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

doi:10.1016/j.jadohealth.2004.01.004

Journal of Adolescent Health

Volume 35, Issue 5, November 2004, Pages 350-359

https://doi.org/10.1016/j.jadohealth.2004.01.004 Get rights and content

Abstract

Purpose

To examine associations between family meal patterns (frequency, priority, atmosphere, and structure of family meals) and disordered eating (unhealthy weight control behaviors, binge eating, and chronic dieting) in adolescent girls and boys.

Methods

Survey and anthropometric data were collected from 4746 ethnically diverse adolescents from public middle and senior high schools who participated in the Project EAT study (Eating Among Teens). Variables of interest included family meal patterns and disordered eating behaviors. Logistic regressions were performed to examine associations between family meal patterns and disordered eating behaviors adjusting for body mass index, sociodemographic characteristics, family connectedness, and weight pressures within the home.

Results

In general, adolescents who reported more frequent family meals, high priority for family meals, a positive atmosphere at family meals, and a more structured family meal environment were less likely to engage in disordered eating. For example, 18.1% of girls who reported 1–2 family meals/week engaged in extreme weight control behaviors compared with 8.8% of girls who reported 3–4 family meals/week. Making family meals a priority, in spite of scheduling difficulties, emerged as the most consistent protective factor for disordered eating. Associations between family meal patterns and disordered eating behaviors tended to be stronger among girls than among boys. Family meal patterns were more consistently associated with unhealthy weight control behaviors than with chronic dieting and binge eating. Although associations between family meals and disordered eating were weakened after adjusting for more global familial factors, including family connectedness and weight-specific pressures within the home, a number of the associations remained statistically significant, suggesting an independent relationship between family meals and disordered eating.

Conclusion

Family meals have the potential to play an important role in the prevention of unhealthy weight control behaviors among youth. Findings suggest that attention needs to be directed toward increasing family meal frequency and creating a positive environment for family meals.

Section snippets

Study population and study design

Data for the present study were drawn from Project EAT (Eating Among Teens), a comprehensive study of adolescent nutrition and obesity. The study population included 4746 ethnically diverse adolescents from 31 public middle schools and high schools from urban and suburban school districts in the St. Paul/Minneapolis area of Minnesota. The mean age of the study population was 14.9 years (SD = 1.7); 34.3% were in middle school and 65.7% in high school.

Data were collected in schools during the

Family meal patterns and disordered eating: Unadjusted associations

Adolescent girls who reported more frequent family meals, high priority of family meals, a positive atmosphere at meals, and a more structured meal environment were at decreased risk for engaging in unhealthy weight control behaviors and chronic dieting (Table 1). Atmosphere at family meals was also inversely associated with binge eating.

Among adolescent boys, family meal frequency and all measures of family meal environment (priority, atmosphere, and structure of family meals) were inversely

Family meal patterns and disordered eating

The current study aimed to explore associations among different aspects of family meal patterns and a range of disordered eating behaviors among adolescent girls and boys. The findings show that there are strong associations between both family meal frequency and family meal environment (priority, atmosphere, and structure/rules of meals) and disordered eating behaviors. Associations tended to be stronger and more consistent among girls than boys.

Associations between family meal patterns and

Acknowledgements

This study was supported by grant MCJ-270834 (D.N.-S., principal investigator) from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Service Administration, U.S. Department of Health and Human Services. The first author also acknowledges The Dannon Institute for its sabbatical leave support.

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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.
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Eating meals as a family is connected to positive mental and physical health of children and parents. However, studies in this area are limited to families with biological parents as caregivers. This ignores millions of children in foster and kinship families, many of whom have experienced trauma and may benefit from consistent mealtimes. Using a merger of the 2017–2019 National Survey of Children’s Health, we examined the frequency of family meals between a random sample of children living with a biological parent and those living with foster and kinship families (n = 81,562). We also explored predictors, including child special healthcare needs, of more frequent mealtimes for children living with foster and kinship families (n = 3,358). Results showed that 79 % of foster families ate together most days of the week, and that biological and kin families ate together less frequently. Interaction effects showed foster families caring for children with special needs were at 2.8 greater odds of more frequent mealtimes than children with special needs in kin or grandparent families. Further research is needed to explore how foster parents create the time and space to eat consistent meals, and how those strategies translate to families in the general population.
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?
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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
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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 (M_age = 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.
Intuitive Eating among Parents: Associations with the Home Food and Meal Environment
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Parents have a role in shaping the eating behaviors of young children and the intergenerational transmission of eating attitudes. However, little is known regarding how parental intuitive eating practices are related to characteristics of home food and meal environments.
To investigate the relationship between parental intuitive eating and the home food and meal environment.
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Participants from 750 unique households (470 mothers, 280 fathers) were surveyed in young adulthood (Mean [M] age = 31.4 years, Standard Deviation [SD] = 1.5). Baseline enrollment of participants in the population-based Project EAT study was conducted in Minneapolis-St. Paul, Minnesota, schools.
Intuitive eating was assessed via self-report.
Modified Poisson regression models were conducted, adjusting for age, race/ethnicity, and socioeconomic status.
Among mothers, higher intuitive eating scores were associated with greater likelihood of usually having fruits and vegetables in the home (prevalence ratio [PR] = 1.03) and with lower likelihood of usually having salty snacks and soda pop in the home (PR = 0.91). Higher intuitive eating scores were also associated with greater likelihood of usually serving fruits and vegetables at dinner among mothers (PR = 1.07). Among both mothers (PR = 1.08) and fathers (PR = 1.07), higher intuitive eating scores were associated with greater likelihood of usually having enough time and energy to prepare meals.
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The effects of work-to-family enrichment (WtoFE) have been examined on outcomes such as family and job satisfaction, with scarce research on the potential effects of WtoFE on the food domain. To fill in this gap, the present study explored actor and partner effects between WtoFE, the perception of the atmosphere of family meals (AFM), and satisfaction with food-related life (SWFoL) in different-sex dual-earner parents with adolescent children using the Actor-Partner Interdependence Model; the mediating role of AFM between WtoFE and SWFoL was also tested. Questionnaires were administered to 473 different-sex dual-earner parents and one of their adolescent children (average age 12.5 years, 51.4% male) in Temuco, Chile. The three family members answered the Project-EAT Atmosphere of family meals scale and the Satisfaction with Food-related Life Scale. Parents answered a measure of WtoFE based on the Work-Home Interaction Survey. Analyses were conducted using structural equation modelling. Results showed a positive association from WtoFE to SWFoL, directly and through the perception of the atmosphere of family meals in both parents (actor effects). Both parents’ WtoFE was associated with their adolescent children’ SWFoL via the adolescent’s perception of the atmosphere of family meals, while the mother’s perception of the atmosphere of family meals was directly associated with the adolescent’s SWFoL (partner effects). Findings suggest that resources that mothers and fathers acquire from work and invest via WtoFE have positive effects on their own and their adolescent children’s perception of the atmosphere of family meals and SWFoL. As higher WtoFE has also been related to other positive outcomes in the job and health domains in workers, policymakers and organizations must aim to promote WtoFE in working parents.

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Original articleAre family meal patterns associated with disordered eating behaviors among adolescents?

Abstract

Purpose

Methods

Results

Conclusion

Section snippets

Study population and study design

Family meal patterns and disordered eating: Unadjusted associations

Family meal patterns and disordered eating

Acknowledgements

J Adolesc Health

J Am Diet Assoc

J Am Diet Assoc

J Nutr Educ

J Nutr Educ

Ethnic/racial and socioeconomic differences in dieting behaviors and body image perceptions in adolescents

Int J Eat Disord

Weight control practices of U.S. adolescents and adults

Ann Intern Med

Weight-related concerns and behaviors among overweight and non-overweight adolescentsImplications for preventing weight-related disorders

Arch Pediatr Adolesc Med

Correlates of unhealthy weight-control behaviors among adolescentsImplications for prevention programs

Health Psychol

Dieting and disordered eating during early and middle adolescenceDo the influences remain the same?

Int J Eat Disord

A prospective study of familial and social influences on girls' body image and dieting

Int J Eat Disord

Dinner conversation. Meal therapy to differentiate eating behavior from family process

J Psychosoc Nurs Ment Health Serv

Family meals in the treatment of adolescent anorexia nervosa

Eur Eat Disord Rev

Family mealtime while growing upAssociations with symptoms of bulimia nervosa

Eat Disord J Treat Prev

Correlates of bulimia nervosaEarly family mealtime experiences

Adolescence

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