More than 30% of children and youth aged 9–19 years are overweight or obese, and rates continue to increase (1). Parents play a critical role in the development of children's eating habits and weight-related behaviors through exposure, availability, and accessibility of foods in the home (2). The family meal setting has the potential to substantially impact the dietary intake of children (3) and may provide an important avenue for obesity prevention. However, opportunities for families to have meals together have been negatively affected by changes in our society (4,5), and data suggest that the frequency of family meals may be declining (5).
Positive associations between nutrient intake patterns, including intakes of fiber, fat, several vitamins and minerals, and fruits and vegetables, and family meal frequency have been previously reported among children (6) and adolescents (7,8,9). Similarly, the frequency of family meals has also been shown to have significant inverse associations with consumption of soft drinks (6,9) and high-fat foods (6). Research has also found significant inverse associations with disordered eating (10,11,12,13,14). Thus, there is evidence that family meal frequency may promote nutritious dietary intake and protect against disordered eating. Only a handful of studies have examined the associations of family meal frequency and overweight or obesity. Gillman et al.(6) found a modest inverse association between age-adjusted BMI and family dinner frequency among youth aged 9–14 years in a cross-sectional study. Taveras et al. (14) reanalyzed these data controlling for potential covariates (socioeconomic status (SES), age, maturational stage, baseline height, race/ethnicity, girls' menstrual status, physical activity, inactivity, and energy intake) and found that the odds of being overweight were significantly lower among youth who reported eating family dinner most or every day in a typical week during the past year. In addition, Taveras et al. (14) also assessed longitudinal associations between family dinner frequency and the 1-year incidence of becoming overweight; however, the significant cross-sectional associations did not hold up in the longitudinal analyses. In an analysis of a nationally representative, racially diverse population of adolescents, Sen (15) examined racial/ethnic differences in the associations between family dinner frequency and overweight status, incidence of overweight, and cessation of overweight over a 3-year period among adolescents (adjusting for age, puberty, height, and several other demographic characteristics) and found that family dinner frequency was inversely associated with being overweight among white adolescents in both cross-sectional and longitudinal analyses; however, findings were not significant for Black and Hispanic youth. Similar results were found in longitudinal analyses for the cessation of overweight. Most recently, Gable et al. (16) assessed family meal frequency and overweight onset in a longitudinal study of school-age children while controlling for gender, race, and SES, and found significant inverse associations between family meal frequency and overweight onset.
The primary purpose of the present investigation is to describe associations between the frequency of family meals and overweight status over a 5-year period in a large and ethnically diverse population of adolescent males and females. With the exception of the study of early school-age children (16), previous research has been limited in time to a 1-year incidence of overweight. Thus, this study will extend previous research by assessing 5-year associations between family meal frequency and overweight. This study will also elucidate the influence that potential confounding variables (e.g., physical activity, energy intake) have on the associations between family meal frequency and overweight by presenting findings with adjustment of demographic characteristics only and then with additional adjustments of activity level and energy intake. All of the studies examining family meal frequency and overweight to date have adjusted for demographic factors (or stratified by them); only the study by Taveras et al. (14) further adjusted for activity and energy intake, and presented only adjusted findings. A deeper understanding of how statistical adjustments influence the associations between family meal frequency and overweight are warranted. This study will also present analyses stratified by cohort (high school students moving into young adulthood (C1) and students of early adolescence moving into high school (C2)) as the association between family meal frequency and overweight may be different as adolescents develop. Finally, this study will take advantage of the racial/ethnic diversity of the Project EAT sample and assess racial/ethnic differences in the associations between family meal frequency and overweight.