CDC to Re-evaluate the HECAT- the Health Curriculum Guide for Grades K-12

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The HECAT (Health Education Curriculum Analysis Tool) is a tool from the CDC (Centers for Disease Control and Prevention) that assists school systems in setting their health curriculums. Therefore, in order for schools and health educators to change their health and nutrition messages for students, the HECAT needs to change first and foremost.

The need for change is the HECAT and the health curriculums that follow the HECAT are based primarily on obesity prevention. The language often used in health curriculums to describe how students should eat is the word “healthy”. The definition of “healthy” is very clear in the HECAT- there are “healthy” foods and “unhealthy” foods. I wonder how the CDC, school systems, health educators and teachers decide what healthy choices are for students.

Additionally, learning “healthy” eating to avoid obesity implies that children and others in larger bodies are not healthy. This message creates weight bias at a time when a child’s body is constantly changing as they are growing into young adults.  The terms “weight control”, “maintaining a healthy weight”, and “weight management” are commonly used in health curriculums. Think of the potential harm there is in classifying nutrition and health in such concrete terms: a thin body equals healthy and a larger body equals unhealthy. These concrete messages around health disregard inclusivity and diversity among students.  Rather than learning to eat based on obesity prevention and weight management, children need to listen to their bodies and eat intuitively as they grow and their nutrient needs change.

The CDC must re-evaluate the HECAT in consultation with nutriton education and eating disorder experts. The HECAT and health curriculums that precede it need to consider the following:

  1. “Ob*sity prevention” should not be the basis of the health curriculum or nutrition education. The curriculum should promote a student’s healthy relationship with food and their bodies. Rather than focusing on weight, health and nutrition education must focus on body appreciation, care, respect, and trust by eating foods that both nourish and satisfy, while also enjoying physical movement.
  2. Health Curriculums should accept and respect the diversity of all body shapes and sizes. The seemingly “healthy body shape” is not inclusive in honoring the ethnic and racial diversity in our school systems, among students, faculty, friends, and family members. 
  3. Health and nutrition education must accept and respect the diversity of all body shapes and eliminate weight-stigmatizing language from health and nutrition education such as “ob*sity”, “ov*rweight”, “weight management”, “healthy body weight”, “weight control”, etc. All students, in all body sizes, need health and nutrition education. There are those in large and small bodies who are healthy, just as there are those in large and small bodies who are unhealthy.
  4. Do not label food as healthy/unhealthy or good/bad. Nutrition has no moral value. Nutrition is too complex to label in such concrete terms.
  5. Reconsider age appropriate nutrition education for elementary students. Students that age are too young to have moral values attached to food by labeling food as healthy or unhealthy and good or bad.  Again, nutrition is too complex to describe in such concrete terms.
  6. Students should not count calories as part of the health curriculum. Calorie counting is a diet as the purpose of counting calories is to manage weight. Calorie counting may be harmful to some and may lead to disordered eating or trigger an eating disorder.
  7. Health Curriculums should reinforce positive body image talk and education.
  8. Health educators and teachers need to be mindful of their own weight bias.
  9. Health educators and teachers need to be mindful of their own nutrition bias. What is healthy for one person may not be healthy for another person.
  10. Consider the impact of what you say or do as a health educator or teacher. Health Curriculums must set better guidelines so all students feel included and safe in the diverse world of nutrition and health.


Sarah Ganginis MS, RD, LDN

Contributions by: Dana Snook, RDN, LDN, CIC