The Mediterranean diet is inspired by foods eaten in countries that border the Mediterranean Sea. This includes Greece, Spain, France, and southern Italy. In some ways, the Mediterranean diet is like other heart-healthy diets. It promotes foods such as fish, fruits, vegetables, beans, and whole grains. It does not include many meats, dairy products, or sweets. In other ways, the Mediterranean diet is different. For example, it allows for more calories from fats, like olive oil. The diet also allows for moderate intake of wine.

Path to improved health

Studies show that the Mediterranean diet has many health benefits. These are greater when combined with exercise. The diet can help you lose or maintain weight. It also helps to manage your blood pressure, blood sugar, and cholesterol levels. In older adults, it can improve your brain function. Following the Mediterranean diet may also protect against some chronic diseases, such as:

• Heart disease
• Cancer
• Type 2 diabetes
• Alzheimer’s disease
• Parkinson’s disease

You can integrate the Mediterranean diet into your lifestyle. Try some of the tips below. Talk to your doctor or a dietician if you have questions.

• Make vegetables, fruits, and whole grains the base of your meals. Your meals should center around these foods. Choose a wide mix of fruits and vegetables and prepare them in simple ways. For example, you can roast your vegetables in the oven. If you sauté them, use olive oil instead of butter. Switch to whole-grain breads, pastas, and cereals. Try different whole grains, such as brown rice, quinoa, and millet.
• Use unsaturated fats instead of saturated fats. Make good choices about which fats you eat. When cooking, choose unsaturated fats, such as olive or canola oil. Limit your intake of saturated fats, such as butter, margarine, and coconut oil. Choose low-fat dairy products.
• Choose fresh, healthy snacks. Nuts are good snacks and a natural source of unsaturated fat. Eat a small handful of walnuts, cashews, almonds, or pistachios. Spread some all-natural peanut butter (with no added sugar or fillers) on a slice of whole-grain bread. Fresh vegetables are another good option. Eat them with hummus or olive oil instead of sour cream or cheese.
• Get most of your protein from plant sources, poultry, and fish. During the week, try eating mostly vegetarian meals. You can combine lentils, beans, or chickpeas with whole grains and vegetables. Once or twice a week, bake or grill fish, such as salmon, trout, or tuna. When you eat meat, choose poultry instead of red meat. Keep your portions at 3 to 5 oz. (the size of a deck of cards). Avoid red meat, sausage, bacon, and other high-fat meats.
• Raise a glass.On the Mediterranean diet, you can consume a moderate amount of wine. Red wine may have more health benefits than white wine. Women (or men over age 65) can drink up to 1 glass of wine a day. Men under age 65 can have up to 2 glasses a day. Drinking more than this can increase your risk of health problems.
• Limit sweets. Try to reduce your intake of soda, sweetened cereals, granola bars, and desserts. You only should consume these once or twice a week. Instead, if you have a sweet tooth, try eating a piece of fresh, dried, or baked fruit.
• Stay active. Remember, exercise helps boost the effects of the Mediterranean diet. Try to get at least 30 minutes of moderate exercise 5 days a week. A moderate exercise raises your heart rate and makes you break a sweat. Pick something that you enjoy. Walking, hiking, swimming, and riding a bike are good options.

Things to consider

New studies continue to find health benefits from the Mediterranean diet. However, there are health concerns that you should be aware of. If your iron levels are low, make sure you eat foods rich in iron and vitamin C. Combining foods such as spinach (high in iron) and strawberries (high in vitamin C) can help your body absorb iron. You also may have a calcium loss from eating fewer dairy products on this diet. Ask your doctor if you should take a calcium supplement.

Questions to ask your doctor

• Is a Mediterranean diet meant to be short-term or long-term?
• Should my kids follow the Mediterranean diet, too?
• Are there vitamins or supplements I should take that go with the Mediterranean diet?

Resources

American Heart Association: What is the Mediterranean Diet?

National Institutes of Health, MedlinePlus: Mediterranean Diet

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If you have high blood pressure, you can lower it with small lifestyle changes. Work with your doctor to develop a plan for lowering your blood pressure. Part of the plan may also include taking blood pressure-lowering medicine. However, your lifestyle changes will be just as important.

Path to improved health

How do tobacco products affect blood pressure?

The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster. This temporarily raises your blood pressure. When you quit smoking or using other tobacco products, you can lower your blood pressure. Stopping tobacco significantly lowers your risk of heart disease and stroke.

What about losing weight and exercising?

If you’re overweight, losing weight usually helps lower blood pressure. Regular exercise is a good way to lose weight. It also seems to lower high blood pressure even if you don’t lose weight. And even a 5 pound weight loss can bring down blood pressure significantly if you are overweight.

Is sodium really off limits?

Not everyone is affected by sodium. However, sodium can increase blood pressure in some people. Most Americans who have a healthy blood pressure should limit the sodium in their diet to 2,300 mg per day. African Americans, older adults, and people who have high blood pressure should limit the sodium in their diet to 1,500 mg per day. Your doctor may tell you to limit your sodium even more.

To lower your sodium intake, don’t add salt to your food. Check food labels for sodium. Some foods, such as potato chips, obviously have a lot of sodium. But you may not realize how much sodium is in food like bread, canned vegetables, soups, and cheese. Also be aware that some medicines contain sodium.

Do I need to quit drinking alcohol?

In some people, alcohol causes blood pressure to rise quite a bit. In other people, it doesn’t. If you drink alcohol, limit it to no more than 1 drink per day for women or 2 drinks per day for men. One drink is a can of beer, a glass of wine (4-5 oz.), or 1 shot (jigger) of liquor. If your blood pressure increases when you drink alcohol, it’s best to not drink any alcohol.

Does stress affect my blood pressure?

Stress may affect blood pressure. To combat the effects of stress, try relaxation techniques or biofeedback. These things work best when used at least once a day. Ask your family doctor for advice.

Do other health conditions cause high blood pressure?

A little more than half of people who have diabetes have high blood pressure too. Talk to your doctor about other health conditions that could be causing your high blood pressure.

How can I know if changing my lifestyle is helping?

One of the best ways to know if what you are doing is working is to see for yourself. Consider buying a home blood pressure monitor. Use it to see whether what you are doing is lowering your blood pressure numbers. Ask your doctor to recommend a monitor.

Even if doing the things mentioned in this article don’t decrease your blood pressure, they still will promote your overall health and are worth continuing.

Things to consider

Not lowering your blood pressure puts you at higher risk for certain diseases. These can include:

• Stroke
• Heart attack
• Heart failure
• Kidney disease
• Early death

Questions to ask your doctor

• What are the symptoms of high blood pressure?
• What is considered normal blood pressure?
• Can I lower my blood pressure through lifestyle changes alone?
• What are the side effects of blood pressure medicine?
• Could any medications I am taking raise my blood pressure?

Resources

Centers for Disease Control and Prevention: Manage High Blood Pressure

National Institutes of Health, MedlinePlus: Controlling Your High Blood Pressure

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Losing weight is literally a numbers game. Eating fewer calories or exercising to burn off calories typically results in weight loss over time. One pound of body fat is equal to 3,500 calories. If you need to lose 2 pounds of body weight, you need to eat 7,000 fewer calories each week. This means eating an average of 1,000 fewer calories each day.

If you factor in exercise, you may not need to lower your daily calories quite as much to still lose weight. For example, if you cut calories by 700 but you also exercise to burn 250 calories each day, you’ll still lose 2 pounds a week.

While it may seem simple, losing weight is often more complex than adding or subtracting calories. You should always talk to your doctor before making big changes to your diet or exercise routine.

Path to improved health

Create a plan

You and your doctor should work together to decide how many calories your body needs each day. You can get an idea of how many calories you need based on your weight, age, height, and lifestyle. You should also take into consideration any health conditions or physical limitations you may have.

If you need to lose a lot of weight, you will gradually continue to decrease your calories over time. Doctors and weight loss experts generally recommend if you go a few weeks without losing weight, it’s time to recalculate your calorie goal.

Track your progress

While you’re counting calories, it’s important to document everything you eat. Keep a calorie tally so you always know how many calories you have left. There are many free mobile apps that can help you easily track your calories throughout the day. You can input the foods you eat, the amount of water you drink, and any exercise or physical activity. You can also track them with a notebook and pen. Either way will work as long as you’re consistent with your tracking.

Make calories count

Following a low-calorie diet while exercising is one of the most successful ways to lose weight and keep it off. Even if you have a lot of weight to lose, try not to be intimidated. Research shows that losing just 5% of your body weight can have a positive impact on your health.

The best way to stick with a low-calorie diet is to make the most of your calories. Not all calories are created equal. If you don’t make good choices with your limited calories, you’re going to end up hungry and irritable. This is especially true if you’re opting for junk food over real food.

Here are some tips for making the most of your calories:

• Don’t skip the protein. Try to eat some protein at every meal. Protein helps keep you full and helps your body burn calories. Research studies show that protein increases your metabolism (the speed that your body burns calories). It also helps decrease your appetite because you feel fuller. There are many sources of protein. Try to choose lean meats, eggs, cottage cheese, fish, nuts, and legumes (such as beans or edamame).
• Don’t drink your calories. Water is the best thing to drink when trying to lose weight. Staying hydrated will help you burn calories. Try to avoid all sugary drinks such as sodas, fruit juices, sports drinks, and alcohol.
• Dump the junk. Sure, you may give in to a craving every once in a while, but don’t make a habit of it. The calories from junk food are also called empty calories. This is because they don’t do anything to nourish your body. And they don’t keep you full very long, either. It’s best if you can remove or limit them.
• Watch your carbs. Carbohydrates (carbs) have two categories: simple and complex. Complex carbs are generally your healthy carbs. They include vegetables, potatoes, and whole grains. Simple carbs are often called refined carbs. They include white bread, white rice, potato chips, sugars, and processed food (fast food and boxed food). Fruit contains sugar, which is technically a simple carb, but it’s still considered a component of a healthy diet.

Note portion sizes

Food portions are often larger than they should be. This is especially true in restaurants. But you can still eat out while watching calories. Before you begin eating, decide to eat half your meal at the restaurant and take the other half home. Dividing your meal on your plate may help you see when you’ve eaten half. Another option is to order one meal and split it with a friend or family member eating with you. Remember: the more food you eat, the more calories you take in.

Things to consider

It may be tempting to cut calories even lower for faster weight loss. But it’s harder to maintain a severe restriction of calories. Getting too few calories is not good for your body. It needs healthy food to create energy. You could end up malnourished. Plus, research shows that people who restrict calories too much and lose weight too quickly usually end up gaining back the weight they lose.

In general, doctors suggest that women should not restrict themselves to fewer than 1,200 total calories per day. Men should not let their daily calories drop below 1,800.

Questions for your doctor

• Will a low-calorie diet work for me?
• Is a low-calorie diet the best way for me to lose weight?
• What foods should I eat while on a low-calorie diet?
• What foods should I avoid while on a low-calorie diet?
• Should I exercise while on a low-calorie diet?
• Are there any medicines or supplements that would help me stick to a low-calorie diet?

Resources

Centers for Disease Control & Prevention: Cutting Calories

Centers for Disease Control & Prevention: Finding a Balance

National Institutes of Health, MedlinePlus: Diets

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Your body’s cells face threats every day. Viruses and infections attack them. Free radicals also can damage your cells and DNA. Some cells can heal from the damage, while others cannot. Scientists believe molecules called free radicals can contribute to the aging process. They also may play a part in certain health conditions, like cancer, diabetes, and heart disease.

Antioxidants are substances that help stop or limit damage caused by free radicals. Your body uses antioxidants to balance free radicals. This keeps them from causing damage to other cells. Antioxidants can protect and reverse some of the damage. They also boost your immunity.

Path to improved health

Free radicals are natural or man-made elements. They can be:

• Chemicals your body produces by turning food into energy.
• Environmental toxins, like tobacco, alcohol, and pollution.
• Ultraviolet rays from the sun or tanning beds.
• Substances found in processed food.

There are things you can do to help fight free radicals and reduce the damage they cause. You can stop smoking, get sun exposure safely, and eat healthy. Antioxidants may also help. Your body produces some antioxidants. The best way to get additional antioxidants is through certain foods and vitamins. Common antioxidants include:

• Vitamin A
• Vitamin C
• Vitamin E
• Beta-carotene
• Lycopene
• Lutein
• Selenium

You can get most of these antioxidants by eating a healthy diet. This includes a mix of colorful fruits and vegetables. Whole grains, seeds, and nuts also provide good nutrients.

• Vitamin A is in milk, butter, eggs, and liver.
• Vitamin C is in most fruits and vegetables. Fruits such as berries, oranges, kiwis, cantaloupes, and papayas provide essential antioxidants. Vegetables such as broccoli, bell peppers, tomatoes, cauliflower, Brussels sprouts, and kale are also great choices.
• Vitamin E is in some nuts and seeds. For example, almonds, sunflower seeds, hazelnuts, and peanuts contain vitamin E. It can also be found in green leafy vegetables, such as spinach and kale, as well as soybean, sunflower, corn, and canola oils.
• Beta-carotene is in brightly colored fruits and vegetables. Eat fruits such as peaches, apricots, papayas, mangoes, and cantaloupes. Eat vegetables such as carrots, peas, broccoli, squash, and sweet potatoes. It also is in some green leafy vegetables, such as beet greens, spinach, and kale.
• Lycopene is in many pink and red fruits and vegetables. This includes pink grapefruits, watermelon, apricots, and tomatoes.
• Lutein is in green leafy vegetables such as spinach, collard greens, and kale. You also can find it in broccoli, corn, peas, papayas, and oranges.
• Selenium is in pasta, bread, and grains, including corn, wheat, and rice. You can find it in animal products, like beef, fish, turkey, and chicken. You also can find it in many nuts, legumes, eggs, and cheeses.

Each antioxidant has a different chemical makeup. Each one provides different health benefits. Too much of one antioxidant can be harmful. Talk to your doctor before changing your diet or taking supplements.

Things to consider

Doctors recommend eating a balanced diet that include fresh fruits and vegetables. A lot of produce has natural antioxidants. It also contains important minerals, fiber, and other vitamins. Eating healthy can help lower your risk of certain diseases. However, antioxidants alone do not prevent chronic conditions.

Some people choose to take antioxidant supplements. However, many are not balanced. They are also not approved or regulated by the U.S. Food and Drug Administration (FDA). This means that the ingredients and suggested dose listed on the bottle may not be correct.

Your body responds to antioxidants in different ways. Some can cause health risks or negative effects on your health. For instance, people who smoke are in danger of getting lung cancer. Taking high doses of beta-carotene can increase your risk of this disease. Antioxidants also can interact with some medicines.

Talk to your doctor before taking high doses of antioxidants. They can help you determine what, if any, supplements are right for you.

Questions to ask your doctor

• What other antioxidants can I find in food?
• How many antioxidants should I try to consume every day?
• How do I know what types of antioxidants are good for me?
• Should I take antioxidant supplements if I’m a smoker?
• Should I take antioxidant supplements if I already have cancer?

Resources

National Cancer Institute: Antioxidants and Cancer Prevention

National Institutes of Health, MedlinePlus: Antioxidants

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It is up to us to take charge of our health. Focusing on your physical and mental health can prevent a lot of conditions and injuries that can lead to illness and death. Men have some different health care needs than women. Unfortunately, men need to pay more attention to their health, as they are more likely to:

• Smoke
• Drink more alcohol
• Make unhealthy or risky choices
• Delay regular checkups and medical care

The tips below can help men live long and healthy lives.

Path to improved health

Eat a variety of foods to balance your diet. Vegetables and fruits are key to getting the right nutrients. Include lean protein, such as fish and poultry, and high-fiber foods. Limit your intake of sugar, sodium (salt), and saturated fat.

Men should get at least 150 minutes of moderate activity each week. This could be walking, jogging, bicycling, or swimming. Sports, such as basketball and tennis count as well. Men also should do exercises to strengthen their muscles. This can lower their risk of falls and injuries. It is especially important as they age. Regular exercise helps with weight management. It can reduce the risk of cancer and certain health conditions, including heart disease, stroke, and diabetes. Increasing the amount of exercise each week can lead to weight loss.

There are other lifestyle changes men should make to maintain their health:

• Lose weight if you’re overweight.
• Don’t smoke or use tobacco.
• Limit how much alcohol you drink. Men should have no more than 2 drinks a day.
• Protect your skin from the sun.
• Manage your stress.
• Practice safe sex.
• Avoid risky or harmful actions or choices. Extreme sports and stunts increase your chance of injury or death. Wear seatbelts in moving vehicles. Wear helmets when riding bicycles and motorcycles. Always avoid texting while driving.

It is also important to consider mental health. To start, manage your stress levels. If you become anxious or depressed, get help right away. Treatment, in the form of therapy, medicine, and a support system, can improve your condition. If you have suicidal thoughts, call 988, the Suicide and Crisis Lifeline, which is answered around the clock.

Things to consider

Diet and exercise play big roles in your day-to-day health. They can help lower blood pressure and levels of bad cholesterol. However, preventive health care is more than that. It is about listening to your body and knowing how to prevent disease. The goal is to manage your health in a way that avoids health issues or catches them before they start

One way to go about this is to see your primary care doctor at least once a year for a routine checkup. Don’t just visit your doctor when you are ill. Another way is to stay on top of vaccines and screenings. Vaccines keep your immune system strong. Screenings find problems early and can lead to more successful outcomes. Below are some examples of vaccines and screenings for men. Talk to your doctor about other needs based on your health and family history.

• Every 6 to 12 months, get dental and eye exams.
• Every year, get a flu and COVID-19 vaccine.
• Every 1 to 2 years, get your blood pressure checked. Talk to your doctor about how often you should have your cholesterol levels tested. The results can help predict and prevent your risk of heart disease and diabetes.
• As an adult, get the Tdap vaccine. This protects against tetanus, diphtheria, and pertussis (whooping cough). Every 10 years after that, get the Td booster vaccine.
• Starting at age 50, get regular tests for colon cancer. Get it earlier if you have suspicious symptoms or a family history of colon cancer and colon polyps.
• Starting at age 55, men can be offered prostate cancer screenings with a prostate specific antigen (PSA) test based upon discussion of the risks versus benefits between you and your doctor.
• Around age 60, get vaccinated for conditions, such as shingles and pneumonia.

Health insurance plans cover preventive health care. This includes most screenings, vaccines, and visits. If you have a health issue, follow your doctor’s treatment orders. They are designed to relieve or remove symptoms and prevent the issue from getting worse.

Questions to ask your doctor

• What is the purpose of preventive health care?
• How do I know which shots and screenings to get, and when?
• How do I know what preventive services my health insurance pays for?
• Should I take any medicines, vitamins, or supplements to prevent illness or injury?

Resources

National Institutes of Health, MedlinePlus: Health Screening for Men

Office of Disease Prevention and Health Promotion: Men: Take Charge of Your Health

United States Department of Agriculture: MyPlate.gov

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It is common for people to be lacking in nutrients. This can happen if your body doesn’t get enough of one or more nutrients. You may have a nutrient insufficiency or inadequacy. An even lower level of lacking nutrients is called a deficiency.

There are two types of nutrients: macronutrients and micronutrients. Macronutrients include fats, protein, and carbohydrates. Micronutrients include vitamins and minerals. These substances give your body energy and help prevent disease.

According to the U.S. Department of Agriculture (USDA), many Americans don’t get enough potassium, calcium, and vitamin D. Many women who are menstruating or pregnant do not get enough iron and folate. Vegetarians, vegans, and older adults are at higher risk for not getting enough vitamin B12.

To find whether you are at risk for common nutrient shortfalls, download, print, and complete the questionnaire below. Discuss your answers with your family doctor.

Download the Nutrient Shortfall Questionnaire (1-page PDF file; both English and Spanish versions available)

Path to improved health

If your doctor determines you have a nutrient shortfall, they will work with you to improve your health. They also may refer you to a registered dietician.

You can get micronutrients through a variety of healthy foods. These include:

• Fruits
• Vegetables
• Whole grains
• Legumes (dried beans and peas)
• Nuts and seeds
• Low-fat and fat-free dairy products
• Lean meats and fish

Aim to get vitamins and minerals from fresh foods that you prepare yourself. This ensures that your body can absorb them properly. Eating a diet of healthy, fresh foods is better than taking a lot of supplements.

If you have a nutrient deficiency, be sure to eat foods that are good sources of that nutrient. You can find more information from the USDA about foods that are high in potassium, calcium, and vitamin D.

Iron and folate are especially important for menstruating or pregnant women. Good sources of iron are lean meats, poultry, and seafood. You can also get iron from foods such as white beans, lentils, and spinach. Good sources of folate are legumes, oranges, and spinach. If you are pregnant or trying to get pregnant, your doctor may suggest you take a vitamin supplement that contains iron and at least 400 mcg of folate.

Vitamin B12 is mainly found in fish, shellfish, meat, and dairy products. Older adults may have trouble absorbing vitamin B12 from their food. If you are 50 years of age or older, ask your doctor if you should take a vitamin B12 supplement.

Questions to ask your doctor

• Are there certain things that put me more at risk of having a nutrient shortfall?
• What are the symptoms or signs of having a nutrient shortfall?
• How do I know if my body is absorbing nutrients properly or not?
• What nutrients do I have a shortage of?
• Are there diet and/or lifestyle changes I can make to correct my nutrient shortfall?

Resources

American Academy of Family Physicians: Changing Your Diet: Choosing Nutrient-rich Foods

American Academy of Family Physicians: Nutrition: How to Make Healthier Food Choices

Health.gov: Dietary Guidelines for Americans

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Children need a certain number of calories to grow and develop. But if a child takes in more calories than he or she uses, the body stores these extra calories as fat. In children who are otherwise healthy, weight gain most often happens because a child takes in more calories than he or she uses.

Why is it important for my child to learn good eating and exercise habits?

Good nutrition and regular physical activity can help your child achieve and maintain a healthy weight. Teach your child good eating and exercise habits when he or she is young. Those good habits will continue to benefit your child as he or she grows into an adult. According to the USDA’s MyPlate program, staying fit helps prevent the health problems that being overweight or having obesity can cause later in life, including:

• Heart disease
• Diabetes
• High blood pressure
• High cholesterol
• Asthma
• Sleep apnea
• Some types of cancer
• Liver problems and arthritis (with severe obesity)

A child who is overweight or has obesity also may be teased or bullied about their weight. They may feel bad about their body or feel isolated and alone. These feelings can interfere with a child’s ability to learn, make friends, and interact with others.

It is important for parents to role model healthy behavior for their children. Be supportive as your child works to achieve a healthy weight. Use language that describes being healthy and strong. Avoid language that focuses on weight loss, dieting, and achieving a certain size. Most of all, be positive and encouraging.

Path to improved health

By teaching and encouraging healthy eating habits, you are giving your child important tools for a lifetime of healthy living. You can shape your child’s views on healthy eating by setting a good example.

Help your child make healthy food choices 

• Be a good role model. Choose healthy foods and snacks for yourself.
• Have healthy snacks (for example, fruits like apples and bananas, and raw vegetables like carrots and celery) readily available in your home.
• Include plenty of low-fat proteins, vegetables, and whole grains in the meals you make.
• Be persistent in your efforts to introduce healthy food options. Children are not always open to new things right away. If you continue to offer healthy choices, you will improve the chances that your child will develop healthy eating habits.
• Teach your child how to make healthy choices for school lunches.
• Avoid fast-food dining. If you do eat at a fast-food or sit-down restaurant, choose the healthiest options available.
• Forget the “clean plate rule.” Let your child stop eating when he or she feels full.
• Meet nutritional needs primarily from foods and beverages.
• Choose a variety of options from each food group.
• Pay attention to portion size.

How can I encourage my child to be more physically active?

As a parent or primary caregiver, you have a lot of influence on your child. Although you may not realize it, what you do affects the choices they make. If your child sees you being physically active on a regular basis, they will be more likely to be active, too.

Make physical activity part of your family’s normal routine. For example, you might take the dog for a walk together each morning or play basketball before dinner every evening. Find physical activities that you enjoy doing together as a family.

The American Academy of Family Physicians (AAFP) recommends that all children participate in physical activity for at least an average of 30-60 minutes a day. The AAFP encourages parents and schools to make physical activity a priority. Prolonged periods of physical inactivity should be discouraged in both the home and school.

Limit screen time

Limit your child’s screen time to no more than 1 to 2 hours a day. Screen time includes playing video or computer games, surfing the Internet, texting, and watching TV. Set a good example by limiting your own screen time, too.

Things to consider

Watch for any changes in your child’s usual eating or exercise habits. For example, does your child seem to be eating out of boredom, for comfort, or in response to other emotions? This is called emotional eating. Emotional eating can lead to weight gain. It may also be a sign that your child is struggling to deal with feelings like depression or stress.

Pay attention to the warning signs of an eating disorder. These include:

• Being overly concerned about calories
• Having anxiety about body weight
• Not eating at all
• Binge eating
• Exercising excessively

Eating disorders such as anorexia and bulimia are unusual in children, but they can occur. The risk increases as a child grows into a teen and young adult.

If you have any concerns about your child’s behavior, be sure to talk to your family doctor.

Questions for your doctor 

• How much should my child be eating?
• How often should my child be eating?
• What are the correct portion sizes for my child?
• How often should my child exercise?
• My child is a picky eater. How can I get him or her to eat more?
• My teen says he or she is always hungry. Can that be true?

Resources

The U.S. Department of Agriculture: MyPlate

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Energy drinks were first sold in the United States in the 1990s. Now, there are hundreds of options. Related products have been made, like energy shots, chews, and snacks.

Energy product companies target kids and teens under the age of 18. College students also use a high amount of energy drinks. A lot of companies are known to give products to kids for free. Some drinks even taste like candy so kids like the taste. This makes them more common and attractive. However, energy drinks can cause harmful health issues.

What are energy drinks?

Energy drinks differ from soft drinks and sports drinks. Soft drinks have a lower amount of caffeine. Sports drinks can have vitamins, carbs, and sugar. You should drink them after an intense workout to restore the fluid balance in your body.

Most energy drinks list caffeine and vitamins as the main ingredients. This makes them sound healthy and attractive, but that is false. Energy drinks claim to increase focus and improve performance. They contain a lot of added stimulants, such as:

• An herb used to prevent tiredness and improve mental speed. It also is used to promote weight loss and increase sexual desire. Guarana also contains caffeine. That makes the total amount of caffeine in the energy drink even higher.
• A supplement used to improve memory and endurance.
• An herb used to help reduce stress, strengthen muscles, and improve endurance.
• Synephrine (bitter orange). An herb used to promote weight loss.
• L-carnitine l-tartrate (LCLT). A supplement used to increase energy, memory, and speed. It also is used to break down fat.
• Yerba mate. An herb used to prevent tiredness and improve mood.
• An herb used to increase focus and prevent tiredness.
• John’s Wort. An herb used to reduce stress and improve mood.

These aren’t always harmful by themselves. When combined with caffeine, they can cause health issues.

Why it’s important

A big problem with energy drinks is there is little control from the U.S. Food and Drug Administration (FDA). This means that a lot of the ingredients haven’t been fully tested. Also, there are no laws on the product labels. So drinks may not list the correct amount of caffeine.

Soft drinks have about 30 milligrams (mg) of caffeine per serving. Coffee has about 100 mg of caffeine per cup. Energy drinks can have anywhere from 100 to 400 mg of caffeine per serving.

Energy drink companies don’t help. Their advertising can be forceful and dishonest. Some ads promise that energy drinks make you popular. For instance, Red Bull says their drink “gives you wings.” Rockstar invites users to “party like a rockstar.” Amp suggests that it is “energy you need, flavors you crave.” These claims make energy drinks seem safe and stylish.

Doctors worry about the dangers of energy drinks. Side effects differ based on the person, type, and amount used. Reactions to energy drinks include:

• Headaches, stomachaches, or diarrhea
• Chest pain
• Anxious or nervous feelings
• Dizziness or lack of focus
• Inability to fall asleep
• Weight gain or diabetes due to the sugar and calories of energy drinks
• Dental issues

Severe health issues also can occur from using energy drinks, such as:

• Addiction and withdrawal
• High blood pressure
• Seizures
• Heart problems. Many people report rapid heartbeat. Major use has been linked to uneven heartbeat or heart failure. Rare cases have been linked to death.

Children tend to be more sensitive to caffeine. It can be harmful to their growth. People who have heart conditions or asthma also are at greater risk.

Path to improved health

The American Academy of Family Physicians (AAFP) states that the FDA should set guidelines. Labels should be standard and truthful. Products should be tested and controlled. AAFP also is against marketing and selling energy products to kids under 18 years old.

Until this happens, there are precautions we can take. You should be aware of these risks and talk to your kids about them. Promote a healthy diet with regular sleep and exercise. People who do this should have enough natural energy. Having one energy drink now and then might be OK. But drinking them all the time could affect your health.

Schools also can help fight the use of energy drinks. The Centers for Disease Control and Prevention (CDC) states that schools should offer healthy drinks only. Energy drinks should not be an option. The National Federation of State High School Associations (NFHS) also states that student athletes should not use energy drinks. They can make kids sick and unable to perform. Some ingredients in energy drinks can show up on drug tests.

Things to consider

There is another dangerous trend with energy drinks. It has become common to mix them with alcohol. Mixing them can make you feel less drunk than you are. It also affects your ability to make good choices. The same is true if you mix energy drinks with illegal drugs or certain medicines.

Talk to your doctor if you or your child has any health issues from consuming energy drinks. They will need to stop using them. They also may need treatment for their symptoms.

Questions to ask your doctor

• How much caffeine can I safely have every day?
• How many energy drinks is too many?
• How do I know if my health issues are caused because I drink energy drinks?

Resources

American Academy of Family Physicians, American Family Physician: The Potential Adverse Health Effects of Energy Drinks

Centers for Disease Control and Prevention, CDC Healthy Schools: Energy Drinks

National Institutes of Health, MedlinePlus: Caffeine

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Vegans avoid eating all animal products, including meat, eggs, and dairy. They also don’t eat food that has an animal source, like gelatin and honey. For many, veganism is about more than food choices. People choose to be vegan for health, ethical, and/or environmental reasons. Strict vegans do not use any products made from animals. This includes materials, such as leather, fur, silk, or wool. They also avoid using certain soaps and cosmetics.

Path to improved health

A well-planned vegan diet can offer you the fulfillment of following your beliefs and may give you the enjoyment of living a longer, healthier life. The vegan diet may provide health benefits, including: 

• Lower cholesterol levels
• Lower blood pressure
• Lower intake of saturated fats
• More vital nutrition
• Decreased risk of type 2 diabetes, heart disease, and certain cancers
• Healthier body weights

The vegan lifestyle requires careful attention. It can be hard to get enough of the vitamins and minerals found in animal products. You have to eat a balance of foods to avoid health risks. Focus on including the nutrients below in your diet.

• Iron plays a key role in the production of red blood cells. These cells help carry oxygen throughout your body. Good sources of iron include beans, broccoli, raisins, wheat, and tofu. Iron-fortified cereals also are a good source. Iron found in non-meat sources is harder to digest. You should eat foods rich in vitamin C, such as oranges and broccoli. They help your body absorb iron.
• Protein is an important component for almost every part of your body. Your skin, bones, muscles and organs need protein to be healthy. Amino acids are the building blocks of protein. Without meat and dairy, you still need to consume essential amino acids. Vegans can get protein from nuts, peanut butter, seeds, grains, and legumes. Non-animal products like tofu and soymilk also provide protein. Vegans have to consider getting enough “complete proteins.” A complete protein contains all the amino acids your body needs to help maintain your metabolism.
• Calcium builds strong bones and helps prevent osteoporosis. This is a disease that weakens your bones and can cause breaks. Soybeans and dark leafy greens, like broccoli, bok choy, and kale, contain calcium. You also can drink fortified soymilk and juices. Calcium supplements also are available.
• Vitamin D also plays an important role in bone health. It helps your body absorb calcium and promote bone growth. Your body produces some vitamin D in response to sunlight. You should get 10 minutes of sun exposure 3 to 4 times a week, if possible. Based on where you live, this should be all the vitamin D you need. Make sure you always use safe practices in the sun. If you need more vitamin D, look for fortified products. This includes soymilk, rice milk, and some cereals.
• Vitamin B12 helps produce red blood cells and prevent anemia. Vitamin B12 is mainly found in fish, shellfish, meat, and dairy products. Try to eat products fortified with this vitamin. This includes soymilk and some cereals. Talk to your doctor about taking a B12 supplement. Check the label to make sure it doesn’t contain animal products.
• Zinc is vital to your immune system. You can find it in beans, nuts, and soy products.
• Omega-3 fatty acids improve your heart health and brain function. Flaxseed meal and oil are two sources. You also can look for food products fortified with omega-3 from a plant source. Talk to your doctor about taking an omega-3 supplement. Check the label to make sure it doesn’t come from fish oil.

Vegans need to pay close attention to labels. This applies to food and supplements. Be aware of the following “small print” ingredients:

• Carmine/cochineal is a common food coloring. It comes from crushed beetles.
• Shellac is a glaze that comes from beetles. It is often found on shiny hard candies and sprinkles.
• Casein is a milk product sometimes found in protein shakes.
• Whey is a dairy product. It appears as an additive in a wide variety of foods.

Things to consider

As a vegan, you can have a lifetime of good health. However, this requires making balanced choices. Try not to indulge in junk foods. You should eat high quality foods with nutrients your body needs. Keep an eye out for signs of nutritional problems. This includes changes in your weight, skin, or hair.

If you have questions or concerns, talk to your family doctor. If you have special health needs, such as diabetes, consult your doctor before starting a new diet. They can help you make the best nutritional choices for your health.

Questions to ask your doctor

• What are the side effects of switching to a vegan diet?
• Can a vegan diet help manage certain diseases and conditions?
• Can I follow the vegan diet if I am pregnant or breastfeeding?
• Are there any medicines that might have animal products in them?

Resources

The Vegetarian Resource Group: Veganism in a Nutshell

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Micronutrients are the vitamins and minerals found in food. They nourish your body and are essential to your overall health. Choosing foods each day that are rich in vitamins and minerals is the best way to give your body what it needs to be healthy. This is because it is easier for your body to absorb micronutrients through food than a multivitamin alone.

Every 5 years, the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) publish The Dietary Guidelines for Americans. These Guidelines are based on scientific evidence and provide recommendations to make healthy eating choices. The current Guidelines (2020-2025) include 4 main themes:

• Follow a healthy dietary pattern at each life stage (infancy through adulthood).
• Choose nutrient-dense foods and beverages based on preference, culture, and budget.
• Balance the food groups and maintain healthy calorie limits.
• Limit intake of sodium, saturated fat, added sugars, and alcohol.

According to the USDA, most Americans do not meet these guidelines. An average American’s diet scores 59 out of 100 on the Healthy Eating Index (HEI). A person’s individual eating choices are critical to creating healthy eating habits over time.

Path to improved health

The purpose of The Dietary Guidelines for Americans is to improve your overall health. This can decrease your chance of having a diet-related chronic condition and increase your length of life. Keep in mind, it is never too late or too early to eat healthy.

The Guidelines include 3 key dietary principles to help improve Americans’ eating choices and patterns.

• Consuming healthy foods and beverages is the best way to meet your body’s nutritional needs.
• Selecting a variety of foods and beverages from each food group is necessary to create a balanced diet.
• Following recommended portion sizes helps to maintain calorie intake.

Research consistently finds that most Americans don’t get enough vitamins and minerals in their diets. In fact, more than 50% of adults have one or more diet-related chronic conditions, such as obesity, type 2 diabetes, cardiovascular disease, or cancer. In particular, Americans do not get enough of the following nutrients:

• Calcium
• Potassium
• Fiber
• Vitamin D
• Iron

Below are examples of foods and beverages that are high in certain micronutrients. Keep in mind that not all examples are appropriate for each life stage. Talk to your doctor or refer to the Guidelines for more recommendations and specific information on portion sizes. 

Calcium

Your body needs calcium to build strong bones and teeth in childhood and adolescence. As an adult, you need additional calcium to maintain bone mass. Calcium can also affect muscle movement, blood flow, and the release of hormones. According to the USDA, the average American adult (ages 19-50) eating roughly 2,000 calories per day should get 1,000 milligrams (mg) of calcium each day.

The following foods and beverages are good sources of calcium:

• Nonfat or low-fat plain yogurt (4 to 8 oz)
• Nonfat or low-fat cheese (3/4 to 1 1/2 oz)
• Low-fat milk (1%), fat-free milk, or unsweetened soy, almond, or rice milk (1/2 to 1 cup)
• Fish and seafood, such as salmon or sardines (1 to 3 oz)
• Tofu (1/4 to 1/2 cup)
• Cooked spinach or kale (1/2 to 1 cup)

Who might not get enough?

• Adolescents ages 4 to 18 years
• Adults older than 50 years
• Adults who have gone through menopause
• People who are Black or Asian
• People who are lactose intolerant
• People who follow a vegetarian or vegan diet

Quick Tip: Almonds contain calcium and are the perfect snack. Pack a handful to take to work or school for a healthy boost.

Potassium

A diet rich in potassium helps your body maintain a healthy blood pressure. It is also required for normal cell function, kidney function, nerve transmission, and muscle contraction. The USDA recommends that the average American adult should consume 280 mg of potassium each day.

The following foods and beverages are good sources of potassium:

• Nonfat or low-fat plain or Greek yogurt (4 to 8 oz)
• Low-fat milk (1%), fat-free milk, or unsweetened soy milk (1/2 to 1 cup)
• Coconut water (1/2 to 1 cup)
• Cooked potato or sweet potato (1/2 to 1 cup)
• Cooked butternut squash (1/2 to 1 cup)
• Cooked spinach or broccoli rabe (1/2 to 1 cup)
• Cooked portabella mushrooms (1/2 to 1 cup)
• Raw carrots (1/2 to 1 cup)
• Avocado (1/4 to 1/2 cup)
• Cooked beans, such as white, kidney, or pinto (1/4 to 1/2 cup)
• 100% vegetable or tomato juice (1/2 to 1 cup)
• 100% orange or pineapple juice (1/2 to 1 cup)
• Banana or grapefruit (1 piece)
• Kiwi, melon, or cherries (1/2 to 1 cup)
• Dried peaches, prunes, apricots, or raisins (1/4 cup)
• Fish and seafood, such as salmon, tilapia, or catfish (1 to 3 oz)
• Meat, such as pork, beef, or lamb (1 to 3 oz)
• Tofu (1/4 to 1/2 cup)
• Pistachios (1/2 to 1 oz)

Who might not get enough?

• People who have inflammatory bowel disorder (IBD), Crohn’s disease, or ulcerative colitis
• People who use certain medicines, such as diuretics or laxatives

Quick Tip: Cut up a banana and mix it with a cup of low-fat or nonfat yogurt to make a healthy snack or light lunch.

Dietary Fiber

Fiber is a necessary nutrient to keep your digestion system working correctly. It also helps your body regulate blood sugar, control hunger, and maintain a healthy weight. Getting enough fiber in your diet can help prevent diabetes and lower blood pressure and cholesterol. On average, an American adult should consume 28 grams (g) of dietary fiber each day based on a 2,000-calorie diet.

The following foods and beverages are good sources of fiber:

• Whole grain, wheat, oat, or bran cereal (1/2 to 1 cup)
• Popcorn (1 1/2 to 3 cups)
• Cooked bulgur or barley (1/4 to 1/2 cup)
• Whole wheat crackers or tortilla (1/2 to 1 oz)
• Cooked beans, such as white, black, or garbanzo (1/4 to 1/2 cup)
• Cooked peas, artichoke, or Brussels sprouts (1/2 to 1 cup)
• Cooked broccoli, cauliflower, or carrots (1/2 to 1 cup)
• Cooked spinach, kale, cabbage, or collard greens (1/2 to 1 cup)
• Cooked beets or mushrooms (1/2 to 1 cup)
• Pear, apple, orange, or grapefruit (1 piece)
• Raspberries, strawberries, blueberries, or blackberries (1/2 to 1 cup)
• Dried figs, prunes, or dates (1/4 cup)
• Almonds, hazelnuts, pistachios, or pine nuts (1/2 to 1 oz)
• Pumpkin or sunflower seeds (1/2 to 1 oz)
• Chia or flax seeds (1/2 to 1 tablespoon, Tbsp)

Quick tip: Add berries and chia seeds to your morning cereal to boost your fiber intake.

Vitamin D

Your body needs vitamin D so that it can absorb calcium to promote bone growth, maintain strong bones, and prevent osteoporosis. Vitamin D also helps your muscles move and your immune system to fight off bacteria and viruses. The average American adult needs 600 International Units (IU) of vitamin D each day. It can be difficult to get enough vitamin D through diet alone because there are not a lot of food choices rich in vitamin D. In fact, some primary food sources of vitamin D come from foods that have added vitamin D, called fortified foods.

The following foods and beverages are good sources of vitamin D:

• Nonfat or low-fat plain yogurt (4 to 8 oz)
• Nonfat or low-fat cheese (3/4 to 1 1/2 oz)
• Low-fat milk (1%), fat-free milk, or unsweetened soy, almond, or rice milk (1/2 to 1 cup)
• Nonfat kefir (1/2 to 1 cup)
• 100% orange juice (1/2 to 1 cup)
• Fish and seafood, such as salmon, canned tuna, tilapia, or freshwater rainbow trout (1 to 3 oz)
• Raw mushrooms (1/2 to 1 cup)

Who might not get enough?

• Infants who are breastfed
• Adults older than 70 years
• People who don’t get sun exposure (especially those living in the northern parts of the U.S.)
• People who have dark skin
• People who are obese
• People who have health conditions that limit fat absorption, such as Crohn’s disease, celiac disease, or ulcerative colitis

Quick tip: Most milks in the United States are fortified with vitamin D. Start or end your day with a serving of low-fat, fat-free, or unsweetened milk.

Iron

Iron is a mineral that your body needs to support proper growth and development. Your body uses iron to produce hemoglobin, myoglobin, and some hormones. The average daily recommended amount of iron for an adult American (ages 19-50) is 13 mg.

The following foods and beverages are good sources of iron:

• Cooked beans, such as lima, soy, garbanzo or white (1/4 to 1/2 cup)
• Cooked potato with skin or sweet potato (1/2 to 1 cup)
• Cooked spinach, collard greens, or Swiss chard (1/2 to 1 cup)
• Cooked beets, leeks, or acorn squash (1/2 to 1 cup)
• Cooked mushrooms (1/2 to 1 cup)
• 100% prune juice (1/2 to 1 cup)
• Cashews (1/2 to 1 oz)
• Seafood, such as shrimp, clams, mussels, oysters, or clams (1 to 3 oz)
• Meat, such as beef, duck, lamb, or turkey (1 to 3 oz)
• Organ or game meats (1 to 3 oz)

Who might not get enough?

• Infants ages 7 to 12 months
• Adolescents and adults who have menstrual cycles
• People who are pregnant or breastfeeding
• People who have a low immune system
• People who follow a vegetarian or vegan diet

Quick tip: Enjoy a baked potato with black beans or mushrooms for a tasty lunch and healthy dose or iron.

Things to consider

Not getting the vitamins and minerals your body needs can have serious consequences for your health. An overall lack of nutrients can lead to malnutrition. Some deficiencies can even be life-threatening.

Additionally, getting too much of certain vitamins or minerals in your system can also be dangerous. For example, high levels of vitamin A during pregnancy can cause problems with fetal development. For this reason, it is very important to talk your doctor before you start taking any supplements. This is especially important if you are pregnant or have existing health conditions.

When to see a doctor

A lack of one or more vitamins or minerals can be hard to diagnose. Some nutrient deficiencies do not have symptoms, while others have symptoms that vary. General symptoms include:

• Loss of hair
• Weakness or fatigue
• Depression or anxiety
• Increased irritability
• Worsening vision or dry eyes
• Tingling or numbness in your hands and feet
• Bleeding gums
• Cracks in the corners of your mouth
• Acne-like bumps on your cheeks, upper arms, thighs, or buttocks

Your doctor may perform blood tests to check the levels of certain vitamins or minerals. If you are unable to get all the nutrients you need from food alone, your doctor can help you decided if dietary supplements are needed.

Questions to ask your doctor

• How do I know if I’m getting enough vitamins and minerals?
• What can I do to increase the amount of vitamins and minerals I get through food?
• Should I be taking a multivitamin or other dietary supplement?
• Should my child be taking a multivitamin or other dietary supplement?
• Does it matter where I buy my vitamins?
• Is one brand of vitamins better than another?
• Do vitamins have any negative side effects?
• Depending on where I live, could I get enough vitamin D from sun exposure?

Resources

National Institutes of Health (NIH): Dietary Supplement Fact Sheets

U.S. Departments of Agriculture and Health and Human Services: The Dietary Guidelines for Americans, 2020-2025

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