How Can Eating Right Help the Family Dinamic

Ann Behav Med. Author manuscript; bachelor in PMC 2013 Apr 5.

Published in concluding edited course as:

PMCID: PMC3617927

NIHMSID: NIHMS448128

Examining the Relationships Between Family Meal Practices, Family unit Stressors, and the Weight of Youth in the Family unit

Leslie A. Lytle, Ph.D., R.D., Mary O. Hearst, Ph.D., M.P.H., Jayne Fulkerson, Ph.D., David M. Murray, Ph.D., Brian Martinson, Ph.D., Elizabeth Klein, Ph.D., Keryn Pasch, Ph.D., Chiliad.P.H., and Anne Samuelson, 1000.P.H.

Leslie A. Lytle

Division of Epidemiology and Community Wellness, School of Public Health, Academy of Minnesota, Minneapolis, MN 55454, United states of america

Mary O. Hearst

Segmentation of Epidemiology and Customs Health, School of Public Wellness, University of Minnesota, Minneapolis, MN 55454, Us

Jayne Fulkerson

School of Nursing, Academy of Minnesota, Minneapolis, MN 55454, United states

David G. Murray

Division of Epidemiology, College of Public Health, Ohio Land University, Columbus, OH 43210, U.s.

Brian Martinson

HealthPartners Research Foundation, Minneapolis, MN, USA

Elizabeth Klein

Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, Us

Keryn Pasch

Kinesiology and Wellness Education, Academy of Texas at Austin, Austin, TX 78701, USA

Anne Samuelson

Segmentation of Epidemiology and Customs Wellness, School of Public Health, Academy of Minnesota, Minneapolis, MN 55454, U.s.

Abstract

Background

Research is limited on how the social environment of the home is related to childhood obesity.

Purpose

The purpose of this research was to examine the relationships between positive family unit meal practices, family stressors, and the weight of youth and to examine parental weight status as a moderator of these relationships.

Methods

The study enrolled 368 parent/kid dyads from a Minnesota sample. We used mediation assay to examine the associations

Results

Families represented by an overweight parent reported fewer positive family meal practices (p<0.001), higher levels of depression (p=0.01), and fewer family rules (p=0.02) as compared to families represented by a salubrious weight parent. For overweight parents, positive family meal practices mediated the relationship between some family stressors and kid weight.

Conclusions

This research suggests that the abode environment may affect the weight of children in the family, and the result is more than pronounced in families with at least one overweight parent.

Keywords: Family meal practices, Family stressors, Youth weight

Introduction

A potential contributor to the epidemic of childhood obesity is the changing confront of families. In the by 30 years, the proportion of dual-income households has increased from 17% to 39% as parents strive to provide for their families and as women's role in the workplace has evolved [i]. This societal shift has meant that aspects of the home surround that may impact eating behaviors and weight outcomes of family unit members take changed including the frequency and quality of family repast time, foods fabricated available at meals, the frequency of eating out, office modeling behaviors of parents and amounts of family stressors to which families are exposed. The role of the domicile social environment is an area of research that is understudied.

Much has been written about the human relationship betwixt family meal practices and the eating behaviors of youth in the family unit. In general, eating meals together as a family, having parents office model good for you eating habits and having healthful foods bachelor in the habitation have been shown to exist positively related to the eating habits and health outcomes of youth [2–7]. In addition, parents who have an involved and caring parenting style rather than a decision-making style accept children who eat healthier diets [eight–ten]. Several studies accept examined the association of family meal frequency and obesity; findings take been inconsistent. Modest inverse associations have been found between family dinner frequency and children'south body mass index (BMI) and overweight [xi–13], with fewer significant associations among adolescents [13, fourteen], particularly in longitudinal analyses.

Across family meal practices, parental part modeling and parenting style, it is reasonable to expect that other elements of home life may touch family health behaviors and outcomes. The socioeconomic status of the family has a profound impact on all health related bug including foods that are consumed and the weights of family members [15]. In addition, family level stress, strain and lack of resiliency has been examined with regard to impact on the mental and social health of families [xvi–18]. Family stress may stalk from general causes of stress such as economic pressures in the family, strain from juggling work and family unit responsibilities, time demands and pressures, or the mental wellness condition of the adults in the firm including levels of depression. Stress may as well be specific to health and eating activities with parents feeling stressed about having fourth dimension to prepare and provide healthy foods, family satisfaction with meals, or making and enforcing family rules well-nigh meal time [14, 19].

One family stressor that has been inadequately studied is perceived and real time demands. Balancing the responsibilities of piece of work, school and adult and youth activities is a significant challenge for most families. These time demands may reduce a parent's real or imagined ability to back up their kid in practicing healthy eating and activity behaviors and their ability to appoint in those behaviors themselves equally good part models. Fourth dimension demands may cause a parent to believe that they disappoint their child every bit they demand to miss schoolhouse or other family unit social events. Feeling out of remainder may be a stressor for adults in the family unit that challenges their ability to be an intentional parent [20].

Another stressor may be parents' perceptions of their ability to enforce rules with their kid. As parents' lives become busier fighting the battles with their child about what to eat or time spent watching television may sideslip as a priority; family peace and relaxation may exist more important than standing one's ground with regard to eating and television conflict. It is also possible that parents that fear they are disappointing their child may be more than willing to give into their requests for treats or more screen time.

Parents may also be stressed by their internal expectation that there should be family rules almost what and when children eat and how much television that they scout; stress comes from an expectation that, as adults, they should be in command and is heightened when actual control is elusive [21]. It may well exist that stress comes from a disconnect between past family history (i.e., "When I was a kid…") and the options that gimmicky families accept with regard to family unit meal practices, time demands, and the ability to have and enforce rules.

To our knowledge, there is no examination of these potential family stressors and how they may bear on the eating, action and weight-related outcomes of children in the home. Information technology is reasonable to look that higher levels of stressors makes information technology more difficult to practise healthy family meal practices and that both are related to weight-related outcomes of family unit members.

Information technology is also reasonable to expect that the weight status of an developed in the family may affect family repast practices and stressors. With over 60% of adults in the United States beingness overweight or obese [22], examining the potential impact of adults' weight condition on how they manage meal times and family stressors is warranted. Adults' own struggles with food choices, portion size, and mindless eating are probable to be evident in their ain eating patterns and the food choices available at domicile. A "do what I say and non what I do" approach to health behaviors is not likely to be successful. However, very little has been written about how the weight condition of adult family members affects the family meal environment and what has been examined has had a very narrow focus [23].

The purpose of this research was to examine the relationships between positive family repast practices, family stressors and the weight of youth and adult family members and to examine parental weight status as a moderator of these relationships. To that end, this paper (ane) describes a prepare of newly adult measures to assess family meal practices and stressors hypothesized to exist related to the weight of children in the family, (2) examines the extent to which variables representing family meal practices and family stressors differ by the weight status of the participating adult, (3) evaluates whether family unit meal practices mediate the relationship between family stressors and kid'southward BMI, and (4) examines parental weight every bit a moderator of the relationships. We hypothesize that positive family unit meal practices will mediate the relationship between family stressors and child BMI status and that the relationships volition differ in families where at least one parent is overweight.

Methods

This enquiry is from the Etiology of Childhood Obesity study, a longitudinal cohort study examining factors at multiple levels of influence that may affect obesity risk in youth. The conceptual model used in the Etiology Of Childhood Obesity research is described elsewhere [24]. In brief, the etiologic research from which this study is drawn examines correlates and predictors of factors believed to be associated with unhealthy weight gain in youth including individual-level attitudes and behaviors of youth and one adult in their family unit, the dwelling house and school environment and the physical environment of neighborhoods surrounding the child's school and dwelling house using Geographical Data Systems. The Academy of Minnesota's Institutional Review Board canonical the study. Data specific to this enquiry are fatigued from the youth and parent data.

Sample and Recruitment

From June 2007 through March 2008, 374 parent/child dyads were recruited from the membership of Health Partners wellness plan within the seven-canton metropolitan expanse of Minneapolis and St. Paul, Minnesota. In order to recruit a sample representing both healthy and overweight youth and adults, recruitment was targeted to make full a 2×2 tabular array crossing child weight status (<85th% for sex/historic period vs. ≥85th% for sex/age) with parent weight status (BMI<25 vs. BMI≥25). Additional goals were to recruit a sample including at least xx% racial and ethnicity minorities, and to obtain a sample with a moderate amount of clustering past school (e.m., multiple students per school).

To be eligible for enrollment, youth were required to be electric current Wellness Partners members, in grades 6 through xi in the fall of 2007, residing in one of the randomly selected middle or high-school districts included in the sample, have a parent willing to participate and be willing to allow their names and contact information to be sent from Health Partners to the study team at University of Minnesota for farther eligibility screening, consent and measurement. Parent/kid dyads were ineligible if they planned to motility from the surface area in the next 3 years, had a medical condition that afflicted their growth, were non-English speaking or otherwise had difficulty comprehending English language, or had any other physical or emotional condition that would affect their diet/activeness levels or make information technology difficult to consummate measurements. Recruitment was initiated at Health Partners through invitation letters mailed to the participants' homes. These letters invited parents to contact the study squad at the University of Minnesota if potentially interested for further eligibility screening.

Measures

Kid and parent tiptop, weight and body composition were taken at a dispensary visit by trained staff using a Shorr height lath and a Tanita bioelectrical impedance device that assesses body weight and composition. For the youth, BMI z scores were derived from information from the Centers for Disease Control and Prevention Growth Charts [25]. Underweight students (<fifth percentile for BMI) were dropped from this assay (n=vi). For the parents, healthy weight was defined as BMI≤25 kg/mⁱⁱ and overweight/ obese defined as BMI >25 kg/1000².

Parents too completed a self-written report survey that included parent sexual practice, age and race and elicited information on socioeconomic status including parental education level and if the family qualified for free and reduced meals at the kid's school. Child's historic period and sex was taken from the student survey.

The parent survey also included items to assess (1) positive family repast practices based on practices identified in the literature equally related to eating behaviors or health outcomes including; family unit meals eaten together, meals eaten in the car, purchasing foods from fast nutrient, eating with the television on, phone use during meal time and serving fruits, vegetables, milk and soft drinks at dinner time; (2) questions written to tap family stressors that potentially challenge positive family meal practices including: perceived time demands, the being of family rules around meal fourth dimension, and perceived difficulty enforcing rules; (3) low [26]; and (iv) stress [27]. We combined the positive family unit repast practices into an index, giving each family a point for each positive practice. For case, respondents scored a "1" if they answered that fruit was served at dinner or if they did not let their child to watch television during a meal. Throughout the paper, we use the term "family stressors" to describe the items tapping stressors specific to meal time too as the more than full general measures of depression and stress. Face validity of the newly created questions was established through consultation with experts in the field and internal consistency of the scales was evaluated using Cronbach's alpha. Tabular array ane shows the questions representing the positive family meal practices alphabetize and the family stressors. All of the scales show moderate to good internal consistency including: fourth dimension demands (α=0.81), family rules (α=0.62), dominion enforcement (α=0.82), the depression scale [26] (α=0.82), and the stress scales [27] (α=0.78). In add-on, construct validity was assessed past examining the bivariate relationships between the constructs and health-related outcomes, including child and parent BMI. As expected, the positive family repast practice index was inversely related to child BMI (r=−0.29; p<0.0001) and parent BMI (r=−0.30; p< 0.0001). Likewise, perception of more time demands was positively related to child BMI (r=0.15; p=0.003) and adult BMI (r=0.17; p=0.001).

Table 1

Item descriptions, response options, and internal consistency reliability of major variables and constructs. (n=368)

Construct, source, Cronbach blastoff	Question
Positive family unit meal patterns index	During the past seven days how many times…(response categories: never, 1–two times, 3–4 times, 5–6 times, 7 times)
Source: Original	Did all, or most, of your family living in your dwelling house swallow dinner or supper (i.e., the evening meal) together?
Cronbach α non applicable; index	Did all, or nearly of your family living in your home eat breakfast together?
	Was at least ane parent present when your child ate his/her evening meal?
	Was a family evening meal purchased from a fast food eatery and eaten either at the fast food eatery or at domicile?
	During the past calendar month, how often…(response categories: never or rarely, once or twice/month, about once/calendar week, several times/week, almost every day)
	Was at least one type of vegetable (other than potatoes) served at dinner in your dwelling house?
	Was fruit served at dinner in your home?
	Was milk served at dinner in your dwelling?
	Were soft drinks (soda, pop) served at dinner in your domicile?
	Hold or disagree with the post-obit statements (response categories: strongly disagree, disagree, agree, strongly agree)
	I allow my child to watch Tv set during a family unit repast
	I allow my child to respond the phone during a family unit meal
	My child ofttimes eats meals in the car (do not include snacks)
Time demands	Agree or disagree with the following statements about y'all and your family (response categories: strongly disagree, disagree, concord, strongly concur)
Source: Original	I feel also decorated with work or other demands
Cronbach α=0.81	I frequently disappoint my children considering I am too busy with work or other demands (for, instance, miss attention your kid's sport/school events)
	I accept a healthy balance between work, other demands on my time, and quality time for my family unit and myself
	If I was less busy, I would be able to help my child make healthier nutrient choices
	If I was less busy, I would be able to help my child exist more than physically agile
	If I was less decorated, I would exist happier
	I am confident that I tin find a healthy residual between work, other demands on my fourth dimension and quality time for my family and myself
	If I was less decorated, I would be able to eat a healthier diet
	If I was less busy, I would be able to be more physically agile
Family rules	Concord or disagree with the following statements (response categories: strongly disagree, disagree, agree, strongly agree)
Source: Original	We have family rules about what/when children eat
Cronbach α=0.62	We have family rules nearly time spent on Goggle box/video games
	When I was a child, my parents enforced rules about what/when I ate
	When I was a kid, my parents enforced rules about Tv set watching
Rule enforcement	Agree or disagree with the following statements (response categories: strongly disagree, disagree, agree, strongly concur)
Source: Original	It is difficult for me to enforce rules virtually what/when my child eats
Cronbach α=0.82	It is difficult for me to enforce rules about time spent on Boob tube or video games
	When I feel like I've disappointed my child, I'1000 more likely to give into requests for treats
	When I feel similar I've disappointed my child, I'chiliad more likely to give into requests for fast nutrient
	When I feel like I've disappointed my child I'm more probable to give into requests to play video games or watch TV or videos
Depression	During the by 12 months, how often have you been bothered or troubled by…(response categories: not at all, somewhat, very much)
Source: Kandel Davies [21]	Feeling likewise tired to do things?
Cronbach α=0.82	Having trouble going to slumber or staying asleep?
	Feeling unhappy, sad, or depressed?
	Feeling hopeless nigh the hereafter?
	Feeling nervous or tense?
	Worrying too much about things?
	Changes in your ambition?
Stress	In the last calendar month, how often have yous felt that…(response categories: never, almost never, sometimes, adequately often, very ofttimes)
Source: Cohen et al. [22]	You were unable to control the of import things in your life?
Cronbach α=0.78]	Confident about your ability to handle your personal problems?
	Things were going your way?
	Difficulties were piling up then loftier that you could not overcome them?

Analyses

Descriptive characteristics of the full sample and the sample stratified past parent weight condition were calculated and tested for differences by weight status using chi square and t test statistics. Mediation analyses to assess the positive family meal practice index as a potential mediator betwixt family stressors and kid BMI-z scores were conducted following the procedures suggested by MacKinnon [28]. Separate models were run for each of the family unit stressor variables. Unadjusted and adjusted models were run for each of the post-obit steps: We outset estimated the association for the family unit stressors and the issue (BMI z score) which MacKinnon labels C. Next, we estimated the association between each family stressor variable and the mediator (positive family unit meal practices), which MacKinnon labels A. We estimated the association of the mediator (positive family meal practices) and the outcome (BMI z score), adjusted for the effects of the family stressor variables, which MacKinnon labels B. Finally, we assessed the effect of the family stressor on the outcome, adjusted for the mediator, which MacKinnon labels C′. The mediated effect was calculated using the production of coefficients method, as A*B [29]. The standard error was calculated using the Sobel method [thirty]. A statistical test of the mediated effect AB/σ _AB was evaluated using the z-distribution. Finally, the percent of the association mediated by the positive family unit meal practise index was calculated as the estimate of the mediated effect (AB) divided by the total effect of the intervention, or (AB/AB+C).

All statistical models used generalized estimating equations to account for schoolhouse level clustering. We used PROC GENMOD to perform the GEE assay, identifying the school as the cluster in the REPEATED statement. Nosotros used robust standard errors, an independent working correlation matrix, an identify link and a normal variance function. We accept data from 368 youth who were enrolled in 149 schools. With this number of schools, we are confident that the asymptotic assumption for the use of an independent working correlation is safe. As parent weight status was identified a priori as a possible effect modifier, interactions were tested on unadjusted multivariate models by parent weight status. Significant models (p<0.05) were subsequently stratified by healthy weight and overweight status of parents, with the same steps conducted for assessing mediation, in fully adjusted models. All analyses were conducted using SAS five.nine.1 of the SAS Organization for Windows [SAS Institute, SAS/STAT, SAS Constitute, Editor. 2002–2003: Cary, NC.]

Results

Univariate Results

Table two shows the characteristics of the total sample and stratified past the weight status of the participating parent. The full sample of responding adults was made up of 82% female person respondents, was primarily Caucasian, well educated and 16% of the sample qualified for complimentary and reduced luncheon for their children at school. Beyond the total sample, the mean age of children represented was fourteen years of age and there were slightly more females. About 1/iii of the children were classified as overweight or obese. The mean BMI z score for the children was 0.56 (sd=1.03) and the mean BMI for the participating adult was 28.04 (sd=half-dozen.58). All the items for the positive family repast practise index and family stressor variables for the total sample were near mid-range and showed adept variance.

Table 2

Demographic, weight, positive family unit repast practice index, and stressor scale characteristics for the total sample and stratified by parent weight status

	Full sample (n=368)	Healthy weight parent (northward=151)	Overweight/obese parent (n=217)	Chi-Sqr./T-Stat	p valuea
Variable
Demographics and weight status: adult
Female (%)	82.0	89.four	78.iii	7.68	0.006
Parent reporting "White" race (%)	86.4	95.4	eighty.2	17.48	<0.001
Parent with college education (%)	64.0	71.3	59.0	5.87	0.02
Family unit qualifies for free or reduced dejeuner (%)	sixteen.0	9.3	20.seven	8.seventy	0.003
BMI (mean, SD)	28.04 (vi.58)	22.39 (1.91)	31.98 (5.77)	t=−19.lxx	<0.001
Demographics and weight condition: child
Kid historic period (hateful, SD)	fourteen.0 (one.7)	xiv.0 (ane.7)	xiv.0 (1.7)	t=0.22	0.82
Child female person (%)	51.9	45.7	49.8	0.59	0.44
Child weight status:
Good for you weight (%)	68.5	79.5	60.8	24.47	<0.001
Overweight (%)	xiii.9	xiv.6	13.4
Obese (%)	17.7	vi.0	25.viii
BMI z score (mean, SD)	0.56 (1.03)	0.nineteen (0.91)	0.82 (1.03)	t=−six.02	<0.001
Parent survey information (mean, SD)
Positive family unit meal practicesb (range=0–11)	vi.07 (ii.39)	6.eight (2.06)	5.55 (ii.47)	5.10	<0.001
Depression (range=10–30)	15.79 (4.45)	xv.10 (iv.01)	16.27 (4.69)	−2.49	0.01
Stress (range=4–19)	viii.06 (two.91)	seven.70 (ii.74)	viii.32 (ii.99)	−2.03	0.04
Time demands (range=9–32)	20.88 (3.81)	20.38 (iii.27)	21.22 (four.12)	−2.08	0.04
Lack of family rules (range=4–16)	ix.61 (two.09)	9.31 (1.96)	9.81 (ii.sixteen)	−two.27	0.02
Difficulty with rule enforcement (range=6–22)	12.54 (2.90)	12.33 (2.72)	12.69 (three.02)	−1.18	0.24

As shown in Tabular array 2, there were demographic differences between good for you weight and overweight parents and overweight parents were nigh twice as probable equally healthy weight parents to accept an overweight child. In relation to the positive family meal practise index and family stressor variables, compared to families represented by a salubrious weight parent, the families represented past an overweight parent reported significantly fewer positive family meal practices and had college scores on depression, stress, experienced more time demands and reported fewer family rules as compared to healthy weight parents.

Arbitration Results

Table 3 shows the parameter estimates for the mediation models examining the relationship betwixt the family stressors and child's BMI in the total sample and also stratified by the weight condition of the parent; testing for interactions suggested a stratified analysis. Column C represents the directly effect between each stressor and child BMI z score and shows a positive and statistically significant human relationship for depression in all of the samples and, in the full sample and the overweight sample, a positive and statistically significant relationship between kid BMI z score and stress and time demands. In the total sample and good for you weight parent sample, a positive and statistically meaning relationship was also seen between child BMI z score and difficulty enforcing rules.

Table three

Parameter estimates for the effect of the positive family repast practice index as a mediator of family stressors on child BMI z scores, stratified by parental weight status

	C	SE C	C′	SE C′	A	SE A	B	SE B	AB	SE AB	z	% Med
Full sample (n=368)
Depressiona	0.046*	0.011	0.034*	0.011	−0.063*	0.027	−0.063*	0.025	0.004	0.002	one.66	7.5
Stressa	0.039*	0.017	0.023	0.016	−0.08	0.042	−0.065*	0.025	0.005	0.003	one.55	11.9
Time demandsa	0.033*	0.014	0.018	0.014	−0.125*	0.029	−0.061*	0.025	0.008	0.004	ii.thirteen*	xviii.6
Lack of family unit rulesa	0.029	0.027	0	0.026	−0.253*	0.054	−0.069*	0.024	0.017	0.007	2.4*	37.eight
Difficulty enforcing rulesa	0.039*	0.018	0.019	0.018	−0.199*	0.043	−0.061*	0.026	0.012	0.006	2.13*	23.9
Healthy weight parents (n=151)
Low	0.044*	0.017	0.037*	0.017	−0.076	0.052	−0.048	0.036	0.004	0.004	0.99	7.6
Stress	0.027	0.027	0.023	0.025	−0.110	0.073	−0.055	0.040	0.006	0.006	ane.02	18.3
Fourth dimension demands	0.026	0.020	0.022	0.019	−0.077	0.053	−0.054	0.036	0.004	0.004	ane.04	thirteen.8
Lack of family rules	0.007	0.034	−0.001	0.034	−0.138*	0.069	−0.059	0.037	0.008	0.007	1.25	53.eight
Difficulty enforcing rules	0.048*	0.024	0.039	0.025	−0.212*	0.056	−0.044	0.037	0.009	0.008	1.13	sixteen.3
Overweight parents (n=217)
Depression	0.048*	0.014	0.043*	0.013	−0.066*	0.030	−0.087*	0.030	0.006	0.003	one.75	x.vii
Stress	0.045*	0.022	0.024	0.021	−0.076	0.049	−0.080*	0.028	0.005	0.004	1.11	9.5
Time demands	0.037*	0.017	0.024	0.018	−0.151*	0.033	−0.086*	0.028	0.013	0.005	2.55*	26.0
Lack of family rules	0.043	0.033	0.012	0.034	−0.326*	0.069	−0.096*	0.029	0.313	0.067	iv.68*	42.1
Difficulty enforcing rules	0.037	0.023	0.019	0.024	−0.197*	0.056	−0.093*	0.030	0.018	0.008	two.33*	33.1

The values in the A column evidence the human relationship betwixt each family stressor examined and the positive family repast do index, adjusting for educatee age, sex activity, parental race, if the family qualified for free and reduced lunch, and parental educational activity. Across all three samples, statistically pregnant and negative associations were seen betwixt positive family meal practices and lack of family rules and difficulty enforcing rules; fewer rules and more problems with rule enforcement were related to less positive family repast practices. For the total sample and the sample of overweight parents, depression and perceived fourth dimension demands were also negatively related to positive family unit meal practices.

The values in column B correspond the relationship betwixt the positive family meal practise index and child BMI z score adjusted for each family stressor. In both the full sample and the sample of overweight parents, the relationships between positive family meal practices and child BMI z score were statistically significant and negative; the relationships were stronger in the overweight sample. There were no statistically meaning relationships betwixt positive family repast practices and child BMI z scores in the families represented by a salubrious weight parent.

The statistical significance of the arbitration analysis is identified through the z statistic and the tested relationship is illustrated in Fig. ane. For the sample that included a healthy weight parent, there was no evidence that positive family unit meal practices mediated the relationship between the family stressors and BMI. Nevertheless, for the total sample and overweight parents, the positive family unit meal practice index appeared to mediate the relationship betwixt time demands, lack of family rules and difficulty enforcing family rules and the child's BMI. Figure 1 shows the mediation model using the full sample for the three family stressors that prove statistical significance. Lack of family rules had the strongest bear on in the models tested with 37.8% of the human relationship between family unit rules and child BMI explained through family meal practices. The relationships are stronger in the overweight sample for time demands, lack of family rules and difficulty enforcing rules; in the overweight sample 42.1% of the human relationship between lack of family rules and child BMI is explained through family meal practices (Table three).

Mediation models for the effect of positive family meal practices on the relationship between significant family stressors on child BMI z scores (n=368) (Adjusted for student age, student gender, parental college education (Y/N), qualify for free or reduced cost luncheon (Y/North) and parental race). a Time demands every bit family stressor; z score=2.13 (p<0.05); % mediation=xviii.six%. b Lack of family rules as a family unit stressor; z score=2.4 (p<0.05); % mediation=37.viii. c Difficulty enforcing rules every bit a family stressor; z score=2.xiii (p<0.05); percent mediation=23.9

Discussion

The purpose of this enquiry was to examine the relationships between family meal practices, family unit stressors and the weight of youth and adult family unit members and to examine parental weight condition as a moderator of these relationships. This research presents the positive family repast practice index as a robust construct that is related to family unit stressors. In addition, in families where at least ane of the parents is overweight, the positive family unit meal practice alphabetize was negatively related to child BMI-z score and was a mediator between several family stressors and child BMI. This research also presents 3 newly developed constructs to assess family stressors related to time demands, lack of family rules and difficulty enforcing rules. The internal consistency and the construct validity of the scales were demonstrated.

We examined how family meal practices and family level stressors may differ by families represented by a healthy weight versus an overweight parent (Table 2). Families represented by an overweight parent reported fewer positive family repast practices as compared to families represented by a healthy weight parent (p< 0.0001). Looking at the more general measures of stress and depression, we saw differences in reported levels of stress and depression in overweight versus salubrious weight families. Perceptions of time demands and lack of family rules differed by families represented by an overweight as compared to a salubrious weight adult. It appears that difficulty enforcing family rules around mealtime and "giving into" children's requests when they feel that they accept disappointed their child is a stressor for all families, including families where at to the lowest degree ane parent is at a healthy weight. We also found that the positive family repast do alphabetize appears to be an important mediating variable in the pathway between family unit stressors (particularly fourth dimension demands, lack of family rules and difficulty enforcing family rules) and child-level BMI simply only in families where the participating adult was overweight or obese.

The literature on the relationship between family meal patterns and their impact on the weight of children has paid insufficient attention to how family repast time and stressors may vary in homes where at least one parent is overweight as compared to homes where at least one parent is at a good for you weight. In doing then, the normative influence of the parent's own behaviors and potential struggles with their weight have been ignored. Just as adults who smoke may struggle to counsel their children not to fume, adults who are overweight may experience hypocritical or ill equipped to advise their child to practice healthy behaviors related to weight. In addition, parents' own preferences about what, when, where to eat and what to practise or not practise while eating should not exist ignored as important influences on family unit meal patterns and behaviors and health outcomes of youth. Health professionals that are interested in preventing childhood obesity must realize that the advice we requite about healthy repast practices must be heard and accepted by the adults in the family. At the very least, nosotros must admit that adults in the family may be struggling with their own attempts to maintain or achieve a healthy weight and to create healthier environments for themselves and their families. Our findings also suggest that educating parents on the importance of the 11 behaviors that compose the positive family repast do index, regardless of other rules and stressors, may take a positive influence on the weight of children. Counseling parents to do a number of very specific mealtime behaviors every bit delineated in the positive family meal practice index (east.g., always serve at to the lowest degree one fruit and vegetable at meals, don't offer soft drinks at meals, accept an adult present at meals, turn the television off, etc.) may be easier and have a greater impact on weight condition than attempting to eliminate or command stressors.

Findings from the mediation assay propose that in families where at least one adult is overweight, family stressors touch on child level BMI both directly and through their impact on family unit meal practices. This finding suggests that family-based interventions may do good from a focus on the stressors that appear to have the most stiff impact on child BMI, including managing fourth dimension demands, making family unit rules around what occurs during repast fourth dimension and enforcing those rules and not giving in to children'due south demands when we worry that we have disappointed them.

The findings from this research demand to be viewed in light of the report'southward limitations. The external validity of the study is express past the study'due south pocket-size sample of adults and youth from ane metropolitan area. Further testing in larger, more than diverse samples is warranted. In add-on, this research merely examines one adult and one child in each family unit. Certainly the weight of other adults and children in the family may affect the relationship between family stressors, mealtime practices and the overall repast and weight culture of family members in the household. However, to engagement, population level information on unabridged families that examine these factors are not available and would be costly to collect. Our results advise that even having i parent that is at a healthy weight may offer some protective benefit to children in the dwelling through more salubrious family unit meal practices and family rules, lower levels of stress and depression and fewer perceived fourth dimension demands.

Another limitation is that nosotros did non examine how the stressors or family repast practices bear on specific eating behaviors or nutrient intake. For this written report nosotros chose to use BMI as the outcome of interest, both considering of its direct human relationship to health outcomes and because of the minimal bias in an objective measurement of weight. Inquiry examining which specific dietary behaviors are affected past family stressors and family meal patterns may be useful.

A last limitation is that we employed a GEE assay for the mediation work. Mediation analyses are typically run with general linear models or general linear mixed models. We could not use these models because information technology was not possible to correctly model the complex correlation blueprint in our data. The regression coefficients should be unaffected by GEE, and the standard errors should be correctly estimated using GEE. But we recognize that this arroyo has not been validated requiring circumspection in our estimation.

In conclusion, this enquiry introduces several new measures that can be used in population-based research representing family stressors and family meal practices. In addition, this enquiry strongly suggests that the weight of adults in the family may moderate the relationship between family unit stressors, family meal practices and the BMI of youth in the family. These findings have implications for designing family-based programs related to promoting the good for you weight of children and for etiologic research to better understand the relationship between family unit meal practices, family stressors and weight of children in the family.

Footnotes

Conflict of Involvement Argument The authors have no conflict of interest to disclose.

Contributor Information

Leslie A. Lytle, Segmentation of Epidemiology and Customs Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.

Mary O. Hearst, Division of Epidemiology and Customs Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, Us.

Jayne Fulkerson, School of Nursing, University of Minnesota, Minneapolis, MN 55454, USA.

David M. Murray, Partition of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.

Brian Martinson, HealthPartners Research Foundation, Minneapolis, MN, U.s..

Elizabeth Klein, Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.

Keryn Pasch, Kinesiology and Health Education, University of Texas at Austin, Austin, TX 78701, USA.

Anne Samuelson, Partitioning of Epidemiology and Customs Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, The states.

References

2. Patrick H, Nicklas TA. A review of family unit and social determinants of children'southward eating patterns and diet quality. J Am Coll Nutr. 2005 Apr;24(2):83–92. [PubMed] [Google Scholar]

3. Oliveria SA, Ellison RC, Moore LL, Gillman MW, Garrahie EJ, Singer MR. Parent-kid relationships in nutrient intake: the Framingham children's written report. American Journal of Clinical Nutrition. 1992;56:593–598. [PubMed] [Google Scholar]

4. Johnson S, Birch L. Parents' and children's adiposity and eating manner. Pediatrics. 1994;94:653–661. [PubMed] [Google Scholar]

5. Gillman MW, Rifas-Shiman Southward, Frazier AL, et al. Family dinner and nutrition quality among older children and adolescents. Athenaeum of Family Medicine. 2000;9(iii):235–240. [PubMed] [Google Scholar]

vi. Videon TM, Manning CK. Influence on adolescent eating patterns: the importance of family unit meals. Periodical of Boyish Health. 2003;32(5):365–373. [PubMed] [Google Scholar]

7. Neumark-Sztainer D, Hannan PJ, Story G, 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(3):317–322. [PubMed] [Google Scholar]

8. Schmitz KH, Lytle LA, Phullips GA, Murray DM, Birnbaum AS, Kubik MY. Psychosocial correlates of physical acitivty and sedentary leisure habits in young adolescents: the teens eating for energy and diet at school study. Preventive Medicine. 2002;34:266–278. [PubMed] [Google Scholar]

ix. Nicklas TA, Baranowski T, Baranowski JC, Cullen Thousand, Rittenberry L, Olvera N. Family unit and kid-care provider influences on preschool children's fruit juice and vegetable consumption. Nutrition Reviews. 2001;59:224–235. [PubMed] [Google Scholar]

10. Kremers S, Bruga J, Hein de Vriesa D, Rutger C. Parenting manner and adolescent fruit consumption. Appetite. 2003;41:43–50. [PubMed] [Google Scholar]

11. Gillman MW, Rifas-Shiman S, Frazier Fifty, et al. Family dinner and diet quality among older children and adolescents. Archives of Family Medicine. 2000;9:235–240. [PubMed] [Google Scholar]

12. Taveras EM, Rifas-Shiman South, Berkey CS, et al. Family dinner and adolescent overweight. Obesity Enquiry. 2005;thirteen(5):900–906. [PubMed] [Google Scholar]

13. Sen B. Frequency of family dinner and adolescent body weight status: bear witness from the national longitudinal survey of youth, 1997. Obesity (Silverish Spring) 2006;xiv(12):2266–2276. [PubMed] [Google Scholar]

14. Fulkerson JA, Neumark-Sztainer D, Hannan PJ, Story M. Family meal frequency and weight status among adolescents: Cantankerous-sectional and 5-yr longitudinal associations. Obesity (Silver Bound) 2008;16(xi):2529–2534. [PubMed] [Google Scholar]

xv. Singh GK, Siahpush M, Kogan MD. Rising social inequalities in United states childhood obesity, 2003–2007. Ann Epidemiol. 2010 Jan;20 (1):xl–52. [PubMed] [Google Scholar]

16. Patterson JM. Integrating Family Resilience and Family Stress Theory. Journal of Marriage and the Family. 2002;64(2):349–360. [Google Scholar]

17. Keith PM, Schafer RB. Office Strain and Depression in Two-Job Families. Family Relations. 1980;29(4):483–488. [Google Scholar]

18. Voydanoff P. Piece of work Role Characteristics, Family unit Structure Demands, and Work/Family unit Disharmonize. Journal of Marriage and the Family. 1988;l(3):749–761. [Google Scholar]

19. Fulkerson JA, Kubik MY, Story M, Lytle LA, Arcan C. Are there nutritional and other benefits associated with family unit meals amid at-risk youth? Periodical of Boyish Health. In press. [PMC complimentary article] [PubMed] [Google Scholar]

20. Doherty W. The Intentional Family: How to build family ties in our mod world. Reading, Massachuesetts: Addison-Wesley; 1997. [Google Scholar]

21. Hayes S, Strosahl Grand, Wilson K. Acceptance and Commitment Therapy. New York, New York: The New Guilford Press; 1999. [Google Scholar]

22. Ogden CL, Carroll Dr., Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the Us, 1999–2004. JAMA. 2006;295(13):1549–1555. [PubMed] [Google Scholar]

23. Francis L, Lee Y, Birch 50. Parental weight status and girls' telly viewing, snacking, and trunk mass indexes. Obesity Research. 2003;11:143–151. [PMC costless commodity] [PubMed] [Google Scholar]

24. Lytle LA. Examining the etiology of babyhood obesity: The IDEA study. American Journal of Community Psychology. 2009;xi:143–151. [PMC free commodity] [PubMed] [Google Scholar]

26. Kandel DB, Davies Yard. Epidemiology of depressive mood in adolescents: an empirical study. Curvation Gen Psychiatry. 1982 Oct;39(10):1205–1212. [PubMed] [Google Scholar]

27. Cohen Due south, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior. 1983;24(4):385–396. [PubMed] [Google Scholar]

28. MacKinnon DP, Fairchild AJ, Fritz MS. Mediation assay. Annual Review of Pscyhology. 2007;58:593–614. [PMC free article] [PubMed] [Google Scholar]

29. MacKinnon DP, Dwyer JH. Estimating mediated effects in prevention studies. Evaluation Review. 1993;17(ii):144–158. [Google Scholar]

xxx. Sobel M. Some new results on indirect effects and their standard errors in covariance structure analysis. San Francisco, CA: Jossey-Bass; 1986. [Google Scholar]

bourgeoistaidef.blogspot.com

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617927/

Share this post