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Are family meal patterns associated with overall
diet quality during the transition from early to
middle adolescence? Teri L. Burgess-Champoux,
PhD, RD, LD Nicole I. Larson, MPH, RD Dianne
Neumark-Sztainer, PhD, MPH, RD Peter J. Hannan,
MStat and Mary Story, PhD, RD Division of
Epidemiology and Community Health, School of
Public Health University of Minnesota
BACKGROUND
RESULTS
CONCLUSIONS

• Adolescence
• Energy and nutrient needs elevated to meet needs
  for rapid physical growth and development.
• Adolescent dietary intakes of fruits, vegetables,
  whole grains, and calcium-rich foods were below
  the recommended levels for both males and females
  (NHANES, 1999-2002 Cook and Friday, 2004).
• Poor intakes of fiber, potassium, magnesium, and
  vitamins A and E were also identified as
  potential problems for this age group (Moshfegh
  et al. 2005).
• Family meals
• Cross-sectional studies have shown that eating
  frequent family meals is positively associated
  with enhanced diet quality for adolescents
  (Neumark-Sztainer et al. 2003 Gillman et al.
  2000).
• Present study extends and builds upon previous
  cross-sectional research.

• Key Findings
• Continuity of regular family meals for males and
  females during the transition from early to
  middle adolescence was as follows None (32.2,
  n215), Time 1 only (37.8, n252), Time 2 only
  (8, n53), and at both Time 1 and Time 2 (22.1,
  n149).
• Continuity of regular family meals was positively
  associated with mean daily intakes of vegetables,
  calcium-rich foods, calcium, magnesium,
  potassium, iron, zinc, vitamin B-6, folate, and
  fiber for both male and female adolescents at
  Time 2 (plt0.05) (data not shown).
• Time 2 mean daily intakes of fruits, vegetables,
  whole grains, potassium, magnesium, vitamin E,
  and fiber were below the recommended levels for
  both genders across categories of regular family
  meals (data not shown).

• Adolescents who participated in regular family
  meals reported healthier diets and meal patterns
  compared to adolescents without regular family
  meals.
• Our findings are consistent with previous
  cross-sectional studies and extend these findings
  due to the longitudinal design.
• Study limitations
• Use of self-reported data which are susceptible
  to social desirability bias.
• Limitations of the food frequency questionnaire
  to accurately assess dietary intake.
• Reduced representativeness resulting from
  non-response at Time 2.
• Observational study therefore, unable to
  establish causality.

RESEARCH QUESTIONS AND STUDY HYPOTHESIS
IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE

• Research Questions
• Do family meal patterns during early adolescence
  (middle school) predict diet quality five years
  later in middle (high school) adolescence?
• Do family meal patterns during early adolescence
  (middle school) predict meal patterns (e.g. meal
  frequency) five years later in middle (high
  school) adolescence?
• Hypothesis
• We hypothesized that adolescents who had
  consistent family meals during early to middle
  adolescence would have better overall diet
  quality and eating patterns at follow-up compared
  to adolescents who did not have regular family
  meals.

• Regular family meals during the transition from
  early to middle adolescence contribute to the
  formation of future healthy eating habits and may
  shape recommendations to parents, healthcare
  providers, and educators regarding the importance
  of shared mealtime experiences.
• Disseminating information regarding mealtime
  strategies, the development of food preparation
  skills for parent and child, and the provision of
  simple, healthy recipes are key ingredients which
  may help promote family meals.
• Future research should investigate the various
  levels of influence (i.e. community, school,
  family, and individual) which effect the
  provision of regular family meals.

METHODS AND STUDY DESIGN
REFERENCES

• Project EAT (Eating Among Teens) I and II
• Study design Population-based, longitudinal
  study (Ngt 2500) in middle schools and high
  schools in St. Paul/Minneapolis area.
• Primary aim To examine socio-environmental,
  personal, and behavioral determinants of dietary
  intake and weight status among adolescents.
• Study sample
• n 313 (45) male, n 389 (55) female
  adolescents
• Mean age at Time 1 12.8 years mean age at Time
  2 17.2 years
• Race/ethnicity 37 White, 23 Asian, 41
  African-American/Hispanic/Other
• SES 16 low, 19 low-middle, 32 middle, 18
  upper-middle, 15 high
• Measures
• Time 1 (1998-1999), Time 2 (2003-2004)
• Classroom surveys and the Youth and Adolescent
  Food Frequency Questionnaire (YAQ) (Rockett et
  al. 1995).
• Statistical Analyses
• Gender-stratified generalized linear modeling
  across the four family meal categories adjusted
  for race/ethnicity, SES, and the Time 1 outcome.
• Propensity weighting for non-response bias.

• Cook AJ, Friday JE. Pyramid servings intakes in
  the United States, 1999-2002, 1 day. Beltsville,
  MDUSDA Agricultural Research Service, Community
  Nutrition Research Group, CNRG Table Set 3.0.
• Moshfegh A, Goldman J, Cleveland L. What We Eat
  in America, NHANES 2001-2002 Usual nutrient
  intakes from food compared to dietary reference
  intakes. USDA Agricultural Research Service,
  2005.
• Neumark-Sztainer D, Hannan PJ, Story M, Croll J,
  Perry C. Family meal patterns Associations with
  sociodemographic characteristics and improved
  dietary intake among adolescents. Journal of the
  American Dietetic Association.2003103317-322.
• Gillman MW, Rifas-Shiman SL, Frazier AL, Rockett
  HA, Camargo CA, Field AE, Berkey CS, Colditz GA.
  Familly dinner and diet quality among older
  children and adolescents. Archives of Family
  Medicine.20009235-240.
• Rockett HR, Wolf AM, Colditz GA. Development and
  reproducibility of a food frequency questionnaire
  to assess diets of older children and
  adolescents. Journal of the American Dietetic
  Association.199595336-340.

This study was supported by Grant R40 MC 00319
(PI D. Neumark-Sztainer) from the Maternal and
Child Health Bureau (Title V, Social Security
Act), Health Resources and Services
Administration, Department of Health and Human
Services. Analyses were supported by the Bell
Institute of Health and Nutrition, General Mills
and by the Adolescent Health Protection Research
Training Program grant number T01-DP000112 (PI
L. Bearinger) from the Centers for Disease
Control and Prevention (CDC), Department of
Health and Human Services (DHHS). Its contents
are solely the responsibility of the authors and
do not necessarily represent the official views
of the CDC.
This study was supported by Grant R40 MC 00319
from the Maternal and Child Health Bureau (Title
V, Social Security Act), Health Resources and
Services Administration, Department of Health and
Human Services. Also supported in part by
Adolescent Health Protection Research Training
grant number T01-DP000112 from the Center for
Disease Control and Prevention (CDC), DHHS.