Selected References: Family Meals Compiled by,

Barbara J. Mayfield, MS, RD, 2011

Professional Journal Articles, Reports, and Book Chapters: Abbot JM, Byrd-Bredbenner C. Development of a Self-Directed Home Kitchen Makeover for Mothers of Young Children. The Forum. 2009;14:1-7. Available online at: www.ncsu.edu/ffci This paper describes formative research guiding the development of an intervention designed to improve the ability of mothers of young children to plan, prepare, and serve healthy family meals. Interviews showed that the mothers needed and wanted help in using pre-prepared ingredients to save time; kitchen organization and food storage; and healthy meal preparation and grocery shopping. Abundant Assets Alliance: Developmental Assets: Essential Building Blocks of Human Development. Available at: http://www.abundantassets.org/dev_assets.cfm A framework of developmental assets, developed by the Search Institute, identifies 40 critical factors for young people’s growth and development. Five age-specific lists, describe the 20 external and 20 internal assets for infants, toddlers, preschoolers, elementary-age children, and teenagers. Ackard DM, Neumark-Sztainer D. Family Mealtime While Growing Up: Associations with Symptoms of Bulimia Nervosa. Eating Disorders. 2001;9:239-249. Survey of 560 female college students found that bulemic behaviors are inversely associated with the frequency of family dinner. These associations remained statistically significant after controlling for other familial factors. Agostoni C, Braegger C, Decsi T, et al. Role of Dietary Factors and Food Habits in the Development of Childhood Obesity: A Commentary by the ESPGHAN Committee on Nutrition. J Pediatric Gastroenterol Nutr. 2011;52(6):662-669. This commentary summarized the role of nutrition-related factors on prevention of childhood obesity. Based on the current findings, recommended dietary goals were outlined, including: “Regular family meals should be encouraged.” American Dietetic Association Foundation: Executive Summary of Family Nutrition and Physical Activity Survey. 2003. The State of Family Nutrition and Physical Activity: Are We Making Progress? 2010. Available at American Dietetics Association web site: http://www.eatright.org The goal of this research was to determine factors contributing to unhealthy weight. 615 parent-child pairs were surveyed in 2003 and 754 pairs in 2010. Many positive improvements were seen from 2003 to 2010, including an increase in the frequency of meals eaten at home daily from 52% to 73% of families.

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Anderson SE, Whitaker RC. Household Routines and Obesity in US Preschool-Aged Children. Pediatrics. 2010;125(3);420-428. Paper describes a cross-sectional analysis of a nationally representative sample of 8500 four-year-old children who were in the Early Childhood Longitudinal Study, Birth Cohort. Children who were exposed to three household routines: regularly eating the evening meal as a family, getting enough nighttime sleep, and having limited screen time on weekdays, had a 40% lower prevalence of obesity than those exposed to none of these routines. Arcan C, Neumark-Sztainer D, Hannan P, et al. Parental eating behaviors, home food environment and adolescent intakes of fruits, vegetables and dairy foods: longitudinal findings from Project EAT. Public Health Nutrition. 2007;10(11):1257-1265. Analysis of Project EAT-II data showed that vegetables served at dinner significantly predicted adolescent intake of vegetables for males, females, high school and young adults at 5 year follow-up. Serving milk predicted later dairy intake and parental intakes significantly predicted young adult intakes for fruit, vegetables, and dairy. Ayala GX, Baquero B, Arredondo EM, Campbell N, Larios S, Elder JP. Association Between Family Variables and Mexican American Children’s Dietary Behaviors. J Nutr Educ Behav. 2007;39:62-69. Dietary intake was associated with a variety of family influences. The strongest correlates were availability of fast food in the home and parents purchasing food advertised on TV. Family support for healthful eating and eating meals together were also correlated with more healthful diets. Bauer KW, Neumark-Sztainer D, Fulkerson JA, Story M. Adolescent Girls’ Weight-Related Family Environments, Minnesota. Preventing Chronic Disease. 2011;8(3) http://www.cdc.gov/pcd/issues/2011/may/10_0025.htm. The study sample for this research was racially and ethnically diverse, with a wide range of parental education. One quarter of the girls were foreign born. Results suggest that parents of Asian girls, parents who have more education, and parents who recently immigrated to the US are more able to provide family environments promoting physical activity and healthy diets. Beals D. Eating and Reading: Links Between Family Conversations with Preschoolers and Later Language and Literacy. In Dickinson D, Tabors PO (Eds.) Beginning Literacy with Language: Young Children Learning at Home and School. Baltimore, MD: Paul H. Brookes Publishing. 2001. PP 93-110. Examines the important role mealtime conversations play in the acquisition of vocabulary, which is predictive of later literacy and reading achievement. Befort C, Kaur H, Nollen N, et al. Fruit, Vegetable, and Fat Intake among Non-Hispanic Black and Non-Hispanic White Adolescents: Associations with Home Availability and Food Consumption Settings. J Am Diet Assoc. 2006;106:367-373.

Cross-sectional surveys of adolescents and their parents compared the influence of food availability and where foods were eaten on intakes of fruits, vegetables, and fat. Family meals positively influenced fruit intake. Eating while watching TV and fast-food and restaurant use was common and was associated with higher

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fat intake. Home availability of healthy foods was less important than accessibility, such as making fruits and vegetables ready and inviting to eat.

Bellissimo N, Pencharz PB, Thomas SG, Anderson GH. Effect of Television Viewing at Mealtime on Food Intake After a Glucose Preload in Boys. Pediatric Research. 2007;61(6):745-749. This research group from the University of Toronto wanted to determine to what degree watching TV during meals affected food intake and found that there was an average increase of 228 kcals in the group who watched TV during meals. When given a glucose preload the boys compensated by eating less only in the group that was not watching TV. The authors conclude that television viewing delays normal mealtime satiation and reduces satiety signals from previously consumed foods. Bennett LA, Wolin SJ, Reiss D. Deliberate family process: A strategy for protecting families of alcoholics. British Journal of Addiction. 1988;83:821-829. Alcoholic families have fewer family rituals and routines, and practice them less deliberately, than non-alcoholic families. If alcoholic families make a deliberate effort to maintain family routines this has been shown to have a protective effect on adolescents in these families from becoming alcoholics themselves. Benton D. Role of parents in the determination of the food preferences of children and the development of obesity. International Journal of Obesity. 2004;28:858-869. This review article discusses contributions of both genetics and the environment and discusses how children acquire food preferences. The discussion of parental style includes the emotional climate of the meal. The role of culture is discussed, including meals and television viewing habits. This paper includes interesting information on taste preferences. Berg F, Buechner J, Parham E. Guidelines for Childhood Obesity Prevention Programs: Promoting Healthy Weight in Children. Weight Realities Division of the Society for Nutrition Education. 2002. Available at www.sne.org. Guidelines for healthy eating include: Create a positive environment for meals, eat family meals together, take time to relax, enjoy the food, and feel satiety. Berge JM, Wall M, Neumark-Sztainer D, Larson N, Story M. Parenting Style and Family Meals: Cross-Sectional and 5-Year Longitudinal Associations. J Am Diet Assoc. 2010;110(7):1036-1042. Using data from Project EAT, the authors found that cross-sectional results for girls showed a positive association between authoritative parenting and more frequent family meals. For boys, maternal authoritative parenting was associated with more frequent family meals. Longitudinal results showed that authoritative parents predicted more frequent family meals 5 years later. Birch LL, Fisher JO. Development of Eating Behaviors Among Children and Adolescents. Pediatrics. 1998;101:539-549. This article examines the factors that influence food preferences, food intake, and energy regulation in children. Social context for eating is important due to the eating behaviors of others in the environment, including peers, siblings, and parents. Parental feeding practices and control over children’s eating affect eating behaviors, including preferences, intake and self-regulation.

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Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatric Clin North America. 2001;48(4):893-907. Discusses research on the effects of environmental factors and behavioral mediators on childhood overweight. The authors argue that guidance for parents should include how children develop food habits in the context of the family. Birch LL. Are Social Meals More Nutritious? Journal of Gastronomy. 1993:7(1). This issue focuses on “Taste, Health and the Social Meal” and includes essays, such as one by Leann L. Birch, that reference research looking at how eating is influenced by the social setting. There are also discussions of anthropological evidence supporting the need for people to share meals with family and friends.

Boutelle KN, Birkeland RW, Hannan PJ, Story M, Neumark-Sztainer D. Associations between Maternal Concern for Healthful Eating and Maternal Eating Behaviors, Home Food Availability, and Adolescent Eating Behaviors. J Nutr Educ Behav. 2007;39:248-256. This study used a subset of 714 mother-adolescent pairs from the students who participated in Project EAT. Mothers were interviewed about their concern with eating healthfully and adolescents were asked about their perceptions of their mothers’ concern about eating healthfully. These were compared with maternal and adolescent food intake and the home food environment. The authors concluded that the mother’s concern for healthful eating is associated with maternal eating behavior and the home food environment, but were not as strong a predictor of adolescent behaviors as adolescent perceptions of maternal attitudes. Boutelle KN, Birnbaum AS, Lytle LA, Murray DM, Story M. Associations between Perceived Family Meal Environment and Parent Intake of Fruit, Vegetables, and Fat. J Nutr Educ Behav. 2003:35:24-29. This study suggests that adult eating behaviors are related to a number of mealtime environmental influences. Television viewing during meals and arguments during meals were associated with less healthy intakes. Planning meals in advance was associated with healthier intakes. Boutelle KN, Lytle LA, Murray DM, Birnbaum AS, Story M. Perceptions of the Family Mealtime Environment and Adolescent Mealtime Behavior: Do Adults and Adolescents Agree? Journal of Nutrition Education. 2001:33:128-133. Describes study examining the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior.

Boynton-Jarrett R, Thomas TN, Peterson KE, Wiecha J, Sobol AM, Gortmaker SL. Impact of Television Viewing Patterns on Fruit and Vegetable Consumption Among Adolescents. Pediatrics. 2003;112:1321-1326. Each additional hour of TV viewing was found to decrease fruit and vegetable intake by .14 servings (P=.025), adjusting for anthropometric, demographic, and dietary variables, and physical activity. The authors suggest that consumption of foods advertised on television may replace fruits and vegetables in teen’s diets.

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Brown R, Ogden J. Children’s eating attitudes and behaviour: a study of the modeling and control theories of parental influence. Health Education Research. 2004;19(3):261-271. This study of 112 pairs of parents with their 9-13 year-old children, indicated an important influence of parental role modeling and observational learning in forming eating attitudes and behaviors, including snack food intake, motivators to eat, and body dissatisfaction. Parental control of food intake resulted in increased intake and parental control over behavior using food resulted in greater body dissatisfaction but no difference in intake. Burgess-Champoux TL, Larson N, Neumark-Sztainer D, et al. Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence? J Nutr Educ Behav. 2009;41(2):79-86. Students were surveyed in middle school and then again in high school to assess the association between regular family meals and dietary intake and eating habits. More regular family meals is associated with fewer fast food meals and improved diets with a higher intake of vegetables, calcium, fiber, iron, and vitamins A and B6 as well as other nutrients. Byrd-Bredbenner C, Abbot JM. Improving the Nutritional Quality of the Home Food Environment using Self-Directed Home Kitchen Makeovers. The Forum. 2009;14:1-8. Available online at: www.ncsu.edu/ffci This paper describes a pilot test of a 5-step, self-directed, intervention program designed to help mothers of young children plan, prepare, and serve healthy meals. Results showed significant improvements in their kitchen organization, food storage area, and mealtime planning. Campbell D, Crawford D, Jackson M, et al. Family food environments of 5-6-year-old-children: Does socioeconomic status make a difference? Asia Pacific Journal of Clinical Nutrition. 2002:11(Suppl):S553-S561. Australian study in which parents were surveyed regarding family meal structure, meal preparation, food availability, and media exposure during meals. A total of seven questions measured aspects of family meal structure. Parents of young children considered family meals pleasant and a time to connect and talk. Cason KL. Family Mealtimes: More than Just Eating Together. J Am Diet Assoc. 2006;106(4):532-533. Author recommends that dietetics professionals encourage making family meals a priority and suggests ways they can help families implement strategies to make the most of family meals. Churchill SL, Stoneman Z. Correlates of Family Routines in Head Start Families. Early Childhood Research and Practice. 2004;6(1):1-16. This article defines routines and describes the theories of why they are considered beneficial to children and their families. This study examines the importance of routines within this particular high-risk population on a child’s temperament, mother’s depression, cognitive and social outcomes, and child behaviors. The mothers’ ratings of child temperament, personal depression, and behavioral problems were all favorably influenced by higher levels of routine. Teachers’ ratings of child outcomes were improved by routines for girls but not different for boys.

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Cinotto S. “Everyone Would Be Around the Table”: American Family Mealtimes in Historical Perspective, 1850-1960. New Directions for Child and Adolescent Development. 2006;111:17-34. Family meals resembling today’s ‘ideal’ originated in the Victorian middle-class, including an informal breakfast, a lighter lunch and a more formal and substantial dinner in the evening. Working class families historically had less structured mealtimes, with the exception of Sunday dinners and holiday meals. Immigrant families used the main family meal of the week to hold onto cultural foodways and traditions. Working women, activities outside the home, and eating out became more prevalent in the 1920’s, and was the start of a longing for family mealtime as the time for families to be a family. Traditional family mealtime returned in force during the 1950’s for middle-class families, but in working-class families remained only a practice on Sundays and special occasions. The image of proper family mealtime has remained a symbol of family unity and stability. However, the practice of the ‘idealized’ family meal has been the exception rather than the rule for most American families during most of our history. Cooke LJ, Wardle J, Gibson EL, Sapochnik M, Sheiham A, Lawson M. Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children. Public Health Nutrition. 2003;7(2):295-302. This study found low intake of fruits and vegetables to be common, with one third of the preschoolers not even eating them on a daily basis. Greater fruit intake was associated with maternal education and being Caucasian. Greater vegetable intake was associated with mother’s education, being older, and being female. Parental consumption was the strongest predictor of both fruit and vegetable intake in children. Child food neophobia had a strong negative impact. Coon KA, Goldberg J, Rogers BL, Tucker KL. Relationship Between Use of Television During Meals and Children’s Food Consumption Patterns. Pediatrics. 2001:107(1). The dietary patterns of children from families that watch television during mealtimes may be lower in fruits and vegetables and higher in pizzas, snack foods, and sodas. Cullen KW, Baranowski T, Rittenberry L, Cosart C, Owens E, Hebert D, deMoor C. Socioenvironmental influences on children’s fruit, juice and vegetable consumption as reported by parents: reliability and validity of measures. Public Health Nutrition. 2000;3(3):345-356. This article examines the reliability and validity of a questionnaire assessing parental socio-environmental constructs, including parental style, food- socialization encouraging and discouraging practices, meal planning and shopping practices, food preparation practices, barriers to eating fruits, juices, and vegetables, parent self-efficacy to provide/encourage healthy diets, and fruit, juice, vegetable availability and accessibility. Cutler GJ, Flood A, Hannen P, Neumark-Sztainer D. Multiple Sociodemographic and Socioenvironmental Characteristics Are Correlated with Major Patterns of Dietary Intake in Adolescents. J Am Diet Assoc. 2011;111(2):230-240. Data from Project EAT-I and II were used to identify four dietary patterns at the two time intervals (vegetable, fruit, starchy food, and snack food at time 1 and vegetable and fruit, fast food, starchy food, and snack food at time 2). Results

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showed a positive association between family meal frequency and the vegetable and fruit and the starchy food patterns and inversely associated with the fast food pattern. Denham SA. Relationships Between Family Rituals, Family Routines, and Health. Journal of Family Nursing. 2003;9(3):305-330. Rituals are generally considered celebrations, traditions, religious observances, and symbolic events. Routines are more regular, generally daily, activities that serve to define roles and responsibilities, organize daily life, and reflect family characteristics. Assessing a family’s routines allows practitioners to differentiate between current practices and desired outcomes. Instruments for assessing family routines are described and referenced. Devine CM. A Life Course Perspective: Understanding Food Choices in Time, Social Location, and History. J Nutr Educ Behav. 2005;37:121-128. “A life course perspective focuses on how the life history of groups or individuals in society may explain differences in health… and, can be used to understand how people construct their food and eating choices and how changes in food and eating environment affect those choices.” The temporal framework includes trajectories, transitions, and turning points. The social framework includes social contexts – social class, race or ethnicity, and gender. The historical framework includes changes and trends in social, economic, and health policy. Devine CM, Farrell TJ, Hartman R. Sisters in Health: Experiential Program Emphasizing Social Interaction Increases Fruit and Vegetable Intake among Low-Income Adults. J Nutr Educ Behav. 2005;37:265-270. Sisters in Health is a nutrition education program for low-income women to

Increase fruit and vegetable consumption. Factors found to contribute positively to increased consumption were positive social support in the groups and more positive attitudes about preparing fruits and vegetables. Changes in knowledge were not seen and were not associated with improved intakes. Dickstein S. Family Routines and Rituals – The Importance of Family Functioning. Journal of Family Psychology. 2002:16(4):441-444. Mealtime is viewed as a context in which to obtain naturalistic information about routine family functioning without self-report bias. It is a good way to observe how families negotiate competing agendas. Family functioning assessed during routine mealtime is associated with early childhood social-emotional and behavioral competence. Eisenberg ME, Neumark-Sztainer D, Feldman S. Does TV viewing during family meals make a difference in adolescent substance use? Prev Med. 2009;48(6):585-587. 806 high school students provided survey data regarding family meal frequency, substance use, and general family connectedness. Substance use was compared to family meal and TV during meals. There was a significant difference for girls, but not boys, in substance use between those who had frequent family meals and those who did not. Whether the TV was on during did not alter the association.

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Eisenberg ME, Neumark-Sztainer D, Fulkerson JA, et al. Family Meals and Substance Use: Is There a Long-Term Protective Association? J of Adolescent Health. 2008;43(2):151-156. This study discusses the protective influence of family meal frequency on significantly lower odds of cigarette smoking, alcohol use and marijuana use. Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations Between Family Meals and Psychosocial Well-being Among Adolescents. Arch Pediatr Adolesc Med. 2004:158:792-796. Findings from school-based survey of 4746 adolescents in Minneapolis area suggest eating family meals enhances the health and well-being of adolescents. Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology. 1994:13(5):373-383.

Reports 10-year treatment outcomes of obese children in 4 randomized studies. 34% of the variance in change in percentage overweight was predicted from sex, baseline percentage overweight, self-monitoring weight, meals eaten at home, and family and friends’ support for eating and exercise. Feldman S, Eisenberg ME, Neumark-Sztainer D, Story M. Associations between Watching TV during Family Meals and Dietary Intake Among Adolescents. J Nutr Educ Behav. 2007;39:257-263. Uses cross-sectional survey data from students enrolled in Project EAT study. Approximately one-third of students reported watching television during meals. Authors concluded that watching television during family meals was associated with poorer dietary quality among adolescents, including lower intakes of vegetables, dark green/yellow vegetables, calcium-rich food, and grains and higher intakes of soft drinks compared to adolescents not watching TV at meals. Fiese BH, Foley KP, Spagnola M. Routine and Ritual Elements in Family Mealtimes: Contexts for Child Well-Being and Family Identity. New Directions for Child and Adolescent Development. 2006:111:67-89. This chapter “illustrates family mealtimes as multilayered activities that serve to regulate behavior and hold deep symbolic meaning for participants.” Mealtimes are a place and time to study family interaction patterns and family identity. Optimal family functioning related to mealtime conversation, task accomplishment, affect management, and interpersonal involvement are each described. Family identity is considered the integration of the ritual elements of communication, commitment, and continuity. Clear and direct communication, emotional support and genuine commitment, and a realistic continuity in routine all lend to child well-being and a positive family identity. Fiese BH, Tomcho TJ, Douglas M, Josephs K, Poltrock S, Baker T. A Review of 50 Years of Research on Naturally Occurring Family Routines and Rituals: Cause for Celebration? Journal of Family Psychology. 2002;16(4):381-390. This is a qualitative review of 32 research articles published between 1950 and 2000. Routines and rituals change throughout the family life cycle, becoming more regular and meaningful as children grow older and actively participate. Routines and rituals are closely tied to culture. Family routines are an indication of family organization and are important to family members’ health and well-

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being. Routines may be protective of risks associated with single-parent families. This paper addresses issues of study design, theory, application and policy. Fitzpatrick E, Edmunds LS, Dennison BA. Positive Effects of Family Dinner Are Undone by Television Viewing. J Am Diet Assoc. 2007;107:666-671. Parents/guardians of children enrolled in WIC in New York State were surveyed regarding frequency of eating dinner together, television on during dinner, and frequencies of serving fruits, vegetables and milk. Eating together was positively associated with serving fruits and vegetables. Having the TV on during meals was negatively associated with serving fruits and vegetables. Neither eating together or watching TV was significantly associated with serving milk. Fulkerson JA, Kubik MY, Rydell S, et al. Focus Groups with Working Parents of School-aged Children: What’s Needed to Improve Family Meals? J Nutr Educ Behav. 2011; 43(3):189-193. Focus groups intended to identify parents’ perceptions of the barriers to family meals showed that parents enjoy sharing/bonding at meals, but say they have limited time for meal preparation and are frequently multi-tasking at mealtime. Other concerns included a desire for children to help with cooking but didn’t want the mess and frustration with their children’s limited food likes. Fulkerson JA, Pasch KE, Stigler ME, et al. Longitudinal associations between family dinner and adolescent perceptions of parent-child communication among racially-diverse urban youth. J Fam Psychol. 2010;24(3):261-270. Data for this study was taken from four waves of data collection from Project Northern Chicago, a group randomized trial for the prevention of alcohol use in youth. 5812 students from 61 schools participated between the beginning of 6th grade and the end of 8th grade. Over time both family dinner frequency and teen perceptions of parent-child communication decreased. In spite of this, family meal frequency was positively associated with teen perceptions of parent- child communication scores over time (p<.0001). Fulkerson JA, Rydell S, Kubik MY, et al. Healthy Home Offerings via the Mealtime Environment (HOME): Feasibility, Acceptability, and Outcomes of a Pilot Study. Obesity. 2010;18(suppl 1):S69-S74. The HOME program, consisting of five, 90-minute sessions for children and Parents was studied for its ability to build meal preparation skills and the quality of foods served for family meals. Outcomes post intervention were positive, but not all changes were maintained at 6 months follow-up. Fulkerson JA, Kubik MY, Story M, et al. Are There Nutritional and Other Benefits Associated with Family Meals Among At-Risk Youth? J of Adolescent Health. 2009; 45(4):389-395. This study using surveys of a racially-diverse group of high school students found that frequency of family meals was positively associated with eating breakfast and fruit intake and negatively associated with depressive symptoms. Teens who did not eat family dinners were more likely to be overweight and food insecure.

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Fulkerson JA, Story M, Neumark-Sztainer D, Rydell S. Family Meals: Perceptions of Benefits and Challenges among Parents of 8- to 10-year-old Children. J Am Diet Assoc. 2008:108(4):706-709. This purpose of this study was to examine parental perceptions of the mealtime environment and identify strategies to improve the dietary quality of meals. Parental concerns about picky eating led to 40% of families experienced some conflicts over food. Parents requested help with meal planning, food preparation, and clean-up, more time for meals, assistance with picky eating, new recipes and meal ideas, and decreased conflict during meals. Fulkerson JA, Neumark-Sztainer D, Story M. Adolescent and Parent Views of Family Meals. J Am Diet Assoc. 2006;106:526-532. This study examines the family mealtime environment from the perspectives of both adolescents and parents using survey and interview data from 902 parent- child pairs. Both parents and children perceived family meals positively. However, parents and younger teens were more likely to say family meals were an important priority than older teens. Scheduling difficulties increased with age and mealtime rules were expected more in younger teens. Parents were less likely than children to report television viewing during family meals. Gable S, Britt-Rankin J, Krull J. Ecological Perspectives and Developmental Outcomes of Persistent Childhood Overweight. Electronic Report from the Economic Research Service. June 2008. Available at: www.ers.usda.gov This study uses data from 8000 children in the Early Childhood Longitudinal Study-Kindergarten Cohort. SES, gender, race, and behavioral and environmental factors all influence risk of persistent overweight. For each additional hour of television a child watched, their odds of being overweight increased 3%. For each family meal per week that they did not experience, the odds of overweight increased by 9%. Gable S, Chang Y, Krull JL. Television Watching and Frequency of Family Meals Are Predictive of Overweight Onset and Persistence in a National Sample of School-Aged Children. J Am Diet Assoc. 2007;107:53-61. Participants in the Early Childhood Longitudinal Study-Kindergarten Cohort, were assessed at four points between kindergarten entry and third grade to identify eating and activity factors associated with onset and persistence of overweight. “Children who watched more television and ate fewer family meals were more likely to be overweight for the first time at spring semester third grade.” These two factors, along with neighborhood safety, were predictive of persistent overweight. Gable S, Lutz S. Household, Parent, and Child Contributions to Childhood Obesity. Family Relations. 2000;49(3):293-300. Reports on a study of 65 parent-child pairs using parent-completed surveys and child BMI. Results suggest that efforts to curb childhood obesity should address

improving parent knowledge of child nutrition and reducing child television viewing.

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Gentile DA, Walsh DA. A normative study of family media habits. Applied Developmental Psychology. 2002;23:157-178. Study documents family media habits in six areas. Findings suggest that families that practice positive media habits in one area tend to practice positive habits in other areas. The survey asked how often a TV is on during meals. Responses were 18% always, 22% often, 26% sometimes, 18% rarely, and 16% never. Gidding SS, Dennison BA, Birch LL, et al. Dietary Recommendations for Children and Adults. Circulation. 2005;112:2061-2075. American Heart Association Scientific Statement. Provides guidelines for “Improving Nutrition in Young Children” including “Have regular family meals to promote social interaction and role model food-related behavior.” Gillespie AH, Smith LE. Food Decision-Making Framework: Connecting Sustainable Food Systems to Health and Well-Being. Journal of Hunger and Environmental Nutrition. 2008;3:328-346. This article gives an overview of the theoretical basis of the framework and describes interrelationships among the components. The Food Decision- Making Framework (FDF) considers behavior change within the context of families and communities. Gillespie AH, Gillespie GW. Family Food Decision-Making: An Ecological Systems Framework. Journal of Family and Consumer Sciences. 2007;99(2):22-28. The authors describe (and illustrate) the family food decision-making frame- work and state that it “provides a basis for discerning and describing different food decision-making styles, assessing a particular family’s food decision- making processes, identifying opportunities and constraints in family micro and macroenvironments, and establishing goals for change. It guides families, practitioners, and researchers in identifying effective points of intervention and assessing priority research questions.” Gillespie GW, Gillespie AH. Community Food Systems: Toward a Common Language for Building Productive Partnerships. Cornell Community Nutrition Program, Division of Nutritional Sciences, Cornell University. 2000. Available at: http://www.cce.cornell.edu/programs/foodsystems/references.html. This paper discusses family and community food decision-making and defines a variety of terms, including “family.” Gillespie AH, Achterberg CL. Comparison of family interaction patterns related to food and nutrition. Journal of the American Dietetic Association. 1989;89:509-512. Most of the families with young children in this study ate the evening meal together. Mothers showed a more positive attitude toward the importance of nutrition than fathers. Family interaction scores were highest when mothers were employed part-time and when parental education was higher. Income did not make a difference.

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Gillman MW, Rifas-Shirman SL, Frazier AL, et al. Family dinner and diet quality among older children and adolescents. Arch Family Med 2000; 9:235-40. Results of national survey of 16,000 youth participating in the “Growing Up Today Study.” Identified relationships between frequency of family dinners with higher intakes of nutrients and decreased intake of fried foods and soft drinks. Haines J, Kleinman KP, Rifas-Shiman Sl, et al. Examination of Shared Risk and Protective Factors for Overweight and Disordered Eating Among Adolescents. Archives of Pediatric and Adolescent Medicine. 2010;164(4):336-343. This research, using questionnaires to assess risk and protective factors, found that a higher frequency of family meals was inversely related to bingeing, purging, and overweight. Hammons AJ, Fiese BH. Is Frequency of Shared Family Meals Related to the Nutritional Health of Children and Adolescents? [published online ahead of print May 2, 2011] Pediatrics. 2011;127(6);e1-10. http://pediatrics.aappublications.org/content/early/201104/27/peds.2010-1440 This paper discusses meta-analysis of 17 studies that examined overweight, food consumption and eating patterns, and disordered eating. Frequent family meals increased the odds of eating healthy foods and decreased the odds of eating unhealthy foods, likelihood of overweight, and disordered eating. Hanson NI, Neumark-Sztainer D, Eisenberg ME, Story M, Wall M. Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods. Public Health Nutrition. 2005;8(1):77-85. This study surveyed 902 adolescents and their parents. Household food availability and parental dietary intake were associated with adolescent intake. Harrington KF, Franklin FA, Davies SL, Shewchuk RM, Binns MB. Implementation of a family intervention to increase fruit and vegetable intake: the Hi5+ experience. Health Promot Pract. 2005;692):180-189. This article describes a fruit and vegetable promotion program that consisted of Family Fun Nites, which were at-home family meal sharing and game evenings. Hendy HM, Williams KE, Camise TS, Eckman N, Hedemann A. The Parent Mealtime Action Scale (PMAS). Development and association with children’s diet and weight. Appetite. 2009;52(2):328-339. The PMAS was developed to identify dimensions of mealtime behaviors used by parents. This paper examines the scale’s ability to explain variance in children’s diet and weight status. Mothers exhibited more “gentle” PMAS actions whereas fathers exhibited more “forceful” PMAS actions. Henry BW. The Importance of the Where as Well as What and How Much in Food Patterns of Adolescents. J Am Diet Assoc. 2006;106(3):373-375. This brief application article encourages nutrition professionals to provide teens with information about how and why to make healthful food choices and take into account barriers to healthy eating.

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Heymann SJ, Earle A. The impact of parental working conditions on school-age children: the case of evening work. Community, Work & Family. 2001; 4(3):305-325. Reports a negative impact of parental evening work on the home environment for children, aged 5-10, from the National Longitudinal Survey of Youth. Hoerr S,Utech AE, Ruth E. Child Control of Food Choices in Head Start Families. J Nutr Educ Behav. 2005;37:185-190. This study examined 6 key feeding constructs: offering new foods many times, offering a variety of vegetables, having the child seated while eating, permitting the child to decide how much to eat, establishing regular mealtimes, and not using food as a reward. Discussion questions are listed as well as positive and negative responses. Results suggest parents perceived many barriers, gave in readily to children and displayed inappropriate feeding practices. Hoerr S, Horodynski MA, Lee SY, Henry M. Predictors of Nutritional Adequacy in Mother-Toddler Dyads from Rural Families with Limited Incomes. J Am Diet Assoc. 2006;106:1766-1773. The purposes of this study were to predict the MAR (Mean Nutritional Adequacy) score from intakes of fruits, vegetables, and dairy foods in low-income mothers and their toddlers and determine whether having a child seated while eating was predictive of the child’s nutritional adequacy. Results showed that children who remained seated while eating at all meals had better diet quality. Ikeda, JP. Promoting Family Meals and Placing Limits on Television Viewing: Practical Advice for Parents. J Am Diet Assoc. 2007;107:62-63. This brief application article provides practical advice in how to counsel parents in limiting their child’s screen time and promoting family meals. Suggested questions to ask that will help identify motivators and barriers are included. Jabs J, Devine CM, Bisogni CA, Farrell TJ, Jastran M, Wethington E. Trying to Find the Quickest Way: Employed Mothers’ Constructions of Time for Food. J Nutr Educ Behav. 2007;39:18-25. This paper discusses the concept of time scarcity, the most commonly cited barrier to family meals; and examines how mothers’ constructions of time relate to time for the tasks associated with food provisioning for their families. In-depth interviews with working mothers identified three “timestyles”: Active, reactive, and spontaneous. The three time management strategies employed were planning, coordination, and prioritization. Johnson DB, Birkett D, Evans C, Pickering S. Promoting Family Meals in WIC: Lessons Learned from a Statewide Initiative. J Nutr Educ Behav. 2006;38:177-182. This article describes an educational intervention for WIC families designed to promote family meals. Program development, key messages, components, pilot-testing, implementation, and evaluation are all described. The program was studied in randomly selected agencies, with other agencies serving as controls, implementing a similar program promoting physical activity. Intervention was shown to result in a statistically significant increase in family meals.

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Kirk MC, Gillespie AH. Factors Affecting Food Choices of Working Mothers with Young Families. Journal of Nutrition Education. 1990;22(4):161-168. Focus groups and interviews of working mothers examined family food choices. Factors influencing food choices most were nutrition, time, catering to family desires, budget and management/organization. Describes mother’s role as nutritionist, economist, manager/organizer, meaning-creator and family diplomat. Larson NI, Nelson MC, Neumark-Sztainer D, Story M, Hannan PJ. Making Time for Meals: Meal Structure and Associations with Dietary Intake in Young Adults. J Am Diet Assoc. 2009;109(1):72-79. These findings are taken from Project EAT-II, using the sample of 20 ½ year olds and comparing taking the time to eat with “eating on the run.” The concept of “time scarcity” was related to planning, preparing and time spent eating meals. Social eating was associated with more nutritious meals and eating on the run with more soft drinks, fast food, fat and less healthy food. Larson NI, Neumark-Stzainer D, Hannan PJ, Story M. Family Meals during Adolescence Are Associated with Higher Diet Quality and Healthful Meal Patterns during Young Adulthood. J Am Diet Assoc. 2007;107:1502-1510. Students enrolled in Project EAT completed surveys and food frequency questionnaires in high school classes and mailed a second set 5 years later. Findings indicated that family meal frequency during adolescence predicted higher intakes of fruit, vegetables, and key nutrients and lower intakes of soft drinks in young adulthood. Family meal frequency was also related to more breakfast meals in females, more dinner meals in both sexes, and a higher priority for meal structure and social eating. Larson NI, Neumark-Stzainer D, Hannan PJ, Story M. Trends in Adolescent Fruit and Vegetable Consumption, 1999-2004. Am J Prev Med. 2007;32(2):147-150. This study measured the change in fruit and vegetable intake of over 2500 teen boys and girls involved in Project EAT, between early, middle, and late adolescence. During the transition from early to middle adolescence, the average total daily fruit and vegetable intake decreased by 0.7 servings for girls and 0.8 servings for boys. Between middle and late adolescence, the decrease was 0.6 servings for both genders. Larson NI, Story M, Eisenberg ME, Neumark-Stzainer D. Food Preparation and Purchasing Roles among Adolescents: Associations with Sociodemographic Characteristics and Diet Quality. J Am Diet Assoc. 2006;106:211-218. This cross-sectional study compared involvement in food preparation and shopping among youth involved in Project EAT with diet quality. Helping with dinner preparation was reported by most teens (68.6%), and nearly half reported shopping for food (49.8%). Several characteristics were associated with a higher reporting of these activities including having more frequent family meals. Being involved in food preparation was associated with improved diet quality. Shopping for food did not make the same positive difference. The authors recommend interventions for teens to teach cooking skills and strategies for making healthful consumer decisions.

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Larson RW, Branscomb KR, Wiley AR. Forms and Functions of Family Mealtimes: Multidisciplinary Perspectives. New Directions for Child and Adolescent Development 2006:111:1-15. This article reviews the history of American family mealtime, including statistics on prevalence from several large national surveys (page 5), showing that most families across demographic groups have meals together 4 or more times per week. Daily family meals were highest in Hispanic and Asian-American families and lowest in African-American families. Current mealtime practices include an increase in take out and eating out, and that most families have the television on during meals, with less emphasis on mealtime etiquette. The impact of mealtime on cultural socialization, literacy and academic outcomes, risk behavior and socioemotional development, and nutrition are all reviewed. Lin W, Liang IS. Family dining environment, parenting practice and preschooler’s food acceptance. SNE 2005 Annual Conference, Orlando, Florida. July 23-27, 2005. Results of this study indicate that the family dining environment and food-related parenting practice were most important to preschooler’s food acceptance. The dining environment included the presence of parents and siblings, and dining condition and atmosphere. Lindsay AC, Sussner KM, Greaney ML, Peterson KE. Influence of Social Context on Eating, Physical Activity, and Sedentary Behaviors of Latina Mothers and Their Preschool-Age Children. Health Educ Behav. 2009;36(1):81-96. Using focus groups this research examined Latina mothers’ perceptions of factors that act as barriers for establishing healthy eating and physical activity habits in their preschool-age children. Among the results lack of time and lack of family meals are mentioned in addition to watching television during meals. Linneman C, Hessler K, Nanney S, Steger-May K, Huynh A, Haire-Joshu D. Parents Are Accurate Reporters of Their Preschoolers’ Fruit and Vegetable Consumption under Limited Conditions. J Nutr Educ Behav. 2004;36:305-308. This study examined whether parents accurately reported their preschoolers’ intake of fruits and vegetables on a food frequency questionnaire compared with an observed meal. Results indicated that parents are accurate in their ability to recall their child’s fruit and vegetable intake. Lugalia TA. A Child’s Day: 2000 (Selected Indicators of Child Well-Being). Current Population Reports, US Census Bureau, Washington, DC, 2003:PP1-20. This is the second report based on data from the Survey of Income and Program Participation (SIPP) which provides a portrait of the well-being of children and their daily activities. About three-fourths of children under age 6 had dinner each day with their designated parent. Sixty-five percent of children aged 6-17 had dinner every day with at least one parent. Mackenzie M. The Feeding Partnership: An Anthropological Perspective on Meals Pediatric Basics. 1995;74:10-16. Describes how across cultures shared family meals cultivate human connections. “Shared meals with children are a fundamental arena for disseminating cultural and emotional connections between and among the generations of a family.”

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Mamun AA, Lawlor DA, O’Callaghan MJ, Williams GM, Najman JM. Positive Maternal Attitude to the Family Eating Together Decreases the Risk of Adolescent Overweight. Obesity Research. 2005;13(8):1422-1430. Children of women who felt that the family eating together was not important had increased odds of being overweight at age 14. This was a stronger determinant than reported frequency of meals eaten together. “Family meals” were not defined and therefore the actual or perceived quality of meal experiences may be related to the mother’s attitude of the importance of family meals. Mancino L, Newman C. Who Has Time to Cook? How Family Resources Influence Food Preparation. Economic Research Report Number 40. Available at: www.ers.usda.gov May 2007. Findings show that characteristics such as income, employment, gender, and family structure impact food preparation decisions. Women and married adults spend more time preparing food than men and single adults. Higher incomes and more time spent working relates to less time spent cooking. Larger family size increases the time spent in food preparation. The study compared the average time spent cooking with the expected time needed to follow the Thrifty Food Plan, finding that the 40 minutes spent cooking by most single parents or two-working parents in low-income households is only half of the 80 minutes needed to follow the TFP recipes. Matheson DM, Wang Y, Klesges LM, et al. African-American girl’ dietary intake while watching television. Obesity Research. 2004;12:32s-37s. This study using data from 210 8-10 year old African-American girls found that 26.9-35% of the girls’ daily caloric intake was consumed while watching television, and 40-50% of all evening meals were eaten while watching TV. Matheson DM, Killen JD, Wang Y, Varady A, Robinson TN. Children’s food consumption during television viewing. Am J Clin Nutr. 2004;79:1088-94. Data was collected from a sample of ethnically-diverse third grade students and a sample of predominantly Latino fifth grade students using 3 nonconsecutive 24 hour dietary recalls. Children recorded whether they were watching television at the time of food consumption. On weekdays 17-18% of total energy was consumed while watching television. This increased to 26% on weekends. Fewer fruits and vegetables were consumed while watching television. Mayfield B. Family Meals Promote Wellness. ADA Digest. Fall 2008;4-5. This article summarizes the benefits of family meals and strategies for public health nutritionists to promote family meals Moens E, Braet C, Soetens B. Observation of Family Functioning at Mealtime: A Comparison Between Families of Children With and Without Overweight. Journal of Pediatric Psychology. 2007;32(1):52-63. This study compared 28 families with an overweight child with 28 families with a normal weight child using both observations and self-reports of parental control and support at mealtime. Parents of overweight children self-reported higher degrees of control and equal amounts of support. Observations at mealtime found that in families with an overweight child maladaptive control strategies were twice as prevalent and the social-affective eating environment was less supportive.

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Monk TH, Burk LR, Klein MH, et al. Behavioral circadian regularity at age 1 month predicts anxiety levels during school-age years. Psychiatry Research. 2010;178: 370-373. This study followed 59 infants for 13 years, logging parental report of when parents fed, changed, played with and comforted their infants at 1 month of age and then periodically over the next 13 years asked about the child’s development. The authors concluded that greater regularity of daily activities, including a reliable interval between meals, may increase predictability of infant demands, enhanced parental perception of need cues, increased parental confidence and stronger care-taking routines, leading to improved parent-infant relationships and infant regulatory capacity, which was shown to help the child be less anxious about new situations and environments when they are older. Moore KA, Chalk R, Scarpa J, Vandivere S. Preliminary Research on Family Strengths. A KIDS COUNT Working Paper prepared by Child Trends, Inc. for the Annie E. Casey Foundation. Baltimore, Maryland. 2002. Discusses how maintenance of family routines (including regular family meals) is positively linked to multiple child outcomes, including academic achievement, self-esteem, and both behavioral and psychosocial adjustment. Everyday activities predict better child outcomes than random, irregular activities, even those that may be more stimulating. Families that are organized and have predictable routines produce children with more positive outcomes. Murray CG. Learning About Children’s Social and Emotional Needs at Snack Time – Nourishing the Body, Mind, and Spirit of Each Child Young Children. 2000;55:43-52. Describes strategies for meeting social-emotional goals during snack time in child care settings. National Center on Addiction and Substance Abuse at Columbia University (CASA). The Importance of Family Dinners VI. 2010. Available at: http://www.casacolumbia.org Accessed: October 1, 2010. This organization has been studying the impact of family meals for over 15 years and has surveyed thousands of teens in order to publish a report each year of the results. They find consistently that teens who eat with their parents 5 or more times a week have higher grades, lower rates of tobacco, alcohol, and drug use, and have stronger family ties. Neumark-Sztainer D, Larson NI, Fulkerson JA, Eisenberg ME, Story M. Family meals and adolescents: what have we learned from Project EAT (Eating Among Teens)? Public Health Nutrition. 2010: 13(7), 1113-1121. This paper provides an overview of more than a decade of research on family meals as part of Project EAT, a large, population-based study of adolescents. Main findings indicate that many adolescents and parents view family meals in a positive light in spite of the diversity of context and frequency of family meals. Benefits of more frequent family meals include improved dietary intake, reduction of disordered eating and substance abuse, and better psychosocial health.

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Neumark-Sztainer D. Preventing Obesity and Eating Disorders in Adolescents: What Can Health Care Providers Do? Journal of Adolescent Health. 2009;44:206-213. This articles provides five evidence-based recommendations for health care providers to help prevent obesity and eating disorders among adolescents. These are: 1) discourage unhealthy dieting; 2) promote a positive body image; 3) encourage more frequent, and more enjoyable family meals; 4) encourage families to talk less about weight and do more at home to facilitate healthy eating and physical activity; and 5) assume that overweight teens have experienced weight mistreatment and address this issue with teens and their families. Neumark-Sztainer D, Eisenberg ME, Fulkerson JA, Story M, Larson NI. Family Meals and Disordered Eating in Adolescents: Longitudinal Findings from Project EAT. Arch Pediatr Adolesc Med. 2008;162(1):17-22. Family meal frequency at time 1 was associated with time 2 disordered eating behaviors, including extreme weight control behaviors, less extreme unhealthy weight control behaviors, binge eating, and chronic dieting. For adolescent girls but not boys, more regular family meals were associated with lower prevalence of time 2 extreme weight control behaviors, even after adjusting for sociodemographic characteristics, BMI, family connectedness, parental encouragement to diet, and extreme weight control behaviors at time 1. Neumark-Sztainer D. Eating Among Teens: Do Family Mealtimes Make a Difference for Adolescents’ Nutrition? New Directions for Child and Adolescent Development. 2006;111:91-105. This article reviews the indicators that adolescents are at risk for poor dietary intake and unhealthy weight control behaviors. The authors describe family meals in homes with teenagers, showing significant diversity in frequency and family meal patterns. Family meals have been associated with improved diet quality in several large-scale studies, including Project EAT, the Growing Up Today Study, and the Add Health Study. Research also indicates a protective impact of family meals on preventing disorder eating behaviors. Neumark-Sztainer D, Wall M, Story M, Fulkerson JA. Are Family Meal Patterns Associated with Disordered Eating Behaviors Among Adolescents? Journal of Adolescent Health. 2004;35:350-359. The authors conclude that in general, adolescents who reported more frequent family meals, high priority for family meals, a positive atmosphere at meals, and a more structured mealtime environment were less likely to engage in disordered eating. The associations were stronger for girls than for boys. 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. 2003;103:317-322. Family meals were found to play an important role in promoting positive dietary intake among adolescents. Improved intakes of fruits, vegetables, grains, calcium-rich foods and lower intakes of soft drinks were associated with more frequent family meals.

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Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. Family Meals Among Adolescents: Findings from a Pilot Study. Journal of Nutrition Education. 2000;32:335-340. Findings from this pilot study indicate the need for further research on the associations between family meal patterns and eating behaviors. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. The “Family Meal”: Views of Adolescents. Journal of Nutrition Education. 2000;32:329-334. Describes results of focus groups with adolescents to increase understanding of family meal patterns and perceptions of adolescents regarding the family meal. Barriers to family meals included schedules, teen desire for autonomy, family conflicts, and dislike for food at meals. Teens believed they would eat better if they ate more frequent family meals.

Ochs E, Shohet M. The Cultural Structuring of Mealtime Socialization. New Directions for Child and Adolescent Development. 2006;111:35-49. “Universally, commensality (the practice of sharing food and eating together in a social group such as a family) is central to defining and sustaining the family as a social unit. In ancient Greece, for example, oikos (family) was stipulated as “those who feed together.” Cultures, communities, and families differ in whether family members eat together and what is eaten according to generation, gender, and social rank. This article discusses language socialization in the context of mealtime conversation and “cultural apprenticeship” (learning through active observation and direct participation) of mealtime behaviors. Olsen SO, Ruiz S. Adolescents’ influence in family meal decisions. Appetite. 2008; 51(3):646-653. This paper describes Norwegian study involving 1000 schoolchildren between the ages of 13 and 18. The researchers analyzed the antecedents of the influence of teens in family meal decisions, specifically for fish as a main meal. Their participation in family decisions were affected by their motivation, family communication patterns, social norms, and parental preferences. Pan BA, Perlmann RY, Snow CE. Food for Thought: Dinner Table as a Context for Observing Parent-Child Discourse. Menn L, Bernstein Ratner N (Eds) Methods for studying language production. Mahwah, NJ: Lawrence Erlbaum. 1999. PP205-224. This book chapter examines the value of dinner-table conversation as a context for observing child language and parent-child interaction. It is based on the Home-School Study of Language and Literacy Development in which children from low-income families were studied in the home and school environment. Patrick H, Nicklas TA, Hughes SO, Morales M. The benefits of authoritative feeding style: caregiver feeding styles and children’s food consumption patterns. Appetite. 2005;44:243-249. This study examined whether caregiver feeding styles were associated with children’s food consumption patterns in African-American and Hispanic families. Results favor authoritative feeding, in which the child is encouraged to eat healthy foods, but is also given some choices about eating options. This feeding style was associated with an increased intake of dairy, fruits, and vegetables.

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Patrick H, Nicklas TA. A review of family and social determinants of children’s eating patterns and diet quality. J Am Coll Nutr. 2005;24(2):83-92. Reviews research which focuses on family and social influences on children’s eating patterns, including whether families eat together. Raynor HA, Jelalian E, Vivier PM, Hart CN, Wing RR. Parent-reported Eating and Leisure-time Activity Selection Patterns Related to Energy Balance in Preschool-and School-aged Children. JNEB. 2009;41(1):19-26. Family meals were one of the factors assessed in this cross-sectional survey of preschool and school-age children. 93% of preschool children regularly ate dinner with a parent, versus only 80.7% of school-age children. Rhee K. Childhood Overweight and the Relationship between Parent Behaviors, Parenting Style and Family Functioning. The ANNALS of the American Academy of Political and Social Science. 2008;615:12-37. This paper examines the influence of parents on the development of eating habits and weight in children. Parental feeding practices discussed include prompting to eat, use of rewards, restricting access to food, and control over child intake. General parent behaviors discussed include exposure to and availability of foods, portion size, and modeling. Parental influences such as parenting style and family functioning (which is where family meals are discussed as a proxy for family functioning) are also discussed as well as interaction of the various factors. Rideout V, Roberts DF, Foehr UG. Generation M: Media in the Lives of 8-18 Year-olds. A Kaiser Family Foundation Study. March 2005. Available at www.kff.org. This report describes the amount and types of media used by young people. The average time spent with media is 6½ hours per day, with about 3 hours as TV, almost 2 hours spent listening to music, and about 1 hour each on the computer and playing video games. This compares to less than an hour doing homework. Rideout V, Hamel E. The Media Family: Electronic Media in the Lives of Infants, Toddlers, Preschoolers and Their Parents. A Kaiser Family Foundation Study. May 2006. Available at www.kff.org. This study used a nationally representative survey and 8 focus groups. It was found that 83% of children age 6 months to 6 years use some type of screen media daily for an average of just under 2 hours. Nearly a third of these children live in a household where the TV is on all or most of the time. 43% of children age 4-6 have a TV in their bedroom. 53% of all children eat a snack or meal in front of the TV on any given day. Robinson-O’Brien R, Neumark-Sztainer D, Hannan PJ, Burgess-Champoux T, Haines J. Fruits and Vegetables at Home: Child and Parent Perceptions. J Nutr Educ Behav. 2009;41(5):360-364. 73 child-parent pairs participated in an evaluation of the Ready. Set. ACTION! (RSA) program, a theater-based pilot study for obesity prevention. Findings indicate that parents and children view the home food environment similarly, with child perceptions more strongly associated with child fruit and vegetable intake.

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Roblin L. Childhood obesity: food, nutrient, and eating-habit trends and influences. Appl Physiol Nutr. 2007;32:635-645. This paper discusses factors related to childhood obesity and includes the role of the family meals, encouraging regular family meals and the reasons for their benefits. They report a Canadian study finding that children who ate supper with their families at least 3 times a week are at decreased risk for being over- weight or obese. Rockett HRH. Family Dinner: More than Just a Meal. J Am Diet Assoc. 2007;107: 1498-1501. This research editorial discusses trends in eating together, showing a decrease over time that appears to be more recently improving. This article also discusses the relationship of family dinner with healthful diets and obesity. Possible confounding variables such as SES, television viewing, and carry out food eaten at home. Rollins BY, Belue RZ, Francis LA. The Beneficial Effect of Family Meals on Obesity Differs by Race, Sex, and Household Education: The National Survey of Children’s Health, 2003-2004. J Am Diet Assoc. 2010;110(9):1335-1339. The impact of family meal frequency on reducing the incidence of obesity was seen in non-Hispanic white children and non-Hispanic black boys. In Hispanic boys in low-education households increased frequency of family meals was related to a slight increase in the incidence of obesity. Rovner AJ, Mehta SN, Haynie DL, et al. Perceived Benefits, Barriers, and Strategies of Family Meals among Children with Type 1 Diabetes Mellitus and Their Parents: Focus Group Findings. J Am Diet Assoc. 2010;110(9);1302-1306. Focus groups revealed that families with children with diabetes experienced the same barriers to family meals as other families, namely busy schedules. Strategies to improve family meals included shopping for foods needed, planning, cooking in advance, and simplified cooking techniques. Satter EM. Dietary Guidelines and Food Guide Pyramid Incapacitate Consumers and Contribute to Distorted Eating Attitudes and Behaviors. 2005. Available at: www.EllynSatter.com. Satter argues that “consumers decode the Dietary Guidelines and MyPyramid as “don’t eat so much; don’t eat the foods you like.” This in turn creates weight preoccupation and anxiety about eating, harming our eating attitudes and behaviors. She proposes that we must “trust ourselves to eat as much as we are hungry for, to eat the foods that we like, and to feel comfortable to do it all over again.” She states that restrained eating is so common it is perceived as normal. Regarding family meals, Satter states that “parents feed themselves and their children best and most reliably when they provide meals that they find richly rewarding to plan, shop for, prepare, provide, and eat.” Satter EM. The Feeding Relationship. Journal of The American Dietetic Association. 1986;86:352-361. Describes the feeding relationship between parent and child from infancy to adolescence. Satter proposes that the feeding relationship is characteristic of the overall parent-child relationship. A positive feeding relationship supports

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good nutrition, food acceptance, developmental eating skills, self-regulation of intake, and socialization. Sen B. Frequency of Family Dinner and Adolescent Body Weight Status: Evidence from the National Longitudinal Survey of Youth, 1997. Obesity. 2006; 14(12):2266-2276. This study explored the associations between overweight and frequency of family meals and how those associations differ with race and ethnicity. Results showed that for whites an increase in family meals frequency reduced the odds for being overweight, or becoming overweight. This was not found for blacks or Hispanics. The author suggests that this may be due to differences in the types and portions of food served at family meals.

Serrano E, Gresock E, Suttle D, Keller A, McGarvey E. Fit WIC: Attitudes, Perceptions and Practices of WIC Staff toward Addressing Childhood Overweight. J Nutr Educ Behav. 2006;38:151-156. WIC staff were surveyed about their weight status, comfort level addressing childhood overweight topics, and recommendations for educational materials and programs. Results showed that weight status and job title were significant factors in feeling comfortable with discussing weight-related issues with WIC participants. Staff with the least training and those who were more overweight were the least comfortable. Staff development and wellness programs were recommended to improve self-efficacy and a more supportive environment. Skinner JD, Ziegler P, Pac S, Devaney B. Meal and Snack Patterns of Infants and Toddlers. Journal of the American Dietetic Association. 2004;104:S65-S70. Describes meal and snack patterns of the 3,022 infants and toddlers in the Feeding Infants and Toddlers Study (FITS). Sloan AE. What, When, and Where America Eats. Food Technology. 2006;1:18-27. Currently, three-quarters of American adults eat the evening meal at home, but only 58% prepare meals at home. Americans take meals home from restaurants more often than eat them at the restaurant. In 2005, the frequency of meals eaten at home averaged 4.9 times per week. Snow CE, Beals DE. Mealtime Talk That Supports Literacy Development. New Directions for Child and Adolescent Development. 2006;111:51-66. Describes the Home-School Study, which observed conversations at playtime and story time and recorded conversations at meal time, then measured later school achievement. Mealtimes offered the greatest opportunities for extended discourse, involving both explanatory and narrative talk. Children are exposed to more sophisticated vocabulary and learn more rare words at mealtime resulting in greater language acquisition and later academic success. Snow CE, Tabors PO, Dickinson DK. Language Development in the Preschool Years. In Dickinson DK, Tabors PO (Eds). Beginning Literacy with Language. Baltimore: Paul H. Brookes Publishing Co. 2001. PP1-25. This book chapter focuses on data collected during the preschool period for the Home-School Study of Language and Literacy Development. Home data included tape recordings of mothers and children reading books, telling stories, playing with toys and of family mealtimes.

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Spear BA. The Need for Family Meals. J Am Diet Assoc. 2006;106(2):218-219. This article encourages health providers who work with adolescents to assess family meal patterns and teen involvement in purchasing and preparing meals; and then provide education to adolescents to help their families with meal preparation and food purchasing. Stitt S. An international perspective on food and cooking skills in education. British Food Journal. 1996;98(10):27-34. This article aims to strengthen the argument for prioritizing food cookery skills in schools as one of the most effective health promotion strategies. Stockmyer C. Remember when mom wanted you home for dinner? Nutrition Reviews. 2001;59(2):57-60. Most (89%) family cooks believe that eating together as a family is important. Average time to prepare a meal is 28 minutes. Television is frequently on during meals, but families claim to still be able to maintain conversations. Stables G. The Changing US Family, and Importance of Healthy, Convenient Family Meals for Children and Youth. ADA Digest. Fall 2008:1-3.. This article discusses the changing American family demographics leading to less frequent family meals, including shifting roles, dual income families, less food preparation skills, and less time for planning, preparing and eating meals together. Story M, Neumark-Sztainer D. Family Meals: Do They Matter? Nutrition Today. 2005;40(6):261-266. This article describes the social value of family meals and the impact of family meals on children’s dietary quality, psychosocial health, and learning. Strategies for promoting family meals are presented. Sweeting H, West P. Dietary habits and children’s family lives. Journal of Human Nutrition and Dietetics. 2005;18(2):93-97. A British school-based survey of 2,146 parents to study the associations between dietary habits at age 11 and family life, which included family structure, meals, and maternal employment status, accounting for socioeconomic factors. Family structure and meals were not found to be associated with children’s diets. Tabors PO, Roach KA, Snow CE. Home Language and Literacy Environment. In Dickinson DK, Tabors PO (Eds). Beginning Literacy with Language. Baltimore: Paul H. Brookes Publishing Co. 2001. PP 111-138. Book chapter describes analysis of research from the Home-School Study, examining how extended discourse, rare-word density, and home support for literacy work together to influence a child’s language skills. Taveras EM, Rifas-Shiman SL, Berkey CS, et al. Family Dinner and Adolescent Overweight. Obesity Research. 2005;13(5):900-906. The frequency of eating family dinner was inversely associated with overweight prevalence at baseline but not with likelihood of becoming overweight in longitudinal analyses.

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Tibbs T, Haire-Joshu D, Schechtman KB, et al. The relationship between parental modeling, eating patterns, and dietary intake among African-American parents. J Am Diet Assoc. 2001;101:535-541. 456 African-American parents participated in the High-Five, Low Fat Nutrition Program, developed through Parents as Teachers, a national program that focuses on parents as role models. The Parental Dietary Modeling Scale used has 6 items, including “I sit with my child at mealtime.” Modeling of healthful dietary behaviors is a good way for parents to influence their child’s intake. Utter J, Scragg R, Schaaf D, Mhurchu C. Relationships between frequency of family meals, BMI and nutritional aspects of the home food environment among New Zealand adolescents. International Journal of Behavioral Nutrition and Physical Activity. 2008;5(50). http://www.ijbnpa.org/content/5/1/50 Data collected at baseline from 3245 ethnically diverse adolescents enrolled in the Pacific Obesity Prevention Communities study, measured frequency of family meals, other aspects of the home food environment, and BMI. Findings indicate that families who have regular family meals have more healthful foods available in the home, support their child eating healthfully, limit television, eat breakfast, eat five fruits and vegetables a day, and pack a lunch from home. Family meals were modestly associated with BMI in bivariate analysis but when demographic characteristics were included in the model, the association was not significant. . Van Horn L. Eating in . . . What a Concept! J Am Diet Assoc. 2007;107:543. Editorial compares the nutrient density of meals eaten away from home with home prepared meals. “A growing consensus suggests that eating at home at the family table is a simple, albeit counter-cultural solution.” Videon TM, Manning CK. Influences on adolescent eating patterns: The importance of family meals. Journal of Adolescent Health, 2003;32:365-373. Provides national estimates of the frequency and determinants of adolescents’ consumption of fruits, vegetables, and dairy foods. Parental presence at the evening meal was associated with a lower risk of poor consumption of fruits, vegetables, and dairy foods as well as the likelihood of skipping breakfast. Weisman Z, Snow CE. Lexical input as related to children’s vocabulary acquisition: Effects of sophisticated exposure and support for meaning. Developmental Psychology. 2001;37:265-279. One of several references about the Harvard Home-School Study of language development in the preschool years. Welsh EM, French S, Wall M. Examining the Relationship Between Family Meal Frequency and Individual Dietary Intake: Does Family Cohesion Play a Role? J Nutr Educ Behav. 2011;43(4):229-235. A cross-sectional survey of 152 adults and 75 adolescents in 90 households showed that family meal frequency was associated with fruit and vegetable intake in adults and intake of sweets and sweetened beverages in teens. It was also positively correlated with perceived family cohesion. Family cohesion was not found to consistently mediate the relationship between frequency of family meals and individual dietary intake.

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Wenrich TR, Brown JL, Miller-Day M, Kelley KJ, Lengerich EJ. Family Members’ Influence on Family Meal Vegetable Choices. J Nutr Educ Behav.2010;42(4):225-234. This study among 61 low-income men and women from rural Appalachian Pennsylvania found that food preparers perceived more costs than rewards in serving vegetables, especially those that are cruciferous, deep orange, and dark green leafy. They served primarily only those vegetables that were acceptable to everyone in the family and ignored unfamiliar vegetables. Whitaker RC. A Review of Household Behaviors for Preventing Obesity in Children. Mathematica Policy Research, Inc. 2004. Report summarizes potential benefits from adopting targeted behaviors to prevent or treat childhood obesity. Increasing the number of meals eaten with family members, especially parents was seen as having both obesity benefits and non-obesity benefits. White J, Halliwell E. Alcohol and Tobacco Use during Adolescence: The Importance of the Family Mealtime Environment. J Health Psychol. 2010;15:526-532. This study from the UK, examined the impact of family meals on substance abuse in teens, looking at not only family meal frequency but also family connectedness, perceived priority, atmosphere and structure of mealtime as predictors of alcohol and tobacco use. They found that the teens’ perception of meals was a more important predictor of substance abuse than frequency.

Wilcox WB. Children at Risk. First Things. 2004;140:12-15. The Commission on Children at Risk concluded “the human person is hardwired to connect to other people” and “the intact, two-parent family and religion play a central role in promoting the social and psychological welfare of children.” This paper also describes the work of Emile Durkheim over a century ago with suicide rates and how they are related to an adolescent’s tie to “an authoritative community” including an intact family. Wind M, de Bourdeaudhuij I, te Velde SJ, et al. Correlates of Fruit and Vegetable Consumption Among 11-Year-Old Belgian-Flemish and Dutch Schoolchildren. J Nutr Educ Behav. 2006;38:211-221. This cross-sectional survey of over 2400 school children in Belgium-Flanders and the Netherlands looked at factors associated with fruit and vegetable consumption. This study found the strongest correlates for both fruit and vegetable intake were taste preferences and parental influence, including both parental modeling and parental demand to eat fruits and vegetables. Other important factors included parental facilitation and home availability. Woodruff SJ, Hanning RM. A Review of Family Meal Influence On Adolescents’ Dietary Intake. Can J Diet Prac Res. 2008;69:14-22, . This review article summarizes the literature on family influence on dietary intake, especially during the teen years and looked at summarizes family meal patterns and reviews the known influences of family meals on dietary intake. Figures illustrating the complex interaction of factors are included.

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Worobey J. Early family mealtime experiences and eating attitudes in normal weight, underweight and overweight females. Eating Weight Disorders. 2002;7:39-44. This study examined college women’s recollections of family mealtimes to determine whether these memories differed between normal weight, overweight, and underweight women. Mealtime communication-based stress was associated with bulemia/food preoccupation and oral control. Underweight women in this study had the highest levels of mealtime stress, but were not anorectic. The strongest correlate with a young woman’s body self-esteem was emphasis on mother’s weight. Parental discussions at mealtimes emphasizing weight-with- appearance-with-worth had a negative impact on daughters and was associated with eating disorders and overweight. Young L, Anderson J, Beckstrom L, Bellows L, Johnson SL. Using Social Marketing Principles to Guide the Development of a Nutrition Education Initiative for Preschool-Aged Children. J Nutr Educ Behav. 2004;36:250-257. This article reports the use of social marketing strategies to develop a nutrition education program for Head Start children. Focus groups determined the campaign concept, followed by piloting the message of trying new foods. A food frequency questionnaire was used to select the novel foods introduced to the children. The program included games and activities, trying new foods at snack time and parent newsletters. Children in the experimental classrooms showed an increase in overall acceptance of new foods. Yuasa K, Sei M, Takeda E, et al. Effects of lifestyle habits and eating meals together with the family on the prevalence of obesity among school children in Tokushima, Japan: a cross-sectional questionnaire-based survey. The Journal of Medical Investigation. 2008;55:71-77. This research examined factors associated with the prevention of obesity and the development of healthy lifestyle habits in elementary and junior high age children. Eating meals as a family every day was associated with a lower rate of obesity. Other positive lifestyle factors included getting enough sleep and eating balanced meals. Zabinski MF, Daly T, Norman GJ, et al. Psychosocial Correlates of Fruit, Vegetable, and Dietary Fat Intake among Adolescent Boys and Girls. J Am Diet Assoc. 2006;106:814-821. This cross-sectional study used questionnaires to determine the correlates of adolescent dietary behavior by assessing a set of psychosocial influences. Their findings suggest that for dietary-change interventions to be effective they will require multiple components, including the need for parents to be encouraged to provide healthful food environments. Zollo P. Getting Wiser To Teens: More Insights into Marketing to Teenagers. Ithaca, NY. New Strategist Publications, 2004. Peter Zollo cites research conducted by Teenage Research Unlimited, in which a national survey of adolescents asked teens what they like to do with their parents. They found that 79% listed “eat dinner at home” as a favorite activity.

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Lay/Professional Books:

Canfield J, Hansen M, Wentworth D. Chicken Soup for the Soul Cookbook Health Communications, Inc., 1995. “The kitchen is the heart of the home. So much of life is lived around the family table . . .” This book combines heartwarming stories of mealtime memories accompanied by recipes. Civitello L. Cuisine and Culture: A History of Food and People John Wiley and Sons, Inc., 2004.

This book presents how throughout history, food has played a critical and defining part in individual cultures and the overall development of civilization. Civitello connects major historical events and describes how and why these events affected and defined the culinary traditions of different societies.

Christopher D. Come to the Table: A Celebration of Family Life. Warner Books, Inc., 1999. Written by the founder of Pampered Chef, this book describes how to honor the tradition of the family table. Counihan C, Van Esterik P. (editors). Food and Culture: A Reader. Routledge, 1997. This book takes a global look at the social, symbolic, and political-economic roles of what, and how, we eat. Contributing authors reveal how food habits and beliefs both present a microcosm of any culture and also contribute to our understanding of human behavior. Doherty W. The Intentional Family: Simple Rituals to Strengthen Family Ties. Harper Collins Publshers, 1997. This book is intended to be a practical guide offering effective methods for opening channels of communication between family members, such as regularly sharing meals, vacation, storytime, etc. The chapter on family meals compares the family meal habits of several families and then outlines the elements of “intentional” family meals. Kerr G. The Gathering Place Camano Press, 1997. “The Galloping Gourmet” celebrates the family dining table as “our last remaining tribal gathering place.” This cookbook takes the reader to 13 ports of call and shares the foods and mealtime traditions of each stop. Meiselman HL. Dimensions of the Meal Aspen Publishers, 2000. This book examines the science, culture, business, and art of eating. Sections cover definitions of meals, the biological bases of the meal, the meal and culture, the meal and cuisine, and designing and producing meals. Miller W, Sparks G. Refrigerator Rights: Creating Connections and Restoring Relationships The Berkley Publishing Group, 2002. This book sites research on the negative impact of social isolation and the importance of connecting with others through meaningful relationships.

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Neumark-Sztainer D. “I’m Like, So Fat!” Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World. The Guilford Press, 2005. This book helps parents and concerned adults respond to the “fat talk” of teens, counteract negative media messages, and provide the truth about nutrition and calories, dieting, and eating out. Ornish D. Love and Survival: 8 Pathways to Intimacy and Health Harper Collins Publishers, 1998. Evidence for the importance of intimate relationships on health. Extensively referenced. Putnam R. Bowling Alone: The Collapse and Revival of American Community Simon and Schuster, 2000. Harvard social scientist describes data showing how Americans have become increasingly disconnected from family, friends, neighbors and our democratic structures and how we may reconnect. Rappoport L. How We Eat: Appetite, Culture, and the Psychology of Food. ECW Press, 2003. This book traces our culinary customs from the Stone Age to the stove-top range and explores the fascinating and often contradictory myths and rituals shaping our eating habits. Satter E. Child of Mine Bull Publishing, 2000. How to Get Your Kid to Eat. . . But Not Too Much (1987, Bull), Secrets of Feeding a Healthy Family (1999, Kelcy Press) Your Child’s Weight: Helping without Harming (2005, Kelcy Press)

These classic books on feeding children, by an expert in nutrition and eating behaviors, spell out the roles of parents and children at mealtime.

Smith A. Back to the Table: The Reunion of Food and Family Hyperion, 2001. A unique cookbook by Oprah Winfrey’s personal chef, written to strengthen family bonds. Stracher C. Dinner with Dad: How I Found My Way Back to the Family Table. Random House, 2007. A New York attorney embarks on a year long experiment to be home with his family in suburban Connecticut for dinner 5 days a week, even helping cook a couple of times a week. The book describes his successes and failures with wit and insight into what matters most about family meals. Weinstein M. The Surprising Power of Family Meals Steerforth Press, 2005. This book contains stories and studies showing how eating together makes families smarter, stronger, healthier, and happier.

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