Doctors’ Notes


A Healthy Food Attitude

In a nation where children and adolescents spend upward of 7.5 hours per day in front of a screen (Kaiser Family Foundation), and with statistics indicating that 32% of American children aged 2 – 19 are considered overweight or obese (Centers for Disease Control and Prevention), these initiatives are incredibly important. An emphasis on feeding children well can reduce or eliminate the chance of troubling health consequences such as high cholesterol and high blood pressure, type 2 diabetes, and sleep apnea, as well as psychosocial consequences such as social discrimination and low self-esteem.

Less prevalent but equally concerning are eating disorders, such as anorexia nervosa, and disordered eating behaviors such as binge eating and calorie restriction, particularly among adolescent girls. We live in a culture where the thin body type portrayed as “ideal” in mass media and advertising is naturally maintained by only 5% of American females. This increased cultural pressure to be thin may arguably be a factor in influencing 80% of 13 year-old girls to “diet” to lose weight, and in shaping unhealthy attitudes about food and weight in general.

This is not encouraging.

family mealtime

With so many challenges — increased opportunities for eating, decreased opportunities for physical activity, conflicting and confusing messages about food, nutrition and eating (just to name a few) — is it possible for our children to develop positive approaches to a healthy lifestyle? The answer is YES.

As parents and adults, WE are in a unique position to positively shape our children’s attitudes about food, eating, weight and health. So this next part will be more reassuring. 


In her book, Your Child’s Weight: Helping Without Harming, therapist and nutritionist Ellyn Satter explains how important it is to make eating and feeding experiences positive and rewarding for children. While she acknowledges that what children eat is important for nutritional health, she further explains that how they are fed is more important than whatthey are fed, to allow for appropriate growth and to develop a healthy relationship with food.

She defines a “Division of Responsibility in Feeding” in which, for toddlers through adolescents, parents and caregivers are responsible for whatwhen, and where  their children eat, and children are responsible for how much and whether they eat. Here’s the quick and dirty translation…


  • Choose healthy foods and prepare them in healthful ways
  • Provide regularly timed meals and snacks (i.e., breakfast, lunch, snack, dinner)
  • Do not allow grazing between meals and snack times
  • Encourage a pleasant atmosphere for eating.

As adults, we provide the opportunities, structure, and support for eating, then hand over the reigns to our children to choose how much and whether to eat from what we provide. After all, who doesn’t like having control? An approach like this this offers the first steps to help children build a healthy relationship with food. 


In addition to working with children and families with food, eating and weight-related challenges, I have two young children of my own. People often ask me what I do to encourage their healthy habits and eating behaviors. My typical responses are, “It’s not as sophisticated as you might think,” and “We’re not perfect.”

We enjoy baking cookies and eating dessert. We also enjoy going out for ice cream and partaking in not-so-healthful choices at the ballpark. And then there’s the Belgian-style café down the street from our house, well known for their famously delicious frites.  Yes – we like those too.  Somehow, referring to them as “frites” makes them seem like healthier than “double-fried fries.” Not so. Nonetheless, we enjoy all of these foods on occasion, while making healthy choices most of the time and enjoying regular activity.

Consider these suggestions for daily practices in your home that can encourage healthy eating behaviors and a healthy attitude about food:

Eat meals as a family, or at least with one adult. 

True — it’s not easy given busy work, school and activity schedules. It’s also a great way to wind down the day, and companionship at mealtimes helps all of us enjoy the social aspects of eating.

Turn off the television during mealtimes, and remove other distractions. 

It’s easier to enjoy meal times for eating and conversation when distractions are removed. With the focus on food, we are also better able to tune in to feelings of fullness.

Give up the food “fight”

Pressuring children to eat foods (i.e., vegetables), or telling them why they should or need to eat them, only increases their resistance. Instead, offer these foods along with other more preferred foods, and forget about bribing with dessert. It only makes dessert seem that much better, and vegetables that much worse.

Include children in growing, shopping, and preparation of foods.  

This is fun for children.  And it helps them develop an appreciation for food and where it comes from.  They are also more likely to eat foods (namely, fruits and vegetables) they pick from the store (or garden) or help prepare.

Maintain structure for meal and snack times. 

This discourages grazing, and provides meal and snack time predictability.

Don’t use food as rewards. 

Instead, offer praise and kind words for a job well done.

Help children recognize hunger and fullness cues. 

Sometimes kids eat a lot, and sometimes, very little. Asking questions like, “Is your stomach telling you your full?” can help them develop an awareness of fullness and prevent overeating.

Refer to less healthful foods as “sometimes foods,” rather than “bad foods”

Talk about putting a damper on eating something delicious. It’s hard to enjoy something when it’s “bad.”

Don’t get me wrong: I would love to tell my kids to never consume fast food, soda, sugary snack foods, or anything containing red food dye. I also know that may make them want all of those items even more. So, what kind of message can positively shape our children’s attitudes about food, eating, weight and health?

Enjoy ALL foods. Some foods nourish our bodies, and make us feel strong and energetic — enjoy these foods most of the time. Other foods don’t offer these same benefits –- just enjoy these foods on occasion.

Anne Marie Kuchera, our Kids Plus Nutrition Consultant, is a Licensed Professional Counselor and Registered Dietitian.