Poor food choices in childhood are core contributors to obesity and chronic diseases during adolescence and adulthood. Food choices and dietary behaviors develop in childhood and are difficult to change in adulthood. Nutrition education in elementary schools can provide children with the information and skills to develop healthy food choices and dietary behaviors. Current approaches for teaching nutrition and dietary behavior are largely ineffective to change elementary school students' food choices. Using a cross-sectional, anonymous mail survey, we asked classroom teachers how to improve nutrition education in 17 Oregon elementary schools. Among 106 teachers who responded, most perceived that nutrition education in elementary school is very to somewhat important (97%) and can improve students' food choices long-term (53%) or at least short-term (16%). Teachers noted multiple barriers for nutrition education, the primary being competing academic expectations (52%), lack of available time (48%), lack of suitable curricula (36%), and a food environment at school and home that does not reinforce what is taught in the classroom. Teachers preferred nutrition education that is integrated into the math, science, and/or English curriculum (54%) and includes a school cafeteria component (70%) and parent participation (53%). In conclusion, there is insufficient time and incentive to teach nutrition education as stand-alone curriculum. Renewed focus should be on developing and implementing nutrition education programs that are integrated in the math, science, and/or English curriculum and that involve and target also the food environment. Unless the food environment at school and home reinforce what is being taught in the classroom, nutrition education will have limited impact on students' food choices.