Skip to main content
PMC home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2016 Jan 31.
Published in final edited form as: J Pediatr. 2014 Sep 27;166(2):296–301. doi: 10.1016/j.jpeds.2014.08.030

The Protective Role of Family Meals for Youth Obesity: 10-year Longitudinal Associations

Jerica M Berge 1, Melanie Wall 2, Tsun-Fang Hsueh 2, Jayne A Fulkerson 3, Nicole Larson 4, Dianne Neumark-Sztainer 4
PMCID: PMC4308550  NIHMSID: NIHMS624731  PMID: 25266343

Abstract

Objective

To examine whether having family meals as an adolescent protects against becoming overweight or obese 10 years later as a young adult.

Study design

Data from Project EAT-III, a longitudinal cohort study with emerging young adults, were used. At baseline (1998-1999) adolescents completed surveys in middle or high schools and at 10-year follow-up (2008-2009) surveys were completed online or via mailed surveys. Young adult participants (n=2117) were racially/ethnically and socioeconomically diverse (52% minority; 38% low income) between the ages of 19-31 (mean age=25.3; 55% female). Logistic regression was used to associate weight status at follow-up with family meal frequency 10-years earlier during adolescence, controlling and testing for interactions with demographic characteristics.

Results

All levels of baseline family meal frequency (i.e., 1-2, 3-4, ≥5 family meals/week) during adolescence were significantly associated with reduced odds of overweight or obesity ten years later in young adulthood as compared with never having family meals as an adolescent. Interactions by race indicated that family meals had a stronger protective effect for obesity in black versus white young adults.

Conclusions

Family meals during adolescence were protective against the development of overweight and obesity in young adulthood. Professionals who work with adolescents and parents may want to strategize with them how to successfully carry out at least one to two family meals per week in order to protect adolescents from overweight or obesity in young adulthood.

Keywords: Family Meals, Adolescents, Overweight, Obesity, Longitudinal

Family meals have been suggested as one potential factor that may be protective against obesity (1-3). Higher frequency of family meals are associated with more consumption of fruit and vegetables (4-6), calcium and whole grains (7-9), lower levels of extreme weight control behaviors and binge eating (8, 10), and better psychosocial health in adolescents (11). These significant associations have held across diverse ethnic/racial backgrounds and sex. However, research examining the association between family meal frequency and adolescent Body Mass Index (BMI) or weight status (i.e., overweight, obese) has shown inconsistent findings (12-22).

To date, the majority of research looking at the association between family meals and adolescent overweight/obesity has primarily been cross-sectional and found mixed results. More specifically, some cross-sectional studies have shown an inverse relationship between the frequency of family meals and adolescent BMI (12-17), and others have shown no association (19, 20, 23, 24). Furthermore, these cross-sectional findings have often been specific to one sex (22) or age group (18, 22), race/ethnicity (18), or social class (18, 22). A meta-analysis also noted the limitations of studies described above and further identified that research has mostly been conducted with children (ages 6-12 years) rather than adolescents (ages 13-18 years) or young adults (ages 18 years and older).

Given the high prevalence of adolescent obesity in the US (25, 26), and the likelihood of obesity tracking into adulthood (27), it is important to identify modifiable factors in the home environment that can protect against overweight/obesity through the transition to adulthood. Identifying whether race/ethnicity modifies the association between family meal frequency and young adult overweight/obesity is important in order to identify whether certain groups benefit more from having family meals. The current study addresses these gaps and furthermore examines an important developmental time frame, transitioning from adolescence to young adulthood, which is a common time to gain weight and to have fewer family meals (28).

The main aim of this study is to use longitudinal data from a 10-year population-based study (Project EAT-III) with racially/ethnically and socioeconomically diverse adolescents to investigate whether having frequent family meals as an adolescent is protective for overweight and obesity in young adulthood. Additionally, interactions were examined in order to identify whether associations between family meal frequency in adolescence and overweight/obesity status in young adulthood differ by race/ethnicity. The specific hypotheses for the study are that higher family meal frequency during adolescence will predict lower odds of overweight and obesity longitudinally into young adulthood and race/ethnicity will modify this significant association.

Methods

Data were drawn from the first and third waves of a 10-year longitudinal cohort study designed to examine weight-related variables (eg, dietary intake, physical activity, weight control behaviors, weight status) among adolescents; Project EAT-I and Project EAT-III (Eating and Activity in Teens)(29). The EAT III sample includes participants (n=2,287) who responded to the 10-year follow-up survey. At baseline (ie, Project EAT I), middle school and high school students in 31 public schools in the Minneapolis/St. Paul metropolitan area of Minnesota completed anthropometric measures and surveys in class during the 1998-1999 academic school year. The 10-year follow-up (ie, EAT III) study was designed to follow-up on the original participants in 2008-2009 as they progressed from adolescence into emerging adulthood. Data collection for EAT III ran from November 2008 to October 2009 and was conducted by the Health Survey Research Center in the School of Public Health at the University of Minnesota, Minneapolis. The Institutional Review Board Human Subjects Committee at the University of Minnesota approved all protocols used in Project EAT at each time point.

Of the original Project EAT-I participants (n=4,746), 27.5% (n=1,304) were lost to follow-up primarily for missing contact information at Time 1 (n=411) and no address found at follow-up (n=712) (30). For Project EAT-III, survey invitation letters were sent to participants with a web address and a unique password for completing the online version of the Project EAT-III survey. Participants were able to select an option to be sent a paper version of the survey. Nonresponders were sent three reminder letters. All reminder letters included a postage-paid card for requesting paper copies. The second reminder letter additionally included paper copies of the survey. In addition, reminder postcards were sent to participants who did not complete the survey after logging into the online version or who requested paper copies at some point in the process. Internet tracking services were employed to identify correct addresses when mailings were returned due to incorrect addresses.

A total of 1,257 females and 1,030 males completed Project EAT-III surveys that were determined to be valid and adequately complete for inclusion in analyses. This represented 66.4% of participants who could be contacted (48.2% of the original school-based sample). The majority (86.5%) of survey respondents completed the online survey. One third of participants (29.9%) were in middle school at baseline (mean age = 12.8±0.7 years) and were in emerging young adulthood (mean age = 23.2±1.0 years) at follow-up. Two thirds of participants (70.1%) were in high school at baseline (mean age = 15.9±0.8 years) and were in young adulthood (mean age = 26.2±0.9 years) at follow-up (31).

The Project EAT survey was developed at baseline and revised for use at 10-year follow-up specifically to assess items of relevance to young people as they transitioned into young adulthood and developed more independent lifestyles. The survey is a 221-item survey assessing a range of socio-environmental, personal, behavioral, and familial factors of potential relevance to nutritional health and obesity among adolescents. The survey development is described elsewhere(29). Two-week survey test-retest reliability data were collected from 167 adolescents at baseline and validity of the survey was established and details are previously published(29).

To assess family meal frequency, the exposure variable, adolescents were asked, “During the past seven days, how many times did all, or most, of your family living in your house eat a meal together?” Response options included: never, 1-2 times, 3-4 times, 5-6 times, 7 times, and more than 7 times (Test-retest r=.83).(32) Although this measure is a single item, it has been used in the majority of prior studies looking at family meal frequency,(33-35) thus increasing the ability to compare results across studies. It has also been shown to be reliable and valid with diverse populations (7) (32). The three highest categories were collapsed to allow for meaningful comparisons between parents who had infrequent or occasional family meals with families who had more regular family meals (36).

To assess overweight and obesity status, the outcome variable, self-reported height and weight values were used to calculate body mass index (BMI) [(weight(kg)/height(m2)] at baseline and 10-year follow-up. At baseline, high correlations were found between self-reported and measured BMI in male (r=0.88) and female (r=0.85) adolescents (37). Additionally, at EAT III very high correlations between self-reported and measured BMI were found in a validation subsample of 63 male and 62 female EAT-III study participants (r=0.95 for males and r=0.98 for females). At baseline, overweight status was determined based on a BMI at or above the 85th percentile for sex and age using reference data from the Centers for Disease Control and Prevention (38). Weight status at 10-year follow-up was defined according to current BMI guidelines for adults (overweight: BMI≥25 and < 30 kg/m2; obese: BMI ≥ 30 kg/m2) (39).

Control variables included sex, age, race/ethnicity and socioeconomic status. These variables were assessed by self-report at EAT I. Race/ethnicity was assessed with one survey item: “Do you think of yourself as 1) white, 2) black or African-American, 3) Hispanic or Latino, 4) Asian-American, 5) Hawaiian or Pacific Islander, or 6) American Indian or Native American” and respondents were asked to check all that apply. Those reporting more than one response were assigned to the category “mixed/other” background. As few participants identified their background as “Hawaiian or Pacific Islander” or “Native American,” these youth were also included in the category “mixed/other.” Classification tree methodology (40) was used to generate five categories of Socioeconomic status (SES; Low SES, Low-Mid SES, Middle SES, Mid-High SES, High SES)(41). The prime determinant of SES was the higher education level of either parent. Subsidiary variables were family eligibility for free/reduced-price school lunch, family receipt of public assistance, and parent employment status.

The analytic sample (n=2117) for the current study excluded women who were pregnant at follow-up (n=90) and individuals who did not have self-reported BMI measurement at baseline or 10-year follow-up (n=63) or did not respond to the family meal frequency question at baseline (n=17). For each level of baseline family meal frequency (i.e., never, 1-2, 3-4, 5 or more), the proportion of individuals who were overweight or obese at 10-year follow-up was calculated. Logistic regressions of overweight and obese status at 10-year follow-up predicted by baseline family meal frequency controlling for sex, age, race, SES, and baseline overweight or obese status were conducted to generate ORs of the effect of family meal frequency on overweight and obesity status 10 years later. Tests for interaction were performed between family meal frequency and each of the following: sex, age cohort (younger/older), race/ethnicity, and baseline overweight status. Only the interaction with race was significant and thus results are additionally presented stratified by race/ethnicity. All analyses were performed in 2012 using SAS (V9.2, Cary NC, 2011) and incorporating non-response sampling weights. Tests were considered statistically significant when p-values were less than .05. 95% confidence intervals are given for all odds ratios.

Because attrition from the baseline sample did not occur at random, in all analyses, the data were weighted using the response propensity method (42). Response propensities (i.e., the probability of responding to the Project EAT-III survey) were estimated using a logistic regression of response at 10-year follow-up on a large number of predictor variables from the Project EAT-I survey. Weights were additionally calibrated so that the weighted total sample sizes used in analyses for each sex cohort accurately reflect the actual observed sample sizes in those groups. The weighting method resulted in estimates representative of the demographic make-up of the original school-based sample, thereby allowing results to be more fully generalizable to the population of young people in the Minneapolis/St. Paul metropolitan area. Specifically, the weighted sample was 48.4% white, 18.6% African American, 19.6% Asian (primarily Hmong), 5.9% Hispanic, 3.3% Native American, and 4.2% mixed or other race/ethnicity. The sample was well-distributed across the five categories of socioeconomic status: 18.0% low, 19.0% low-middle, 26.2% middle, 23.3% upper-middle, and 13.5% high. Respondents with 10-year follow-up data included in analyses were more likely to be female, higher SES, White, and from the older cohort than those not included, but these differences were eliminated through the use of non-response weighting. After weighting there were no differences in baseline weight status between responders and non-responders. However, even after weighting for non-response and controlling for demographics, respondents had on average lower family meals at baseline than non-respondents (3.5 meals per week vs 3.9, p-value <.001).

Results

Table I shows the proportion of young adults who were overweight at 10-year follow-up by each baseline level of family meal frequency (i.e., never, 1-2, 3-4, 5 or more). At 10-year follow-up, 51% of the sample was overweight and 22% were obese. Among adolescents who reported that they never ate family meals together (15% of the sample) at baseline, 60% of them were overweight at 10-year follow-up and 29% were obese. In comparison, among adolescents who reported that they ate 1-2, 3-4, or 5 or more family meals together at baseline, 47-51% of them were overweight at 10-year follow-up and 19-22% were obese.

Table 1. Percent overweight or obesity at 10-year follow-up by frequency of family meals at baseline.

% (n) Family
meal frequency
at baseline		 % (n) Overweight
(BMI ≥25 <30 kg/m2)
at 10-year follow-up by family meals at baseline		 % (n) Obese
(BMI ≥30 kg/m2)
at 10-year follow-up by family meals at baseline
Overall Sample 100% (n=2117) 51% (n=1070) 22% (n=458)
Family Meals Frequency:
 Never 15 (310) 60 (187) 29 (91)
 1-2 19 (413) 47 (196) 22 (89)
 3-4 22 (475) 51 (242) 19 (91)
 5 or more 43 (920) 49 (446) 20 (187)
Open in a new tab

Table II shows adjusted (adjusted for baseline demographic characteristics and overweight or obese status) odds ratios and 95% confidence intervals for 10-year follow-up overweight and obese status by baseline family meal frequency. Overall, all levels of baseline family meal frequency (ie, 1-2, 3-4, 5 or more per week) during adolescence were significantly associated with reduced odds of overweight 10-years later in young adulthood compared with never having family meals during adolescence. In addition, 3-4 and 5 or more family meals per week during adolescence were significantly associated with reduced odds of obesity 10-years later in young adulthood compared with never having family meals during adolescence. For example, the OR of 0.55 in Table II indicates that adolescents who had 1-2 family meals at baseline had 45% decreased odds of being overweight 10-years later as young adults compared with young adults who never had family meals as adolescents (baseline). Additional post-hoc tests did not find any significant differences between the different levels of family meal frequency (ie, 5 or more meals did not show any improvement compared with 3-4 meals).

Table 2. Odds ratiosa of young adult overweight status or obesity at 10-year follow-up.

10-year follow-up Overweight
(BMI ≥25 <30 kg/m2)
Odds Ratio		 95% Confidence Interval (CI) 10-year follow-up Obese
(BMI ≥30 kg/m2)
Odds Ratio		 95% Confidence Interval (CI)
Family Meal Frequency at Baseline:
 Never Reference Reference
 1-2 vs. Never 0.55 0.38-0.79 0.67 0.44-1.02
 3-4 vs. Never 0.60 0.42-0.85 0.50 0.33-0.76
 5 or more vs Never 0.63 0.46-0.87 0.68 0.47-0.99
Open in a new tab
a

Odds ratios and 95% confidence intervals from logistic regression controlling for baseline gender, age, race, SES, and overweight or obese status.

Bolded numbers indicate statistical significance at p < 0.05.

A significant interaction between family meal frequency and race was found when predicting odds of obesity at 10-year follow-up (Likelihood ratio test for interaction = 28.5, d.f. = 5, p<.0001). The interaction indicated that the strongest protective effect of increasing family meal frequency during adolescence on obesity was among Black young adults. Specifically, Black adolescents who had 1-2 family meals vs Never (OR=0.60; CI=0.49-0.73), 3-4 family meals vs Never (OR=0.30; CI=0.19-0.47), or 5 or more family meals vs never (OR=0.15; CI=0.07-0.31) had reduced odds of obesity as young adults. No significant associations were found between family meals and obesity in any of the other races in stratified analyses, and no interaction between race and family meals was found when considering overweight status as the outcome rather than obesity.

Discussion

Overall, results from the current study suggest that having family meals as an adolescent is protective for young adult overweight and obesity 10 years later. All levels of family meal frequency (ie, 1-2, 3-4, 5 or more) were protective for young adult overweight compared with never having family meals. Additionally, 3-4 and 5 or more family meals per week were protective for young adult obesity compared with never having family meals. This study lends support to previous limited research on family meals that has shown family meal frequency is inversely associated with adolescent overweight/obesity (12-17). Furthermore, results from the current study extend prior research by showing that having family meals in adolescence is protective for overweight/obesity longitudinally into young adulthood.

Our results also indicated a stronger protective effect of family meal frequency on obesity among Black young adults compared with White young adults. This finding supports previous results showing differences in the benefits (eg, healthful dietary intake, weight status) of family meals by race/ethnicity (not protective for Hispanic boys) (43). However, due to the limited overall significant interactions by race/ethnicity, sex, SES, and age in the current study, results suggest that family meals may be protective for adolescents across all race/ethnicities, sex, age, and SES status.

There are several potential mechanisms that may explain the protective association between family meal frequency and young adult overweight/obesity. First, it may be that family meals are healthier than other meals because it is common to serve fruits and vegetables during the meals.(44) Additionally, family meals may provide opportunities for emotional connection among family members, creating a supportive environment for emotion regulation and a sense of security that gives children the ability to regulate their own eating behaviors in their day-to-day lives.(45) Third, parental modeling of healthful eating behaviors and recognizing satiety cues may also be occurring at family meals.(46) Thus, it would be important for future research to examine further the potential mechanisms behind the results found in the current study such as looking at the emotional atmosphere at the meal, the quality and quantity of food served, and modeling behavior that occurs during family meals. Furthermore, although it is unclear why having only 1-2 family meals per week was protective for adolescents, it may be the case that the routines/patterns and associated benefits of family meal patterns (ie, supportive environment, connection) established in childhood carry forward into adolescence and young adulthood. For example, if families have frequent families meals with their young children (eg, 4-5 per week), by the time their child reaches adolescence—and they have to reduce meal frequency due to activities or work schedules—the benefits and protective nature of family meals may be sustainable because of previously exerted efforts.

Informing parents that even having one to two family meals per week may protect their child from overweight or obesity in young adulthood would be important.(47) Results from the current study may also help bolster the evidence-base for pushing efforts forward to create workplace policies and procedures that allow for parents to have more flexible hours, benefits for less than full time employment, and providing employees greater control over where and when their work is done in order for families to have more frequent family meals.(47) The findings from the current study may also be useful for informing future research on family meals. For example, it would be important to understand more about the potential mechanism(s) contributing to the association between family meal frequency and reduced risk of overweight/obesity in young adults (eg, the context and emotional atmosphere of the family meal, the content of conversations at the meal, who is present at the meals, distractions such as TV, texting or electronic tablets/games that may moderate the protective influence of family meals) (48).

One limitation of the study includes self-reported BMI. Although a validity sub-study was conducted with these adolescents and self-reported BMI and objectively measured BMI were highly correlated, it is still preferable to have objectively measured weight and heights. Additionally, the generalizability of study findings may be limited as all the baseline data were collected in the Minneapolis/St. Paul area of Minnesota. Furthermore, frequency of family meals was differentially reported by responders vs. non-responders to the EAT survey (3.7 vs. 3.9 meals per week respectively). However, because responders to the project EAT survey were more likely to eat fewer family meals on average than non-responders, current analyses focus on families who may have adolescents at higher risk of obesity. Thus, results are able to speak to protective factors for this at-risk population. Finally, this study was not able to address why having family meals was protective for adolescence. Examining the quality (ie, emotional atmosphere, interpersonal interactions) of family meals would be an important next step to potentially provide more details regarding why family meals are protective and how they function on a day-to-day basis so more families can take advantage of the protective nature of family meals.

Acknowledgments

Supported by the National Heart, Lung, and Blood Institute (R01 HL093247 [PI: D.N.-S.]) and Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01HD061940 [to M.W. and T.-F. H.; PI: M.W.]).

Footnotes

Nonstandard Abbreviations: Project EAT-I and Project EAT-III (Eating and Activity in Teens)

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health.

The authors declare no conflicts of interest.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

References

  • 1.McIntosh WA, Dean W, Torres CC, Anding J, KKubena KS, Nyga R. In: The American family meal. M HL, editor. New York: CRC Press; 2009. [Google Scholar]
  • 2.McIntosh WA. In: The family meal and its significance in global times. G R, editor. Boulder, CO: Westview Press; 1999. [Google Scholar]
  • 3.Chan JC, Sobal J. Family meals and body weight. Analysis of multiple family members and family units. Appetite. 2011;57:517–24. doi: 10.1016/j.appet.2011.07.001. [DOI] [PubMed] [Google Scholar]
  • 4.Robertson W, Friede T, Blissett J, Rudolf MCJ, Wailis M, Stewart-Brown S. Pilot of “Families for Health”: Community-based family intervention for obesity. Archives of Disease in Childhood. 2008;93:921–6. doi: 10.1136/adc.2008.139162. [DOI] [PubMed] [Google Scholar]
  • 5.Lissau I. Prevention of overweight in the school arena. Acta Paediatrica Supplement. 2007;96:12–8. doi: 10.1111/j.1651-2227.2007.00164.x. [DOI] [PubMed] [Google Scholar]
  • 6.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;103:317–22. doi: 10.1053/jada.2003.50048. [DOI] [PubMed] [Google Scholar]
  • 7.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;32:335–40. [Google Scholar]
  • 8.Neumark-Sztainer D, Eisenberg ME, Fulkerson JA, Story M, Larson NI. Family meals and disordered eating in adolescents: Longitudinal findings from Project EAT. Archives of Pediatrics and Adolescent Medicine. 2008;162:17–22. doi: 10.1001/archpediatrics.2007.9. [DOI] [PubMed] [Google Scholar]
  • 9.Larson NI, Neumark-Sztainer D, Hannan PJ, Story M. Family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood. Journal of the American Dietetic Association. 2007;107:1502–10. doi: 10.1016/j.jada.2007.06.012. [DOI] [PubMed] [Google Scholar]
  • 10.Haines J, Gillman MW, Rifas-Shiman S, Field AE, Austin AB. Family dinner and disordered eating behaviors in a large cohort of adolescents. Eating Disorders. 2010;18:10–24. doi: 10.1080/10640260903439516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among adolescents. Archives of Pediatrics and Adolescent Medicine. 2004;158:792–6. doi: 10.1001/archpedi.158.8.792. [DOI] [PubMed] [Google Scholar]
  • 12.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. Journal of the American Dietetic Association. 2007;107:53–61. doi: 10.1016/j.jada.2006.10.010. [DOI] [PubMed] [Google Scholar]
  • 13.Gillman MW, Rifas-Shiman SL, Frazier AL, Rockett HR, Camargo CA, Jr, Field AE, et al. Family dinner and diet quality among older children and adolescents. Archives of Family Medicine. 2000;9:235–40. doi: 10.1001/archfami.9.3.235. [DOI] [PubMed] [Google Scholar]
  • 14.Sen B. Frequency of family dinner and adolescent body weight status: Evidence from the National Longitudinal Survey of Youth, 1997. Obesity. 2006;14:2266–76. doi: 10.1038/oby.2006.266. [DOI] [PubMed] [Google Scholar]
  • 15.Taveras E, Rifas-Shiman S, Berkey C, Rockett H, Field A, Frazier A, et al. Family dinner and adolescent overweight. Obesity Research. 2005;13:900–6. doi: 10.1038/oby.2005.104. [DOI] [PubMed] [Google Scholar]
  • 16.Yuasa K, Sei M, Takeda E, Ewis A, Munakata H, Onishi C, 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. J Med Invest. 2008;55:71–7. doi: 10.2152/jmi.55.71. [DOI] [PubMed] [Google Scholar]
  • 17.Anderson SE, Whitaker RC. Household routines and obesity in US preschool-aged children. Pediatrics. 2010;125:420–8. doi: 10.1542/peds.2009-0417. [DOI] [PubMed] [Google Scholar]
  • 18.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. Journal of the American Dietetic Association. 2010;110:1335–9. doi: 10.1016/j.jada.2010.06.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.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;13:1422–30. doi: 10.1038/oby.2005.172. [DOI] [PubMed] [Google Scholar]
  • 20.Utter J, Scragg R, Schaaf D, Mhurchu CN. Relationships between frequency of family meals, BMI and nutritional aspects of the home food environment among New Zealand adolescents. The international journal of behavioral nutrition and physical activity. 2008;5:50. doi: 10.1186/1479-5868-5-50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Woodruff SJ, Hanning RM, McGoldrick K, Brown KS. Healthy eating index-C is positively associated with family dinner frequency among students in grades 6-8 from Southern Ontario, Canada. European Journal of Clinical Nutrition. 2010;64:454–60. doi: 10.1038/ejcn.2010.14. [DOI] [PubMed] [Google Scholar]
  • 22.Fulkerson JA, Pasch KE, Stigler MH, Farbakhsh K, Perry CL, Komro KA. Longitudinal Associations Between Family Dinner and Adolescent Perceptions of Parent-Child Communication Among Racially Diverse Urban Youth. Journal of Family Psychology. 2010;24:261–70. doi: 10.1037/a0019311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Woodruff SJ, Hanning RM, McGoldrick K, Brown KS. Healthy eating index-C is positively associated with family dinner frequency among studnets in grades 6-8 from Southern Ontario, Canada. European Journal of Clinical Nutrition. 2010;64:1272–9. doi: 10.1038/ejcn.2010.14. [DOI] [PubMed] [Google Scholar]
  • 24.Wurback A, Zellner K, Kromeyer-Hauschild K. Meals patterns among children and adolescents and their associations with weight status and parental characteristics. Public Health Nutrition. 2009;12:71–7. doi: 10.1017/S1368980009004996. [DOI] [PubMed] [Google Scholar]
  • 25.Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 2006;295:1549–55. doi: 10.1001/jama.295.13.1549. [DOI] [PubMed] [Google Scholar]
  • 26.Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012;307:483–90. doi: 10.1001/jama.2012.40. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Pi-Sunyer FX. The obesity epidemic: Pathophysiology and consequences of obesity. Obesity Research. 2002;10(Suppl 2):97S–104S. doi: 10.1038/oby.2002.202. [DOI] [PubMed] [Google Scholar]
  • 28.Nonnemaker JM, Morgan-Lopez AA, Pais JM, Finkelstein EA. Youth BMI trajectories: evidence from the NLSY97. Obesity (Silver Spring, Md) 2009;17:1274–80. doi: 10.1038/oby.2009.5. [DOI] [PubMed] [Google Scholar]
  • 29.Neumark-Sztainer D, Story M, Hannan PJ, Croll J. Overweight status and eating patterns among adolescents: Where do youth stand in comparison to the Health People 2010 Objectives? American Journal of Public Health. 2002;92:844–51. doi: 10.2105/ajph.92.5.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Eisenberg ME, Berge JM, Fulkerson JA, Neumark-Sztainer D. Weight comments by family and significant others in young adulthood. Body image. 2011;8:12–9. doi: 10.1016/j.bodyim.2010.11.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Larson N, Neumark-Sztainer D, Harwood EM, Eisenberg ME, Wall M, Hannan PJ. Do young adults participate in surveys that ‘go green’? Response rates to a web and mailed survey of weight-related behaviors. International Journal of Child Health and Human Development. 2011;4:225–31. [PMC free article] [PubMed] [Google Scholar]
  • 32.Fulkerson JA, Neumark-Sztainer D, Story M. Adolescent and parent views of family meals. Journal of the American Dietetic Association. 2006;106:526–32. doi: 10.1016/j.jada.2006.01.006. [DOI] [PubMed] [Google Scholar]
  • 33.Larson NI, Neumark-Sztainer D, Hannan PJ, Story M. Family meals during adolescence are associated with higher food quality and healthful meal patterns during young adulthood. Journal of the American Dietetic Association. 2007;107:1502–10. doi: 10.1016/j.jada.2007.06.012. [DOI] [PubMed] [Google Scholar]
  • 34.Goldfield GS, Murray MA, Buchholz A, Henderson K, Obeid N, Kukaswadia A, et al. Family meals and body mass index among adolescents: effects of gender. Applied Physiology, Nutrition, and Metabolism. 2011;36:539–46. doi: 10.1139/h11-049. [DOI] [PubMed] [Google Scholar]
  • 35.Utter J, Denny S, Robinson E, Fleming T, Ameratunga S, Grant S. Family meals and the well-being of adolescents. Journal of Paediatrics and Child Health. 2013;49:906–11. doi: 10.1111/jpc.12428. [DOI] [PubMed] [Google Scholar]
  • 36.Berge JM, MacLehose R, Loth KA, Eisenberg ME, Fulkerson JA, Neumark-Sztainer D. Family meals: Associations with weight and eating behaviors among mothers and fathers. Appetite. 2012;58:1128–35. doi: 10.1016/j.appet.2012.03.008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37.Himes J, Hannan P, Wall M, Neumark-Sztainer D. Factors associated with errors in self-reports of stature, weight, and body mass index in Minnesota adolescents. Annals of Epidemiology. 2005;4:272–8. doi: 10.1016/j.annepidem.2004.08.010. [DOI] [PubMed] [Google Scholar]
  • 38.Barlow S. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120:S164–S92. doi: 10.1542/peds.2007-2329C. [DOI] [PubMed] [Google Scholar]
  • 39.Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Archives of Internal Medicine. 1998;158:1855–67. doi: 10.1001/archinte.158.17.1855. [DOI] [PubMed] [Google Scholar]
  • 40.Breiman L, Friedman J, Olshen R, Stone C. Classification and regression trees. Belmont, CA: Wadsworth International Group; 1984. [Google Scholar]
  • 41.Neumark-Sztainer D, Wall M, Larson NI, Eisenberg ME, Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Journal of the American Dietetic Association. 2011;111:1004–11. doi: 10.1016/j.jada.2011.04.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Little R. Survey nonresponse adjustments for estimates of means. Int Stat Rev. 1986;54:139–57. [Google Scholar]
  • 43.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. Journal of the American Dietetic Association. 2010;110:1335–9. doi: 10.1016/j.jada.2010.06.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 44.Neumark-Sztainer D, Maclehose R, Loth K, Fulkerson JA, Eisenberg ME, Berge J. What's for dinner? Types of food served at family dinner differ across parent and family characteristics. Public Health Nutr. 2012:1–11. doi: 10.1017/S1368980012004594. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Videon TM, Manning CK. Influences on adolescent eating patterns: The importance of family meals. Journal of Adolescent Health. 2003;32:365–373. doi: 10.1016/s1054-139x(02)00711-5. [DOI] [PubMed] [Google Scholar]
  • 46.Berge J, Wall M, Bauer K, Neumark-Sztainer D. Parenting characteristics in the home environment and adolescent overweight. Obesity. 2009;17:1–8. doi: 10.1038/oby.2009.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Breaugh J, Frye N. Work and family conflict: The importance of family-friendly employment practices and family-supportive supervisors. Journal of Business and Psychology. 2008;22 [Google Scholar]
  • 48.Berge JM, Jin SW, Hannan P, Neumark-Sztainer D. Structural and Interpersonal Characteristics of Family Meals: Associations with Adolescent Body Mass Index and Dietary Patterns. Journal of the Academy of Nutrition and Dietetics. 2013;113:816–22. doi: 10.1016/j.jand.2013.02.004. [DOI] [PMC free article] [PubMed] [Google Scholar]

RESOURCES