Abstract
Background
Multiple studies and guidelines emphasize the benefits associated with family meals.
However, family meals are not well defined and little research has been conducted
to determine whether mealtime characteristics are associated with the healthfulness
of foods served.
Objective
The objective of this study was to define and measure specific mealtime characteristics
and examine whether these characteristics are associated with the healthfulness of
meals served to young children from low-income families, as measured by the Healthy
Meal Index (HMI).
Participants/setting
Study participants included 272 young children from low-income families residing in
southeast Michigan during 2011 to 2013.
Design
For this cross-sectional study, parents videorecorded 757 mealtimes that were coded
for four mealtime variables and meal healthfulness using the HMI. Mealtime characteristics
included Eating at a Table (vs not), Served Family-Style (vs not), TV Off (vs not),
and Parent Partakes (sits and eats or drinks with child) (vs not). A Family Meal was
defined as a meal that had all four measured mealtime characteristics.
Main outcome measures
All meals were scored using the HMI, which has two components: the HMI Adequacy score
(based on the presence of foods that are recommended for a healthy diet) and the HMI
Moderation score (based on the absence of foods recommended to be consumed in moderation).
The scores are summed to obtain the HMI Total score.
Statistical analyses performed
Generalized estimating equations tested the associations of mealtime characteristics
with HMI scores, controlling for child sex and age, and parent education and race/ethnicity.
Results
In adjusted models, Family Meals were positively associated with HMI Adequacy (P=0.02) and Total (P=0.05) scores. Eating at a Table was positively associated with HMI Moderation (P=0.01) and HMI Total (P=0.01) scores. Served Family-Style was positively associated with HMI Adequacy scores
(P=0.04). TV Off was associated with higher HMI Total scores (P=0.05). Parent Partakes was not associated with HMI scores.
Conclusions
Family Meals were associated with greater healthfulness of the foods served. Characteristics
of mealtime that are commonly utilized to define Family Meal were differentially associated
with meal healthfulness.
Keywords
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Biography
N. Kasper is a postdoctoral fellow, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor; at the time of the study, she was a graduate student, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor.
Biography
S. C. Ball is a senior research area specialist, Department of Nutritional Sciences, School of Public Health, and the Michigan Nutrition Obesity Research Center, University of Michigan, Ann Arbor.
Biography
K. Halverson is a regulatory affairs specialist, The Wonderful Company, Los Angeles; at the time of the study, she was a nutrition specialist and graduate student, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor.
Biography
A. L. Miller is associate professor of health behavior & health education, and a research associate professor, Center for Human Growth and Development, University of Michigan, Ann Arbor.
Biography
D. Appugliese is the chief executive officer, Appugliese Professional Advisors LLC, Easton, MA.
Biography
J. C. Lumeng is professor of nutritional sciences, School of Public Health; research professor, Center for Human Growth and Development; and professor of pediatrics and communicable diseases, Medical School, University of Michigan, Ann Arbor.
Biography
K. E. Peterson is professor of nutritional sciences and chair, Department of Nutritional Sciences, and professor of global public health, School of Public Health, University of Michigan, Ann Arbor.
Article info
Publication history
Published online: March 18, 2019
Accepted:
January 9,
2019
Received:
November 29,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was supported by grant 5R01HD061356 from the National Institutes of Health. S. C. Ball, K. Halverson, and N. Kasper and were supported in part by the University of Michigan Momentum Center.
AUTHOR CONTRIBUTIONS N. Kasper conceived of the study question, statistical methods, and wrote the manuscript; S. C. Ball and K. Halverson conducted the literature review and assisted in writing the manuscript; A. L. Miller, J. C. Lumeng, and K. E. Peterson designed the study and oversaw data collection and analyses; and D. Appugliese conducted all data analysis and provided statistical expertise. All authors reviewed and commented on subsequent drafts of the manuscript.
Identification
Copyright
© 2019 by the Academy of Nutrition and Dietetics.
