There’s a lot of public and parental attention on childhood health and nutrition, and as a pediatric dietitian, I think promoting child nutrition is incredibly important, but we cannot do so at the expense of increasing their risk of developing disordered relationships with food, their bodies, and exercise. Here are six ways we can help children develop healthy lifestyle habits and positive relationships with food.

1. Encourage children to eat regular meals and avoid irregular eating patterns. Skipping meals and snacks is far too common these days. Kids learn, incorrectly, from other kids at school, adults in their lives, even some medical professionals, that it’s okay, even desirable, to go more than 4-5 hours without eating. Fasting for weight management is generally inappropriate for kids and teenagers because they require adequate nutrition for the rapid periods of growth they’re undergoing. From a counseling perspective, the risk of a child developing a negative relationship with food by way of intentional fasting is simply not worth it. Instead, offer a structured eating pattern of about 3 meals and 1-2 snacks each day, and we, as adults, can do our best to model this positive lifestyle habit to them. For more information, watch my video about the benefits of structuring your child’s eating schedule and this article from Kids Eat in Color.
2. Teach a child to pay attention to their internal hunger and satiety cues. Portion size recommendations can be a helpful tool, but they are inadequate when used alone. Our bodies are dynamic and some days, we just feel hungrier or fuller, and while recommended portion sizes can be a helpful starting place, they might not be accurate in reflecting what our bodies actually need each day. Try showing them the hunger and fullness scale and talking to them about how it can help us understand our body’s levels of hunger and fullness. For more information, watch my kid-friendly video about this tool.
3. As often as possible, enjoy meals together as a family. Children who eat with their families more often are more likely to eat more fruits and vegetables, experience fewer depressive symptoms, and are less likely to engage in disordered eating behaviors – just to name a few benefits. Mealtimes can be valuable opportunities for parental modeling of positive mealtime behaviors and for family bonding. At the same time, I recognize that not everyone experiences healthy home environments. If able, as an adult in the household, try promoting positive family mealtime environments – now this takes time and consistent baby steps if it’s not already happening routinely and if there are relational tensions that need to be worked through. Connecting with mental health support, like a therapist, would be great for this. One guideline I suggest starting off with is to set boundaries on what’s brought up in conversation – keep discussions topics positive for everyone present, minimize fighting, and avoid criticism (this includes topics, like eating more, eating less, and body shaming). Another idea is to brainstorm conversation topics beforehand if your family isn’t used to interacting with one another positively. These question cards are designed for teenagers and adults, but there are kid-friendly ones out there, and you can even find a free list of family-friendly dinner table questions online and write them down on slips of paper that you can all take turns selecting.
   • For more information, take a look at FMI’s supporting research that documents the advantages of family meals and the list of resources in The Magic of the Family Meal.
4. Offer opportunities to enjoy movement – I tend to use the word “movement” more often than “exercise” because there can be negative connotations around exercise for some people, kids included. “Movement,” on the other hand, is a far broader category and is more likely to encompass some additional activities outside of organized sports or gym class that your kids enjoy. Movement doesn’t have to be a chore nor stressful for their bodies. Find things they can have fun with – walking the dog, playing freeze dance in the living room, going on a scavenger hunt at the park, swimming in the community pool, riding their bike, following a kid-friendly zumba or yoga video on YouTube, playing Pokemon Go at the mall or simply walking around the mall – but maybe with an empty wallet. When it comes to teenagers, I try to remind them that movement helps release stress and they can even have their TV time when they’re gently peddling on a stationary bike, but that screen time has to be within the limits that their caregivers set. Lastly, consider ideas that we as adults can do together with them. Kids can smell double standards from a mile away, even from a young age. Approaching lifestyle modifications with a family-wide lens helps prevent a child from feeling singled out, keeps the changes sustainable, and is beneficial for everyone’s health – physical, emotional, mental, and spiritual.
5. Promote a healthy self-image and body satisfaction. We live in a world where the media is constantly telling us that our bodies are not good enough and is trying to sell us ways to achieve idealized body types. Elementary school kids are exposed to these messages, and kids are receptive – they’re picking these messages up. While we can’t single-handedly control the media, we, as the adults in their lives, can teach them to value their bodies and all the other traits that make them unique. Practice with them what it means to be grateful for what our bodies can do – legs that can run and play soccer, arms that can give hugs, a mouth that can smile and brighten a room. Teach them that our bodies are dynamic and change over time. Our bodies are resilient and bounce back from injuries and illnesses, but they also need to be taken care of and treated with gentleness – we’re not robotic machines. Making healthy lifestyle changes will help our bodies feel stronger – the end goal shouldn’t be to achieve a specific body image when so many uncontrollable factors affect our body size and shape. Remind children that the bodies represented in media do not reflect the sheer diversity of body sizes and shapes that exist in real life. And refrain from weight-talk – about our own weights, their weights, or anyone else’s. Rather than commenting on someone’s weight or body shape, compliment a personality trait or clothing item. Lastly, avoid using nicknames or pet names for children or adults in the household that are based on one’s physical size. Those can really hurt someone’s feelings. Let’s shift diet culture by raising a future generation that respects their bodies and others’ as the gifts they are.
6. Help them learn to manage stress in a healthy way. Child and adolescent brains don’t manage stress the same way adult brains do, and let’s face it, even adults have trouble managing stress! To start off, set boundaries so they turn off screens at least 30 minutes before bed and get at least 8 hours of quality sleep each night. It’s easier to regulate emotions when we’re getting enough sleep, and if your child is struggling with sleep, consider talking to their pediatrician about a referral to a sleep specialist. Secondly, work with your children to develop a toolbox of strategies they can resort to when they’re stressed out. As a pediatric dietitian, I recognize that there’s an emotional component to food. Foods don’t only give us pleasure because they taste good or are associated with a celebratory experience. Certain foods actually boost our serotonin levels, our “happy hormone.” I like to make myself a cup of hot chocolate every now and then when I’m stressed out. However, relying solely on food to help us feel better when we’re stressed out isn’t going to address the root cause of the stress. Similarly, eating to suppress our emotions or starving our bodies as a form of punishment or a way to get control is not productive nor healthy. Instead, let’s add other calming activities to their toolkit to help lift their mood – going for a walk, playing with a pet, crying it out with a trusted family member, having some alone time and coloring, watching a TV show, or praying. Lastly, don’t hesitate to reach out to therapists, school counselors, or other mental health experts for extra support, particularly on complicated or long-term challenges.

Like this content? Hannah is a pediatric dietitian who cares about equipping families with knowledge and strategies to support healthy lifestyles and positive relationships with food throughout childhood and adolescence. A full, self-paced child nutrition course, Balanced Bites, is available online now: https://themakerstable.thinkific.com/courses/balanced-bites

References:

• American College of Pediatricians (2021). The Benefits of the Family Table. https://acpeds.org/position-statements/the-benefits-of-the-family-table 
• Caldwell, A. R., Terhorst, L., Skidmore, E. R., & Bendixen, R. M. (2018). Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 31(4), 505–512. https://doi.org/10.1111/jhn.12531
• Delozier, A (2023). How to Talk to Your Kids About Weight & Health: A Parent’s Guide. Kids Eat in Color. https://kidseatincolor.com/how-to-talk-to-kids-about-weight-and-health/ 
• Harrison, M. E., Norris, M. L., Obeid, N., Fu, M., Weinstangel, H., & Sampson, M. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian family physician Medecin de famille canadien, 61(2), e96–e106. 
• Neumark-Sztainer D. (2005). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents?. The International journal of eating disorders, 38(3), 220–227. https://doi.org/10.1002/eat.20181 
• Snuggs, S., & Harvey, K. (2023). Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions. Nutrients, 15(13), 2841. https://doi.org/10.3390/nu15132841 
• Stabouli, S., Erdine, S., Suurorg, L., Jankauskienė, A., & Lurbe, E. (2021). Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link. Nutrients, 13(12), 4321. https://doi.org/10.3390/nu13124321