Family Meal Frequency and Association with Household Food Availability in United States Multi-Person Households: National Health and Nutrition Examination Survey 2007-2010

Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship

Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.

Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth

Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.

Living Environment Considerations on Obesity Prevention Behaviors and Self-Efficacy among Chinese Americans

The aim of this study is to ascertain if the living environment (type of residential neighborhood and number of household members) will elucidate differences in obesity risk reduction behaviors and self-efficacy in Chinese Americans. A cross-sectional survey design was used to recruit participants from Los Angeles County and New York City metropolitan areas. A total of 650 adults were recruited from diverse socioeconomic backgrounds. Descriptive statistics were measured for 19 behaviors reflecting food intake and portion size control and items measuring self-efficacy and attitudes. T-tests were applied for the two categories of living environment. The mean age of the sample was 36.3 years. The 'high income' neighborhood group indicated a greater frequency of behaviors, including choosing steamed over fried foods (p < 0.01) and using small amounts of oil (p < 0.05). In general, this group exhibited more favorable attitudes and stronger self-efficacy to perform health behaviors. Multiple regression analyses point to the impact of self-efficacy in predicting behaviors. Nutrition professionals must assess client's living environments in the adoption of obesity prevention behaviors and the fostering of behavioral confidence.

Comparison of Dietary Behaviors and the Prevalence of Metabolic Syndrome in Single- and Multi-Person Households among Korean Adults

Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals' dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS) as well as explore factors associated with MetS according to household type among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey 2014-2018, we included 21,944 Korean adults with available health examination and dietary recall data. Based on self-reported information, individuals were divided into two household types: single- and multi-person households. We used multivariable logistic regression to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for MetS and its components after adjusting for potential covariates. Among the study population, 9.19% and 90.81% lived in single-person and multi-person households, respectively. Individuals in single-person households had a higher energy intake overall and a greater percentage of energy from animal protein; total, saturated, and monounsaturated fats; and animal source foods and a lower percentage of energy from carbohydrates, plant protein, and plant source foods than those from multi-person households (all, p < 0.05). Individuals living in single-person rather than multi-person households were more likely to consume milk/dairy products, alcoholic and non-alcoholic beverages, oils/fats, and others but were less likely to consume vegetables/mushrooms, fruits, seaweeds, and fish/shellfish (all, p < 0.05). Living alone was associated with higher energy intake from main meals and foods prepared away from home but a lower dietary variety score and fewer total main meals consumed (all, p < 0.05). Skipping breakfast, frequent eating out, food insecurity, and MetS combination phenotypes significantly differed by household type. Individuals living alone had higher odds of MetS (AOR: 1.14, 95% CI: 1.02-1.29), abdominal obesity (AOR: 1.14, 95% CI: 1.01-1.28), elevated blood pressure (AOR: 1.28, 95% CI: 1.12-1.47), and elevated fasting blood glucose (AOR: 1.18, 95% CI: 1.05-1.33) than those living with others. Compared with those in multi-person households, individuals in single-person households tend to have health and dietary behaviors that increase vulnerability to MetS; therefore, establishing health care strategies and nutrition policies according to household type is necessary.

Changes in Sugary Beverage Consumption and Public Perceptions in Upstate New York After Implementation of a Community Awareness Campaign and Healthier Vending Strategies

OBJECTIVE

We evaluated the impact of a community-based healthy beverage procurement and serving practices program, and educational media campaign, on residents' behaviors and beliefs regarding sugary beverages.

DESIGN

Repeated cross-sectional population surveys in 2013 and 2014 were conducted, as well as semistructured interviews with key informants. We employed multivariate differences-in-differences regression analysis, adjusting for demographics and weight status, using the survey data. Key informant interviews were reviewed for common themes.

SETTING

Three rural counties in upstate New York with high prevalence of children living in poverty and childhood obesity.

PARTICIPANTS

Residents of Broome, Cattaraugus, and Chautauqua, with Chemung as a control, reached through cross-sectional random-digit-dial landline and cellular telephones, and practitioners involved in intervention implementation.

INTERVENTION

Community organizations were encouraged through presentations to leadership to adopt healthier vending policies, providing more low- and no-sugar options, and were provided assistance with implementation. In addition, a media campaign supported by presentations to the public aimed to educate residents regarding the health consequences of sugary beverage consumption.

OUTCOME MEASURES

The survey measured population demographics and sugary beverage consumption frequency, availability, beliefs about harmfulness, and support for regulation, pre- and postintervention. Key informant interviews elicited perceived program challenges and successes.

RESULTS

Compared with temporal trends in the control county, availability of regular soda in the intervention counties decreased (differences-in-differences estimator: β = -.341, P = .04) and support for regulation increased (differences-in-differences estimator: β = .162, P = .02). However, there were no differences regarding beliefs about harmfulness or consumption. Practitioners confirmed that the intervention increased awareness but was insufficient to spur action.

CONCLUSION

Although public education on the harmfulness of sugary beverages and provision of healthier options in some vending machines successfully impacted soda availability and support for regulation, it did not reduce consumption. This intervention seems promising but should be paired with other community-based interventions for a more comprehensive approach.

Changes in Parent and Child Skin Carotenoids, Weight, and Dietary Behaviors over Parental Weight Management

(1) The objective was to determine changes in parent-child (ages 7-18) dyad skin carotenoids spanning parental participation in a medical weight management program (WMP), and associations with parent BMI, child BMIz, fruit/vegetable intake, and family meals and patterns. (2) The study design was a longitudinal dyadic observational study with assessment at WMP initiation, mid-point (3-months), and conclusion (6-months). Twenty-three dyads initiated the study, 16 provided assessments at 3 months, and 11 at program conclusion. Associations between parent and child carotenoids (dependent variables) and parent BMI, child BMIz, increases in fruit/vegetable intake, and family meals and patterns were analyzed using Pearson's correlations and independent samples t-tests. Repeated measures ANOVA assessed changes in weight status and carotenoids. (3) Parents experienced significant declines in BMI and skin carotenoid levels over 6 months. Parent and child carotenoids were correlated at each assessment. At initiation, parent BMI and carotenoids were inversely correlated, child carotenoids were associated with increased family meals, and never consuming an evening fast food or restaurant meal were associated with increased parent and child carotenoids. (4) Results demonstrate skin carotenoids are strongly correlated within dyads and may be associated with lower parental BMI and positive family meal practices.

Home food environment and associations with weight and diet among U.S. adults: a cross-sectional study

BACKGROUND

The home provides the physical and social context for the majority of eating behaviors for U.S. adults. This study describes eleven dimensions of the home food environment among a national sample of U.S. adults and identifies which are associated with diet quality and overweight/obesity.

METHODS

A national sample of U.S. adults ages 18 to 75 was recruited from an online survey panel. Respondents (n = 4942) reported on foods available in the home, including 1) fruit and vegetables, 2) salty snacks/sweets, 3) less healthy beverages, as well as 4) food placement, 5) shopping practices for fruits and vegetables, 6) food preparation, 7) portion control methods, 8) family meals from restaurants, 9) family household practices around TV and eating, 10) presence of a TV in the dining area, and 11) ownership of a scale. Self-reported height and weight, fruit and vegetable intake, and percent calories from fat were also assessed.

RESULTS

Mean household size was 2.6, 32.7% had children in the home, and 23.1% lived alone. The majority were White (67.7%), with 12.3% Black and 14.3% Hispanic. Mean age was 44.4 and 48.3% were men. In multivariable models, seven features of the home food environment were associated with meeting the recommended fruit and vegetable intake guidelines, with food placement, meal preparation, frequency of shopping for fruit, and a greater variety of fruits and vegetables available in the home most strongly associated. Eight of 11 features were associated with percent energy from fat, including restaurant food for family meals, salty snacks and sweets availability, less healthy beverages availability, food placement, meal preparation, frequency of shopping for fruit, family eating with the TV on, and having a TV in the dining area. More diverse fruit and vegetable availability was associated with lower odds of overweight/obesity, and more frequent family eating while watching TV was associated with increased odds of overweight/obesity.

CONCLUSION

Targeting these dimensions of the home food environment may be a promising approach for future intervention research.

Family as a health promotion setting: A scoping review of conceptual models of the health-promoting family

Background

The family is a key setting for health promotion. Contemporary health promoting family models can establish scaffolds for shaping health behaviors and can be useful tools for education and health promotion.

Objectives

The objective of this scoping review is to provide details as to how conceptual and theoretical models of the health promoting potential of the family are being used in health promotion contexts.

Design

Guided by PRISMA ScR guidelines, we used a three-step search strategy to find relevant papers. This included key-word searching electronic databases (Medline, PSycINFO, Embase, and CINAHL), searching the reference lists of included studies, and intentionally searching for grey literature (in textbooks, dissertations, thesis manuscripts and reports.)

Results

After applying inclusion and exclusion criteria, the overall search generated 113 included manuscripts/chapters with 118 unique models. Through our analysis of these models, three main themes were apparent: 1) ecological factors are central components to most models or conceptual frameworks; 2) models were attentive to cultural and other diversities, allowing room for a wide range of differences across family types, and for different and ever-expanding social norms and roles; and 3) the role of the child as a passive recipient of their health journey rather than as an active agent in promoting their own family health was highlighted as an important gap in many of the identified models.

Conclusions

This review contributes a synthesis of contemporary literature in this area and supports the priority of ecological frameworks and diversity of family contexts. It encourages researchers, practitioners and family stakeholders to recognize the value of the child as an active agent in shaping the health promoting potential of their family context.

Family Meal Practices and Weight Talk Between Adult Weight Management and Weight Loss Surgery Patients and Their Children

OBJECTIVE

To identify predictors associated with specific family meal practices and weight talk among patients participating in weight management programs (WMPs) and weight loss surgery (WLS) and their children.

DESIGN

Cross-sectional survey.

SETTING

Two US weight management centers.

PARTICIPANTS

259 patients (aged ≥ 18 years) in either WMP (n = 101) or WLS (n = 158) and residing with a child (aged 2-18 years) MAIN OUTCOME MEASURE(S): Dependent variables: family meal practices (Project EAT) and weight talk (investigator-created). Covariates: family communication (Family Communication Scale), family discouragement for making eating habit change (Social Support for Eating Habits Survey), child age, sex, and perceived weight status, and WMP or WLS participation.

ANALYSIS

Binomial and ordinal regression models determined the odds of engaging in specific family meal practices and weight talk, including covariates.

RESULTS

Patients had increased odds of engaging in family dinners if they reported lower family discouragement (P = .003) and had younger children (P < .001), and increased odds of engaging in family breakfast if they had higher family communication (P = .002) and younger children (P = .020). Patients had increased odds of talking about their child's weight if their child was perceived to have an overweight/obese weight status (P < .001). Patients with older children had increased odds of talking about their weight with their child (P = .021).

CONCLUSIONS AND IMPLICATIONS

Additional research assessing the family meal practices and weight talk in the families of adults pursuing weight loss could yield important evidence that could lead to improved patient outcomes, and safely promote healthy behaviors and prevention of obesity in children.

Age and gender influence healthy eating and physical activity behaviours in South African adolescents and their caregivers: Transforming Adolescent Lives through Nutrition Initiative (TALENT)

Objective:

To: (i) understand facilitators and barriers to healthy eating practices and physical activity in younger and older urban adolescent South African boys and girls; and (ii) understand how the views of caregivers interact with, and influence, adolescent behaviours.

Design:

Semi-structured focus group discussions (FGD) were conducted in July 2018. Data were analysed using thematic analysis.

Setting:

Soweto, Johannesburg, South Africa.

Participants:

Seventy-five participants were stratified into eight FGD as follows: two for young boys and girls (10–12 years); two for older boys and girls (15–17 years); two for caregivers of young adolescents (boys and girls); and two for caregivers of older adolescents (boys and girls).

Results:

Unlike their caregivers, adolescents were not motivated to eat healthily and failed to appreciate the need to develop consistent patterns of both healthy eating and physical activity for their long-term health. Although adolescents gained independence with age, they commonly attributed unhealthy food choices to a lack of autonomy and, thereby, to the influence of their caregivers. Adolescents and caregivers perceived their engagement in physical activity according to distinct siloes of recreational and routine activity, respectively. Both similarities and differences in the drivers of healthy eating and physical activity exist in adolescents and caregivers, and should be targeted in future interventions.

Conclusions:

Our study identified a complex paradigm of eating practices and physical activity in South African adolescents and their caregivers. We also highlighted the need for a new narrative in addressing the multifaceted and interrelated determinants of adolescent health within urban poor settings.

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.

The impact of environmental, parental and child factors on health-related behaviors among low-income children

Multi-level factors act in concert to influence child weight-related behaviors. This study examined the simultaneous impact of variables obtained at the level of the home environment (e.g., mealtime ritualization), parent (e.g., modeling) and child (e.g., satiety responsiveness) with the outcomes of practicing healthy and limiting unhealthy child behaviors (PHCB and LUCB, respectively) in a low-income U.S.

SAMPLE

This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (β: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (β: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (β: -0.19, 95% CI: -0.29; -0.10). More parental covert control (β: 0.44, 95% CI: 0.35; 0.54), more parental overt control (β: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (β: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors.

Maternal Feeding Practices among Children with Feeding Difficulties-Cross-sectional Study in a Brazilian Reference Center

BACKGROUND

Given the positive influence of responsive caregiving on dietary habits in childhood, to raise awareness of caregivers regarding their behavior is crucial in multidisciplinary care on infant feeding.

OBJECTIVES

To identify the most common responsive and non-responsive feeding practices in mothers of children with feeding complaints, as well as to seek associations between practices and caregivers' profile.

METHODS

Cross-sectional study with 77 children under 18 years old, with complaints of feeding difficulties. Data were collected during interviews with mothers: child age, gender, duration of exclusive breastfeeding, presence of organic disease, dynamics of bottle use, self-feeding practices and posture at meals, use of appropriate feeding equipment; basic information about the mothers (parity and level of education), caregiver feeding style, presence of coercive feeding, frequency and characteristics of family meals. Statistical analysis considered significance level at 5%.

RESULTS

The non-responsive profile predominated among mothers (76.2%, with the Authoritarian style being the most prevalent-39.7%). The responsive profile was characterized by absence of coercive feeding, stimulation of self-feeding practices, use of appropriate feeding equipment and meal environment, with interaction at meals. Non-responsive profile consisted of both inadequate environment and posture at meals, use of distraction and coercive feeding, lack of shared meals, and disregard for children's hunger signals. Only the habit of sharing meals with children was associated with mothers' profile, and considered a protection factor against non-responsive care (OR 0.23; 95% CI 0.06-0.88). Both Authoritarian (p = 0.000) and indulgent mothers (p = 0.007) breastfed exclusively for longer time than negligent ones. There was a higher level of interaction with children in "responsive" parental style (OR 0.056; p = 0.01) compared to other feeding styles.

CONCLUSION

Results highlight the need for educational interventions focused on caregivers' behaviors.

No Time for Family Meals? Parenting Practices Associated with Adolescent Fruit and Vegetable Intake When Family Meals Are Not an Option

BACKGROUND

Despite research linking family meals to healthier diets, some families are unable to have regular meals together. These families need guidance about other ways to promote healthy eating among adolescents.

OBJECTIVE

Our aim was to examine the association between various parenting practices and adolescent fruit and vegetable (F/V) intake at different levels of family meal frequency.

DESIGN

We conducted a cross-sectional, population-based survey of influences on adolescent weight-related behaviors using Project EAT (Eating and Activity in Teens) 2010.

PARTICIPANTS/SETTING

Participants were 2,491 adolescents recruited from middle/high schools in Minneapolis/St Paul, MN.

MEASURES

Adolescent F/V intake was ascertained with a food frequency questionnaire. Survey items assessed frequency of family meals and F/V parenting practices (availability, accessibility, parent modeling, parent encouragement, and family communication).

STATISTICAL ANALYSES

Linear regression models were used to examine associations with and interactions among family meals and parenting practices. Models were adjusted for age, sex, socioeconomic status, race/ethnicity, and energy intake (kilocalories per day).

RESULTS

Family meals, F/V availability, F/V accessibility, F/V modeling, and encouragement to eat healthy foods were independently associated with higher F/V intake. Of the 949 (34%) adolescents who reported infrequent family meals (≤2 days/wk), mean F/V intake was 3.6 servings/day for those with high home F/V availability vs 3.0 servings/day for those with low home F/V availability. Similar differences in mean F/V intake (0.3 to 0.6 servings/day) were found for high vs low F/V accessibility, parental modeling, and parent encouragement for healthy eating. Frequent family meals in addition to more favorable parenting practices were associated with the highest F/V intakes.

CONCLUSIONS

Food parenting practices and family meals are associated with greater adolescent F/V intake. Longitudinal and intervention studies are needed to determine which combination of parenting practices will lead to improvements in adolescent diets.

Is one's usual dinner companion associated with greater odds of depression? Using data from the 2014 Korean National Health and Nutrition Examination Survey

BACKGROUND

Support from one's family has been reported to have a positive effect on depression severity. Hence, family dinnertimes, when whole family can gather together, can be effective to depression by providing support from family.

AIMS

We investigate the association between the dinner companion and depression, and the differences in this association by gender, living arrangement and household composition.

METHODS

We used the Korea National Health and Nutrition Examination Survey 2014 data. A total of 4,181 individuals were included. We classified participants by their dinner companions as follows: dinner with family, dinner with others and eating alone. Depression was measured by using the 9-item Patient Health Questionnaire. Logistic regression analysis was used to investigate the association.

RESULT

Those who ate dinner alone (odds ratio (OR): 1.53, 95% confidence interval (CI): 1.04-2.25) had higher depression rate compared to those who had dinner with family. The subgroup analysis indicated that men, those who live with others and those living in a second-generation household who ate dinner alone had greater odds of having depressive symptoms.

CONCLUSION

Those who usually eat dinner alone have greater odds of developing depression compared to those who have dinner with their family. As such, family dinnertimes may help to alleviate depressive moods.