“Raising a healthy eater takes years. Children learn bite by bite, food by food, meal by meal. The goal of raising a healthy eater is to help your child grow up with positive eating attitudes and behaviors; it is not to get him to eat his peas for tonight’s supper.”

Ellyn Satter, MS, MSSW, RDN

As we discussed previously, what we feed kids is important to ensure that they are meeting their nutrient requirements. But, just as important is how we feed kids. The structure and environment that parents provide when feeding not only shapes nutrition, but it also eating behaviors, weight regulation, and children’s relationship with food. Families who regularly eat together have children who eat more fruits and vegetables, have healthier body weights, and are less likely to engage in risky behaviors like the use of drugs, alcohol, or tobacco later in life.^[1]

Family meals have many nutritional, social, and emotional benefits. In this section, we will discuss best practices for creating positive mealtime routines and supporting the development of healthy eaters.

The Division of Responsibility

One of the most widely used frameworks for feeding children is Ellyn Satter’s Division of Responsibility (sDOR). Ellyn Satter is a dietitian, family therapist, and internationally recognized authority on eating and feeding. The Division of Responsibility outlines the optimal relationship between parent and child when it comes to feeding: the parent determines the what, where, and when of feeding, and the child chooses how much to eat and whether to eat from the foods provided.^[2]

The caregiver’s role with feeding:

• Provide structured, sit-down meals and snacks at predictable times
• Decide what foods will be offered at meals and snacks
• Make mealtimes pleasant and pressure-free
• Teach age-appropriate table manners
• Offer primarily water between meal and snack times
• Be considerate of food preferences without catering to likes and dislikes
• Trust that children know how much food to eat and will grow in a way that is healthy for them

The child’s jobs with feeding:

• Eat the amount of food he or she needs
• Learn to eat a variety of foods served at family meals
• Practice age-appropriate table manners
• Grow into the body that is right for him or her

 

The Division of Responsibility is built on trust: trust that children know when they are hungry and full, that they want to eat, and that they want to learn to eat grown-up foods. Caregivers best support this process by providing the structure of regular family sit-down meals and snacks and modeling relaxed, enjoyable eating.

The Division of Responsibility is an authoritative approach, providing structure and limits, but allowing the child autonomy within those limits. At meals and snack times, caregivers promote children’s independence by allowing them to pick and choose foods from what has been made available and deciding how much to eat.

As a child learns to eat grown-up foods, every day will look slightly different—some days eating a lot and other days eating very little.  Caregivers should not cross the Division of Responsibility by pressuring a child to eat more or less of something; this kind of pressure backfires and interferes with a child’s ability to listen to their internal cues.

Pressure can be positive: praise, rewards, bribing, making special food, playing games, or talking about nutrition to encourage kids to eat more of nutritious foods or less of “bad” foods. Pressure can also be negative: restricting, threatening, punishing, shaming, or withholding dessert or fun activities. Instead of pressure, caregivers should be encouraged to follow the Division of Responsibility in feeding.

Eating Competence

Eating competence is an evidence-based model that defines the interrelated spectrum of eating attitudes and behaviors.^[3] The model is based on the principle that internal cues of hunger, appetite, and satiety are reliable and can be used to inform food selection and guide energy balance and body weight regulation.

According to Ellyn Satter, eating competence includes four core components:

1. Eating attitudes
2. Food acceptance attitudes and skills
3. Internal regulation attitudes and skills
4. Contextual attitudes and skills related to meals and structure

Satter describes eating competence this way:

“Eating Competence is being positive, comfortable, and flexible with eating as well as matter-of-fact and reliable about getting enough to eat of enjoyable food. Even though they don’t worry about what and how much to eat, competent eaters do better nutritionally, are more active, sleep better, and have better lab tests. They are more self-aware and self-accepting, not only with food, but in all ways. To be a competent eater, be relaxed, self-trusting, and joyful about eating, and take good care of yourself with food.”^[4]

Modern nutrition advice often focuses on avoidance of foods and reliance on outside indicators, such as diet plans, to guide eating. Eating competence is the opposite, encouraging people to seek food that is enjoyable and to let internal processes such as hunger and satiety guide eating.

Eating competence comprises both permission and discipline.^[5]

• Permission is choosing foods that are enjoyable and eating those foods in amounts that are satisfying, based on hunger, appetite, and satiety.
• Discipline is providing the structure of regular meals and sit-down snacks and paying attention to internal regulators while eating.

modeling eating competence at home

A caregiver’s own eating behaviors can play an important role in shaping a child’s relationship with food.  It is more difficulty to raise eating-competent children if adults do not model a positive, relaxed approach to eating.

Questions caregivers may reflect on include:

• Do you feel generally positive about eating and food?
• Do you enjoy eating a variety of foods and feel open to trying new foods?
• Do you trust your hunger and fullness cues to guide how much you eat?
• Do you have structured meals and snacks?

meal planning to support eating competence

Meal planning is a good place to start when working on building eating competence. Tips for meal planning:^[6]

• Start with foods that rest of the family is currently eating, and group those foods into meals and snacks.
• Try to provide food from each of the food groups for meals, and from 2 to 3 groups for snacks (dairy, fruit, vegetable, protein, and grain).
• Include a familiar, easy-to-like food such as bread, rice, or pasta at every meal so family members always have something comfortable to eat.

• Pair familiar foods with new or less-preferred foods.

• Include fat in food preparation to make foods satisfying and enjoyable.
• Let each family member choose what tastes good to them from what is provided on the table.

The Picky Eater

Picky eating is common in young children and is considered a part of normal development. It is only a concern when children get “stuck” and food acceptance does not improve over time.

Following the Division of Responsibility and adjusting expectations can help prevent common traps that limit food acceptance, such as:

• Catering the menu to exclusively “kid” foods or preferred foods
• Making a separate meal when your child complains about what is offered
• Asking your child what they want to eat
• Pressuring your child to eat
• Offering food outside of scheduled meal and snack time

The primary goal when feeding a picky eater is to keep mealtimes pleasant and low-pressure. By providing structure through regular meals and snacks and giving a child permission to choose from what is offered, caregivers can support both food acceptance and a healthy relationship with food.

For more information on how to raise a healthy eater check out the following resources:

• Satter, E. (2008). Secrets of Feeding a Healthy Family: How To Eat, How To Raise Good Eaters, How to Cook. Madison, WI: Kelcy Press.
• Satter, E. (2000). Child of Mine: Feeding with Love and Good Sense. Boulder, CO: Bull Publishing Company.
• Ellyn Satter Institute Website

attributions

This section is an adaptation of “Raising Healthy Eaters” in Nutrition: Science and Everyday Application, v. 1.0 by Alice Callahan, PhD; Heather Leonard, MEd, RDN; and Tamberly Powell, MS, RDN licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.