There is ample evidence from repeat food surveys that people are actually and passively changing their food habits. Understanding the reasons for this are vital to any efforts by clinicians to enable individuals to move in an increasing healthful direction with their food intake, and to dispel the pessimism that often prevails about the ability to make a useful contribution to nutritional status by changing food intake. Current success and failure rates are predicated on inadequate methods and inappropriate outcome measures, rather than an inability to achieve outcomes. Factors that allow for or encourage change are food availability, exposure to new food experiences, food memory, pleasure, eating with peers or companions, health interest and changing constructs and beliefs about food. It is possible to change the health impact of food by non-food means like physical activity, stress management, recreational activities, improved relationships, changing the work environment and through adequate sleep (including siesta). Yet another consideration is that the full consequences of food choice are not appreciated with more and more food-health relationships being defined (e.g. with cataract, macular degeneration, in depression and cognitive function). These various approaches require a management strategy that underpins the field of behavioural therapy. In this approach it is possible to make progress through small but consequential changes, like climbing the stairs, or increasing intake of particular foods like fish or drinking more water; and exploring and contracting ways to do these things.