18-21 years guidance

Introduction

You are now an adult, though you may not feel like one yet! Whether you are in school, working, or figuring out your next steps in life, there are things you can do to work towards a healthy and successful future. If you are interested, you can see several helpful articles here, and you can look through the rest of the page below for advice.

Sleep

As stated here, healthy adults should generally get at least 7 hours of sleep each day. Getting enough good-quality sleep is helpful for your mood, health, and ability to think and function, so there are several reasons to prioritize getting good sleep. If you do want to prioritize your sleep but are having issues, read through this article and this article for several tips, and look through sleepfoundation.org for additional advice. If you are still having trouble and are not sure what to do, discuss this with your doctor.

Nutrition

Good nutrition is key to maintain a healthy body weight and to improve your overall health. I will present general nutrition guidelines below, as well as tips for obtaining and maintaining a healthy body weight.

Liquid recommendations

It is completely fine to drink water and nothing else. If you do want to drink other liquids, click on the button to learn more:

Milk: It is recommended to have 3 total servings of dairy a day, where 8 ounces of milk is 1 serving. Thus, you can drink milk as part of your 3 servings of dairy. Low-fat milk is generally preferred. If you do not want to consume this much dairy then try to get vitamin D and calcium elsehwere in your diet. A good alternative to regular milk is fortified soy milk.
Juice: It is recommended to have no more than 8 ounces of 100% fruit juice per day. Other types of juice are generally not considered part of a healthy diet. If you do drink more juice be careful to brush your teeth well as sugary drinks make cavities more likely. You should avoid juice if you are trying to lose weight.
Soda/pop: This is not part of a healthy diet; you can have this occasionally but try not to make it a regular thing.
Alcoholic beverages: These are illegal under the age of 21 in the USA and generally are not considered part of a healthy diet. That said, if you are going to drink, be responsible.
Coffee/tea: These are ok to consume but be careful of lots of extra calories from cream or sugar if your weight is a concern. It is generally recommended to keep your caffeine intake to <400 milligrams per day, so keep this in mind as well.
Artificially sweetened beverages: These generally have 0 calories and can be helpful for weight management purposes though it is not clear if there are safety concerns with drinking lots of these long-term. It would likely be safest to stick to water and drink these occasionally.

Food recommendations

Generally all food groups are recommended to some degree. The food groups include fruits, vegetables, grains, protein-foods, dairy, and oils. Click on the cards below to learn more about all of these, how to consume them in healthier or less healthy ways, and how much you should consume per day.

Fruits

Vegetables

Grains

Protein foods

Dairy

Oils

Adjusting eating based on your weight

Besides following general healthy eating guidelines regarding what you eat, you may want to adjust how much you eat and your eating choices based on your weight. Click on any of the 3 buttons below if you want to learn more.

If you are losing weight and you do not know why, check with your doctor to make sure there is no underlying health condition that is causing this (such as diabetes).
If you are not eating much then try to prioritize the healthier and more nutritious food options when you do eat. Since you are not eating much food it is more important to try to get the healthy nutrients in when you can.
The key to gaining more weight is to consume more calories, so you need to find a way to make this happen.
You can attempt to add more calories to what you eat and drink by adding peanut butter, olive oil, or cheese to what you already eat. Read through this blog post for several other examples of how to add or modify foods to include more calories.
You can consider making "weight gaining" shakes to drink. For example, mix whole milk, oatmeal, peanut butter, and a banana together, put it in a blender, and see what this tastes like. Find a recipe you like and use this to consume more calories by drinking this in addition to what you are already eating.
You can try to eat smaller meals more frequently to get your body used to processing food more regularly. Then you can slowly increase the amount of food at each of these meals or snacks to build up your ability to take in more calories throughout the day.

If you are happy with your body weight then you should continue eating mostly the more nutritious food options discussed above while letting your natural hunger and fullness cues guide how much you eat.
You can periodically check your body weight (for example, every 2-4 weeks) to make sure you stay in a range you are happy with. Then if you notice you are gaining or losing weight undesirably you can make adjustments to account for this before it becomes a bigger issue.

If you want to lose weight you will need to eat fewer calories. While in theory you can exercise a lot to burn more calories, in practice this is not very effective for losing significant amounts of weight. The main exercise you will want to do is resistance training so you can maintain your muscle while losing fat. Losing the fat itself primarily comes down to eating fewer calories.
When you eat less food you will naturally get more hungry, so it is important to optimize your nutrition to minimize your hunger levels. Several tips for food choices include:
- Foods with protein and fiber are often more effective at decreasing hunger, so try to eat protein-rich foods with some source of fiber (such as fruits, vegetables, or whole grains) at each meal or snack.
- Minimally processed foods that require more chewing, such as fruits, vegetables, whole grain options, and lean meats, often decrease hunger more than more highly processed foods (baked goods, hot dogs, chips, and other junk and snack food items). Try to prioritize the minimally processed foods; these will usually have fewer ingredients on the nutrition label.
- Hunger can be triggered by the sight or smell of foods, or simply knowing that treats or other desirable food is available. Optimize your "food environment" by removing the tempting junk food, snack food, and other treats from your home so you are not as triggered to consume it.
There are a few other eating strategies that can help you eat fewer calories:
- Only eat when you are hungry, and eat to the point of not feeling hungry, not to the point of feeling full. On a scale of 1-10, if 1 is completely starving and 10 is completely full, aim to stop eating when you are at a 6-7.
- Eat more slowly or take 20 minute breaks between first and second servings. If you eat too much food too quickly you will not give yourself a chance to feel full until you have had more food than you need. For a few meals purposefully eat smaller amounts of food for a first serving and see how you feel after 20 minutes. If you feel satisified then you will know you can be fine with smaller portions.
- Eat for your hunger levels, not your appetite. Hunger is your need for food, like when you are starving and will eat anything. Appetite is your desire for food with certain qualities, such as when you are full after dinner (meaning you are not hungry) but you still have room for dessert (meaning your appetite has a craving for the dessert). In general do not indulge your appetite, or if you do make sure it is with small amounts of food (ie, one bite-sized cookie instead of one large cookie).
If the above advice fails, consider counting calories:
- Sign up for an app such as myfitnesspal and start using it to track how many calories you eat each day.
- Purchase a kitchen scale to weigh out your foods, as this is more accurate than measuring by volume (for example, weighing out 90 grams of something is more accurate than measuring out 1/2 cup).
- Consider using the NIH Body Weight Planner to get some idea of how many calories you need to eat to lose weight at a desired rate.
- Weigh yourself regularly to track your progress.
- After 2-3 weeks if you are not losing weight successfully, then decrease your calorie goal by a few hundred calories and continue tracking for another few weeks.
- Initially try to track everything until you start making good progress. Once you are happy with your rate of progress, you can back off on the tracking if you would like. You can always start tracking more rigorously in the future if you stop progressing as quickly as you would like.
Ask your doctor for help with weight loss if this advice is not helpful enough.

If at any point in time you are concerned that you are developing unhealthy eating habits, where you are excluding certain food groups, binge eating, restricting your food intake too much, or anything else, please discuss this with your doctor.

Exercise

Adults should generally perform at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity, or a combination of the two, each week. They should also perform muscle-strengthening physical activity for all the major muscle groups at least twice per week. Click on the cards below to learn more about these.

Aerobic

Muscle

Safety

There are several safety concerns for young adults. You can read through several tips here, here, and here. Some key points include:

Have a list of emergency numbers (poison control, fire department, police department, whatever else is relevant) and keep this in your phone.
Always be safe in a car. This means wear a seat belt, never text while driving, do not let other people distract you, and do not get in the car with someone else driving if they seem unsafe (typically from alcohol intake or other drug use).
While you should generally stay away from drugs for health and legal reasons, you should especially never take medicines, drugs, or other substances if you are not completely sure what they are. For example, many recreational drugs are laced with other compounds such as fentanyl, making them very dangerous.
If you feel that you are having trouble with your mental health (such as depression, anxiety, thoughts of suicide, or anything else), get professional help. Colleges should have resources for you in this situation and if you are not in college you can talk to your doctor to get linked with appropriate resources.
If you are sexually active or intend to become sexually active, practice safe sex. If birth control is a consideration discuss this with your doctor. If you do not have a doctor, consider going to a Planned Parenthood or using the over the counter pill. Make sure you have condoms and use them appropriately to help prevent pregnancy and to protect yourself from acquiring sexually transmitted infections.

Vaccines

If you are caught up on all your vaccines then you may still be eligible to receive the Meningococcal B vaccine. You can discuss this with your doctor. You may also receive a flu vaccine (if it is the flu season) and a COVID-19 vaccine.

If, however, you are not caught up on your vaccines, now that you are an adult you can choose to get caught up without needing parental consent. All the standard vaccines have been given to millions of people and we know that they are safe and effective. If you would like more information, look through the "Helpful Websites" listed below, and discuss this with your doctor.

Helpful websites

Vaccine Education Center Healthy Children

CDC Kids Health

Conclusion

Hopefully this page gave you some useful advice for living a healthy life. Continue to go to yearly check-ups and look to switch to an adult doctor who can care for you moving forward.