Journal of Nutrition Education and Behavior
Volume 41, Issue 2 , Pages 79-86, March 2009

Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence?

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN

Article Outline

Abstract 

Objective

To examine longitudinal associations of participation in regular family meals (≥ 5 meals/week) with eating habits and dietary intake during adolescence.

Design

Population-based, longitudinal study (Project EAT: Eating Among Teens). Surveys were completed in Minnesota classrooms at Time 1 (1998-1999) and by mail at Time 2 (2003-2004).

Setting

Baseline surveys were completed in Minneapolis/St. Paul, Minnesota, schools and by mail at follow-up.

Participants

677 adolescents (303 males and 374 females) who were in middle school at Time 1 (mean age = 12.8 ± 0.74 years) and high school at Time 2 (mean age = 17.2 ± 0.59 years).

Main Outcome Measures

Dietary intake, frequency of meals, and fast-food intake patterns.

Analysis

Generalized linear modeling stratified by gender and adjusted for race/ethnicity, socioeconomic status, and the Time 1 outcome.

Results

Regular family meals were positively associated with Time 2 frequency of breakfast, lunch, and dinner meals for males and breakfast and dinner meals for females. Among males, regular family meals were negatively associated with Time 2 fast-food intake. Regular family meals were also positively associated with Time 2 mean daily intakes of vegetables, calcium-rich food, fiber, calcium, magnesium, potassium, iron, zinc, folate, and vitamins A and B6 among both genders.

Conclusions and Implications

Regular family meals during early adolescence may contribute to the formation of healthful eating habits 5 years later. Parents should be made aware of the importance of shared mealtime experiences.

Key Words: adolescent, family meals, diet quality, meal patterns

 

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Introduction 

Adolescence is one of the most dynamic developmental periods during the life span. Total energy and nutrient requirements are highest during this time period to meet needs for physical growth and development; however, adolescents often fail to meet these elevated dietary needs.1, 2 According to National Health and Nutrition Examination Survey data (NHANES, 1999-2002), adolescent dietary intakes of fruits, vegetables, whole grains, and calcium-rich food are less than recommended among both males and females.3, 4 Low intakes of dietary fiber, potassium, magnesium, and vitamins A and E have also been identified as potential problems for this age group.4 Although numerous factors within an adolescent's environment can impact eating patterns and dietary intake, research suggests that familial influences are strong.5 Meal structure; parental intakes, attitudes, and modeling; food socialization practices; and availability and accessibility of food influence adolescent eating behavior within the family context.6

Historically in the United States, family meals were once considered an important daily ritual that involved home-prepared food eaten at a consistent time with the entire family around the table.7 Since the 1960s, the social context of family meals has changed as more women have entered the workforce and the number of children and adolescents living in single-parent households has grown.7, 8, 9 Changing lifestyles with increased reliance on convenience food and meals prepared outside the home has altered the eating patterns of children and their families.9 There is limited data for longitudinal assessment of meals eaten together. Examining meal patterns of preadolescents over a 21-year period in Louisiana, Nicklas et al reported a significant decline in the percentage of dinner meals eaten at home by children, from 89% in 1973 to 76% of meals in 1994.10

Despite changes in the social context and nature of family meals, a growing body of scientific evidence, primarily from cross-sectional studies, has shown that frequent eating of family meals is positively associated with enhanced diet quality for adolescents.11, 12, 13 Adolescents who consume family meals on a regular basis (≥ 5 meals/week) have improved intakes of several key nutrients including dietary fiber, calcium, folate, iron, and vitamins B6, B12, C, and E.11, 12, 13 A higher frequency of family meals has been positively associated with intake of fruits, vegetables, grains, and calcium-rich food, whereas infrequent family meals has been associated with higher soft drink consumption and saturated fat intake.11, 12 Limited research has examined the potential long-term benefits of regular family meals for adolescents.14

The present study aims to extend the findings of previous research and build on previous work done on family meals in the Project Eating Among Teens (EAT) sample11, 15 by examining longitudinal associations between family meal patterns and dietary intake in a sample of adolescents during the transition from early (middle school) to middle (high school) adolescence. A longitudinal investigation provides evidence regarding the long-term effects of regular family meals on the eating behaviors and dietary patterns of adolescents. The authors hypothesized that adolescents who had regular family meals in middle school would have better quality diets and eating patterns 5 years later when they were in high school.

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Methods 

Sample and Study Design 

Data for the present study were drawn from Project EAT, a population-based, longitudinal study designed to examine socioenvironmental, personal, and behavioral determinants of dietary intake and weight status among an ethnically diverse sample of adolescents. The study sample for the current analysis included 303 (45%) male and 374 (55%) female adolescents with a mean age at baseline (EAT-I: 1998-1999) of 12.8 ± 0.74 years and a mean age at follow-up (EAT-II: 2003-2004) of 17.2 ± 0.59 years.

For Project EAT-I (Time 1), 1608 adolescents in seventh or eighth grade from urban and suburban public middle schools within the St. Paul/Minneapolis metropolitan area completed classroom surveys and the Youth and Adolescent Food Frequency Questionnaire (YAQ).11 Five years later, Project EAT-II (Time 2) aimed to resurvey the original participants by mail to examine changes in eating patterns and weight.16 Participants were mailed a revised version of the Project EAT-I survey and the YAQ.17, 18 Although Project EAT-I also surveyed adolescents in high school classrooms (n = 3074), only adolescents who were in middle school in 1998-1999 (n = 1608) are included in the current analysis. Of the original middle school cohort, 448 participants (28%) were lost to follow-up, primarily because of missing contact information. Surveys were completed by 806 participants of the remaining cohort (1160 participants), representing 50% of the original middle school cohort and 70% of those contacted for Project EAT-II. Participants at Time 2 were included in the sample for the current study only if they also responded to the YAQ at both Time 1 and Time 2.

The adolescents in high school at Time 1 were not included, because the majority were no longer living with their families at follow-up (EAT-II) and the research questions of the present study relate specifically to changes in dietary intake during the transition from early to middle adolescence. Data from the older cohort on associations between family meals during middle adolescence and dietary intake during young adulthood have been previously reported.15 The Institutional Review Board Human Subjects Committee and the research boards of the participating school districts approved all study protocols used in Projects EAT-I and EAT-II.

Survey Development and Measures 

Development of the survey instrument was guided by Social Cognitive Theory (SCT) and focus group discussions with adolescents.19, 20 Social Cognitive Theory emphasizes the importance of socioenvironmental influences on health behavior, and family meals emerged as a socioenvironmental factor of potential relevance to food choices and eating patterns in focus groups with adolescents.19 Thus, items assessing family meals were included in the Project EAT survey.

Family Meals 

Frequency of family meals was assessed at Time 1 and Time 2 with the survey question: “During the past 7 days, how many times did all, or most, of your family living in your house eat a meal together?” Response options were never, 1-2 times, 3-4 times, 5-6 times, 7 times, and more than 7 times. To be consistent with previous studies,21, 22, 23, 24 having regular family meals was defined as participating in 5 or more family meals per week. The cut-point of 5 meals was selected to represent a majority of days per week. Four categories were constructed to describe having regular family meals during the transition from early to middle adolescence: (1) no regular family meals at Time 1 or Time 2; (2) regular family meals at Time 1 only; (3) regular family meals at Time 2 only; and (4) regular family meals at both time points.

Meal Frequency 

Frequency of consuming breakfast, lunch, and dinner meals during the past week was assessed using 3 separate items. Response options for each item were never, 1-2 days, 3-4 days, 5-6 days, and every day. Frequency of consuming fast-food meals during the past week was assessed using 1 item.25 Response options were never, 1-2 times, 3-4 times, 5-6 times, 7 times, and more than 7 times. All of the meal frequency questions were assessed at Time 1 and Time 2. To more easily permit comparisons of mean meal frequencies, the number of meals was assigned 0, 1.5, 3.5, 5.5, 7, and 10 to the 6 response options.

Dietary Intake 

Adolescents' intakes were assessed at Time 1 and Time 2 using the self-administered 149-item semiquantitative YAQ.17, 18 The reproducibility of this instrument had been previously examined with a multiethnic sample of children and adolescents (N = 179) 9 to 18 years of age who completed the YAQ twice, 1 year apart. Pearson correlation coefficients for energy-adjusted nutrients ranged from 0.26 for protein and iron to 0.58 for calcium.17 Overall, the mean correlation was higher for females (r = 0.44) compared to males (r = 0.34).17 Energy intakes less than 400 kcal or greater than 7000 kcal were deemed implausible; respondents with implausible energy intakes (n = 48) were excluded from the study sample.26, 27, 28 Mean servings of fruits, vegetables (excluding french fried potatoes), dark green and orange vegetables (eg, spinach, sweet potatoes), whole grains (eg, breakfast cereals, dark bread), calcium-rich food (eg, milk, yogurt, cheese), and soft drinks were examined. A complete listing of the food items within each food category has been previously published.11 Nutrients assessed included energy (kcal), total fat (percentage of total energy), saturated fat (percentage of total energy), calcium (mg), magnesium (mg), sodium (mg), potassium (mg), iron (mg), zinc (mg), vitamin A (μg), vitamin C (mg), vitamin E (mg), vitamin B6 (mg), folate (μg), and dietary fiber (g). Food and nutrient intakes were compared to the 2005 Dietary Guidelines for Americans and the Institute of Medicine Dietary Reference Intakes (DRI).29, 30 These guidelines were used to define a healthful diet.

Sociodemographic Characteristics 

Sociodemographic characteristics of the sample including gender, race/ethnicity, and socioeconomic status (SES) were based on self-reported data at Time 1. Race/ethnicity was assessed using 1 question: “Do you think of yourself as (a) white, (b) black or African American, (c) Hispanic or Latino, (d) Asian American, (e) Hawaiian or Pacific Islander, or (f) American Indian or Native American.” Participants could select more than 1 response option. Race/ethnicity data were collapsed into 3 categories: White, Asian, and African American/Hispanic/Other owing to the size of the sample and because Asian adolescents had significantly different family meal patterns compared to other minority groups.11 Participants selecting more than 1 response option were classified as African American/Hispanic/Other. The primary determinant of SES was parental education level, as defined by the higher level of education by either parent. Additional determinants of SES included family eligibility for public assistance, eligibility for free or reduced-cost school meals, and employment status of the mother and father.31 Five categories of SES were generated using classification tree methodology: low, low-middle, middle, upper-middle, and high.32

Statistical Analyses 

Analyses were conducted using the Statistical Analysis System (SAS, version 8.2, Cary, NC, 2001) stratified by gender and adjusted for race/ethnicity, SES, and Time 1 of the outcome eating behavior or food/nutrient intake (Model 1). Dietary intake outcomes were also adjusted for total energy consumption using the regression approach to control for potential confounding of the association between regular family meal frequency and dietary intake with total energy intake (Model 2).11, 33 P values are treated descriptively to draw attention to important characteristics of dietary intake and meal patterns.

Means were generated for Time 2 meal frequencies and dietary intake of food and nutrients across the 4 family meal categories. Generalized linear modeling with repeated measures using generalized estimating equations (GEE) to estimate standard errors (Proc Genmod) was used to predict each Time 2 outcome of interest (ie, meal frequencies and dietary intake) across the 4 family meal categories. A 4-point linear contrast over the estimated coefficients was used to evaluate a monotonic response across the 4 family meal categories (ordered a priori as no regular family meals, Time 1-only family meals, Time 2-only family meals, and both Time 1 and Time 2 family meals, to reflect proximity of eating behaviors at Time 2). Additional testing was done to contrast category 1 (no regular family meals) and category 4 (regular family meals at both Time 1 and Time 2). When the dependent variable of interest exhibited positive skewness, testing was carried out using the square root transformation.

Attrition in the study sample was not equal across demographic characteristics, as Time 2 participants were more likely to be female, white, and of higher SES than Time 1 participants. Therefore, the response propensity method was used to account for differential response rates to the Project EAT-I and Project EAT-II surveys by weighting observations inversely to the score summarizing propensity to respond.34 This method allowed current weighted estimates to be representative of the demographic makeup of the original Project EAT sample. The weighted ethnic/racial and SES proportions of the study sample were as follows: 36% white, 23% Asian, and 41% African American/Hispanic/Other. The proportions for SES were low (16%), low-middle (19%), middle (32%), upper-middle (18%), and high (15%).

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Results 

Frequency of Regular Family Meals 

Regular family meals (≥ 5 meals/week) during the transition from early to middle adolescence were reported as follows: regular family meals at neither Time 1 or Time 2 (32%, n = 215); regular family meals at Time 1 only (38%, n = 252); regular family meals at Time 2 only (8%, n = 53); and regular family meals at both Time 1 and Time 2 (22%, n = 149). Thus, there was a steep decline in regular family meals as adolescents went from early adolescence (60%) to middle adolescence (30%).

Associations between having regular family meals and eating patterns in middle adolescence 

Regular family meals were positively associated with Time 2 frequency of eating breakfast (Ptrend = .01), lunch (Ptrend = .01), and dinner (Ptrend < .001) for males and eating breakfast (Ptrend < .001) and dinner (Ptrend = .02) for females (Table 1). Adolescent males who reported eating regular family meals at both Time 1 and Time 2 had a lower frequency of fast-food meal consumption at Time 2 (P = .01). In comparison to adolescents who never ate regular family meals, those who reported having regular family meals at both Time 1 and Time 2 consumed approximately 1 fewer fast-food meal per week. No significant differences in lunch or fast-food meal consumption by regular family meals were observed for females.

Table 1. Meal Frequencies (Days in Past Week) among Adolescents at Time 2 by Having Regular Family Mealsa
Regular Family Mealsb
NoneTime 1 onlyTime 2 onlyBoth Time 1 and Time 2
Frequency of meal typeMean (SE) n = 215Mean (SE) n = 252Mean (SE) n = 53Mean (SE) n =149PtrendcPvalued
Males (n = 303)
Breakfast3.5 (0.24)3.1 (0.21)4.1 (0.50)4.3 (0.32).01.05
Lunch4.9 (0.21)5.1 (0.18)5.3 (0.42)5.8 (0.27).01.01
Dinner5.9 (0.15)5.9 (0.13)6.7 (0.31)6.7 (0.20)< .001.002
Fast food2.6 (0.21)2.2 (0.18)2.2 (0.44)1.5 (0.28).01.01
Females (n = 374)
Breakfast3.1 (0.21)3.3 (0.20)4.1 (0.46)4.3 (0.24)< .001< .001
Lunch5.2 (0.18)5.3 (0.17)5.1 (0.37)5.2 (0.20).76.86
Dinner5.9 (0.14)5.3 (0.13)6.1 (0.30)6.2 (0.16).02.13
Fast food2.3 (0.19)2.0 (0.17)2.2 (0.40)1.9 (0.21).31.17

SE indicates standard error.

aWeighted model is adjusted for race/ethnicity, socioeconomic status, and Time 1 of the outcome eating behavior

bRegular family meals is defined as ≥ 5 meals per week

cP value for linear trend across categories of regular family meals

dP value for linear contrast between none and regular family meals at both Time 1 and Time 2.

Associations between having regular family meals and dietary intake in middle adolescence 

Associations between regular family meals and dietary intake at Time 2 for adolescent males and females controlling for race/ethnicity, SES, and Time 1 of the food or nutrient intake are shown in Table 2, Table 3. Regular family meals were positively associated with mean daily intakes of vegetables, calcium-rich food, dietary fiber, and several nutrients (calcium, magnesium, potassium, iron, zinc, vitamin B6, and folate) for both male and female adolescents at Time 2 (Ptrend < .05). Intakes of several food items (eg, vegetables) and nutrients (eg, potassium, magnesium) that were found to be associated with regular family meals were less than recommended in the overall sample at Time 2.29, 30 Statistically significant associations were not found for energy intake or consumption of soft drinks for either gender across categories of regular family meals. Regular family meals had a positive association with sodium intake for females (Ptrend = .009) but not males (Ptrend = .09).

Table 2. Daily Dietary Intakes of Male Adolescents (n = 303) at Time 2 by Having Regular Family Meals (≥ 5 Meals/Week)a
Regular Family Meals
NoneTime 1 OnlyTime 2 OnlyBoth Time 1 and Time 2
Mean (SE) n = 98Mean (SE) n = 117Mean (SE) n = 25Mean (SE) n = 57PtrendbPvaluec
Food (servings)Dietary Guidelinesd
Fruits≥ 41.6 (0.15)1.7 (0.13)1.7 (0.30)2.3 (0.20).02.008
Vegetables≥ 51.3 (0.13)1.3 (0.11)1.9 (0.26)1.7 (0.17).01.03
Dark green and orange vegetables≥ 10/wk2.1 (0.04)2.1 (0.04)3.5 (0.09)3.5 (0.06).04.03
Whole grains≥ 30.9 (0.09)1.0 (0.08)1.2 (0.19)1.1 (0.12).05.06
Calcium-rich food≥ 33.0 (0.19)3.0 (0.17)3.9 (0.40)3.7 (0.26).005.009
Soft drinksN/A1.4 (0.10)1.4 (0.09)1.4 (0.21)1.2 (0.14).34.34
NutrientsDRIe
Energy (kcals)N/A1987 (99.0)2070 (87.2)2335 (203.6)2182 (132.0).14.25
Calcium (mg)13001008 (60.1)1039 (53.1)1317 (123.7)1253 (80.6).004.005
Magnesium (mg)340243 (13.0)254 (11.5)297 (26.9)305 (17.4).002.002
Sodium (mg)< 2300 mg2248 (124.4)2380 (109.8)2633 (256.4)2572 (166.0).09.05
Potassium (mg)47002454 (136.0)2515 (119.7)3018 (279.1)3145 (181.2)< .001< .001
Iron (mg)7.713.6 (0.85)14.3 (0.75)16.4 (1.7)16.3 (1.1).04.03
Zinc (mg)8.511.0 (0.68)11.8 (0.60)14.8 (1.4)13.6 (0.91).007.008
Vitamin A (μg RAE)630894 (63.0)860 (55.6)1188 (129.6)1220 (84.0).001.001
Vitamin C (mg)63136 (9.0)136 (7.9)142 (18.5)163 (12.0).09.07
Vitamin E (mg)f125.9 (0.38)6.4 (0.34)7.5 (0.78)7.2 (0.51).02.02
Vitamin B6 (mg)1.01.6 (0.09)1.6 (0.08)1.9 (0.18)1.9 (0.11).009.008
Folate (μg)g330539 (31.1)560 (27.5)614 (64.1)645 (41.6).04.02
Fiber (g)3814 (0.87)15 (0.77)17 (1.8)18 (1.2).01.004

N/A indicates not applicable; RAE, retinol activity equivalents; SE, standard error.

aWeighted model is adjusted for race/ethnicity, socioeconomic status, and Time 1 intake of food or nutrient

bP value for linear trend across categories of regular family meals

cP value for linear contrast between none and regular family meals at both Time 1 and Time 2

dDietary Guidelines for Americans 2005 recommendations for a 2000-calorie diet. Values for dark green and orange vegetables are weekly intakes

eDietary Reference Intakes (DRI) for magnesium, iron, folate, and vitamins A, C, E and B6 are Estimated Average Requirements. Values for calcium, potassium, and fiber are Adequate Intakes

fAs α-tocopherol

gAs dietary folate equivalents.

Table 3. Daily Dietary Intakes of Female Adolescents (n = 374) at Time 2 by Having Regular Family Meals (≥ 5 Meals/Week)a
Regular Family Meals
NoneTime 1 OnlyTime 2 OnlyBoth Time 1 and Time 2
Mean (SE) n = 117Mean (SE) n = 135Mean (SE) n = 28Mean (SE) n = 92PtrendbPValuec
Food (servings)Dietary Guidelinesd
Fruits≥ 41.9 (0.15)2.4 (0.14)1.6 (0.31)2.2 (0.17).99.17
Vegetables≥ 51.6 (0.12)1.8 (0.11)1.9 (0.25)2.1 (0.14).004.004
Dark green and orange vegetables≥ 10/wk2.8 (0.04)3.5 (0.04)2.1 (0.09)4.2 (0.05).20.005
Whole grains≥ 30.9 (0.07)0.8 (0.06)1.0 (0.15)1.0 (0.08).09.18
Calcium-rich food≥ 32.7 (0.14)2.5 (0.13)3.4 (0.31)2.9 (0.16).05.19
Soft drinksN/A1.3 (0.09)1.3 (0.09)1.5 (0.20)1.2 (0.10).77.89
NutrientsDRIse
Energy (kcals)N/A1972 (77.4)2048 (72.7)2192 (168.8)2100 (89.3).19.29
Calcium (mg)1300945 (44.5)915 (41.8)1150 (97.2)1050 (51.5).02.05
Magnesium (mg)300246 (10.5)257 (9.9)278 (23.0)284 (12.2).01.008
Sodium (mg)< 2300 mg2169 (92.2)2301 (86.7)2573 (201.2)2496 (106.4).009.01
Potassium (mg)47002484 (111.4)2636 (104.5)2808 (242.7)2898 (128.5).01.002
Iron (mg)7.913.7 (0.69)14.7 (0.65)16.4 (1.5)16.0 (0.80).02.02
Zinc (mg)7.310.9 (0.49)11.0 (0.46)13.2 (1.1)12.3 (0.57).02.05
Vitamin A (μg RAE)485937 (49.4)996 (46.5)1005 (107.8)1095 (57.0).06.02
Vitamin C (mg)56138 (8.2)152 (7.7)148 (17.8)162 (9.4).10.04
Vitamin E (mg)f126.7 (0.32)7.1 (0.30)7.1 (0.69)7.3 (0.36).26.13
Vitamin B6 (mg)1.01.6 (0.07)1.7 (0.07)2.0 (0.15)1.9 (0.08).005.008
Folate (μg)g330551 (25.9)601 (24.4)645 (56.5)648 (29.9).01.01
Fiber (g)2615 (0.74)17 (0.70)16 (1.6)18 (0.85).005< .001

N/A indicates not applicable; RAE, retinol activity equivalents; SE, standard error; DRI, Institute of Medicine Dietary Reference Intakes.

aWeighted model is adjusted for race/ethnicity, socioeconomic status, and Time 1 intake of food or nutrient

bP value for linear trend across categories of regular family meals

cP value for linear contrast between none and regular family meals at both Time 1 and Time 2

dDietary Guidelines for Americans 2005 recommendations for a 2000-calorie diet. Values for dark green and orange vegetables are weekly intakes

eDietary Reference Intakes (DRI) for magnesium, iron, folate, and vitamins A, C, E and B6 are Estimated Average Requirements. Values for calcium, potassium, and fiber are Adequate Intakes

fAs α-tocopherol

gAs dietary folate equivalents.

Additional analyses were conducted controlling for energy intake as well as race/ethnicity, SES, and Time 1 of the food or nutrient intake (data not shown). Statistically significant associations between regular family meals and mean daily intakes at Time 2 of the following nutrients remained for both genders: magnesium (Ptrend < .001), potassium (Ptrend < .001), vitamin B6 (Ptrend < .01), and dietary fiber (Ptrend < .05).

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Discussion 

Using SCT as the theoretical framework, the current study examined 5-year longitudinal associations of having regular family meals with dietary intake and meal patterns of adolescents. Intakes of adolescents were compared to the 2005 Dietary Guidelines for Americans and The Institute of Medicine DRI to consider the impact of regular family meals on dietary quality.29, 30 Regular family meals during the transition from early to middle adolescence played an important role in enhancing overall diet quality for youth. In general, adolescents who participated in regular family meals reported more healthful diets and meal patterns compared to adolescents without regular family meals. These findings are consistent with previous cross-sectional studies that examined the association between frequency of family meals and diet quality in adolescents.11, 12, 13 The longitudinal design of the present study extends these findings and supports the hypothesis that adolescents who consistently had regular family meals (both Time 1 and Time 2) during the transition from early to middle adolescence have better diet quality and eating patterns 5 years later compared to adolescents without regular family meals. Regular family meals at both Time 1 and Time 2 were associated with greater frequency of consuming breakfast and dinner meals and increased intakes of vegetables, calcium-rich food, dietary fiber, and several nutrients including calcium, magnesium, potassium, iron, and zinc 5 years later among both adolescent males and females.

An important finding from this study is that although adolescents with regular family meals at both Time 1 and Time 2 had better diet quality, the data presented here suggest that on average overall dietary adequacy was not achieved for the entire study sample. These findings are consistent with current national consumption data that identified dietary intake of fruits, vegetables, whole-grains, potassium, magnesium, vitamin E, and dietary fiber as problematic for this age group.3, 4

Previous research has demonstrated that eating patterns established during adolescence may often track into adulthood.35 Family meal patterns of adolescents change during the transition from middle school to high school owing to several factors, including scheduling conflicts, dissatisfaction with family relationships, and a desire for greater autonomy.19 Family mealtime is one socioenvironmental influence on adolescent dietary intake within the context of other influences (ie, other socioenvironmental factors, personal factors, and behavioral factors). These findings showed that dinner meal frequencies were higher than breakfast or lunch frequencies for both adolescent males and females. The evening dinner meal could provide an opportunity for family members to not only share a meal together, but also to establish and maintain open communication that promotes the development of stronger family relationships and enhanced adolescent well-being.22 That said, it should be noted that for some families it may be more practical to eat either breakfast or lunch together, and the authors suspect that both the nutritional and social benefits would be similar. The strength of parental influence extends beyond childhood; therefore, parents should be encouraged to continue modeling healthful eating behaviors and provide a healthful food environment at home throughout key developmental milestones of their children's lives. Furthermore, providing adolescents with the knowledge and skills to develop greater self-efficacy to select healthful food has the potential to positively impact their future health and overall well-being.

This study had several strengths and limitations that need to be considered when interpreting the current findings. Strengths of the study included the longitudinal design and the socioeconomic diversity of the study sample. The longitudinal design allowed for examining the long-term effects of regular family meals on diet quality and meal patterns of adolescents, and the sample diversity will allow for greater generalization of the results. Limitations of the study included the use of self-reported data obtained from the adolescent participants that are susceptible to social desirability bias, limitations of the food frequency questionnaire to accurately assess dietary intake of adolescents, and potential biases resulting from nonresponse at Time 2 that the authors aimed to correct by the use of propensity weighting.34

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Implications for Research and Practice 

These findings suggest that having regular family meals during the transition from early to middle adolescence positively impacts the development of healthful eating behaviors for youth. Findings from the current analysis, in conjunction with similar findings from a longitudinal analysis of older adolescents transitioning to young adulthood,15 strongly suggest that regular family meals have long-term nutritional benefits. Experimental findings are needed to confirm this assertion.

The importance of incorporating shared mealtime experiences on a consistent basis during this key developmental period should be emphasized to parents, health care providers, and educators. Disseminating information regarding mealtime strategies, developing the food preparation skills of parents and their children, and providing simple, healthful recipes are potential interventions that may help to promote regular family meals. Future research in this area should investigate the various levels of influence (ie, community, school, family, and individual) that impact the provision of regular family meals. A greater understanding is also needed of other factors that may influence food choices at family meals, including frequency of meals consumed away from home, use of convenience food, television viewing during mealtime, and the frequency that adolescents help with meal preparation. Examining associations between family meal frequency with regard to the types and portion sizes of food consumed during family meals, accessibility and availability of fresh produce, and family income is needed. Finally, identification of predictive factors that are amenable to change through the development and evaluation of behavioral interventions targeting adolescents and their families is also warranted.

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Acknowledgments 

Data collection was supported by grant R40 MC 00319 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Service 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 Training Program grant number T01-DP000112 from the Centers for Disease Control and Prevention (CDC), Department of Health and Human Services. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

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 Data collection was supported by grant R40 MC 00319 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Service 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 Training Program grant number T01-DP000112 from the Centers for Disease Control and Prevention (CDC), Department of Health and Human Services.

PII: S1499-4046(08)00194-2

doi:10.1016/j.jneb.2008.03.113

Journal of Nutrition Education and Behavior
Volume 41, Issue 2 , Pages 79-86, March 2009

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