Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial

Carolyn Gunther, Catherine Rogers, Christopher Holloman, Laura C Hopkins, Sarah E Anderson, Carla K Miller, Kristen A Copeland, Jamie S Dollahite, Keeley J Pratt, Alison Webster, Allison N Labyk, Christine Penicka, Carolyn Gunther, Catherine Rogers, Christopher Holloman, Laura C Hopkins, Sarah E Anderson, Carla K Miller, Kristen A Copeland, Jamie S Dollahite, Keeley J Pratt, Alison Webster, Allison N Labyk, Christine Penicka

Abstract

Background: Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2).

Methods: Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2).

Results: One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills.

Conclusions: Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity.

Trial registration: NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.

Keywords: Blood pressure; Childhood obesity; Family meals; Food preparation skills; Racial minority.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT Flow Diagram of the 10-Week Quasi-Experimentally Designed Simple Suppers Study for 4- to 10-Year Old Children

References

    1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief. 2017;288:1–8. doi: 10.1017/S1368980017000088.
    1. Hales CM, Fryar CD, Carroll MD, Freedman DSOC. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018;319(16):1723–1725. doi: 10.1001/jama.2018.3060.
    1. Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and Socioeconomic Status in Children and Adolescents: United States, 2005–2008. Vol 127.; 2010.
    1. Halfon N, Larson K, Slusser W. Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Acad Pediatr. 2013;13(1):6–13. doi: 10.1016/j.acap.2012.10.007.
    1. Taras H, Potts-Datema W. Obesity and student performance at school. J Sch Health. 2005;75(8):291–295. doi: 10.1111/j.1746-1561.2005.00040.x.
    1. Barlow SE. Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007;120(Supplement):S164–S192. doi: 10.1542/peds.2007-2329C.
    1. Berge JM, Wall M, Hsueh T, Fulkerson JA, Larson N, Neumark-sztainer D. The protective role of family meals for youth obesity: 10-year longitudinal associations. J Pediatr. 2015;166(2):296–301. doi: 10.1016/j.jpeds.2014.08.030.
    1. Cason K. Family mealtimes: more than just eating together. J Acad Nutr Diet. 2006;106(4):432–433.
    1. Fulkerson JA, Larson N, Horning M, Neumark-sztainer D. A review of associations between family or shared meal frequency and dietary and weight status outcomes across the lifespan. J Nutr Educ Behav. 2014;46(1):2–19. doi: 10.1016/j.jneb.2013.07.012.
    1. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127(6):e1565–e1574. doi: 10.1542/peds.2010-1440.
    1. 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. J Am Diet Assoc. 2007;107(9):1502–1510. doi: 10.1016/j.jada.2007.06.012.
    1. Skafida V. The family meal panacea: exploring how different aspects of family meal occurrence, meal habits and meal enjoyment relate to young children’s diets. Sociol Heal Illn. 2013;35(6):906–923. doi: 10.1111/1467-9566.12007.
    1. Videon TMC. Influences on adolescent eating patterns: the importance of family meals. J Adolesc Health. 2003;32(5):365–373. doi: 10.1016/S1054-139X(02)00711-5.
    1. Welsh EM, French SA, Wall M. Examining the relationship between family meal frequency and individual dietary intake: does family cohesion play a role? J Nutr Educ Behav. 2011;43(4):229–235. doi: 10.1016/j.jneb.2010.03.009.
    1. Dallacker M, Hertwig R, Mata J. The frequency of family meals and nutritional health in children: a meta-analysis. Obes Rev. 2018;19(5):638–653. doi: 10.1111/obr.12659.
    1. Fink SK, Racine EF, Mueffelmann RE, Dean MN, Herman-Smith R. Family meals and diet quality among children and adolescents in North Carolina. J Nutr Educ Behav. 2014;46(5):418–422. doi: 10.1016/j.jneb.2014.05.004.
    1. 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. J Am Diet Assoc. 2007;107(1):53–61. doi: 10.1016/j.jada.2006.10.010.
    1. 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. J Am Diet Assoc. 2010;110(9):1335–1339. doi: 10.1016/j.jada.2010.06.004.
    1. 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. Eur J Clin Nutr. 2010;64(5):454–460. doi: 10.1038/ejcn.2010.14.
    1. Lee HJ, Lee SY, Park EC. Do family meals affect childhood overweight or obesity?: nationwide survey 2008-2012. Pediatr Obes. 2016;11(3):161–165. doi: 10.1111/ijpo.12035.
    1. Valdés J, Rodríguez-Artalejo F, Aguilar L, Jaén-Casquero MB, Royo-Bordonada MA. Frequency of family meals and childhood overweight: a systematic review. Pediatr Obes. 2013;8(1):1–14. doi: 10.1111/j.I2047T-6310.201Y2.00104.x.
    1. Fulkerson JA, Rydell S, Kubik MY, et al. Healthy home offerings via the mealtime environment (HOME): feasibility, acceptability, and outcomes of a pilot study. Obesity. 2010;18(n1s):S69–S74. doi: 10.1038/oby.2009.434.
    1. Fulkerson JA, Neumark-Sztainer D, Story M, et al. The healthy home offerings via the mealtime environment (HOME) plus study: design and methods. Contemp Clin Trials. 2014;38(1):59–68. doi: 10.1016/j.cct.2014.01.006.
    1. Fulkerson JA, Friend S, Flattum C, et al. Promoting healthful family meals to prevent obesity : HOME Plus , a randomized controlled trial. Int J Behav Nutr Phys Act. 2015:1–12. 10.1186/s12966-015-0320-3.
    1. Dwyer L, Oh A, Patrick H, Hennessy E. Promoting family meals: a review of existing interventions and opportunities for future research. Adolesc Health Med Ther. 2015;6:115–131. doi: 10.2147/AHMT.S37316.
    1. Bird Chris, Michie Colin. Measuring blood pressure in children. BMJ. 2008;336(7657):1321–1321. doi: 10.1136/bmj.a150.
    1. Fulkerson JA, Neumark-Sztainer D, Hannan PJ, Story M. Family meal frequency and weight status among adolescents: cross-sectional and 5-year longitudinal associations. Obesity. 2008;16(11):2529–2534. doi: 10.1038/oby.2008.388.
    1. Neumark-Sztainer D, Eisenberg ME, Fulkerson JA, Story M, Larson N. Family meals and disordered eating. Arch Pediatr Adolesc Med. 2008;162(1):17–22. doi: 10.1001/archpediatrics.2007.9.
    1. Neumark-Sztainer D, Wall M, Story M, Fulkerson JA. Are family meal patterns associated with disordered eating behaviors among adolescents? J Adolesc Health. 2004;35(5):350–359. doi: 10.1016/j.jadohealth.2004.01.004.
    1. Anderson LN, Lebovic G, Hamilton J, et al. Body mass index, waist circumference, and the clustering of Cardiometabolic risk factors in early childhood. Paediatr Perinat Epidemiol. 2016;30(2):160–170. doi: 10.1111/ppe.12268.
    1. Ramirez-Silva Ivonne, Rivera Juan A, Trejo-Valdivia Belem, Stein Aryeh D, Martorell Reynaldo, Romieu Isabelle, Barraza-Villarreal Albino, Avila-Jiménez Laura, Ramakrishnan Usha. Relative Weight Gain Through Age 4 Years Is Associated with Increased Adiposity, and Higher Blood Pressure and Insulinemia at 4–5 Years of Age in Mexican Children. The Journal of Nutrition. 2018;148(7):1135–1143. doi: 10.1093/jn/nxy068.
    1. Freemark M. Predictors of childhood obesity and pathogenesis of comorbidities. Pediatr Ann. 2014;43(9):357–360. doi: 10.3928/00904481-20140825-06.
    1. Birch L, Arbor A, Savage JS, Ventura A. From infancy to adolescence. Can J Diet Pr Res. 2009;68(1):1–11. doi: 10.1097/MD.0000000000000215.
    1. Hunter JG, Cason KL. Kids in the kitchen-. Clemson University Cooperative Extension- Home and Garden Information Center .
    1. Verhage CL, Gillebaart M, van der Veek SMC, Vereijken CMJL. The relation between family meals and health of infants and toddlers: a review. Appetite. 2018;127(April):97–109. doi: 10.1016/j.appet.2018.04.010.
    1. Rogers C, Anderson SE, Dollahite JS, et al. Methods and design of a 10-week multi-component family meals intervention: A two group quasi-experimental effectiveness trial. BMC Public Health. 2017;17(1). 10.1186/s12889-016-3908-x.
    1. Bartholomew LK, Parcel GS, Kok G. Intervention mapping: a process for developing theory- and evidence-based health education programs. Heal EducBehav. 1998;25(5):545–563. doi: 10.1177/109019819802500502.
    1. Bandura A. Social cognitive theory. 1989. pp. 1–60.
    1. Blumberg J, Bialostosky K, Hamilton WL, Briefel RR. U.S. household food security survey module: six-item short form. Am J Public Health. 1999;89(September):1231–1234. doi: 10.2105/AJPH.89.8.1231.
    1. Burrows TL, Martin RJ, Collins CE. A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water. J Am Diet Assoc. 2010;110(10):1501–1510. doi: 10.1016/j.jada.2010.07.008.
    1. Bliss R. Researchers produce innovation in dietary recall. U.S. Dept. of Agriculture: Agricultural Research Service; 2004.
    1. University of Minnesota Nutrition Coordinating Center. Nutrition Data System for Research. 2015. .
    1. Guenther P, Casavale K, Kirkpatrick S, Reedy J. Update of the healthy eating index: HEI-2010. J Acad Nutr Diet. 2014;113(4):1–20. doi: 10.1016/j.jand.2012.12.016.Update.
    1. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign IL: Human Kinetics Books; 1988.
    1. Centres for Disease Control and Prevention. Anthropometry procedures manual. Natl Heal Nutr examinatory Surv. 2007;(January):102. .
    1. Growth Charts - Z-score Data Files. CDC National Center for Health Statistics. .
    1. Fryar CD, Gu Q, Ogden CL. Anthropometric reference data for children and adults: United States, 2007–2010. Vital Health Stat 11. 2012;(252):1–48. . Accessed January 28, 2019.
    1. Nhlbi. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Bethesda, MD; 2004. .
    1. Corporation IBM. SPSS software 24. 2017.
    1. Statistical R. .
    1. Muzaffar H, Metcalfe JJ, Fiese B. Narrative review of culinary interventions with children in schools to promote healthy eating: directions for future research and practice. Curr Dev Nutr. 2018;2(6):1–10. doi: 10.1093/cdn/nzy016.
    1. Utter J, Larson N, Laska MN, Winkler M, Neumark-Sztainer D. Self-perceived cooking skills in emerging adulthood predict better dietary behaviors and intake 10 years later: a longitudinal study. J Nutr Educ Behav. 2018;50(5):494–500. doi: 10.1016/j.jneb.2018.01.021.
    1. Allirot X, da Quinta N, Chokupermal K, Urdaneta E. Involving children in cooking activities: a potential strategy for directing food choices toward novel foods containing vegetables. Appetite. 2016;103:275–285. doi: 10.1016/j.appet.2016.04.031.
    1. Méjean C, Lampuré A, Si Hassen W, et al. Influence of food preparation behaviors on 5-year weight change and obesity risk in a French prospective cohort. Int J Behav Nutr Phys Act. 2018;15(1):120. doi: 10.1186/s12966-018-0747-4.
    1. Clifford Astbury C, Penney TL, Adams J. Comparison of individuals with low versus high consumption of home-prepared food in a group with universally high dietary quality: a cross-sectional analysis of the UK National Diet &amp; nutrition survey (2008–2016) Int J Behav Nutr Phys Act. 2019;16(1):9. doi: 10.1186/s12966-019-0768-7.
    1. Avery A, Anderson C, McCullough F. Associations between children’s diet quality and watching television during meal or snack consumption: A systematic review. Matern Child Nutr. 2017;13(4). 10.1111/mcn.12428.
    1. Vik Frøydis N, Bjørnarå Helga, Øverby Nina C, Lien Nanna, Androutsos Odysseas, Maes Lea, Jan Natasa, Kovacs Eva, Moreno Luis A, Dössegger Alain, Manios Yannis, Brug Johannes, Bere Elling. Associations between eating meals, watching TV while eating meals and weight status among children, ages 10–12 years in eight European countries: the ENERGY cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity. 2013;10(1):58. doi: 10.1186/1479-5868-10-58.
    1. Trofholz Amanda C., Tate Allan, Loth Katie, Neumark-Sztainer Dianne, Berge Jerica M. Watching Television while Eating: Associations with Dietary Intake and Weight Status among a Diverse Sample of Young Children. Journal of the Academy of Nutrition and Dietetics. 2019;119(9):1462–1469. doi: 10.1016/j.jand.2019.02.013.
    1. Trofholz AC, Tate AD, Miner MHBJ. Associations between TV viewing at family meals and the emotional atmosphere of the meal, meal healthfulness, child dietary intake, and child weight status. Appetite. 2017;180:361–366. doi: 10.1016/j.appet.2016.10.018.
    1. Kasper N, Mandell C, Ball S, Miller AL, Lumeng J, Peterson KE. The healthy meal index: a tool for measuring the healthfulness of meals served to children. Appetite. 2016;103:54–63. doi: 10.1016/j.appet.2016.02.160.
    1. Sexton K, Greaves IA, Church TR, et al. A school-based strategy to assess children's environmental exposures and related health effects in economically disadvantaged urban neighborhoods. J Expo Sci Environ Epidemiol. 2010;10:682–694. doi: 10.1038/sj.jea.7500132.
    1. Boushey C J, Kerr D A, Wright J, Lutes K D, Ebert D S, Delp E J. Use of technology in children’s dietary assessment. European Journal of Clinical Nutrition. 2009;63(S1):S50–S57. doi: 10.1038/ejcn.2008.65.
    1. Allman-Farinelli M, Gemming L. Technology interventions to manage food intake: where are we now? Curr Diab Rep. 2017;17(11):103. doi: 10.1007/s11892-017-0937-5.
    1. Casperson SL, Sieling J, Moon J, Johnson L, Roemmich JN, Whigham L. A Mobile phone food record app to digitally capture dietary intake for adolescents in a free-living environment: usability study. JMIR mHealth uHealth. 2015;3(1):e30. doi: 10.2196/mhealth.3324.
    1. Hunter J, Cason K. Kids in the kitchen. South Carolina: Clemson; 2008.
    1. McGowan HM, Nix RL, Murphy SA, Bierman KL. Investigating the impact of selection bias in dose-response analyses of preventive interventions. Prev Sci. 2010;11(3):239–251. doi: 10.1007/s11121-010-0169-2.
    1. Pyatak EA, Carandang K, Vigen CLP, et al. Occupational therapy intervention improves glycemic control and quality of life among young adults with diabetes: the resilient, empowered, active living with diabetes (REAL diabetes) randomized controlled trial. Diabetes Care. 2018;41(4):696–704. doi: 10.2337/dc17-1634.
    1. Fulkerson JA, Farbakhsh K, Lytle L, et al. Away-from-home family dinner sources and associations with weight status, body composition, and related biomarkers of chronic disease among adolescents and their parents. J Am Diet Assoc. 2011;111(12):1892–1897. doi: 10.1016/j.jada.2011.09.035.
    1. Davis JN, Ventura EE, Cook LT, Gyllenhammer LE, Gatto NM. LA sprouts: a gardening, nutrition, and cooking intervention for Latino youth improves diet and reduces obesity. J Am Diet Assoc. 2011;111(8):1224–1230. doi: 10.1016/j.jada.2011.05.009.
    1. Pastor-Barriuso Roberto, Banegas Jos R., Damin Javier, Appel Lawrence J., Guallar Eliseo. Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure: An Evaluation of Their Joint Effect on Mortality. Annals of Internal Medicine. 2003;139(9):731. doi: 10.7326/0003-4819-139-9-200311040-00007.
    1. Fruh SM, Mulekar MS, Crook E, Hall HR, Adams J, Lemley T. The family meal challenge. J Christ Nurs. 2018;35(3):191–197. doi: 10.1097/CNJ.0000000000000503.
    1. Anderson JD, Newby R, Kehm R, Barland P, Hearst MO. Taking steps together: a family- and community-based obesity intervention for urban, Multiethnic Children. Heal Educ Behav. 2015;42(2):194–201. doi: 10.1177/1090198114547813.
    1. Davis DS, Goldmon MV, Coker-Appiah DS. Using a community-based participatory research approach to develop a faith-based obesity intervention for African American children. Health Promot Pract. 2011;12(6):811–822. doi: 10.1177/1524839910376162.
    1. Lutz A. Cost to eat at every major fast food chain - Business Insider. Business Insider. . Published 2015.
    1. Kneipp SM, Lutz BJ, Levonian C, Cook C, Hamilton JB, Roberson D. Women’s experiences in a community-based participatory research randomized controlled trial. Qual Health Res. 2013;23(6):847–860. doi: 10.1177/1049732313483924.
    1. Mode NA, Evans MK, Zonderman AB. Race, neighborhood economic status, income inequality and mortality. PLoS One. 2016;11(5):1–15. doi: 10.1371/journal.pone.0154535.
    1. Foster E, Bradley J. Methodological considerations and future insights for 24-hour dietary recall assessment in children. Nutr Res. 2018;51:1–11. doi: 10.1016/j.nutres.2017.11.001.
    1. Gibson RS, Charrondiere UR, Bell W. Measurement errors in dietary assessment using self-reported 24-hour recalls in low-income countries and strategies for their prevention. Adv Nutr An Int Rev J. 2018;8(6):980–991. doi: 10.3945/an.117.016980.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe