Meal Participation Research Articles

Impact of Participation in Home-Delivered Meals on Nutrient Intake, Dietary Patterns, and Food Insecurity of Older Persons in New York State

The aim of this study was to determine if (1) participation in Home-Delivered Meals (HDM) results in improved dietary patterns and nutrient intake, lower food insecurity, and reduced loss of weight; (2) subgroups of older persons are more likely to benefit; and (3) nutritional indicators of impact other than nutrient intake may be useful. The design used was quasi-experimental, with longitudinal assessment of individuals on HDM at baseline (before receipt of services), 6, and 12 months, and comparison to non-randomized group receiving other services. Outcomes included measured weight and height, 24-hour dietary recall, and food insecurity. Paired t test, multiple linear regression, and selection models using multiple logistic regression were performed. All older persons in three New York State counties referred for aging services over a 5-month period were asked to participate (n = 456), and 212 agreed (171 on HDM). At 6 months, the sample size was 101 (34 discharged, 42 hospital/died/moved, 26 chose not to continue), and at 12 months it was 68 (similar reasons). After receiving meals for 6 and 12 months, participants showed greater improvement in most dietary intake variables than either a non-HDM comparison group or HDM participants who ate no HDM meal on the day of assessment. Compared to initial values, participants improved significantly in some variables for dietary patterns, nutrient intake, and nutrient density, and were less likely to be food insecure. Furthermore, HDM was more likely to impact those living alone and those with poorer initial status. This study provides strong evidence that HDM has a positive impact on the nutritional well-being of older persons. Food insecurity and dietary patterns are useful nutritional indicators of impact.

Improving Food Environments in Schools: Tracking Progress

Making healthful food choices is an essential part of a healthy lifestyle ( 1 US Department of Health and Human ServicesHealthy People 2010. 2nd ed. US Government Printing Office, Washington, DCNovember 2000 Google Scholar , 2 American Dietetic AssociationPosition of the American Dietetic Association: Nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc. 2008; 108: 1038-1047 Google Scholar , 3 US Department of Health and Human Services and US Department of AgricultureDietary Guidelines for Americans 2005. http://www.health.gov/dietaryguidelines/dga2005/document/default.htm Google Scholar ). However, the diets consumed by most American children are not consistent with the Dietary Guidelines for Americans ( 3 US Department of Health and Human Services and US Department of AgricultureDietary Guidelines for Americans 2005. http://www.health.gov/dietaryguidelines/dga2005/document/default.htm Google Scholar ). Children's consumption of vegetables, fruits, and whole grains is substantially less than recommendations, and consumption of discretionary calories from solid fats and added sugars exceeds recommendations by a wide margin ( 4 Cole N. Fox M.K. Diet Quality of American School-Age Children by School Lunch Participation Status: Data from the National Health and Nutrition Examination Survey, 1999-2004. US Department of Agriculture, Food and Nutrition Service, Alexandria, VA2008 Google Scholar , 5 Cole N. Fox M.K. Diet Quality of Americans by Food Stamp Participation Status: Data from the National Health and Nutrition Examination Survey, 1999-2004. US Department of Agriculture, Food and Nutrition Service, Alexandria, VA2008 Google Scholar , 6 Guenther P.M. Dodd K.W. Reedy J. Krebs-Smith S.M. Most Americans eat much less than recommended amounts of fruits and vegetables. J Am Diet Assoc. 2006; 106: 1371-1379 Google Scholar , 7 Gleason P.M. Suitor C.W. Children's Diets in the Mid-1990s: Dietary Intake and Its Relationship with School Meal Participation. US Department of Agriculture, Food and Nutrition Service, Office of Analysis and Evaluation, Alexandria, VA2001 Google Scholar ). Poor dietary habits, coupled with low levels of physical activity, have contributed to a dramatic increase in the prevalence of childhood obesity over the last 4 decades. In 2007-2008, the prevalence of obesity among children age 6 to 11 years was five times what it was in 1971-1974 (20% vs 4%), and the prevalence among adolescents age 12 to 19 years was approximately 3.5 times higher (18% vs 5%) ( 8 Institute of Medicine, Committee on Progress in Preventing Childhood ObesityProgress in Preventing Childhood Obesity: How Do We Measure Up?. The National Academies Press, Washington, DC2007 Google Scholar , 9 Ogden C.L. Carroll M.D. Curtin L.R. Lamb M. Flegal K.M. Prevalence of high body mass index in U.S. children and adolescents, 2007-2008. JAMA. 2010; 303: 242-249 Google Scholar ). M. K. Fox is a senior researcher, Mathematica Policy Research, Inc, Cambridge MA.

Family Meals and Parents' Challenges

The objective of this study was to evaluate how Swedish parents regard their children's participation in meals. Taped interviews with sixty-two parents, responsible for meals at home, were transcribed and evaluated. This article is restricted to the twenty-one middle class families in the group. Through analysis of the interviews, we evaluated how middle class parents set out to mediate a certain approach to food and eating. Children were simultaneously expected to learn their own family's eating habits and those of society in general. We found that the parents viewed their children's participation in meals as an integration process. These data confirm that demarcation, a classic socialization impulse, is used to teach children their family's eating habits. However, the socialization process also includes diversity, to broaden the child's tastes outside the family, and experimentation, to encourage the child to try new dishes and flavors.

Participation of 1,725 fourth‐grade children in the School Breakfast Program (SBP) and National School Lunch Program (NSLP): Comparing study records to parental responses on consent forms

On study records created for a validation study of dietary recall accuracy, research staff indicated which children participated (obtained meals) in SBP and NSLP on 10 to 29 random days per fourth‐grade child between August and May. For analyses, we used a cutpoint of whether children participated on ≥50% of days. Parents responded to 2 questions on consent forms regarding children's usual participation in school meals (breakfast; lunch). For the 1,126 children who participated in SBP on ≥50% of days, 66% of consent forms indicated that breakfast was usually eaten at school, 27% at school and home, 5% at home, 1% not eaten, and 1% indicated a combination of responses; for the 599 children who participated in SBP on <50% of days, consent forms indicated 23%, 27%, 42%, 4%, and 4%, respectively. For the 1,672 children who participated in NSLP on ≥50% of days, 91% of consent forms indicated that lunch was usually from school, 2% brought from home, 5% from school and brought from home, and 2% not eaten or a combination of responses; for the 53 children who participated in NSLP on <50% of days, consent forms indicated 28%, 62%, 10%, and 0%, respectively. In summary, parental responses of children's participation had acceptable accuracy for NSLP, but not for SBP. Funded by R21HL088617 and R01HL074358.

Children's body mass index, participation in school meals, and observed energy intake at school meals

BackgroundData from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria).MethodsData were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age.ResultsBreakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria.ConclusionsFor fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.

Daily Participation in School Meals, Observed Energy Intake at School Meals, and Fourth-Grade Children's Body Mass Index Percentile

Daily Participation in School Meals, Observed Energy Intake at School Meals, and Fourth-Grade Children's Body Mass Index Percentile

Daily participation in school meals and 4th‐grade children's age/sex body mass index percentile

We used data from R01 HL074358 to establish cost‐efficient preliminary evidence concerning a possible relationship between childhood obesity and daily participation in the School Breakfast Program (SBP) and National School Lunch Program (NSLP). Research questions: What is the relationship between age/sex body mass index percentile (BMI%) and daily SBP and NSLP participation during 4th grade? Does this differ by a) SBP and NSLP participation separately versus combined, b) sex, c) breakfast location, and d) school year? To calculate BMI%, we weighed and measured children in the morning in the spring of their 4th‐grade year. Information about 180 possible days of SBP/NSLP participation for each of 1,557 4th graders (90% Black) was obtained from administrative records provided by the school district for 17, 17, and 8 schools for 3 school years (2004‐05, 2005‐06, 2006‐07). For the 3 respective school years, 6, 6, and 7 of the schools had breakfast in the classroom (BIC); the others had breakfast in the cafeteria. For daily NSLP participation, there was a school‐year effect on BMI% (p = 0.0456; highest for Year 3 [76.10%]; lowest for Year 2 [71.61%]) and a marginally significant breakfast‐location effect on BMI% (p = 0.0568; higher for BIC [74.72%] than in the cafeteria [72.08%]). The results illustrate a provocative association between BIC and childhood obesity that warrants further investigation. Funded by R21 HL088617.

Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence?

Objective To examine longitudinal associations of participation in regular family meals (≥ 5 meals/week) with eating habits and dietary intake during adolescence. Design Population-based, longitudinal study (Project EAT: Eating Among Teens). Surveys were completed in Minnesota classrooms at Time 1 (1998-1999) and by mail at Time 2 (2003-2004). Setting Baseline surveys were completed in Minneapolis/St. Paul, Minnesota, schools and by mail at follow-up. Participants 677 adolescents (303 males and 374 females) who were in middle school at Time 1 (mean age = 12.8 ± 0.74 years) and high school at Time 2 (mean age = 17.2 ± 0.59 years). Main Outcome Measures Dietary intake, frequency of meals, and fast-food intake patterns. Analysis Generalized linear modeling stratified by gender and adjusted for race/ethnicity, socioeconomic status, and the Time 1 outcome. Results Regular family meals were positively associated with Time 2 frequency of breakfast, lunch, and dinner meals for males and breakfast and dinner meals for females. Among males, regular family meals were negatively associated with Time 2 fast-food intake. Regular family meals were also positively associated with Time 2 mean daily intakes of vegetables, calcium-rich food, fiber, calcium, magnesium, potassium, iron, zinc, folate, and vitamins A and B 6 among both genders. Conclusions and Implications Regular family meals during early adolescence may contribute to the formation of healthful eating habits 5 years later. Parents should be made aware of the importance of shared mealtime experiences.

The Third School Nutrition Dietary Assessment Study: Summary and Implications

Bringing school meals in line with the 2005 Dietary Guidelines will involve more than changing nutrient standards and revising menu planning regulations. SNDA-III provides evidence that, despite the hard work of many individuals, schools, and organizations, SMI goals were not fully achieved. Strategies are needed to enhance the ability of schools to offer healthier meals.

School Breakfast Program but Not School Lunch Program Participation Is Associated with Lower Body Mass Index

Background Rates of overweight and obesity have increased dramatically during the past 2 decades. Children obtain a large fraction of their food energy while at school. Objective To estimate the relationship between participation in school meal programs and children's body mass index (BMI) and their likelihood of being overweight or obese, testing the hypothesis that school meal participation influences students' weight status, as measured by their BMI and indicators of overweight and obesity. Design A cross-sectional design in which a regression model was used to estimate the association between participation in the School Breakfast Program and National School Lunch Program and children's BMI and risk of overweight or obesity, controlling for a wide range of student and school characteristics. Subjects/setting Participants included a nationally representative sample from the third School Nutrition Dietary Assessment Study of 2,228 students in grades 1 through 12 for whom height and weight measurements were obtained. These students, along with their parents, each completed a survey. Statistical analyses performed Multivariate regression models were used to examine the relationship between usual school meal participation and BMI and indicators of whether students were overweight or obese. These models controlled for students' demographic and socioeconomic characteristics, levels of physical activity, usual eating habits, screen time, and school characteristics. Results No evidence was found of any relationship between usual school lunch participation and any of four different measures of weight status based on students' BMI. School breakfast participation was associated with significantly lower BMI, particularly among non-Hispanic, white students. Conclusions There was no evidence that either the school breakfast or lunch program is contributing to rising rates of childhood obesity. In fact, School Breakfast Program participation may be a protective factor, by encouraging students to consume breakfast more regularly.

Forecasting Meal Participation in University Residential Dining Facilities

ABSTRACT The purpose of this study was to determine which forecasting model would most accurately predict meal participation at university residential dining facilities. Forecasting techniques including naïve, moving average (3 versions), and simple exponential smoothing were applied to data collected from two dining halls over 15 weeks. An analysis of the forecasting models using Mean Absolute Deviations (MAD), Mean Squared Errors (MSE), and Mean Absolute Percentage Errors (MAPE) indicated that simple mathematical forecasting techniques provided better predictions (MAPE ≤ 6.4%) than the naïve method in all cases studied. Moving average methods outperformed other methods 83% of the time. Implications are discussed.

School Meal Participation and Obesity Among Children

Understanding the role of school meal program participation in children's risk of obesity is critical to improving the weight status of America's children. The most complete and up‐to‐date data to address these issues is from the nationally representative data collected in the 2005 third School Nutrition Dietary Assessment Study (SNDA‐III). In this study, we will use SNDA‐III data to examine whether participation in the National School Lunch Program (NSLP) or School Breakfast Program (SBP) affects children's body mass index (BMI) or risk of obesity. This relationship will be estimated through multivariate analysis, with a wide range of variables controlling for confounding factors, including demographic and socioeconomic factors, physical activity, and parents’ perceptions of their child's dietary habits. To test the sensitivity of the results, we also estimate a propensity score model and instrumental variables model. Finally, we examine potential explanations for any observed effects of program participation on BMI, including children's overall food energy intake, intake of macronutrients such as fat and cholesterol, and patterns of food consumption over the course of a day.

Food and Weight-Related Patterns and Behaviors of Hmong Adolescents

Objective Little is known about the food and weight-related behaviors of Hmong adolescents. This study assessed these behaviors in Hmong adolescents and determined if they differed between Hmong and white teens or by country of birth. Design School-based cross-sectional study. Subjects/setting Hmong (n=649) and white (n=2,260) adolescents from 31 public middle and high schools in the Minneapolis/St Paul, MN, metropolitan area who participated in Project EAT (Eating Among Teens). Main outcome measures Family meals, grocery shopping, and meal preparation; consumption of breakfast, snacks, and fast foods, physical activity and inactivity; body satisfaction, weight concern, body mass index, and weight-control behaviors. Statistical analyses performed Variables were compared across race/ethnicity and by country of birth using χ 2 tests and general linear model regression. Results Hmong students reported greater participation in family meals and more involvement with food purchasing and preparation. Fast-food consumption was similar among groups. Hmong teens reported less frequent breakfast consumption. The prevalence of overweight was higher in Hmong male adolescents than white male adolescents, but similar among female adolescents. Hmong students reported higher levels of weight concern, body dissatisfaction, dieting, unhealthful weight-control behaviors, less physical activity, and more inactivity than white students. Hmong male adolescents participated in extreme unhealthful weight-control behaviors four times more often than white male adolescents. Conclusions Hmong adolescents appear to be at increased risk for obesity, body dissatisfaction, and unhealthful weight-control behaviors compared to white adolescents. There is a need for culturally tailored interventions to address these nutrition and weight issues among Hmong adolescents.

Promoting Family Meals in WIC: Lessons Learned from a Statewide Initiative

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in Washington State developed a module to be used at local WIC agencies to promote family meals. Needs assessment and formative evaluation ensured that the module met the needs of WIC staff and clients. The Promoting Family Meals module includes background information on family meals, tools for training WIC staff, outlines for group sessions, handouts tailored to each client’s stage of change, children’s coloring sheets, bookmarks, banners, and posters. After the first 6 months of use, there was a statistically significant (F = 26.17, df = 3, P < .001) increase in family meal participation in intervention agencies as compared to controls.

397 Do Eating Habits have an Effect on Obesity Among Greek Adolescents?

Introduction: It has been shown that there is a high prevalence of overweight and obese children at 7 and 18 years in Greece, but there is limited information from the literature regarding their eating habits.Aim: To identify a possible association of eating habits among adolescents with their body mass index (BMI) at 18 years. Population and method: Individuals were 3415 adolescents born in April 1983, who responded to pre-coded questionnaires sent out through the high schools of the country. The self-reported data was examined using multiple linear regression analysis with BMI as the dependent variable. Independent variables were breakfast meals, devouring large amounts of food, stress-related eating, participation in family meals, consumption of home-delivery food, eating elsewhere- not at home and gender.Results: Adolescents that have breakfast daily (p<0.001) or 1–3 times a week (p=0.008) have lower BMI. Youngsters who often eat elsewhere, not at home, also have a lower BMI (p=0.001). In contrast, devouring large amounts of food (p<0.001) and stress-related eating (p<0.001) are significant risk factors for higher BMI. Differences appeared when stratified by gender. BMI for grls rises when devouring large amounts of food (p=0,003), whereas this was non-statistically significant for boys. BMI for boy decreases when they often order home-delivery food (p=0.04), which was found to be non-statistically significant for girls.Conclusions: Greek families need to realize the contribution of breakfast to body shape, as it is one of the most important meals of the day. Obesity prevention programs ought to establish healthy eating habits from an early age. Alternative methods to deal with stress, rather than eating, need to be promoted.

The “Family Meal”: Views of Adolescents

The study objectives were to (1) increase our knowledge about family meal patterns of adolescents, (2) identify factors that adolescents perceive as reasons for not eating meals with their family, and (3) assess adolescents’ perceptions on whether they eat more healthful foods at family meals than in other eating situations. Focus group discussions were conducted with 141 adolescents from 7th and 10th grade health education classes from urban public junior and senior high schools in Minnesota. Twenty-one focus groups were audiotaped, tapes were transcribed verbatim, transcripts were reviewed for emerging themes, and themes were coded using content analysis procedures. For some adolescents, family meals were part of their daily routine, whereas for others, family meals were not the norm. Diversity also existed with regard to the context of family meals, such as activities during meals and settings for meals. Major reasons for not having meals as a family included parent and teen schedules, teen desire for autonomy, dissatisfaction with family relations, and dislike of food served at family meals. Most of the adolescents thought that they would eat more healthful foods if they ate more often with their families. Key factors that appeared to influence whether participation in family meals would lead to a more healthful diet included food availability at meals, rules around mealtimes, and health-related attitudes of family members. There is great diversity in both the quantity and quality of meals in the families of adolescents. Health care providers working with youth and their families should inquire about family meals and encourage the practice of eating with family members, taking into account what is feasible for a particular family.

Nutritional Screening Of Utah Rural And Urban Elderly

LEARNING OUTCOME: To identify three demographic variables associated with nutrition risk and the overall prevalence of nutrition risk among congregate meal participants in Utah.This study was designed to determine the degree of nutritional risk present within the elderly population in rural and urban areas in the state of Utah by conducting an initial nutrition screening using the Determine Your Nutritional Health checklist developed by the Nutrition Screening Initiative. Congregate meal sites were stratified according to urbanization and fifteen centers were selected from both rural and urban counties. Participants at each site completed a Determine Your Nutritional Health checklist and survey asking demographic data including age, sex, marital status, living situation, frequency of participation in congregate meals, and if they had previously used the checklist.A total of 838 valid surveys was collected from 29 congregate meals sites throughout the state of Utah. Fifty-seven percent of participants scored in the “utritional health”ory, 27.7 percent were at moderate nutrition risk, and 15.4 percent scored in the high nutrition risk category. Checklist statements one, seven, and eight (“I have an illness or condition that made me change the kind and/or amount of food I eat” ; “I eat alone most of the time” ; and “I take 3 or more different prescribed or over-the-counter drugs a day”) had the highest percentages of positive responses at 28.9,33.1, and 39.7 percent, respectively.Nutrition risk category was significantly associated with gender (P=0.04), marital status (P=0.00), and cohabitation status (P=0.00). Women, unmarrieds, and individuals living alone scored more frequently in a higher nutrition risk category.Results of this study reflect influences on nutrition risk found in a sample of congregate meal participants in the state of Utah. These results can help the state of Utah identify the common risk factors within this segment of its population, i.e. gender, marital status, cohabitation status, acute/chronic disease, eating alone, and polypharmacy, to plan education and/or intervention for individuals who are at risk.

Influence of selected psychosocial factors on dietary intake in the elderly.

The rapidly increasing elderly population in the United States is causing mounting concerns about their health and well-being. Diet is an important part of health. The objective of this study was to see if gender, marital status and congregate meal participation influenced dietary intake in the non-institutionalized elderly. The randomly selected 290 elderly men and women were interviewed using food frequency and diet history methods. Men had a better nutrient intake than women for selected nutrients. Single elderly of both sexes had a better nutrient intake than the married elderly. Congregate meal participants had a poorer nutrient intake than the non-participants.