The book outlines an eating and activity plan specifically for adolescent girls–a group that is vulnerable to becoming overweight, being concerned about weight, and developing poor body image, she said.

Part of the problem, said Cheung, is that young girls–and their parents–look for quick-fix fad diets to get slim in response to societal pressures to be thin and to the stigma of obesity. "People ask me what the best diet is for teens," she said. "I answer that we need to instill good habits. We need to be good role models. Our children should enjoy their food and have fun participating in routine physical activity. They need to understand that eating nutritious food, being fit, and maintaining a healthy weight is about balance. It’s not about a diet. It’s about a way of life."

To that end, Cheung has developed what she calls The Cactus Plan, an illustration designed to teach adolescent girls healthy lifestyle habits. Cheung said what she describes as the scientifically outdated USDA food pyramid is not adequate for teens. Relying on current research, The Cactus Plan incorporates many of the recommendations from HSPH Department of Nutrition Chair Walter Willett’s science-based "Healthier Food Guide Pyramid."

Developing the cactus imagery allowed Cheung to be flexible and imaginative in presenting practical information. Branches of the cactus, for example, illustrate the idea that routine physical activity and a nutritious eating plan are equal partners in promoting and maintaining a girl’s health.

The cactus graphic also offered the opportunity to use a broader image setting in which to highlight health messages. For example, use of the moon in the background reminds girls to get enough sleep. A sun informs them to get enough vitamin D from moderate sun exposure (about 15 minutes each day), without going to the extreme of overexposure. A rainbow encourages them to express their feelings. Smaller needle-covered cactus sections–the "pricklies"–represent foods and habits to avoid or limit (For example, limiting television viewing and screen time to less than two hours a day).

Cheung emphasizes in the book the importance of having a good body image–a difficult message to convey against an unrelenting tide of television shows, movies, magazines, and music videos that glorify thinness. "Having the goal of achieving the body type pushed by the media and the fashion and fitness industries can really get in the way of your healthy development," Cheung and Jukes write. "Don’t sacrifice your health and energy to perform well for the sake of fulfilling somebody else’s shallow definition of beauty."

They encourage girls to consider the motivation of the companies that market images to them. "While watching commercials or checking out magazine ads, it’s important to identify just whose interests are being served," they write.

They not only encourage girls to think for themselves–but also to act to help change the environment around them, instructing girls on how to advocate effectively at school for more nutritious food choices and a wider variety of safe, supervised, fun physical activities.

Cheung hopes that by targeting the current teen-girl population, healthier messages about nutrition and fitness will be passed to future generations. Today’s girls are tomorrow’s parents–and they will likely play large roles in the eating and lifestyle habits of their families.

"My hope is that these girls will grow up with a lifestyle plan that helps them attain optimal health," said Cheung, "and then they will be able to apply the plan to everyone around them."

--CH