with extralettuce, tomato, and onions.3 Turkey sub with mustard. A tuna salad sandwich usually ismade with mayonnaise, which is high in fat. Mustard is fat-free.4 Baked potato. Since french fries are fried, they tend to be higherin fat than a baked potato. Choose low-fat cheese when addingtoppings, and limit the amount of butter and sour cream onthe potato.Check out CDC’s interactive tool to examine whatyou eat! Learn how to create healthy plates andadd colorful fruits and veggies to your

A Healthy Mind = A Healthy BodyFeeling good about your body is just as important as eating healthyfoods and getting physical activity. Why? Having a good image ofyour body helps build confidence and self-esteem. In other words,it helps you be a healthy person.Feeling good about your body means…Knowing that you are beautiful and unique.Accepting your natural body shape.Knowing that who you are has little to do with how you look.Saying no to unhealthy dieting, like skipping meals or eating verylittle.46

What is an Eating Disorder?An eating disorder is an extreme way of thinkingabout — and behaving toward — weight and food.Eating disorders are common in girls and womenand are serious health problems. They can includeanorexia, bulimia, and binge-eating disorder.It’s important to see a health care provider if youthink you may have an eating disorder. For moreinformation about eating disorders, including signsand symptoms, go

Dealing with StressThere are lots of reasons why teens can feelstressed, including schoolwork, problems athome or at school, or even low self-esteem.A little stress, like during a sports competition,can push you to do your best, but major stresscan lead to health problems like depression oreating disorders.Signs of Stress*Feeling downFeeling tiredHeadachesStomachachesSleeping problemsLaughing or crying for no reasonBlaming othersNegative attitudeNot enjoying your usual activitiesFeeling overwhelmed* Some of these signs are also linked to a more serious conditioncalled depression. For more information about depression go

Stress BustersBe physically activeEat healthy foods regularly(including healthy snacks)Get enough sleepLimit caffeine (soda oftenhas caffeine, as do coffeedrinks)Take a break (for example:listen to music or draw)Spend time with friendsTalk to someone you trust,like a friend or parent49

Eating and FeelingsFor some people, eating is away to deal with emotionssuch as stress, boredom, orsadness. Find out the answersto common questions aboutfeelings and eating, known as“emotional” eating.— Answers provided by Carol LynnTrippitelli, M.D.Q How would a person know if she is eating foremotional reasons?A Keeping track of your eating habits and mood can helpanswer this question. If you’re worried about this issue, trywriting down what you eat during the day. Also, write downwhat your mood was like each time you ate something.Include emotional stresses like exams or family problems(See page 35 for an example).50Q Can emotional eating be unhealthy?A Yes it can, when it starts to get in the way of daily life orrelationships with friends, family, and others. In some cases,emotional eating can become binge-eating disorder. This isa problem where a person eats very large amounts of foodin one sitting and feels out of control while doing so (knownas bingeing). Binge eating disorder is defined as bingeing atleast twice a week for six months.

Q Why would someone think they feel hungryif they’re really sad or stressed out?A They may have become used to eating as a way to dealwith stress. Food can feel comforting when feeling sador anxious. Also, an increased appetite (feeling hungrier)could be a sign of clinical depression. A person with clinicaldepression would have five or more of these symptoms forat least two weeks:Depressed or irritable moodEating more or less than usualFeeling worthless or guiltyLoss of interest in activities/hobbiesSleeping more or less than usualHaving a hard time thinking or concentratingLow energyThoughts of death or suicideIf you think you may be depressed, you should see adoctor or psychiatrist to get an evaluation and establisha treatment plan.Q What are some ways to prevent emotional eating?A Learn healthier ways to deal with stress. Avoid unhealthydieting, like eating very little or skipping meals. In the longrun, these habits can lead people to want to overeat or binge.Get medical treatment for a mood disorder, like depressionor feelings of anxiety, if these are problems. Once theseconditions are better under control, it can be easier to dealwith the emotional eating issues.Dr. Trippitelli is a psychiatrist in private practice in Washington, D.C., and a clinical assistantProfessor of Psychiatry at Georgetown University Hospital.51

Look Around You52

TV, Internet, cell phone apps,movies, music, and magazinesare all types of media manyteens use every day. What yousee, hear, and read in the mediacan affect the way you look atthe world — and how you thinkof yourself.553

Media SmartsThe “perfect” body: Is this for real?The media is filled with pictures of perfect bodies. Butis this how people really look? Not really. Think about it:Most runway models really weigh too little, whichisn’t healthy.Many photos you see are airbrushed to take out allwrinkles, pimples, sags, and bags.TV and movie stars have whole teams of people tocook their food, do their hair and makeup, and evenhelp them stay in shape.54

Teens see about 40,000television ads everyyear. Most are for candy,cereal, and fast food.Companies use many ways to getyou to take notice. Look at thefood ads the next time you turnon your TV. How are things beingsold to you?Saying the product will makeyou popular or better lookingFeaturing sports heroes andTV and movie starsShowing kids who look olderand more perfect than thekids/teens the ad targetsMaking you feel good, likeshowing a mother and daughtereating togetherMany foods are made overso they look good enoughto eat on camera — evenafter a long photo shoot.Here are just a few examples:Brown food dye, cookingoil, or even petroleumjelly (like Vaseline) canmake burgers look juicy.White glue can replacemilk so a bowl of cereallooks ready to eat forhours — without a soggymess.A squirt of dishwashingliquid keeps a cup ofhot cocoa looking hot andbubbly.Playing music andsound effects thatare enticingUsing cartooncharacters toget your attention55

Reality CheckTake a look around your home and school andanswer these questions.At your homeWhat foods can you snack on at home? (check all that apply)Sweets Chips Fruit VeggiesLow-fat or fat-free yogurtLow-fat or fat-free cheeseOtherIf you pack a lunch for school, what foods can you choose from athome? (check all that apply)Sandwich Leftovers Sweets ChipsLow-fat yogurt Fruits VeggiesOtherWhat is there to drink in your house? (check all that apply)Water Soda Fruit drinksWhole milk Low-fat or skim milkOtherHow often does your family eat meals together at home?Every day Sometimes Rarely Don’t knowDo you have bikes, balls, jump ropes, or other sports equipmentat home?YesNo56

At your schoolDoes the cafeteria serve fruits and vegetables that look andtaste good?Every day Sometimes Rarely Don’t knowDoes the cafeteria serve fast food like cheeseburgers and frenchfries?Every day Sometimes Rarely Don’t knowIf your school has vending machines, can you buy fruit, bakedcrackers, water, or low-fat milk from them?Yes No ExplainHow often do you go to P.E. or gym class each week?Every day Two or more days One day NeverHow often can students use balls, jump ropes, or other sportsequipment before or after school?Every day Sometimes Rarely Don’t knowIf your school has a gym, track, weight room, or pool, can you usethem before or after school?Every day Sometimes Rarely Don’t knowNeverChicago students say “healthier lunches!”A group of high school students in Chicago spoke out abouttheir school lunch menus at a meeting of the Chicago Boardof Education. They wanted to replace frozen, processed foodsand add more vegetables and other nutritious foods. The CEO ofthe public school system responded by including less salt andsugar, and more fruits and veggies, on the next year’s menu.— ABC World News with Diane Sawyer.“Food Fight: High School Lunches.” March 24, 2010.57

You Can Makea DifferenceAt homeAsk your parent or caregiver about…Adding healthy snack and bag lunch foods to the shopping list.Eating some meals at home as a family when you can.Having balls, bikes, or jump ropes available at home.At schoolTalk to a teacher, principal, or school administrator about…Offering better food choices in the school cafeteria and vendingmachines.Adding more P.E. or gym class time during school hours.Letting students use school sports equipment (jump ropes orballs) or gyms, weight rooms, or pools before or after hours.Posting a student survey about food and physical activity on yourFacebook page or school website.Other ways to make changes at your schoolJoining or organizing a student group or school wellnesscommittee to develop priorities.Passing out a student survey about food and physical activity.Writing letters to school principals or school administrators.Contacting local newspapers and TV and radio stations.Getting your parents and your school’s PTA to help you.For more information about making changes at your school, go or

Health Websites for Teen GirlsLearn more about nutrition, exercise, stressmanagement, and more by visiting these

“If you learn good habits early, you’ll carrythem with you for the rest of your lives.So let’s act. Let’s get going. Let’s move.”— Michelle Obama60

A Toolkit for Healthy Teens & Strong FamiliesOWH Helpline: 800-994-9662September 2012

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