Are family meal patterns associated with disordered eating behaviors among adolescents?

Adolescents' mental health is associated with food parenting practices among British Columbian families

BACKGROUND

Adolescence is a developmental period marked by significant changes related to the body and food parenting practices. However, few studies have explored child-level psychological correlates of these practices during adolescence. Our study examined whether adolescents' weight status, weight concerns, self-esteem, and anxiety were associated with food parenting practices, and whether these associations significantly differed by adolescents' gender among 297 families in British Columbia, Canada.

METHODS

Parents (47 years, 76% mothers) completed a food parenting practice item bank. Adolescents (14 years, 52% girls) self-reported their height and weight, weight concerns, self-esteem, and anxiety. Covariate-adjusted regression models evaluated the association of adolescents' weight and mental health with nine practices (main effects). Interactions were used to evaluate the moderating role of gender, and further decomposed in all models to examine simple effects within each gender group.

RESULTS

Main-effect models showed positive associations between: (1) weight concerns and child involvement, (2) weight concerns and accommodating practices, (3) self-esteem and healthy eating opportunities, and (4) self-esteem with meal routines, as well as negative associations between: (5) self-esteem and accommodating practices, (6) self-esteem and coercive control, and (7) anxiety and rules and limits. In these 7 models interactions with gender were not significant; however, in all cases (except in model 5) the decomposed effects showed only significant associations among girls. A significant gender interaction emerged in (8) the association between anxiety and coercive control, but the decomposed effects were not significant for either gender. Adolescents' weight status was not associated with food parenting practices in any model.

CONCLUSIONS

Food parenting practices are associated with mental health indicators among British Columbian families; however, future studies should examine multidirectional relationships between these practices, adolescents' mental health, and eating habits.

A randomized controlled trial to test the efficacy of a brief Triple P discussion group to increase healthy feeding practices and reduce risk factors for infant obesity

OBJECTIVE

Test the efficacy of a brief 2-hr parenting intervention in increasing protective factors against and reducing risk factors for infant obesity.

METHOD

A 2 (Baby Healthy Living Triple P vs. care-as-usual) × 3 (baseline, postintervention, 6-month follow-up) design was used. Eighty-two parents of 4- to 18-month-old infants meeting at least two risk factors for early childhood obesity (e.g., parent/child overweight, low education level) were randomized to intervention (n = 42) or control group (n = 40). Parents questionnaires and child weight status was measured.

RESULTS

Results showed an intervention effect on a primary outcome, early feeding practices (restrictive: d = 0.44, 95% CI [-0.01,0.88], pressuring: d = 0.11, 95% CI [-0.32,0.54], nonresponsive behaviors: (d = 0.32, 95% CI [-0.11,0.75]), and on a secondary outcome, feeding beliefs (d = 0.29, 95% CI [-0.14,0.73]). No beneficial impact was found on other primary outcomes (responsiveness in feeding: quantity d = 0.50, 95% CI [-0.03,1.03]) and nutritive d = 0.52, 95% CI [-0.03,1.07], mealtime environment: d = 0.35, 95% CI [-0.78,0.08], self-efficacy in responsive feeding: d = 0.21, 95% CI [-0.22,0.64]), or secondary outcomes (parental self-efficacy: d = 0.08, 95% CI [-0.50,0.35]), parent emotional eating (d = 0.01, 95% CI [-0.43,0.43]), food restraint (d = 0.42, 95% CI [-0.85,0.02]), and body satisfaction (d = 0.01, 95% CI [-0.43,0.43]) and child weight status (d = 0.11, 95% CI [-0.54,0.32]).

CONCLUSIONS

Promising though limited support was demonstrated for a brief, low-intensity program to help parents in the prevention of obesity for infants at risk.

The Influence of the Home Food Environment on the Eating Behaviors, Family Meals, and Academic Achievement of Adolescents in Schools in the UAE

The eating behavior (EB) and habits developed during adolescence tend to persist into adulthood, with parents and caregivers playing a significant role in shaping their children's food choices. The home environment is a crucial setting for developing eating behavior during adolescence. This study aimed to explore the influence of the home food environment (HFE) and its correlates on EB, family meals (FMs), and academic achievement among adolescents in schools in the United Arab Emirates (UAE). A cross-sectional study was conducted with 304 school-aged adolescents from the UAE. The questionnaire included sociodemographic data, dietary habits, information related to the HFE (food availability and accessibility), physical activity, sleep patterns, and academic achievement. Several questionnaire items were combined to create an HFE score. These questions included the frequency of weekly family meals, meal preparation practices, and accessibility to healthy and unhealthy food products and snacks at home. The HFE score was dichotomized into favorable and unfavorable HFE scores. Similarly, EB and FM scores were generated by combining responses to various related questions. The participants' weights and heights were measured. The findings reported that more than half (55%) of the adolescents were either overweight or obese. The majority of the participants had favorable HFE (57.2%), EB (69.1%), and FM scores (58.2%). The significant correlates to the HFE were as follows: male participants whose parents attended college (OR: 0.31; 95% CI: 0.15-0.62; p < 0.001), high academic achievers (OR: 1.98; 95% CI: 1.02-3.82; p = 0.043), and those who were physically active (OR: 1.80; 95% CI: 1.14-2.85; p = 0.012), were more likely to have favorable HFE. Moreover, the HFE score showed a highly significant positive correlation with the EB score (r = 0.573, p < 0.001) and the FM score (r = 0.384, p < 0.001). These results underscore the critical role of a healthy HFE in shaping healthy positive eating behaviors and food choices among adolescents. They provide a foundation for developing effective, evidence-based policies that can impact the health and academic success of adolescents in the UAE.

Determinants of Disordered Eating Behaviours (DEBs) among Adolescent Female School Students in Riyadh, Saudi Arabia: A Qualitative Study

The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m2 to 27.51 kg/m2. EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.

Protective role of family mealtime frequency against disordered eating behaviors: Racial and ethnic differences

Family mealtimes have been recognized for their positive effect on child and adolescent health outcomes. Frequent family meals have been shown to have protective effects in reducing disordered eating behaviors, but the variability of these effects across different racial and ethnic backgrounds has been less explored. To address the gap, the current study utilizes a sample of 33,417 families with children (ages 6-17) in the United States who participated in the 2022 National Surveys of Children's Health (NSCH). Logistic regressions were conducted to examine the association between family mealtime frequency and the manifestation of disordered eating across youth from diverse racial/ethnic backgrounds. Our findings revealed that frequent family mealtimes are associated with a lower risk of engaging in disordered eating behaviors in youth. However, there were disparities in the associations between family mealtime frequency and the prevalence of disordered eating behaviors among children from different racial/ethnic backgrounds. Youth who never participated in family mealtimes were at a greater risk of engaging in disordered eating behaviors among those identifying as non-Hispanic Black or of 'other' racial groups. In youth identifying with multiple races, the frequency of family was not associated with the odds of disordered eating behaviors. The results provide insights into the nuanced influence of family mealtime frequency on disordered eating based on diverse racial/ethnic groups. This highlights the need for future studies to identify factors associated with racial/ethnic identities that may contribute to disordered eating behaviors in youth to identify the unique needs and challenges faced by families in leveraging the protective effect of family mealtimes.

Disordered eating prevention: Co-designing a brief intervention for use in Community Child Health Services

Dietary habits established in childhood, often persist into adulthood highlighting the importance of early intervention. However, limited interventions exist promoting "how" to establish healthful eating behaviors in children. To create impactful interventions, it is important they are based on evidence and co-designed with end-users. Fifteen child health nurses participated in this co-design study, underpinned by the Knowledge to Action Framework. Child health nurses reviewed evidence-based statements and then workshopped practical strategies. Findings from the co-design sessions were used to inform the development of a preventive intervention. The study has important health marketing implications for conducting co-design with child health nurses.

Longitudinal associations between family meal quality and quantity: Does one matter more for child, parent, and family health and well-being or are they synergistic?

It is unknown how family meal quantity (i.e., frequency) and quality (i.e., meal healthfulness and interpersonal quality) are associated with child, parent, and family health and well-being over time. This study aimed to examine longitudinal associations between family meal quantity and quality and child, parent, and family health and well-being and whether there was a synergistic effect between family meal quantity and quality. Children ages 5-9 and their parents from six racial/ethnic groups participated in this longitudinal cohort study. Regression models adjusted for socio-demographic characteristics examined family meal quantity, interpersonal quality, and nutritional quality at baseline and interactions between quantity and quality, in relation to changes in child, parent, and family health outcomes from baseline to 18-month follow-up. Higher family meal quantity predicted reduced obesity prevalence, improved diet quality and less food fussiness, food responsiveness, and conduct problems among children at follow-up. Higher family meal quality predicted improved diet quality, lower emotional problems, less food responsiveness, and fewer peer relationship problems among children, improved diet quality and reduced psychological distress for parents, and less family chaos at follow-up. One interaction between family meal quantity and quality was found for child peer relationship problems. Overall, family meal quantity and quality were independently important for child health and well-being and for some parent and family health outcomes. Clinicians working with families may want to emphasize the importance of both family meal quantity and quality, as these longitudinal findings suggest potential benefits for the entire family.

The interplay between food insecurity and family factors in relation to disordered eating in adolescence

This study examined the association between food insecurity and both binge eating and unhealthy weight-control behaviors (UWCBs) and assessed whether such associations differ by factors within the family environment. Data were collected from a diverse sample of adolescents (Mage = 14.5 years; 54.1% female) and their parents/guardians (N = 2137 dyads) participating in EAT 2010 (Eating and Activity over Time). Food-insecure adolescents were more likely to report binge eating (prevalence ratio [PR] = 1.94; 95% confidence interval [CI]: 1.41-2.69) and UWCBs (PR = 1.34; 95% CI: 1.21-1.49) than food-secure adolescents. Family meal importance (p = .03) and family communication (p < .001) significantly moderated the association between food insecurity and UWCBs, such that the association was weaker at lower levels of these factors. Significant interactions with parental weight talk/concern (p < .001) and weight teasing (p = .04) indicated a weaker association between food insecurity and UWCBs in the presence of these factors. Findings indicate that the association between food insecurity and UWCBs among youth is less salient in the absence of family protective factors and in the presence of family risk factors for UWCBs, indicating the importance of targeting food insecurity itself, regardless of the presence of family risk or protective factors for UWCBs.

Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention

Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.

Parenting Styles, Food Parenting Practices, Family Meals, and Weight Status of African American Families

Parents influence adolescents' weight status through different strategies used in the home environment, including parenting styles (PSs), food parenting practices (FPPs), and family meal frequency. As the prevalence of obesity is higher among African American adolescents, investigation of which parental strategies serve as an adjustable factor for the prevention of obesity is critical. First, this study aims to examine the relationship between the different parenting influences and obesity statuses of both parents and 10-17-year-old adolescents among African American families. Second, it aims to examine the correlation between PSs and FPPs and frequency of family meals. A total of 211 parent-adolescent dyads completed an online survey using Qualtrics. Four PSs (i.e., authoritative, authoritarian, setting rules/expectations, and neglecting) and four FPPs (i.e., monitoring, reasoning, copying, and modeling) were identified for this study, along with family meal frequency. Body mass index (BMI) percentile and BMI were used to assess the obesity status of the adolescents and parents, respectively. No correlation was found between the adolescents' and parents' obesity status and the PSs and FPPs, while the adolescents' BMI percentile was significantly correlated with parental BMI. However, a higher number of family meals decreased the likelihood of obesity among the adolescents to some extend and depended on the type of BMI used. An authoritative PS was the only style related to family meal frequency, while three FPPs, namely, monitoring, reasoning, and modeling, were related to a greater number of family meals in African American families. The findings of this study can be used in the development of parental education workshops/sessions, with consideration of the cultural differences in African American families, and can help parents to adopt the best parenting strategy to promote the healthy weight status of their adolescents.

Gender differences in family meal frequency and their association with substance use and mental health among middle and high school students

Background

Family meals are associated with adolescent health outcomes. Studies have reported that girls are less likely than boys to have dinner with their families.

Purpose

This study examined gender differences in family meal frequency and the relationship between meal frequency and other health measures, using a large and representative sample of California middle and high school students.

Methods

This study analyzed data from the 2019-2020 California Student Tobacco Survey (159,904 students in grades 8, 10, and 12). Dinner with the family 5-7 times per week was defined as high frequency. Students reported substance use (of tobacco, marijuana, and alcohol) and rated their mental health and happiness in their home life. All analyses were weighted to reflect the California student population.

Results

Fewer than half (44.7%) of students reported a high frequency of family meals, with boys more likely than girls and those who identified their gender in another way the least likely to do so (48.3%, 42.2%, 34.0%, respectively). Gender differences persisted across demographics and the quality of family relationships, and were evident as early as eighth grade. Less frequent family meals were associated with poorer mental health (OR = 1.34, 95% CI: 1.29-1.40) and substance use (OR = 1.27, 95% CI: 1.21-1.32), controlling for the effects of demographics and family dynamics.

Conclusion

Gender differences in family meal frequency emerge early in adolescence and persist across demographics and family relationships. Given that family meals play a protective role in an adolescent's life, these gender differences are concerning.

The Impact of Unhealthy Behaviors on Personalized Well-Being Index in a Sample of School Dropout Adolescents

(1) Background: here is a growing need for integrated and multidimensional approaches to health, especially in a particular category of populations, school-dropout (SD) adolescents, who are traditionally more prone to risky behavior. This study aimed to describe the association between possible risk factors (substance use, eating disorders, social addiction) and well-being perception through the application of a personalized well-being index (PWBI) in SD youths. (2) Methods: Data were collected in 450 school-dropout adolescents (19 ± 2 years, male 308); the health-related quality of life (HRQoL) and risk behaviors were assessed by means of a battery of standardized questions. (3) Results: The results revealed an altered perception of well-being in association with eating disorders (p < 0.001), the use of psychotropic drugs (p < 0.001), and the amount of their consumption (p < 0.05). In particular, there was a decrease in emotional state (p < 0.001) and PWBI (p < 0.001) in the presence of eating disorders, and an impairment in all PWBI components, emotional states (p < 0.001), lifestyle habits (p < 0.05), and social contexts (p < 0.001) when taking psychotropic drugs. (4) Conclusions: risk or unhealthy behaviors significantly worsen individual well-being. This study highlights the change of paradigm from a disease-oriented model to an educationally strength-based model when monitoring psychosocial well-being in order to define preventive and health promotion strategies in a vulnerable category of the population.

Children's experiences of meals after obesity treatment: a qualitative follow-up four years after a randomized controlled trial

Background

The practice of eating together, commensality, is rarely explored in the context of childhood obesity treatment. This is noteworthy given long-standing debates about the physical, psychosocial, and societal benefits of meals, especially family meals. Moreover, as children with obesity experience weight bias and stigma both within and outside the home, it is important to examine meals as a locus of social exchange around food and the body. Our study is based on the premises that eating together (i) matters and (ii) occurs in different environments with diverse social organization, where food-related interactions create varying arrangements of individuals, groups, their statuses, and their actions.

Method

The study explores children’s experiences of meals in different social contexts. Thirty-two children (age 8–10 years) living in Sweden were interviewed, 4 years after they entered an obesity intervention trial. Thematic analysis was applied to the data.

Results

We thematized three meal types, with each meal type having two subthemes: (i) “The family meal”, with “Shared routines, rituals, and rules” and “Individual solutions and choices”; (ii) “The school meal”, with “Rules and norms of the school” and “Strategies of the child”; and (iii) “The friend meal”, with “Handling food that was disliked” and “Enjoyment of food”. These three different meal types carried different experiences of and knowledge about how they were socially organized.

Conclusions

While the children spoke about the family and school meals as meaningful, the friend meal stood out as particularly positive. Contrary to our expectations, the children did not express experiences of weight bias or obesity stigma around meals, nor did they speak negatively about parental control of their food intake. Our findings, especially regarding the friend meal, have implications for further research into commensality and social influences on eating among children with obesity, from early childhood into adolescence.

Family meals, positive versus negative emotion suppression, and emotional eating: examining adolescent-parent dyadic associations

PURPOSE

The present study aimed to extend existing research by examining adolescent-parent dyadic associations among adaptive and maladaptive family meal characteristics, positive and negative emotion suppression, and emotional eating.

METHOD

Participants included a community-based sample of adolescents and parents (N = 1646 dyads) who participated in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Dyad members both completed measures assessing family meal characteristics (family meal importance beliefs, family mealtime television watching), emotion suppression, and emotional eating via online surveys. Actor-partner interdependence models were used to examine dyadic associations among the assessed family meal characteristics, positive and negative emotion suppression, and emotional eating.

RESULTS

Multiple within-person (e.g., adolescent-adolescent, parent-parent), cross-dyad member (e.g., adolescent-parent, parent-adolescent), and divergent adolescent versus parent dyadic effects were identified that differed based on the extent to which participants suppressed positive versus negative affect. For example, whereas adolescents' stronger beliefs in the importance of frequent family meals were associated with lower levels of their own suppression of positive emotions and, in turn, lower levels of both their own and their parents' emotional eating, these mediational associations were only identified at the within-person (not cross-dyad member) level among parents.

CONCLUSIONS

Collectively, these findings attest to the complexity of associations among the assessed risk and protective family meal characteristics, the suppression of differentially valenced emotions, and emotional eating that manifest at the adolescent-parent dyadic level. Findings also support the continued use of a family-based perspective to further the understanding of factors that are associated with emotional eating.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Parental Food Communication and Child Eating Behaviours: A Systematic Literature Review

AIM

To review current evidence for parental food communication practices and their association with child eating behaviours.

METHODS

The PRISMA framework guided the reporting of the review; registered with Prospero in July 2020 (blinded for peer review). Eligible studies were critically appraised using the Joanna Briggs Institute tools. Only quantitative studies that included a parental measure of food communication and a child measure of eating behaviour were included.

RESULTS

From 11063 articles 23 were eligible for synthesis. The vast majority (82%) of studies used observational cross-sectional designs. Three involved observing parent-child dyads, with the remainder using questionnaires. Two quasi-experimental designs tested interventions and two randomised control trial were reported. The majority of measures assessing parental food communication were subscales of larger questionnaires. The Caregiver's Feeding Style Questionnaire (CFSQ) was the most direct and relevant measure of parental food communication. Findings of reviewed studies highlighted that "how" parents communicate about food appears to impact child eating behaviours. Using child-centred communication provided promising outcomes for positive child eating behaviours, while parental "diet" communication was found to be associated with poorer dietary outcomes in children.

CONCLUSIONS

Food communication research is in its infancy. However, evidence for the importance of parents' child-focused food communication is emerging, providing a focus for future research and interventions. SO WHAT?: Given the gaps in our understanding about prevention of disordered eating, there is a significant opportunity to explore what food communication strategies may assist parents to communicate about food in a positive way.

Everyday discrimination as a predictor of maladaptive and adaptive eating: Findings from EAT 2018

Various types of stressors are associated with maladaptive eating, but how the stressor of everyday discrimination (e.g., less respect, poorer service) relates to maladaptive eating and adaptive eating remains unclear. We examined everyday discrimination as a predictor of maladaptive and adaptive eating. Data were collected in a population-based study, Eating and Activity over Time (N = 1410, ages 18-30). Everyday discrimination was categorized as none, low, moderate, or high. Outcomes included maladaptive eating (i.e., overeating and binge eating) and adaptive eating (i.e., intuitive eating and mindful eating). Modified Poisson regressions estimated the prevalence ratios (PRs) for overeating and binge eating associated with everyday discrimination. Linear regressions estimated associations between everyday discrimination and intuitive and mindful eating scores. After adjustment for age, ethnicity/race, gender, and socioeconomic status, moderate and high levels of discriminatory experiences were each associated with a significantly greater prevalence of binge eating (PR = 2.2, [95% CI = 1.3-3.7] and PR = 3.1, [95% CI = 2.0-4.7], respectively) and lower intuitive (β = -0.4, [95% CI = -0.7, -0.2] and β = -0.5 [95% CI = -0.8, -0.3], respectively), and mindful eating scores (β = -0.3, [95% CI = -0.6, -0.1] and β = -0.5 [95% CI = -0.8, -0.3], respectively) compared to young adults with no discriminatory experience. Public health efforts to prevent maladaptive eating and encourage the adoption of adaptive eating should consider the potential contribution of everyday discrimination and the need to advocate for equity and inclusion.

Family-to-work enrichment associations between family meal atmosphere and job satisfaction in dual-earner parents

Research on factors related to job satisfaction in parents has mainly focused on work-related variables, paying less attention to family events that may provide parents with resources to invest in the work domain. To contribute to this body of knowledge, this study examined the associations between family meal atmosphere and job satisfaction in dual-earner parents with adolescent children, and tested the mediating role of family-to-work enrichment (FtoWE) between family meal atmosphere and job satisfaction. Questionnaires were administered to 473 different-gender dual-earner parents in Temuco, Chile. Participants answered the Project-EAT Atmosphere of family meals scale, three items that measure FWE from the Work-Home Interaction Survey, and the Overall Job Satisfaction Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modelling. A positive association was found from family meal atmosphere to job satisfaction, directly and via FtoWE in fathers, and only via FtoWE in mothers. No associations were found for these variables between parents, as, one parent's perception of a pleasant family meal atmosphere is positively associated with their own FtoWE and job satisfaction, but not with those of the other parent. These findings suggest policymakers and organizations to account for workers' experiences in the family domain to improve satisfaction in the work domain.

Mealtime emotional climate and child health: A systematic review

BACKGROUND

Positive mealtime emotional climate (MEC) has been linked to better nutrition, psychosocial, literacy and academic outcomes, and fewer behavior problems. However, MEC has been defined in a variety of ways across studies, limiting the ability to synthesize findings and plan future research.

OBJECTIVE

To identify which child characteristics are associated with MEC and to determine how previous studies have measured MEC.

METHODS

We searched three databases (1980-2020) for peer-reviewed articles measuring MEC. Inclusion criteria required at least one child-level outcome related to physical, nutritional, or developmental health; children aged 0-18 years old; and quantitative data using cohort, case-control, intervention, or experimental designs. We used a previously published taxonomy to categorize child/adolescent characteristics as correlates, non-correlates, unclear, or as having insufficient evidence, according to the amount of evidence linking them to MEC. Additionally, we extracted data about the measures and definitions of MEC from each included article.

RESULTS

Out of 668 unique studies identified in the initial search after duplicates removed, 14 met inclusion criteria, and only three used the same measure of MEC. Healthful dietary intake, disordered eating behaviors, and weight/BMI were categorized as correlates of MEC, but links to unhealthy dietary intake are unclear. Several characteristics (e.g. temperament, academic success) were examined in one study only.

CONCLUSIONS

Future research should examine the relationship between MEC and child psychosocial child outcomes and utilize a preschool age group. These findings aid in conceptualizing how MEC has been defined and measured and illuminate the importance of MEC on children's health.

Relationships Between Work-to-Family Conflict and the Food Domain for Dual-Earner Parents With Adolescent Children

The impact of work-to-family conflict (WtoFC) can extend beyond family and work, and to other domains that contribute to well-being, such as the food domain. This study examined associations between WtoFC, perception of atmosphere of family meals (AFM), and satisfaction with food-related life (SWFoL) in dual-earner parents with adolescent children, and tested the mediating role of AFM between WtoFC and SWFoL. Questionnaires were administered to 473 different-sex dual-earner parents and one of their adolescent children (mean age 12.5 years, 51.4% male) in Temuco, Chile. Parents responded to a measure of work-to-family conflict; the three family members answered the Project-EAT Atmosphere of family meals scale, and the Satisfaction with Food-related Life Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modeling. Results showed a negative association from WtoFC to SWFoL in both parents, while a more positive perception of atmosphere of family meals was linked to higher SWFoL in the three family members. Moreover, WtoFC was negatively linked to SWFoL in parents, while only mothers' WtoFC had a negative association with their adolescent children's SWFoL. Policymakers and organizations can contribute to workers' and their families' food-related well-being by fostering policies and measures to reduce WtoFC.

Are there protective associations between family/shared meal routines during COVID-19 and dietary health and emotional well-being in diverse young adults?

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This study found that family/shared meal routines increased from pre-COVID to during COVID-19.

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Engaging in family/shared meals during COVID-19 was associated with well-being in young adults.

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Engaging in family/shared meals was associated with healthy dietary consumption in young adults.

Background

This study examined who is engaging in family/shared meals and associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being among young adults during the COVID-19 pandemic.

Methods

A rapid-response online survey was sent to participants in a ten-year longitudinal study (Eating and Activity over Time: EAT 2010–2018). A total of 585 young adults (mean age = 24.7 ± 2.0 years, 63.3% female) living with at least one family member completed the COVID-EAT (C-EAT) survey during the U.S. outbreak of COVID-19. Items assessed changes in family/shared meal frequency, eating behaviors, and emotional well-being. Regression models adjusting for sociodemographic characteristics examined associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being.

Results

Participants reported an average of 4.6 ± 3.4 family/shared meals per week during COVID-19, a 0.5 meal/week increase from prior to the pandemic (p = .002). Family/shared meal frequency during COVID-19 differed by race/ethnicity, with Asian American participants being most likely to report only 1–2 family/shared meals per week. Family/shared meals during COVID-19 were associated with higher vegetable intake, greater availability of fruits, vegetables, and whole wheat bread in the home, lower levels of depressive symptoms and perceived stress, and greater perceived ability to manage stress in young adults.

Conclusions

Results suggest that engaging in a regular routine, such as family/shared meals, during COVID-19 may have protective associations with dietary health and emotional well-being for young adults. Results may inform practices/routines to offer protective benefits during public health crises such as the current pandemic.

Gender-based eating norms, the family environment and food intake among Costa Rican adolescents

OBJECTIVE

To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents.

DESIGN

Structural equation modelling applied to cross-sectional data, 2017.

SETTING

Urban and rural sites of San José, Costa Rica.

PARTICIPANTS

n 813; 13-18 years old.

RESULTS

Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (β = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (β = -0·24, P < 0·01) and ultra-processed foods (β = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (β = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (β = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (β = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (β = 0·23, P < 0·05) among urban boys and FF intake (β = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (β = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (β = 0·21, P < 0·05; β = 0·14, P < 0·05, respectively) among urban girls.

CONCLUSIONS

Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.

Families' Health Behavior: Validity and Reliability of the Turkish Version of the Family Health Climate Scale

This study aims to adapting the Family Health Climate Scale (FHC Scale) into Turkish and to conduct its validity and reliability analyses. The FHC Scale consists of two subscales, the Physical Activity Scale (FHC-PA) and the Nutrition Scale (FHC-NU). The validity and reliability analyzes of the scales were done separately. The sample included 789 participants (263 students, 263 mothers, 263 fathers). The sample was randomly allocated to two groups. Explanatory Factor Analysis (EFA) was performed on Sample I (132 students, 132 mothers, 132 fathers); and Confirmatory Factor Analysis (CFA) on sample II (131 students, 131 mothers, 131 fathers). As a result of the EFA it was determined that three factors FHC-PA Scale; and four factors FHC-NU Scale were included. The CFA result it was determined that scale models had good fit values. The FHC-Scale could be used as a reliable and valid measurement tool in Turkey.

Baby's first bites: Association between observed maternal feeding behavior and infant vegetable intake and liking

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.

Intervenciones nutricionales en la mejora de la cultura alimenticia y sostenibilidad en hondureños de primer año universitario

Objetivo Evaluar el efecto de intervenciones educativas en la mejora de hábitos alimenticos y adherencia a una dieta saludable y sostenible (dieta mediterránea) en universitarios hondureños en época de COVID-19. La emancipación del hogar ocasiona que los estudiantes universitarios se enfrenten a un nuevo entorno para la planificación de su alimentación durante la transición a su vida universitaria. Métodos Se realizó un estudio observacional de cohorte descriptivo transversal entre febrero y junio 2020. Los datos presentados se derivan de encuestas de conductas alimenticias y adherencia a la dieta mediterránea (DM) antes y después de intervenciones educativas nutricionales. Resultados El grupo con intervenciones mejoró sus conductas alimenticias pasando de poco saludables (media: 14,4) a moderadamente saludables (media: 17,3); de igual forma sucedió en la adherencia a la DM, pasando de baja adherencia (media: 7,6) a adherencia media (media: 8,3). En el grupo control no cambió su adherencia, manteniéndose en baja adherencia; tampoco cambiaron sus hábitos alimenticios, manteniéndose en hábitos poco saludables (p=0,068). Conclusiones Existe evidencia de que el patrón dietético mediterráneo puede ser una opción para reducir los problemas de salud, especialmente, en la época de pandemia, por lo cual esta investigación expuso que un patrón alimenticio mediterráneo puede coexistir en un ambiente latinoamericano una vez que se conocen sus beneficios.

Childhood maltreatment and disordered eating attitudes and behaviors in adult men and women:Findings from project EAT

This study examined gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors in adulthood. Data were derived from 1647 adults (ages 27-33) participating in a population-based, longitudinal study (Project EAT-IV: Eating Among Teens and Young Adults, 1998-2016). Childhood maltreatment (sexual abuse, physical abuse, emotional abuse, emotional neglect) and disordered eating attitudes and behaviors (overeating, binge eating, extreme weight control behaviors, unhealthy weight control behaviors, chronic dieting, weight and shape concerns) were assessed. Relative risk regression models were used to examine whether childhood maltreatment was related to individual disordered eating attitudes and behaviors. Gender differences in these associations were explored. A history of any childhood maltreatment was associated with more than 60% greater risk for chronic dieting and overeating, with additional associations found for binge eating, weight and shape concerns, and unhealthy weight control behaviors. All types of abuse and neglect were associated with at least one type of disordered eating outcome. Examination of the point estimates indicated that emotional neglect was most consistently related to higher risk for disordered eating attitudes and behaviors. Although there were no statistically significant gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors, the patterning of these effects highlighted unique qualitative similarities and differences in these relationships between men and women. Taken together, these findings implicate childhood maltreatment, particularly emotional neglect, as a meaningful risk factor for problematic eating outcomes in both men and women during adulthood.

Family Meals, Conviviality, and the Mediterranean Diet among Families with Adolescents

Two aspects that characterize the Mediterranean diet (MD) are "what" and "how" we eat. Conviviality relates to "how" we eat and to the pleasure of sharing meals with significant people. The most studied concept is "family meals", which includes conviviality, which involves "enjoying" family meals. Given the lack of research on convivial family meals in Mediterranean countries, the purpose of this qualitative study was to analyze the family meal representations and practices of families with 12- to 16-year-old adolescents to assess whether they responded to a pattern of conviviality, and to examine their association with MD adherence. Twelve semi-structured interviews were conducted and food frequency and family meal questionnaires were administered. A food pattern analysis was carried out and digital photos of meals were analyzed to examine eating habits and meal composition, respectively. The findings showed that parents believed family meals are a space for socialization and communication. Items relating to the conviviality of family meals identified in the study were meal frequency, meals at the table, lack of digital distractions, pleasant conversations, and time spent on family meals. Attention should be paid to conviviality in Mediterranean families when designing multi-approach strategies to promote healthy eating among adolescents.

Diet and Health Benefits Associated with In-Home Eating and Sharing Meals at Home: A Systematic Review

In-home and shared meals have been hypothesized to have positive effects. This narrative review examines research on the influence of in-home eating on diet quality, health outcomes, and family relationships. A combination search approach included a search of PubMed, backward searches of previous published reviews, and studies the authors were familiar with. A search identified 118 publications; 54 original studies and 11 review studies were included in this review. Each study was reviewed and summarized. The diverse designs precluded quantitative data synthesis. Relatively strong evidence from cross-sectional research supports the association of shared family meals with favorable dietary patterns in children and adolescents, including consumption of fruits, vegetables, and healthful nutrients. Correlational evidence links shared meals with health and psychosocial outcomes in youth, including less obesity, decreased risk for eating disorders, and academic achievement. Most evidence is cross-sectional, thus, limiting attribution of causality. There is insufficient evidence to conclude that interventions improve the frequency of shared meals, improve diet, or prevent child obesity. Despite the “common wisdom”, the evidence that in-home, shared meals, per se, have positive effects on diet quality, health outcomes, psychosocial outcomes, and family relationships is limited due to weak research designs and single-item measurement of the independent variable. More research, with stronger designs, is warranted.

Disordered eating among Arab and Jewish youth in Israel: the role of eating dinner with the family

Background

Disordered eating (DE), defined as unhealthy eating attitudes and behaviors, is considered a major public health problem among adolescents. Nevertheless, rates of DE among Arab and Jewish adolescents in Israel are still unknown. Furthermore, while previous studies have highlighted the role of frequent family meals as a protective factor against DE, studies examining home family dinners relative to other common dinner options (e.g., eating at home alone, eating out of the home, not eating dinner at all) are largely unavailable. We sought to use representative data of middle and high-school children in Israel in order to identify rates of DE among Arabs and Jews, while examining the relations of home family dinners (vs. other dinner options) with DE.

Methods

A nationally representative school-based survey of 4926 middle and high-school children (11–19 years old) was conducted during 2015–2016. Participants indicated where and with whom they had eaten dinner the day before. The 5-item SCOFF questionnaire was used (> 2 affirmative items were considered a likely case of DE). Height and weight were measured by personnel.

Results

DE was more prevalent among girls (29.7%) relative to boys (12.2%), Arabs (25.1%) relative to Jews (19.5%), and older (25.3%) relative to younger (17.6%) adolescents. Arabs were more likely to eat dinner at home with parents/family (chi² = 10.75, p = .001), or not to eat dinner at all (chi² = 63.27, p < .001), while Jews were more likely to eat dinner alone (chi² = 5.37, p = .021) or to eat dinner out of the home (chi² = 67.65, p < .001). Logistic regressions (stratified by ethnicity and adjusted for gender, age, weight) revealed that family dinners acted as a protective factor against DE, relative to eating out of the home or relative to not eating dinner at all among both ethnic groups, and relative to eating dinner alone among Arabs.

Conclusion

There are differences between Arab and Jewish adolescents in terms of rates of yesterday’s family dinners and DE. Given that eating dinner with the family was linked with lower rates of DE, possible interventions to reduce DE may include educating parents of both Arab and Jewish adolescents regarding the importance of family meals.

A single summative global scale of disordered eating attitudes and behaviors: Findings from Project EAT, a 15-year longitudinal population-based study

OBJECTIVE

The Project EAT Disordered Eating Attitudes and Behaviors (DEAB) scale was created from disordered eating attitudes and behaviors that tend to interrelate. To examine the appropriateness of the scale, we assessed the fit (i.e., how well a single latent factor fits a set of interrelated disordered eating attitudes and behaviors) and the convergent validity over time.

METHOD

Five interrelated disordered eating attitudes and behaviors were assessed in a longitudinal cohort (Project EAT, age 11 to 18 in 1998-1999, N = 1492). Confirmatory factor analysis examined the appropriateness of the DEAB scale. To examine whether individual variables function differently in relation to the latent construct across time, two models were compared: one requiring indicator-level factor loadings to remain equivalent across three time points (baseline [EAT-I], five-year follow-up [EAT-II], and 15-year follow-up [EAT-IV]), and the second allowing the factor loadings to vary over time. To examine the convergent validity, Pearson correlation with body satisfaction, self-esteem, depressive symptoms, and BMI was compared across time.

RESULTS

The fit indices for a single factor structure supported the use of the DEAB scale over time (standardized loadings: 0.60-0.87, 0.67-0.89, 0.59-0.77 at EAT-I, II, and IV respectively). As hypothesized, compared to fewer number of disordered eating attitudes and behaviors, greater number of attitudes and behaviors was associated with lower body satisfaction and self-esteem, and greater depressive symptoms and BMI (p < .01).

DISCUSSION

The Project EAT DEAB scale can be used as a proxy to measure the severity of disordered eating attitudes and behaviors over time in population-based studies.

Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers

OBJECTIVE

Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents' perceptions of family meals in order to understand how parents' past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children.

DESIGN

Semi-structured qualitative interviews.

SETTING

In-person interviews were conducted in participants' homes.

PARTICIPANTS

Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years.

RESULTS

Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents' own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families' approaches to mealtimes.

CONCLUSIONS

Parents' own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.

Family Meal Frequency, Diet, and Family Functioning: A Systematic Review With Meta-analyses

OBJECTIVE

To examine the direction and magnitude of the relation between family meal frequency and dietary and family functioning outcomes in children (aged 2-18 years).

DESIGN

Systematic literature review with meta-analysis.

METHODS

Independent electronic searches, 1 for each outcome of interest, were conducted across 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and PsycINFO. Studies were included if they were peer-reviewed and published in English in the US through December 2018.

MAIN OUTCOME MEASURES

Diet and family functioning.

RESULTS

Dietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There was less clear evidence of this relation in snacks, fast food, and desserts. A positive association was found between family meal frequency or dinner family meal frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs.

CONCLUSIONS AND IMPLICATIONS

There is some evidence to show a positive relation between family meal frequency and dietary outcomes. There is stronger evidence for the relation with family functioning outcomes. Most articles included in the systematic reviews were excluded from meta-analysis owing to inadequate data and high methodological diversity across exposure and outcome variables.

Automatic, wearable-based, in-field eating detection approaches for public health research: a scoping review

Dietary intake, eating behaviors, and context are important in chronic disease development, yet our ability to accurately assess these in research settings can be limited by biased traditional self-reporting tools. Objective measurement tools, specifically, wearable sensors, present the opportunity to minimize the major limitations of self-reported eating measures by generating supplementary sensor data that can improve the validity of self-report data in naturalistic settings. This scoping review summarizes the current use of wearable devices/sensors that automatically detect eating-related activity in naturalistic research settings. Five databases were searched in December 2019, and 618 records were retrieved from the literature search. This scoping review included N = 40 studies (from 33 articles) that reported on one or more wearable sensors used to automatically detect eating activity in the field. The majority of studies (N = 26, 65%) used multi-sensor systems (incorporating > 1 wearable sensors), and accelerometers were the most commonly utilized sensor (N = 25, 62.5%). All studies (N = 40, 100.0%) used either self-report or objective ground-truth methods to validate the inferred eating activity detected by the sensor(s). The most frequently reported evaluation metrics were Accuracy (N = 12) and F1-score (N = 10). This scoping review highlights the current state of wearable sensors' ability to improve upon traditional eating assessment methods by passively detecting eating activity in naturalistic settings, over long periods of time, and with minimal user interaction. A key challenge in this field, wide variation in eating outcome measures and evaluation metrics, demonstrates the need for the development of a standardized form of comparability among sensors/multi-sensor systems and multidisciplinary collaboration.

Disordered Eating Behaviors and 15-year Trajectories in Body Mass Index: Findings From Project Eating and Activity in Teens and Young Adults (EAT)

PURPOSE

Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years.

METHODS

Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years.

RESULTS

At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05).

CONCLUSIONS

Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.

Do Parents Perceive That Organized Activities Interfere with Family Meals? Associations between Parent Perceptions and Aspects of the Household Eating Environment

BACKGROUND

Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals.

OBJECTIVE

Examine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment.

DESIGN

A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study.

PARTICIPANTS

Survey participants were originally recruited in Minneapolis-St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years).

MAIN OUTCOME MEASURES

Parents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables.

STATISTICAL ANALYSES PERFORMED

Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics.

RESULTS

Among parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P<0.001) and those with a school-aged child (P<0.001) vs those with only preschool-aged children.

CONCLUSIONS

Follow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals.

Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial

BACKGROUND

Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2).

METHODS

Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2).

RESULTS

One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills.

CONCLUSIONS

Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity.

TRIAL REGISTRATION

NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.

Turkish Psychometric Properties of the Predictor Scales Affecting Adolescent Obesity

Adolescent obesity is one of the most important public health problems today. Identifying factors that affect obesity in adolescents and developing programs to prevent obesity are very important. This research aims to test Turkish psychometric properties of the scales to predict adolescent obesity (Healthy Lifestyle Choices Scale, Perceived Healthy Lifestyle Difficulty Scale, Activity Knowledge Scale, Nutrition Knowledge Scale, Healthy Lifestyle Attitude Scale, Healthy Lifestyle Belief Scale). The psychometric properties of the Scales were tested test-re-test reliability, the Cronbach's alpha coefficient, the item-total correlation, and the Confirmatory Factor Analysis. The relationship between the Scales was measured using the Spearman's correlation analysis. The level of internal consistency of the scales to predict adolescent obesity was found good. The goodness of fit values of the Belief Scale were measured as significantly high (χ2 = 177.24, df = 0.99, χ2/df = 1.79 (p < .001), Comparative Fit Index = 0.91, Goodness of Fit Index = 0.91, Normed Fit Index = 0.92, Incremental Fit Index = 0.92, Root Mean Square Residual = 0.05, Root Mean Square Error of Approximation Residual = 0.05). The psychometric analyses of the Scales were found to be very similar to the results of the original scales. There was a positive correlation between the Choice, Attitude, Belief, Nutrition and Activity Knowledge Scale, and a negative correlation with the Perceived Difficulty scale. The scales which measure adolescent obesity were accepted as valid and reliable measuring tools. This study will be an important resource for researchers working on the adolescent health and obesity.

Associations Between Early Family Meal Environment Quality and Later Well-Being in School-Age Children

OBJECTIVE

Past research suggests a positive link between family meals and child and adolescent health. Although researchers have often relied on how often families eat together, this may not capture the complexity of the experience. Using a birth cohort, this study examines the prospective associations between the environmental quality of the family meal experience at age 6 years and child well-being at age 10.

METHODS

Participants are 1492 children of the Quebec Longitudinal Study of Child Development. When children were age 6, parents reported on their typical family meal environment quality. At age 10, parents, teachers, and children themselves provided information on lifestyle habits, academic achievement, and social adjustment, respectively. The relationship between early family meal environment quality and later child outcomes was analyzed using a series of multivariate linear regression.

RESULTS

Family meal environment quality at age 6 predicted higher levels of general fitness and lower levels of soft drink consumption, physical aggression, oppositional behavior, nonaggressive delinquency, and reactive aggression at age 10. These relationships were adjusted for child characteristics (sex, temperament problems and cognitive abilities, and baseline body mass index [BMI]) and family characteristics (family configuration and functioning, maternal education, depression, and BMI).

CONCLUSION

From a population-health perspective, our findings suggest that family meals have long-term influences on children's biopsychosocial well-being. At a time when family meal frequency is on a natural decline in the population, this environmental characteristic can become a target of home-based interventions and could be featured in information campaigns that aim to optimize child development.

A healthful home food environment: Is it possible amidst household chaos and parental stress?

PURPOSE

This study examines how household chaos and unmanaged parental stress are associated with and contribute to variance in markers of the home food environment (family meal frequency, perceived barriers to cooking, healthful home food availability). Obtaining a better understanding of these relationships could guide more effective family-based interventions to promote healthful home food environments.

METHODS

The analytic sample included 819 households with children in the population-based Project EAT-IV cohort with survey data from 2015 to 2016. Multiple linear regression was used to generate means and 95% confidence intervals of home food environment variables, and estimates for the contribution of household chaos (defined by frenetic activity, loud noises and disorder), and quartiles of unmanaged parental stress (ratio of perceived stress and ability to manage stress). Model fit was also examined.

RESULTS/FINDINGS

Both household chaos and quartiles of unmanaged parental stress were independently and inversely associated with family meal frequency (p's < 0.001) and positively associated with perceived mealtime preparation barriers (p's < 0.001). Unmanaged parental stress was also inversely associated with healthful home food availability (p = 0.004). Models including demographic characteristics, household chaos scores, and quartiles of unmanaged parental stress index showed significantly improved model fit for all outcomes compared to less comprehensive models. Among families with high chaos, those having 7 + family meals/week were significantly more likely to have lower mealtime preparation barrier scores, younger children and higher healthful home food availability scores than families eating together less often.

CONCLUSIONS

Interventions to assist with parental management of stress and chaos within the home environment (e.g., establishing routines) may increase family meal frequency and the quality of children's home food environments.

Family mealtime negativity and adolescent binge-eating: A replication and extension study in a community sample

OBJECTIVE

To explore differences in family mealtime characteristics and family mealtime emotions among adolescents who report engaging in binge-eating in comparison to those who do not.

METHOD

Adolescents (N = 495) recruited from UK schools/colleges reported on their family mealtime frequency and atmosphere, family mealtime emotions, anxiety, depression and eating psychopathology.

RESULTS

No significant differences were found between adolescents who reported binge-eating (n = 32 boys; n = 82 girls) and those who did not (n = 196 boys; n = 185 girls) on family mealtime frequency or mealtime atmosphere scores. However, boys and girls who binge-eat reported significantly lower levels of positive family mealtime emotions and significantly higher levels of family mealtime anxiety and anger (girls only), compared with their peers who did not report binge-eating.

DISCUSSION

Adolescents who binge-eat experience significantly greater negative emotional responses to family mealtimes than their peers. Further research should explore why these experiences are more negative, including broader familial factors and interactions.

Eating Breakfast and Family Meals in Adolescence: The Role of Body Image

Regularly eating breakfast and meals with family has important health implications for youth. However, the association between eating breakfast and family meals regularly with body image has not been explored. Utilizing the 2009-2010 World Health Organization's Health Behavior in School-Aged Children U.S. survey (N = 12,642), we sought to begin this conversation. Our findings suggest that eating breakfast and meals with parents more regularly may be related to more positive body image. This cross-sectional glance suggests that policies and programs that encourage youth and families to regularly eat breakfast and family meals may also encourage better body image among youth.

The intergenerational transmission of family meal practices: a mixed-methods study of parents of young children

OBJECTIVE

The current mixed-methods study explored qualitative accounts of prior childhood experiences and current contextual factors around family meals across three quantitatively informed categories of family meal frequency patterns from adolescence to parenthood: (i) 'maintainers' of family meals across generations; (ii) 'starters' of family meals in the next generation; and (iii) 'inconsistent' family meal patterns across generations.

DESIGN

Quantitative survey data collected as part of the first (1998-1999) and fourth (2015-2016) waves of the longitudinal Project EAT (Eating and Activity in Adolescents and Young Adults) study and qualitative interviews conducted with a subset (n 40) of Project EAT parent participants in 2016-2017.

SETTING

Surveys were completed in school (Wave 1) and online (Wave 4); qualitative interviews were completed in-person or over the telephone.ParticipantsParents of children of pre-school age (n 40) who had also completed Project EAT surveys at Wave 1 and Wave 4.

RESULTS

Findings revealed salient variation within each overarching theme around family meal influences ('early childhood experiences', 'influence of partner', 'household skills' and 'family priorities') across the three intergenerational family meal patterns, in which 'maintainers' had numerous influences that supported the practice of family meals; 'starters' experienced some supports and some challenges; and 'inconsistents' experienced many barriers to making family meals a regular practice.

CONCLUSIONS

Family meal interventions should address differences in cooking and planning skills, aim to reach all adults in the home, and seek to help parents who did not eat family meals as a child develop an understanding of how and why they might start this tradition with their family.

Resemblance of Diet Quality in Families of Youth with Type 1 Diabetes Participating in a Randomized Controlled Behavioral Nutrition Intervention Trial in Boston, MA (2010-2013): A Secondary Data Analysis

BACKGROUND

Parent-child diet quality resemblance is unknown in families of youth with type 1 diabetes, for whom nutrition is central to disease management.

OBJECTIVE

Examine diet quality resemblance in families of youth with type 1 diabetes participating in a behavioral nutrition intervention trial and investigate whether treatment assignment or family meal frequency modifies resemblance.

DESIGN

This is a secondary data analysis from an 18-month randomized controlled trial conducted August 2010 to May 2013.

PARTICIPANTS/SETTING

Parent-youth dyads (N=136, child age=12.3±2.5 years) were recruited from a northeast US diabetes center.

MAIN OUTCOME MEASURES

Parent and child Healthy Eating Index-2005 (HEI-2005, reflecting adherence to 2005 Dietary Guidelines for Americans) and whole plant food density (WPFD, reflecting intervention target foods) were calculated from 3-day food records collected every 6 months.

STATISTICAL ANALYSIS

Linear random effects models adjusting for demographics and disease characteristics investigated parent-child diet quality resemblance. Separate models examined whether treatment assignment or family meal frequency modified resemblance. Three-way interaction terms examined whether resemblance changed over time by treatment assignment.

RESULTS

Time-varying parent and child HEI-2005 and WPFD were positively associated (P<0.001), and there were no interactions with family meals. Parent-child HEI-2005 resemblance was similar across treatment groups; however, parent-child WPFD resemblance was stronger in the intervention (β±standard error [SE]=.30±.06) vs control families (β±SE=.12±.05). Parent-child HEI-2005 resemblance was similar over time by treatment assignment, whereas parent-child WPFD resemblance increased over time for families in the intervention group (three-way interaction term β±SE=.03±.01).

CONCLUSIONS

Parent and youth diet quality were positively correlated in families of youth with type 1 diabetes. Resemblance was stronger in the intervention group for target foods, but not for a general measure of diet quality. The lack of effect modification by family meal frequency suggests that family diet quality resemblance is not contingent on shared meals.

Association of socio-culture factors with disordered eating behavior: An empirical study on urban young girls of West Bengal, India

A shift towards the concept of thin body image is occurring among the urban girls, as an outcome of mass media exposure. A large section of the girls are involved in attaining thin body image which at times develops dissatisfaction over body weight. Body weight dissatisfaction gives rise to the development of body weight concern and disordered eating behavior. The present research aimed to find out the association of socio-cultural factors with disordered eating behavior among a group of urban girls. The study group included 400 girls aged between 14 and 21 years, residing in the city of Howrah, West Bengal, eastern state of India. Information on socio-demographic characteristics, body weight concern, media habits, and family-peer environments was collected using standard pretested questionnaires. A cross-culturally tested questionnaire developed by Srinivasan and colleagues in 1998, was used to measure disordered eating behavior. Bivariate analyses found significant associations between eating behavior and several socio-cultural factors. Multivariate analysis revealed that education level of fathers and birth order of the participants, body weight concern and peers’ influence were the significant predictors of disordered eating behavior of the study participants. Socio-cultural factors have significant associations with the disordered eating behavior of the study participants.

Weight Bias Internalization Among Adolescents Seeking Weight Loss: Implications for Eating Behaviors and Parental Communication

Background: Emerging evidence has demonstrated a high prevalence of weight bias internalization (WBI) among adults, as well as consistent links between internalization and adverse psychological and physical health. However, research examining WBI in youth and its impact on their health is scarce, especially among youth seeking weight loss treatment who may be particularly vulnerable to weight stigma from peers and parents. To address this research gap, the present study assessed WBI in a weight loss treatment-seeking sample of adolescents, examining associations between internalization and adolescents' eating behaviors and parental weight-related communication. Methods: Adolescents (N = 148, M _age = 15.97 years), completed online self-report measures to assess WBI (using the modified version of the WBI Scale), body weight, binge eating, eating as a coping strategy, and weight teasing from peers and family members. Adolescents also reported on the frequency of parental comments about body weight, parental dieting, and parental encouragement of adolescent dieting. Results: Adolescents expressed a high mean level of internalized weight bias (M = 5.45, SD = 0.88). Higher levels of internalization were observed across increasing body weight categories; no differences were observed for gender or history of weight teasing. WBI was significantly higher among adolescents who reported binge eating and eating to cope with distress. Regression analyses showed that weight-related comments from mothers (but not fathers) significantly predicted adolescents' WBI (including frequency of mothers' comments about adolescents' body weight, comments about their own body weight, and encouragement of their adolescent to diet), as did increased dieting frequency among mothers. Conclusion: The present study provides novel insights to the scant literature on WBI in youth. Findings indicate that WBI is high in both girls and boys engaged in weight loss, and is associated with maladaptive eating behaviors, higher frequency of maternal dieting, and mothers' comments about body weight. These findings have important clinical implications for youth and families engaged in weight loss treatment, and underscore the need for research to clarify adverse effects of internalization on weight-related health in youth and to better understand the role that parental weight communication may have on adolescents' internalization.

Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors

INTRODUCTION

This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating.

METHOD

A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior.

RESULTS

Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations.

DISCUSSION

Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record

Making time for family meals: Parental influences, home eating environments, barriers and protective factors

Frequent family mealtimes have been associated with numerous positive dietary, health, and behavioral outcomes for children and families. This review article summarizes some of the beneficial outcomes associated with having frequent family dinners. Current trends in family dinner frequency are discussed in the context of barriers that influence how often families eat dinner together, including time issues, work issues, and distractions in the home environment. Next, several parental influences and home environment factors that promote healthy and consistent family dinners are outlined. Finally, limitations are discussed and a few practical suggestions are mentioned to help encourage families, employers, and policy-makers to make family mealtimes a regular practice for as many families as possible.

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls

PURPOSE

To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model.

METHODS

Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership.

RESULTS

Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity.

CONCLUSION

Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors

OBJECTIVE

Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors.

DESIGN

Cross-sectional survey in 2015-2016.

PARTICIPANTS

Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study.

VARIABLES MEASURED

Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating.

ANALYSIS

Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status.

RESULTS

In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating.

CONCLUSIONS AND IMPLICATIONS

Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed.