org/ Meets Learning Need Codes for RDs and DTRs 4160, 4090,
and 4050.
uing
tin
Profe
ssi
al
on
Con
RESEARCH ARTICLE
CPE
Edu
cation
INTRODUCTION
The importance of family meals in adolescents lives has
received recent attention. More frequent family meals are
associated with improved dietary intake among adolescents,
including higher intakes of grains, fruit, vegetables, vita-
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
Department of Pediatrics, Division of Adolescent Health and Medicine, University
of Minnesota, Minneapolis, Minnesota
Support for this project came from grant MCJ-270834 (Dianne Neumark-Sztainer,
principal investigator) from the Bureau of Maternal and Child Health (Title V,
Social Security Act), Health Resources and Services Administration, Department of
Health and Human Services, US Public Health Service, through funds from the
Leadership Education in Adolescent Health (LEAH) Fellowship Training Program,
University of Minnesota (grant 1-T71-MC00025-01, Maternal and Child Health
Bureau, DHHS), and from the General Mills Bell Institute of Health and Nutrition.
Address for Correspondence: Shira Feldman MPH, RD, LD, Division of Epidemiology and Community Health, 1300 S. Second St. Suite 300, Minneapolis, Minnesota
55454; Phone: (612) 624-1818; Fax: (612) 624-0315; E-mail: feld0111@umn.edu
258
Feldman et al/TEENS WHO AVOID TV DURING FAMILY MEALS HAVE HIGHER DIET QUALITY
METHODS
Study Design
Data for this study were drawn from Project Eating Among
Teens (Project EAT), which was designed to assess socioenvironmental, personal, and behavioral factors related to
adolescent nutrition. Trained research staff administered
the Project EAT survey and the Youth/Adolescent Questionnaire (YAQ; a food frequency survey) during physical
education, health, and science classes. Data were collected
during the 1998-1999 school year. Study procedures were
approved by the University of Minnesota Human Subjects
Committee and by the research boards of the participating
school districts. Consent procedures were followed according to school policy, with passive consent used in some
schools, and other schools requiring active consent. The
response rate for participation was 81.5%. The Project EAT
survey was guided by Social Cognitive Theory as well as
focus groups conducted with adolescents. The survey was
pretested by seventh and tenth graders and then further
pilot-tested by 161 seventh and tenth graders over a 2-week
interval. Additional details of the Project EAT study have
been described previously.16,17
Study Sample
The study sample included 4746 ethnically and socioeconomically diverse adolescents from 31 public middle and
high schools throughout primarily urban school districts in
the Minneapolis-St. Paul metropolitan area. The sample
was equally divided by gender (50.2% boys, 49.8% girls),
and the mean age was 14.9 years (range 11 to 18), with
34.3% in middle school and 65.7% in high school. The
ethnic/racial backgrounds of participants were as follows:
48.5% white, 19.0% African American, 19.2% Asian
American, 5.8% Hispanic, 3.5% Native American, and
4.0% mixed/other. Of the total sample, 88.6% (n 4206)
completed the YAQ. The final analytic sample consisted of
4064 participants because of missing data on key independent variables and reported caloric intakes outside the
plausible range.
Measures
Family meals. The Project EAT survey assessed frequency of family meals with the question: During the past
seven days, how many times did all, or most, of your family
living in your house eat a meal together? (test-retest Spearman r .74) Response categories were: never, 1-2 times,
3-4 times, 5-6 times, 7 times, or more than 7 times. Prior
research has shown similar dietary intake for adolescents
reporting no family meals or 1 or 2 family meals, but
differences in intakes were seen for adolescents reporting
more than 3 meals.1 Therefore, for the present analysis,
frequency was dichotomized to 3 or more meals versus 2 or
fewer meals eaten together per week.
Journal of Nutrition Education and Behavior Volume 39, Number 5, September/October 2007
RESULTS
Family Meals and Television Watching
Approximately two-thirds (66.9%) of adolescents reported
eating regular family meals, characterized by 3 or more
259
260
Feldman et al/TEENS WHO AVOID TV DURING FAMILY MEALS HAVE HIGHER DIET QUALITY
Table 1. Family Meals and Television Watching By Sociodemographic Characteristics among Adolescents
Boys (%)
Total
School Level
Middle School
(658, 663)*
High School
(1336, 1338)*
Race
White
(1106, 984)*
African American
(304, 328)*
Hispanic
(121, 98)*
Asian
(372, 419)*
Native American
(58, 84)*
Mixed (60, 84)*
Socioeconomic
Status
Low (275, 383)*
Low-Middle
(367, 376)*
Middle
(540, 513)*
Upper-Middle
(524, 440)*
High (294, 270)*
Girls (%)
Family
Meals,
No TV
(n 687)
34.0
Family
Meals,
with TV
(n 624)
30.9
No
Family
Meals
(n 711)
35.2
24.2
42.5
36.1
21.4
32.7
34.1
29.7
28.3
42.1
39.9
29.4
30.7
37.2
25.6
37.2
22.0
37.2
40.8
21.7
36.3
42.1
33.9
42.2
24.0
38.8
27.6
33.7
37.1
37.1
25.8
37.2
38.4
24.3
20.7
53.5
25.9
29.8
32.1
38.1
33.3
38.3
28.3
32.1
35.7
32.1
Family
Meals,
No TV
(n 724)
35.5
Family
Meals,
with TV
(n 686)
33.6
No
Family
Meals
(n 632)
31.0
39.8
36.0
33.2
X2
P Value
21.2
.001
58.9
36.8
.001
.001
29.5
29.4
40.4
36.8
30.2
33.8
29.2
26.1
38.6
30.9
32.1
43.1
32.0
33.9
34.1
29.4
33.9
36.7
40.7
30.5
28.8
37.7
24.6
37.7
45.9
26.2
27.9
53.7
22.2
24.1
X2
P Value
84.1
.001
60.9
.001
84.9
.001
*n (boys, girls)
DISCUSSION
This study explored associations between watching TV
during family meals and dietary intake among adolescents.
The data suggest adolescents watching TV during family
meals are more likely to have a poorer quality diet compared to adolescents eating family meals without watching
TV. Watching TV during family meals was associated with
lower intakes of vegetables, grains, and dairy food, and
higher intakes of soft drinks and fried food. Additionally,
the results show that adolescents eating regular family
meals while watching TV had better quality diets than
adolescents not eating regular family meals.
These findings are consistent with previous research on
family meals and TV viewing.8,9 Coon and colleagues found
that younger children whose families ate 2 or more meals
with the TV on consumed fewer servings of nutrient-rich
food, including grains, fruit, green and yellow vegetables,
beans, and nuts than children whose families ate meals with
the TV on for one or fewer meals. Additionally, in agree-
Journal of Nutrition Education and Behavior Volume 39, Number 5, September/October 2007
261
Table 2. Median Daily Servings from Food Groups by Family Meal Habits (Boys)
Unadjusted Analysis
Median Daily
Servings
Fruit
Vegetables
Dark green/yellow
vegetables
Calcium-rich food
Grains
Soft drinks
Fried food
Snack food
Calories
Adjusted Analysis*
Family
Meals, No TV
2.1
1.4
0.44
Family
Meals, TV
1.9
1.2
0.38
No Family
Meals
1.7
1.0
0.30
P Value
.001
.001
.001
Family
Meals, No TV
2.2
1.4
0.45
Family
Meals, TV
2.0
1.2
0.40
No Family
Meals
2.0
1.1
0.33
P Value
.112
.001
.001
3.4
6.0
1.1
0.49
2.4
2293
3.2
5.7
1.2
0.57
2.6
2253
3.0
5.9
1.3
0.55
2.5
2232
.016
.207
.001
.001
.472
.599
3.2
5.9
1.1
0.55
2.3
2357
3.1
5.6
1.3
0.58
2.4
2271
2.9
5.8
1.3
0.58
2.4
2208
.001
.004
.001
.137
.122
.057
*adjusted for socioeconomic status, school level, race, weekly hours watching TV, caloric intake
,,
superscripts indicate statistically significant differences when different from each other, P .05
dren, food requests and recognition of products were correlated with advertisements seen on TV.26,27 Adolescents
are not immune to advertisements or product placements in
TV shows, and they have been found to be more likely to
desire a particular item when favorite celebrities are depicted using the product.28 The finding that watching TV
during family meals, even after controlling for overall hours
spent watching TV, was associated with a lower quality diet
compared to not watching TV provides evidence that exposure to TV during meals may have a role in eating habits
of adolescents. Given this finding, health professionals,
families, and adolescents should continue advocating for
decreasing the number of TV commercials for low-nutrient
food and increasing commercials for nutrient-dense food,
including fruits and vegetables. Promoting and advertising
healthful food on TV, while decreasing the number of ads
for unhealthful food, has the potential to positively influence dietary intake among adolescents.
Although watching TV during family meals was associated
Table 3. Median Daily Servings from Food Groups by Family Meal Habits (Girls)
Unadjusted Analysis
Median Daily
Servings
Fruit
Vegetables
Dark green/yellow
vegetables
Calcium rich food
Grains
Soft drinks
Fried food
Snack food
Calories
Adjusted Analysis*
Family
Meals, No TV
2.2
1.6
0.54
Family
Meals, TV
2.2
1.5
0.47
No Family
Meals
1.7
1.1
0.36
P Value
.001
.001
.001
Family
Meals, No TV
2.2
1.4
0.48
Family
Meals, TV
2.2
1.3
0.43
No Family
Meals
2.0
1.2
0.40
P Value
.002
.001
.003
2.9
5.5
0.87
0.44
2.3
2030
2.7
5.6
1.1
0.56
2.6
2157
2.2
4.7
1.2
0.50
2.2
1860
.001
.001
.001
.001
.014
.001
2.6
5.4
0.94
0.49
2.2
2139
2.5
5.3
1.0
0.54
2.2
2240
2.3
5.1
1.3
0.56
2.4
1969
.001
.020
.001
.001
.002
.001
*adjusted for socioeconomic status (SES), school level, race, weekly hours watching TV, caloric intake
,,
superscripts indicate statistically significant differences when different from each other, P .05
262
Feldman et al/TEENS WHO AVOID TV DURING FAMILY MEALS HAVE HIGHER DIET QUALITY
IMPLICATIONS
Findings from the current study support results of previous
studies suggesting that regular family meals are associated
with improved dietary quality among adolescents.1-3 The
findings revealed the most healthful diets, with highest
intakes of fruits and vegetables and lowest intakes of soft
drinks and fried food, were seen among adolescents eating
family meals without watching TV. Yet, eating as a family,
even with the TV on, appears to be beneficial, as adolescents reporting watching TV during regular family meals
were found to have a more healthful diet compared to
adolescents not eating regular family meals. Based on findings from the current study and previous studies,1-3,9 dietitians and other health care providers should make efforts to
work with adolescents and families to increase the overall
frequency of family meals. In working with families, practitioners should encourage turning the TV off as often as
possible to maximize the benefits of the family meal.
ACKNOWLEDGMENTS
Support for this project came from grant MCJ-270834 (Dianne Neumark-Sztainer, principal investigator) from the Bureau of Maternal and Child Health (Title V, Social Security
Act), Health Resources and Services Administration, Department of Health and Human Services, US Public Health
Service, through funds from the Leadership Education in Adolescent Health (LEAH) Fellowship Training Program, University of Minnesota (grant 1-T71-MC00025-01, Maternal
and Child Health Bureau, DHHS), and from the General
Mills Bell Institute of Health and Nutrition.
REFERENCES
1. Neumark-Sztainer D, Hannan P, Story M, Croll J, Perry C. Family
meal patterns: associations with sociodemographic characteristics and
improved dietary intake among adolescents. J Am Diet Assoc. 2003;
103:317-322.
2. Gillman M, Rifas-Shiman S, Frazier L, et al. Family dinner and diet
quality among older children and adolescents. Arch Fam Med. 2000;
9:235-240.
3. Videon T, Manning C. Influences on adolescent eating patterns: the
importance of family meals. J Adolesc Health. 2003;32:365-373.
4. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. Family
meals among adolescents: findings from a pilot study. J Nutr Educ.
2000;32:335-340.
5. Taveras E, Rifas-Shiman S, Berkey C, et al. Family dinner and
adolescent overweight. Obes Res. 2005;13:900-906.
6. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. The family
meal: views of adolescents. J Nutr Educ. 2000;32:329-334.
7. Boutelle K, Lytle L, Murray D, Birnbaum A, Story M. Perceptions of
family mealtime environment and adolescent mealtime behavior: do
adults and adolescents agree? J Nutr Educ. 2001;33:128-133.
8. Boutelle K, Birnbaum A, Lytle L, Murray D, Story M. Associations
Journal of Nutrition Education and Behavior Volume 39, Number 5, September/October 2007
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
263
Congratulations to Dr Tom Baranowski, winner of the 2007 JNEB Best Article Award for:
Baranowski T, Missaghian M, Broadfoot A, Watson K, Cullen K, Nicklas T, Fisher J, Baranowski
J, ODonnell S. Fruit and vegetable shopping practices and social support scales: A validation. J
Nutr Educ Behav. 2006; 39:340-351.
Dr. Baranowski is Professor of Pediatrics, Behavioral Nutrition and Physical Activity, at the
Childrens Nutrition Research Center, Baylor College of Medicine, Houston.
The Society for Nutrition Education sponsors the annual JNEB Best Article Award, consisting of
$1000 and a commemorative plaque to the lead author of the winning article.