As a teenager, you go through many changes. Your body is on its way to becoming its adult size. You may notice that you can't fit into your old shoes or that your jeans are now 3 inches too short. Along with these changes, you are probably becoming more independent and making more of your own choices. Some of the biggest choices you face are about your health.

Healthy habits, including eating a healthy diet and being physically active, can help you feel good, look good, and do your best in school, work, or sports. They might also prevent diseases such as diabetes, high blood pressure, heart disease, osteoporosis, stroke, and some cancers when you are older.

Becoming a teen means taking more responsibility for decisions about your body and health. It’s important to understand how your body works and what it needs. That way, you can make smart choices about what you eat and how you keep active. Start by creating healthy habits now.

Eating a good diet is an important place to start. By choosing healthy foods and drinks, you can give your body the nutrients it needs. Nutritionists recommend filling half of your plate fruits and vegetables. Teens need more of certain nutrients like calcium found in milk, yogurt, and cheese—and vitamin D, found in dairy, fortified cereals, and tuna. It’s a good idea to reduce added sugar from foods like cookies, candy, and soda.

Staying at a healthy weight is important, too. But extreme dieting isn’t the answer to extra weight. Cutting out whole food groups or skipping meals can be unhealthy and won’t result in long-term weight loss. Unhealthy dieting can also affect your mood and how you grow. Instead, try to make small changes you can stick to. NIH has online resources to help you reach and stay at a healthy weight.

Regular exercise is also key. Experts recommend teens get 60 minutes of physical activity each day. Three of those days should include a vigorous exercise like jogging or biking.

You lead a busy life. Being young is exciting, but it can also be hectic. Juggling school or work and keeping up with family, friends, and volunteer activities may leave little time for yourself. Being physically active and eating healthy can give you the energy you need to keep up with life's demands and live your best life, regardless of your age.

This information, part of a series of materials for a program called Sisters Together: Move More, Eat Better, shows you how to make regular physical activity and healthy eating part of your daily routine, even when you think you don't have the time. Use this information to help yourself, as well as friends and family members, get healthier. It's never too early or too late to start making small changes to improve your health.

Why should I move more and eat better?

Even though you may be young and healthy now, your chances of developing health problems increase as you get older. Being physically active and making healthy food choices now may lower your chances of developing the following conditions as you age

• type 2 diabetes, or high blood sugar
• high blood pressure
• kidney disease
• heart disease
• stroke
• certain kinds of cancer

Besides being good for your overall health, moving more and eating better also have many other benefits, such as helping you

• have more energy for work, school, play, and family
• feel good about yourself and your health
• look good in the latest styles
• manage weight gain
• manage stress better
• tone your body—without losing your curves
• be a role model for friends and family members

How can I start to move more?

Physical activity can be fun when you do things you enjoy. Try

• taking a dance, yoga, cycling, or other group-fitness class at a nearby community or recreation center
• walking briskly through a mall or park, or around a local school track, if it's safe to do so
• playing with your children or nieces, nephews, or friends' children—dancing, jumping rope, or playing hide-and-seek or tag
• jogging, running, or bike riding

If you can, try being active with a friend or a group. That way, you can cheer each other on, catch up, and feel safer when you're outdoors.

Think you don't have time for physical activity? The good news is you can still benefit by being active for short periods of time throughout the day—even 10 minutes at a time. When you're trying to find time for physical activity, remember that any activity is better than none. So try to move more by making even these small changes to your daily routine

• Get off the bus or subway one stop early if you're in a safe area and walk the rest of the way to where you're going.
• Go for a walk during breaks or at lunchtime while at work or school, if your schedule permits.
• Put physical activity on your daily to-do list. For example, plan on being active right before or right after work, before you get too distracted or busy with other things.

What if I don't want to mess up my hair?

Your hairstyle doesn't have to stand between you and your physical activity

• Try a natural hairstyle, short haircut, braids, twists, locs, weaves, or wigs.
• Wrap a scarf around your hair; when you're done with your workout, remove the scarf and let your hair air dry.

Tip: Some people find physical activity may make their hair look dull or lead to salt buildup. To keep your hair healthy as you stay fit

• Cleanse your scalp with a clarifying product when needed.
• Avoid harsh products that may strip hair of natural oils.
• Limit the use of heat on hair, such as dryers and curling irons. If you use heat, keep on low settings to protect hair from damage.
• For styling ideas, consider viewing YouTube videos and visiting other relevant online hair groups and communities to be informed and inspired.

How can I eat better?

Eating healthy can be a challenge when you don't have time to cook or there seem to be fast and casual food places around every corner. Eating healthy means including vegetables, fruit, protein, whole grains, and low-fat or fat-free dairy foods in your meals. These foods provide important nutrients such as vitamins and minerals—and some also provide fiber.

When planning meals, think about making them healthier by including

• a salad or mix of different-colored vegetables such as spinach; sweet potatoes; and red, green, orange, or yellow peppers
• fat-free or low-fat milk and milk products, or nondairy products such as soy, almond, or rice milk with added vitamin D and calcium
• different-colored fruits, including apples, bananas, and grapes
• lean beef, pork, or other protein foods such as chicken, seafood, eggs, tofu, or beans
• whole grains such as brown rice, oatmeal, whole-wheat bread, and whole-grain cornmeal

To eat healthier without spending a lot of time in the kitchen, try the following tips

• Buy frozen or pre-cut veggies. Add veggies to a salad, stir-fry them with chicken, or microwave them and add to whole-grain pasta and pasta sauce for a quick meal.
• Make enough food for extra meals when you cook. A whole cooked chicken and casseroles with whole grains and veggies may last a few days, so you don't have to cook another meal every day. Be sure to freeze or refrigerate leftovers right away to keep them safe to eat.
• Grab a quick and easy first meal. You can start your day with something simple yet healthy. Try a banana, apple, slice of whole-wheat toast with a teaspoon of peanut butter, or oatmeal topped with berries and a few walnuts. Or you could make oatmeal the day before and heat it up when you're ready to eat it.

Sometimes we may eat even though we're not hungry. Being distracted by television or certain emotions, such as being bored, stressed, or sad, may make you eat without paying attention to how much you're eating or whether you're even really hungry. Be aware of when, where, and why you eat; and try not to do other things while you're eating so you can keep your focus on your food.

Tip

Make sure you're getting enough folate, a B vitamin that helps the body make healthy new cells and prevents birth defects in babies. Dried beans and peas; cereals with added vitamins and minerals; citrus fruits and juices without added sugar, like orange juice; and leafy green vegetables such as spinach and turnip greens are all good sources of folate. A multivitamin also may provide folate in the form of folic acid. All women and teen girls who could become pregnant should get 400 micrograms of folate a day. If you're pregnant, aim for 600 micrograms a day.

Can I still have my favorite foods and drinks as part of a healthy eating plan?

You can enjoy your favorite foods and drinks in healthy ways when you're hanging out with your friends, co-workers, and family, whether at home or out and about. Try these tips

• If you eat pizza, order vegetable toppings like mushrooms, peppers, and spinach instead of salty, high-fat meats like pepperoni or sausage.
• Split a favorite dish or meal with a friend, or eat half and bring the other half home for the next day.
• Downsize your coffee drink from an extra-large to a small, and replace whole milk with low-fat or fat-free milk. Skip the whipped cream and sugary flavored syrups altogether.
• If you're cooking at home, tweak recipes by using less butter, sugar, and salt.
• Limit alcohol intake to one drink a day, and replace sugar-sweetened beverages with water or unsweetened tea. Remember that alcohol and juices, soda, and other sugar-sweetened drinks add unwanted calories.

Control your food portions

You can still enjoy your favorite foods as part of a healthy eating plan if you watch your food portions. Eating smaller portions and not having seconds may help you cut down on calories and fat. If you love macaroni and cheese, have just a small portion, and try making it yourself with low-fat or fat-free milk and cheese. Have a kiddie cone of ice cream or frozen yogurt, or a thin sliver of pie without the whipped cream.

Have a recipe-makeover potluck

Invite some friends over and have them bring their favorite dishes "made over" for eating healthy. Before the potluck, you could plan an outing to a local farmer's market to buy vegetables that are fresh and in season. Each person can explore changing a favorite recipe by using

• herbs and spices instead of salt to add flavor
• canola, olive, or corn oil instead of butter or shortening
• carrots, red peppers, or other in-season vegetables in casserole and pasta dishes to add color, fiber, and vitamins

After your meal, vote on the best recipe. You may even decide to create a cookbook that includes all of the new healthy recipes.

Celebrate Youth!

Enjoy these action-packed years of your youth! Love, laugh, and spend time eating healthy meals and being active with family and friends. Support each other in staying healthy, active, and strong!

As you get older, you’re able to start making your own decisions about a lot of things that matter most to you. You may choose your own clothes, music, and friends. You also may be ready to make decisions about your body and health.

Making healthy decisions about what you eat and drink, how active you are, and how much sleep you get is a great place to start. Here you’ll learn

• how your body works—how your body uses the food and drinks you consume and how being active may help your body "burn" calories
• how to choose healthy foods and drinks
• how to get moving and stay active
• how getting enough sleep is important to staying healthy
• how to ease into healthy habits and keep them up
• how to plan healthy meals and physical activities that fit your lifestyle

Don’t forget to check out the "Did you know?" boxes for even more helpful tips and ideas.

Did you know?

About 20 percent of kids between 12 and 19 years old have obesity. But small changes in your eating and physical activity habits may help you reach and stay a healthy weight.

How does the body use energy?

Your body needs energy to function and grow. Calories from food and drinks give you that energy. 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 and drink to stay powered up. Balancing the energy you take in through food and beverages with the energy you use for growth, activity, and daily living is called "energy balance." Energy balance may help you stay a healthy weight.

How many calories does your body need?

Different people need different amounts of calories to be active or stay a healthy weight. The number of calories you need depends on whether you are male or female, your genes, how old you are, your height and weight, whether you are still growing, and how active you are, which may not be the same every day.

How should you manage or control your weight?

Some teens try to lose weight by eating very little; cutting out whole groups of foods like foods with carbohydrates, or "carbs;" skipping meals; or fasting. These approaches to losing weight could be unhealthy because they may leave out important nutrients your body needs. In fact, unhealthy dieting could get in the way of trying to manage your weight because it may lead to a cycle of eating very little and then overeating because you get too hungry. Unhealthy dieting could also affect your mood and how you grow.

Smoking, making yourself vomit, or using diet pills or laxatives to lose weight may also lead to health problems. If you make yourself vomit, or use diet pills or laxatives to control your weight, you could have signs of a serious eating disorder and should talk with your health care professional or another trusted adult right away. If you smoke, which increases your risk of heart disease, cancer, and other health problems, quit smoking as soon as possible.

If you think you need to lose weight , talk with a health care professional first. A doctor or dietitian may be able to tell you if you need to lose weight and how to do so in a healthy way.

Choose Healthy Foods and Drinks

Healthy eating involves taking control of how much and what types of food you eat, as well as the beverages you drink. Try to replace foods high in sugar, salt, and unhealthy fats with fruits, vegetables, whole grains, low-fat protein foods, and fat-free or low-fat dairy foods.

Fruits and Vegetables
Make half of your plate fruits and vegetables . Dark green, red, and orange vegetables have high levels of the nutrients you need, like vitamin C, calcium, and fiber. Adding tomato and spinach—or any other available greens that you like—to your sandwich is an easy way to get more veggies in your meal.

Grains
Choose whole grains like whole-wheat bread, brown rice, oatmeal, and whole-grain cereal, instead of refined-grain cereals, white bread, and white rice.

Protein
Power up with low fat or lean meats like turkey or chicken, and other protein-rich foods , such as seafood, egg whites, beans, nuts, and tofu.

Dairy
Build strong bones with fat-free or low-fat milk products. If you can’t digest lactose—the sugar in milk that can cause stomach pain or gas—choose lactose-free milk or soy milk with added calcium. Fat-free or low-fat yogurt is also a good source of dairy food.

Healthy Eating Tips

• Try to limit foods like cookies, candy, frozen desserts, chips, and fries, which often have a lot of sugar, unhealthy fat, and salt.
• For a quick snack, try recharging with a pear, apple, or banana; a small bag of baby carrots; or hummus with sliced veggies.
• Don’t add sugar to your food and drinks.
• Drink fat-free or low-fat milk and avoid sugary drinks. Soda, energy drinks, sweet tea, and some juices have added sugars, a source of extra calories. The 2015-2020 Dietary Guidelines call for getting less than 10 percent of your daily calories from added sugars.

Fats
Fat is an important part of your diet. Fat helps your body grow and develop, and may even keep your skin and hair healthy. But fats have more calories per gram than protein or carbs, and some are not healthy.

Some fats, such as oils that come from plants and are liquid at room temperature, are better for you than other fats. Foods that contain healthy oils include avocados, olives, nuts, seeds, and seafood such as salmon and tuna fish.

Solid fats such as butter, stick margarine, and lard, are solid at room temperature. These fats often contain saturated and trans fats, which are not healthy for you. Other foods with saturated fats include fatty meats, and cheese and other dairy products made from whole milk. Take it easy on foods like fried chicken, cheeseburgers, and fries, which often have a lot of saturated and trans fats. Options to consider include a turkey sandwich with mustard or a lean-meat, turkey, or veggie burger.

Your body needs a small amount of sodium, which is mostly found in salt. But getting too much sodium from your foods and drinks can raise your blood pressure, which is unhealthy for your heart and your body in general. Even though you’re a teen, it’s important to pay attention to your blood pressure and heart health now to prevent health problems as you get older.

Try to consume less than 2,300 mg, or no more than 1 teaspoon, of sodium a day. This amount includes the salt in already prepared food, as well as the salt you add when cooking or eating your food.

Processed foods, like those that are canned or packaged, often have more sodium than unprocessed foods, such as fresh fruits and vegetables. When you can, choose fresh or frozen fruits and veggies over processed foods. Try adding herbs and spices instead of salt to season your food if you make your own meals. Remember to rinse canned vegetables with water to remove extra salt. If you use packaged foods, check the amount of sodium listed on the Nutrition Facts label. Figure 1 below shows an updated food label, which the U.S. Food and Drug Administration (FDA) has approved for use on most packaged foods beginning in 2018.

Figure 1. Side-by-Side Comparison of Original and New Nutrition Facts Label

Limit added sugars

Some foods, like fruit, are naturally sweet. Other foods, like ice cream and baked desserts, as well as some beverages, have added sugars to make them taste sweet. These sugars add calories but not vitamins or fiber. Try to consume less than 10 percent of your daily calories from added sugars in food and beverages. Reach for an apple or banana instead of a candy bar.

Did you know?

Many teens need more of these nutrients:

• calcium, to build strong bones and teeth. Good sources of calcium are fat-free or low-fat milk, yogurt, and cheese.
• vitamin D, to keep bones healthy. Good sources of vitamin D include orange juice, whole oranges, tuna, and fat-free or low-fat milk.
• potassium, to help lower blood pressure. Try a banana, or baked potato with the skin, for a potassium boost.
• fiber, to help you stay regular and feel full. Good sources of fiber include beans and celery.
• protein, to power you up and help you grow strong. Peanut butter; eggs; tofu; legumes, such as lentils and peas; and chicken, fish, and low-fat meats are all good sources of protein.
• iron, to help you grow. Red meat contains a form of iron that your body absorbs best. Spinach, beans, peas, and iron-fortified cereals are also sources of iron. You can help your body absorb the iron from these foods better when you also eat foods with vitamin C, like an orange.

Control your food portions

A portion is how much food or beverage you choose to consume at one time, whether in a restaurant, from a package, at school or a friend’s, or at home. Many people consume larger portions than they need, especially when away from home. Ready-to-eat meals—from a restaurant, grocery store, or at school—may give you larger portions than your body needs to stay charged up. The Weight-control Information Network has tips to help you eat and drink a suitable amount of food and beverages for you, whether you are at home or somewhere else.

Did you know?

Just one super-sized, fast food meal may have more calories than you need in a whole day. And when people are served more food, they may eat or drink more—even if they don't need it. This habit may lead to weight gain. When consuming fast food, choose small portions or healthier options, like a veggie wrap or salad instead of fries or fried chicken.

Take the Portion Distortion Quiz to find out how portion sizes have changed over the years.

Be media smart.

Advertisements , TV shows, the internet, and social media may affect your food and beverage choices and how you choose to spend your time. Many ads try to get you to consume high-fat foods and sugary drinks. Be aware of some of the tricks ads use to influence you:

• An ad may show a group of teens consuming a food or drink, or using a product to make you think all teens are or should be doing the same. The ad may even use phrases like “all teens need” or “all teens are.”
• Advertisers sometimes show famous people using or recommending a product because they think you will want to buy products that your favorite celebrities use.
• Ads often use cartoon figures to make a food, beverage, or activity look exciting and appealing to young people.

Don’t skip meals

Skipping meals might seem like an easy way to lose weight, but it actually may lead to weight gain if you eat more later to make up for it. Even if you’re really busy with school and activities, it’s important to try not to skip meals. Follow these tips to keep your body charged up all day and to stay healthy:

• Eat breakfast every day. Breakfast helps your body get going. If you’re short on time in the morning, grab something to go, like an apple or banana.
• Pack your lunch on school days. Packing your lunch may help you control your food and beverage portions and increases the chances that you will eat it because you made it.
• Eat dinner with your family. When you eat home-cooked meals with your family, you are more likely to consume healthy foods. Having meals together also gives you a chance to reconnect with each other and share news about your day.
• Get involved in grocery shopping and meal planning at home. Going food shopping and planning and preparing meals with family members or friends can be fun. Not only can you choose a favorite grocery store, and healthy foods and recipes, you also have a chance to help others in your family eat healthy too.

Did you know?

Get Moving

Physical activity should be part of your daily life, whether you play sports, take physical education (PE) classes in school, do chores, or get around by biking or walking. Regular physical activity can help you manage your weight, have stronger muscles and bones, and be more flexible.

Aerobic versus Lifestyle Activities
You should be physically active for at least 60 minutes a day. Most of the 60 minutes or more of activity a day should be either moderate- or vigorous-intensity aerobic physical activity, and you should include vigorous-intensity physical activity at least 3 days a week. Examples of aerobic physical activity, or activity that makes you breathe harder and speeds up your heart rate, include jogging, biking, and dancing.

For a more moderate workout, try brisk walking, jogging, or biking on flat streets or paths. To pick up the intensity, turn your walk into a jog, or your jog into a run—or add hills to your walk, jog, or bike ride. You don't have to do your 60 minutes a day all at once to benefit from your activity.

As part of your 60 minutes or more of daily physical activity, you should include muscle-strengthening physical activities, like lifting weights, on at least 3 days a week.

Routine activities, such as cleaning your room or taking out the trash, may not get your heart rate up the way biking or jogging does. But they are also good ways to keep active on a regular basis.

Fitness apps that you can download onto your computer, smartphone, or other mobile device can help you keep track of how active you are each day.

Did you know?

Activities add up!

Here's an example of how to fit 60 minutes of physical activity into your day:

10 minutes – to walk or bike to a friend's house
+
30 minutes – of playing basketball
+
10 minutes – of chasing the dog around the yard
+
10 minutes – to walk back home

= 60 minutes of activity!

Have fun with your friends

Being active can be more fun with other people, like friends or family members. You may also find that you make friends when you get active by joining a sports team or dance club. Mix things up by choosing a different activity each day. Try kickball, flashlight tag, or other activities that get you moving, like walking around the mall. Involve your friends and challenge them to be healthy with you. Sign up for active events together, like charity walks, fun runs, or scavenger hunts.

What if I don't have money for sports equipment or activities?

You don't need money or equipment to stay active. You can run or use free community facilities, like school tracks and basketball courts, to be active at least 60 minutes each day. If you want to play a sport or game that you need equipment for, check with your neighbors or friends at school to see if you can borrow or share supplies. Your school guidance counselor or a PE teacher or coach could tell you how much it costs to join a sports team you are interested in. They may know if your school waives or reduces fees, or if you could apply for a “scholarship” for certain activities.

Take it outside

Maybe you or some of your friends spend a lot of time indoors watching TV, surfing the web, using social media, or playing video games. Try getting in some outdoor activity to burn calories instead. Here are other activities to try:

• Have a jump rope or hula hoop contest.
• Play Frisbee.
• Build an obstacle course or have a scavenger hunt.
• Play volleyball or flag football.

If you’re stuck indoors or don’t have a lot of time, try climbing up and down the stairs in your apartment or home. You can also find dance and other fitness and exercise videos online or on some TV channels. Some routines are only 15 or 20 minutes so you can squeeze them in between homework, going out, or other activities. You also can choose active sports games if you have a gaming system.

Tips for cutting back your screen time

Try to limit your screen time to less than 2 hours each day, not counting your homework:

• Replace after-school TV and video-game time with physical activities at home, at school, or in your community.
• Turn off your cellphone or other device before you go to bed. Put them away from your nightstand or bed.

Get Enough Sleep

Sometimes it’s hard to get enough sleep, especially if you have a job, help take care of younger brothers or sisters, or are busy with other activities after school. Like healthy eating and getting enough physical activity, getting enough sleep is important for staying healthy.

You need enough sleep to do well in school, work and drive safely, and fight off infection. Not getting enough sleep may make you moody and irritable. While more research is needed, some studies have shown that not getting enough sleep may also contribute to weight gain.

If you’re between 13 and 18 years old, you should get 8 to 10 hours of sleep each night.

Take Your Time

Changing your habits can be hard. And developing new habits takes time. Use the tips below and the checklist under “Be a health champion” to stay motivated and meet your goals. You can do it!

• Make changes slowly. Don’t expect to change your eating, drinking, or activity habits overnight. Changing too much too fast may hurt your chances of success.
• Figure out what's holding you back. Are there unhealthy snack foods at home that are too tempting? Are the foods and drinks you’re choosing at your school cafeteria too high in fat and sugar? How can you change these habits?
• Set a few realistic goals. If you’re a soda drinker, try replacing a couple of sodas with water. Once you are drinking less soda for a while, try cutting out all soda. Then set another goal, like getting more physical activity each day. Once you have reached one goal, add another.
• Get a buddy at school or someone at home to support your new habits. Ask a friend, brother or sister, parent, or guardian to help you make changes and stick with your new habits.

Planning Healthy Meals and Physical Activities Just for You

Being healthy sounds like it could be a lot of work, right? Well, it doesn't have to be.

Breakfast: a banana, a slice of whole-grain bread with avocado or tomato, and fat-free or low-fat milk
Lunch: a turkey sandwich with dark leafy lettuce, tomato, and red peppers on whole-wheat bread
Dinner: two whole-grain taco shells with chicken or black beans, fat-free or low-fat cheese, and romaine lettuce
Snack: an apple, banana, or air-popped popcorn

Be a health champion

Spending much of your day away from home can sometimes make it hard to consume healthy foods and drinks. By becoming a “health champion,” you can help yourself and family members, as well as your friends, get healthier by consuming healthier foods and drinks and becoming more active. Use this checklist to work healthy habits into your day, whether you’re at home or on the go:

• Each night, pack a healthy lunch and snacks for the next day. Consume the lunch you packed. Try to avoid soda, chips, and candy from vending machines.
• Go to bed at a regular time every night to recharge your body and mind. Turn off your phone, TV, and other devices when you go to bed. Try to get between 8 and 10 hours of sleep each night.
• Eat a healthy breakfast.
• Walk or bike to school if you live nearby and can do so safely. Invite friends to join you.
• Between classes, stand up and walk around, even if your next subject is in the same room.
• Participate in gym classes instead of sitting on the sidelines.
• Get involved in choosing food and drinks at home. Help make dinner and share it with your family at the dinner table.

Are you thinking about being more active? Have you been trying to cut back on less healthy foods? Are you starting to eat better and move more but having a hard time sticking with these changes?

Old habits die hard. Changing your habits is a process that involves several stages. Sometimes it takes a while before changes become new habits. And, you may face roadblocks along the way.

Adopting new, healthier habits may protect you from serious health problems like obesity and diabetes. New habits, like healthy eating and regular physical activity, may also help you manage your weight and have more energy. After a while, if you stick with these changes, they may become part of your daily routine.

The information below outlines four stages you may go through when changing your health habits or behavior. You will also find tips to help you improve your eating, physical activity habits, and overall health. The four stages of changing a health behavior are

• contemplation
• preparation
• action
• maintenance

What stage of change are you in?

Contemplation: “I’m thinking about it.”

In this first stage, you are thinking about change and becoming motivated to get started.

You might be in this stage if you

• have been considering change but are not quite ready to start
• believe that your health, energy level, or overall well-being will improve if you develop new habits
• are not sure how you will overcome the roadblocks that may keep you from starting to change

Preparation: “I have made up my mind to take action.”

In this next stage, you are making plans and thinking of specific ideas that will work for you.

You might be in this stage if you

• have decided that you are going to change and are ready to take action
• have set some specific goals that you would like to meet
• are getting ready to put your plan into action

Action: “I have started to make changes.”

In this third stage, you are acting on your plan and making the changes you set out to achieve.

You might be in this stage if you

• have been making eating, physical activity, and other behavior changes in the last 6 months or so
• are adjusting to how it feels to eat healthier, be more active, and make other changes such as getting more sleep or reducing screen time
• have been trying to overcome things that sometimes block your success

Maintenance: “I have a new routine.”

In this final stage, you have become used to your changes and have kept them up for more than 6 months.

You might be in this stage if

• your changes have become a normal part of your routine
• you have found creative ways to stick with your routine
• you have had slip-ups and setbacks but have been able to get past them and make progress

Did you find your stage of change? Read on for ideas about what you can do next.

Contemplation: Are you thinking of making changes?

Making the leap from thinking about change to taking action can be hard and may take time. Asking yourself about the pros (benefits) and cons (things that get in the way) of changing your habits may be helpful. How would life be better if you made some changes?

Think about how the benefits of healthy eating or regular physical activity might relate to your overall health. For example, suppose your blood glucose, also called blood sugar, is a bit high and you have a parent, brother, or sister who has type 2 diabetes. This means you also may develop type 2 diabetes. You may find that it is easier to be physically active and eat healthy knowing that it may help control blood glucose and protect you from a serious disease.

You may learn more about the benefits of changing your eating and physical activity habits from a health care professional. This knowledge may help you take action.

Look at the lists of pros and cons below. Find the items you believe are true for you. Think about factors that are important to you.

Healthy Eating

Physical Activity

Preparation: Have you made up your mind?

If you are in the preparation stage, you are about to take action. To get started, look at your list of pros and cons. How can you make a plan and act on it?

The chart below lists common roadblocks you may face and possible solutions to overcome roadblocks as you begin to change your habits. Think about these things as you make your plan.

Once you have made up your mind to change your habits, make a plan and set goals for taking action. Here are some ideas for making your plan:

• learn more about healthy eating and food portions
• learn more about being physically active
• make lists of
  • healthy foods that you like or may need to eat more of—or more often
  • foods you love that you may need to eat less often
  • things you could do to be more physically active
  • fun activities you like and could do more often, such as dancing

After making your plan, start setting goals for putting your plan into action. Start with small changes. For example, “I’m going to walk for 10 minutes, three times a week.” What is the one step you can take right away?

Action: Have you started to make changes?

You are making real changes to your lifestyle, which is fantastic! To stick with your new habits

• review your plan
• look at the goals you set and how well you are meeting them
• overcome roadblocks by planning ahead for setbacks
• reward yourself for your hard work

Track your progress

• Tracking your progress helps you spot your strengths, find areas where you can improve, and stay on course. Record not only what you did, but how you felt while doing it—your feelings can play a role in making your new habits stick.
• Recording your progress may help you stay focused and catch setbacks in meeting your goals. Remember that a setback does not mean you have failed. All of us experience setbacks. The key is to get back on track as soon as you can.
• You can track your progress with online tools such as the NIH Body Weight Planner. The NIH Body Weight Planner lets you tailor your calorie and physical activity plans to reach your personal goals within a specific time period.

Overcome roadblocks

• Remind yourself why you want to be healthier. Perhaps you want the energy to play with your nieces and nephews or to be able to carry your own grocery bags. Recall your reasons for making changes when slip-ups occur. Decide to take the first step to get back on track.
• Problem-solve to “outsmart” roadblocks. For example, plan to walk indoors, such as at a mall, on days when bad weather keeps you from walking outside.
• Ask a friend or family member for help when you need it, and always try to plan ahead. For example, if you know that you will not have time to be physically active after work, go walking with a coworker at lunch or start your day with an exercise video.

Reward yourself

• After reaching a goal or milestone, allow for a nonfood reward such as new workout gear or a new workout device. Also consider posting a message on social media to share your success with friends and family.
• Choose rewards carefully. Although you should be proud of your progress, keep in mind that a high-calorie treat or a day off from your activity routine are not the best rewards to keep you healthy.
• Pat yourself on the back. When negative thoughts creep in, remind yourself how much good you are doing for your health by moving more and eating healthier.

Maintenance: Have you created a new routine?

Make your future a healthy one. Remember that eating healthy, getting regular physical activity, and other healthy habits are lifelong behaviors, not one-time events. Always keep an eye on your efforts and seek ways to deal with the planned and unplanned changes in life.

Now that healthy eating and regular physical activity are part of your routine, keep things interesting, avoid slip-ups, and find ways to cope with what life throws at you.

Add variety and stay motivated

• Mix up your routine with new physical activities and goals, physical activity buddies, foods, recipes, and rewards.

Deal with unexpected setbacks

• Plan ahead to avoid setbacks. For example, find other ways to be active in case of bad weather, injury, or other issues that arise. Think of ways to eat healthy when traveling or dining out, like packing healthy snacks while on the road or sharing an entrée with a friend in a restaurant.
• If you do have a setback, don’t give up. Setbacks happen to everyone. Regroup and focus on meeting your goals again as soon as you can.

Challenge yourself!

• Revisit your goals and think of ways to expand them. For example, if you are comfortable walking 5 days a week, consider adding strength training twice a week. If you have limited your saturated fat intake by eating less fried foods, try cutting back on added sugars, too. Small changes can lead to healthy habits worth keeping.

Eat healthy to look and feel better!

Eating healthy foods will...

• Help keep your weight in check.
• Keep you awake and focused in school.
• Help you do your best at sports.

Take it easy on pizza, sweets, and sodas!

They have lots of sugar, salt, and fat.

• Limit cakes, cookies, and other foods made with shortening, butter, and margarine.
• Choose water or fat-free or low-fat milk instead of sugary soda or juice drinks.
• Eat more foods like bananas, beans, and yogurt for potassium to help build strong bones.

Give your body the right fuel!

• Make half of your plate fruits and vegetables.
• Power up with lean meats, chicken, seafood, eggs, beans, nutes, tofu, and other protein-rich foods.
• Build strong bones with fat-free or low-fat milk products for calcium and vitamin D.
• Choose whole grains, like whole-wheat bread, brown rice, and oatmeal, for half of your grain servings.

Snack smart on these!

• Fresh apples, berries, or grapes
• A handful of walnuts or almonds
• A small bag of mini-carrots
• Low-fat or fat-free yogurt
• String cheese
• Peanut butter on whole-wheat crackers

Take control!

One fast food meal can have more calories, fat, and sugar than you need for the whole day.

• Avoid "value-sized" or "super-sized meals."
• Share your meal or take half home when eating out.
• Choose whole-wheat bread, lean meats, and fresh fruit at the school cafeteria

Start strong and plan ahead!

Busy schedules can make it hard to eat smart. Planning ahead can help.

• Jump-start your day with breakfast. It will help you do better in school.
• Bagit! Pack a healthy lunch, like a lean turkey sandwich on whole-grain bread and an apple.
• Snack smart by packing your own high-power nibbles for school or time with friends.

According to a 2012 national survey, nearly 12 percent of children and teens (about one in nine) in the United States are using some form of complementary health product or practice, such as chiropractic or spinal manipulation, yoga, meditation, or massage therapy. Mind and body practices include a variety of procedures and techniques done or taught by a trained practitioner or teacher to help improve health and well-being. Older children and teens can do some mind and body activities on their own (or with help from a parent or guardian), such as relaxation techniques and deep breathing. Mind and body practices are generally safe if used appropriately, but the number of studies looking at their safety specifically for children is limited.

Here are 7 things to know about common mind and body practices for children and teens.

1. Biofeedback, guided imagery, mindfulness, and yoga are some of the mind and body practices that have the best evidence of being effective for children and are low-risk.

2. Acupuncture appears to be safe for most children, but side effects can occur if it’s done by poorly trained practitioners.

3. Massage therapy appears to have few risks when done by a trained practitioner. However, massage therapists need to take extra precautions with people who have certain health conditions, such as bleeding disorders.

4. Relaxation techniques are generally safe for healthy people, including children. However, there have been rare reports that some relaxation techniques might cause or worsen symptoms in people with epilepsy or certain psychiatric conditions, or with a history of abuse or trauma.

5. Spinal manipulation is usually safe for healthy people but is also associated with rare but serious complications.

6. Follow the Centers for Disease Control and Prevention’s vaccination recommendations to safeguard your child against vaccine-preventable diseases. Vaccinating children helps protect our community’s and our children’s health.

7. It’s important that you talk with your child’s health care provider about any complementary health approach that you’re using or considering for your child, and encourage your teenagers to do the same.

If you have a son or daughter who’s leaving the nest this fall—whether off to college, a new job or some other adventure—you’re probably facing a big change in your child’s medical care. For those who are still a couple of years away, it’s a good idea to start thinking about how you and your child will make the transition from pediatric to adult health care—particularly if your child has a chronic disease like asthma or diabetes.

“Pediatric and adult health care are very different,” says Dr. Francine R. Kaufman, a pediatrician and NIH-supported researcher affiliated with the University of Southern California. “In pediatric care there’s really an interaction and a focus on the parents as well as the child. In adult care, it’s very common that the parents are excluded from the encounter altogether.”

That means you might not be there to hear things that could be critical to the health of your child. Your child will also have to learn to make appointments, get prescriptions, keep health records together, make insurance co-payments and manage many other details. “You have to prepare for this transition,” Kaufman says.

When to make the change depends on many things. Some insurers and health care systems require patients to move to adult care by a certain age. Kaufman says families should definitely start to get ready to make the transition by the time a child is 18 years old. At that point, patients are protected by privacy laws. That means a health care provider can’t share information with family or friends unless the patient gives explicit permission, which usually means signing a consent form.

Kaufman recommends discussing the timing with your pediatric care provider well in advance. Ask your doctor how long your child should remain in pediatric care before moving to adult care.

“It really should be collaborative,” Kaufman says. “The patient and family have to be proactive. They shouldn’t just wait for their doctor to bring it up.”

Plan with your pediatrician about how to make a transition that your child feels comfortable with. Kaufman says there should be at least a couple of years where the child takes on more responsibility but still has the family’s support.

“Children need to have a couple of years practicing before they can fully participate in their care,” she says. “They can start by being more vocal during their appointments. Have the child come in with a list of questions and concerns. Children should also be given the opportunity to manage their own medications and make their own appointments.”

Once you have a plan to prepare your child for the transition, you’ll need to find a new doctor. Kaufman advises choosing a primary care doctor well in advance who can help coordinate your child’s care. It’s important not to wait until there’s a problem.

“Many kids wait years without care, or they wait until something happens and then they need care really quickly,” she says. “Find someone you can transfer your records to and have an appointment with before something goes wrong.”

Think in advance about what kinds of doctors your child will need. What will insurance allow? Will your child be able to get appointments—and get to the doctor’s office—when there’s a problem?

The more complex your child’s health care needs, the more providers you usually have to plan for. “That’s where a good medical home really comes in,” Kaufman notes. “You need to find a primary care physician who’s helping coordinate care.” Try to meet with the doctors you’re considering, if possible, to make sure your child is comfortable with them.

Some medical centers set up transition appointments for their teenage patients with chronic diseases. The family, pediatrician and adult care workers all get together to discuss the best way to make the transition. “This really matters for chronic care of an underlying disease such as diabetes, which is team-based,” Kaufman explains. “It’s really important in those situations to have someone from both teams.”

If your medical center doesn’t arrange transition appointments, you can try to set one up yourself. Whether or not that’s practical, you need to make sure the old and new offices are communicating with each other. Check that medical records are transferred over, along with any other information that the doctors will need to care for your child.

The process of changing from pediatric to adult health care may seem daunting at first, but with a little planning, it can all go smoothly. “This transition is really about getting the parents much, much more in the background,” Kaufman says. The best way to do that smoothly is to start planning years in advance for a gradual change.

Graduating to an Adult Doctor

It’s a good idea to give a child at least a couple of years, with the support of the family, to transition to a new doctor. Here are some major steps:

• Make a plan. Ask your pediatric care provider for advice on when to make the transition and how to go about it. It’s usually a good idea to switch by age 18, or a little later for those with a chronic disease.
• Talk to your children about expectations. Explain what they’ll need to do, from the start of the transition to when they become fully responsible for their own health care. (Many with chronic complex diseases may not become fully independent.)
• Have your child gradually play more of a role. Start by having your child make up a list of questions for the doctor, arrange their own appointments and refill prescriptions.
• Choose a new provider. Help your child find a new primary adult health care provider, if possible. Or plan the process he or she will need to go through after moving to a new school or area.
• Send your child’s health information. Make sure the new care provider receives needed information from you and the pediatrician.