Understanding barriers to healthy eating: Children’s choice leading barrier to healthy eating?

What is the problem?

Promoting a healthy diet is a key public health target on a national scale let alone in our local areas. Recent figures show the prevalence of obesity in Year 6 children is 22.7%  which is higher than pre-pandemic levels. The prevalence of childhood obesity is also almost twice as high for children living in most deprived areas.

In 2021, our team at CC4C ran a listening workshop within the local community which gave us useful insights into what health matters are most important to them – maintaining a healthy weight was a key priority. One of our volunteers, Hanan Ghouniem, reached out to us to help provide further healthy eating support for families in her local area, White City, in the face of rising pressure from the cost of living crisis. 

As part of an integrated care team we have a responsibility to develop a better understanding of the issue at hand. From the 64 families we spoke to, children’s choice (or ‘fussy eating’) was the most common barrier to healthy eating as a family.  

What have we done so far?

Over the past 12 months, our previous CC4C trainees and patient engagement team have conducted 4 school assemblies focusing on education of children on healthy eating e.g. 5 a day, sugar intake. These sessions were overall well received by both pupils and teachers, they enjoyed the interactive nature of the assemblies but felt we could use more visual aids to improve! Using PDSA cycles and based on feedback, assembly plans were adjusted.

In this academic cycle we delivered an assembly at a local primary school for children in years 4-6 focusing on vitamins and minerals – we were able to teach children the sources of different vitamins and their roles. We were surprised with the level of knowledge children already had especially about vitamin D!

The children thoroughly enjoyed the session in particular the “Top Trumps” game which aimed to show the benefits of choosing a healthier snack! 
We gained some useful feedback from teachers regarding on potential improvements including relating key parts of information to fun food facts for children to grasp! 

What are our current aims?

Our main aim is to gain a better understanding into the common difficulties that parents experience to implement a healthy diet in children regularly.
Our early discussions with parents in paediatric outpatient department identified health visitors as key healthcare professionals where parents often turn to for advice about healthy eating. We then reached out to local health visitor centres to discuss with parents what they often struggle with in regards to healthy eating.

At these sessions we aimed to share our “Supporting healthy eating in White City” poster which shows parents what free local support is available e.g. local free cooking lessons, holiday activities for families and information on local food banks. 

We also want to continue our good work with local primary schools in delivering further school assemblies to children. 

What have we learned so far?

We have spoken to 64 number of families at a variety of locations ranging from outpatient departments, health visitor centres, CHAT sessions and at schools! We learned the most sessions at health visitor centres and attending after-school runs as they had good attendance from families as compared to some of our community events.

Using thematic analysis we were able to extrapolate 6 common recurring themes that parents raised with regards to healthy eating. The most common themes included children’s choices (in particular fussy eaters) with 44%, lack of time and cost of living (17% equally).

Our next steps

Now that we know the key issues that families struggle with, we can use this to provide targeted support to our local communities! This could be in the form of organising group workshops for families struggling with fussy eating or using our CHAT sessions to share further advice and support available. CHAT webinars stands for “Children’s Health Advice and Tips webinars” which are an opportunity for parents and carers to ask local cildren’s health specialists questions about how look after their children’s health. The CC4C team have been regularly carrying out CHAT sessions at local children’s community centres where we discuss important yet common health topics for parents. 

On a personal level, I was interested to see that a common health belief was that eating healthy is more expensive which is a growing concern for families is in this current economic climate. Perhaps sharing healthy and affordable recipes with families (like recipes from the Change for Life campaign) can help tackle this health belief.  

What does this mean for you?

As a healthcare professional, initial steps can include identifying families that are being effected and having those open discussions about diet can help. If you work with families in White City, you can share our poster that highlights free local support for healthy eating. We have also made our assembly plan on vitamins/minerals available for others to use for free – the session is aimed at children in KS2 and can be delivered in a 25-30 minute time slot.

The Change for Life campaign, launched by Public Health England in 2009, has continued to provide support for healthy eating with a national website and more hands on support in some London boroughs. In Westminster and Kensington and Chelsea Change for Life offers regular workshops for parents and health professionals.


Dr Syed Abdullah Akhter is a GP registrar who has been working with the Connecting Care for Children team as part of his integrated training post. 

Special acknowledgement to our team including Phoebe Rutherford who is the patient engagement lead, working closely with local families, citizens and community groups. Phoebe has created some useful resources to share amongst local families for free support with healthy eating!