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
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, 19992002; 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.
CONCLUSIONS
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%, n=215), Time 1 only (37.8%,
n=252), Time 2 only (8%, n=53), and at both Time 1 and Time 2 (22.1%, n=149).
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.
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 (p<0.05) (data not
shown).
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.
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).
 Reduced representativeness resulting from non-response at Time 2.
Observational study; therefore, unable to establish causality.
RESEARCH QUESTIONS AND STUDY HYPOTHESIS
Meal frequencies among adolescents at Time 2 [mean (SE)] a by the continuity of having regular family meals b
Research Questions:

Do family meal patterns during early adolescence (middle school) predict diet quality
five years later in middle (high school) adolescence?
None
Meals/week

IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE
Regular Family Meals b
Do family meal patterns during early adolescence (middle school) predict meal
patterns (e.g. meal frequency) five years later in middle (high school) adolescence?
Mean (SE)
(n = 215)
a
Time 1 only
Time 2 only
a
a
Mean (SE)
(n = 252)
Mean (SE)
(n = 53)
Both Time 1
and Time 2
Mean (SE) a
(n =149)
Ptrend
c
Males (n = 313)
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.
Breakfast
3.5 (0.24)
3.1 (0.21)
4.1 (0.50)
4.3 (0.32)
0.01
Lunch
4.9 (0.21)
5.1 (0.18)
5.3 (0.42)
5.8 (0.27)
0.01
Dinner
5.9 (0.15)
5.9 (0.13)
6.7 (0.31)
6.7 (0.20)
<0.001
Fast food
2.6 (0.21)
2.2 (0.18)
2.2 (0.44)
1.5 (0.28)
0.01
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
Females (n = 389)
Project EAT (Eating Among Teens) I and II:
Study design: Population-based, longitudinal study (N=> 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.
REFERENCES
Breakfast
3.1 (0.21)
3.3 (0.20)
4.1 (0.46)
4.3 (0.24)
<0.001
Lunch
5.2 (0.18)
5.3 (0.17)
5.1 (0.37)
5.2 (0.20)
0.76
Dinner
5.9 (0.14)
5.3 (0.13)
6.1 (0.30)
6.2 (0.16)
0.02
Fast food
2.3 (0.19)
2.0 (0.17)
2.2 (0.40)
1.9 (0.21)
0.31
a
Weighted model is adjusted for race/ethnicity, socioeconomic status, and Time 1 of the outcome eating behavior.
Regular family meals is defined as ≥ 5 meals per week.
c
P-value for linear trend across categories of regular family meals. Statistically significant p-values (p≤ 0.05) are shown in bold font.
b
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.
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