May 26, 2009

McDonalds or McFamily?

Adolescents have notoriously poor diets. They skip meals, and eat fast foods and snacks high in calories. Fat and sugar replace vegetables, fruits and other nutritious foods.

A National Health and Nutrition Examination Survey spanning 1999 through 2002 showed that adolescent dietary intakes of fruits, vegetables, whole grains, and fiber rich foods are less than recommended, as are critical nutrients such as potassium magnesium and vitamins A and E and calcium. This has major implications for their health and well being during adolescence, their risk for being overweight/obese teens, their potential for premature onset of more typically adult diseases such as diabetes and high blood pressure, and their future risk of some chronic diseases and cancers.

Families can easily overcome the barriers to the family meal by designating certain nights as family nights, turning off the television, not taking phone calls during meals, and making a concerted effort to create the eating experience that was taken for granted in the past.

Family meals at home can influence teens, eating behaviors, by providing wholesome foods, by parents, modeling of healthful food choices, and by providing a social context for eating as a time of family togetherness and communication. However, multiple forces have eroded the traditional family dinner. The television intrudes, limiting talking and interpersonal relating. Working mothers and single parent families with too little time to cook often rely on convenient or fast foods that have been prepared outside the home.

As children progress through adolescence, typical developmental tensions erupt and teens tend to avoid mealtime confrontations and escape the parental radar. Sports practices, after school interests, homework and other commitments often fragment the family schedule in the late afternoon and early evening. Without a determined effort, many families find it impossible to sit down regularly to dine together.

A new study, reported in the February issue of the Journal of Nutrition Education and Behavior has found that parents who are able to buck this trend, particularly while their children are in middle school, will find they have laid the foundation for a lifetime of healthy eating at the family dinner table.

Building on previous research, investigators began with a group of middle school students in 1998-99 whose mean age was 12.8 and revisited the same group five years later in 2003-04 when their mean age was 17.2. They used a standardized food frequency questionnaire and only included students who were available to complete the study at both times. They surveyed family eating patterns, defining regular family meals as eating five or more meals with most members of the household present. They surveyed frequency of eating fast foods, fruits, vegetables, (including dark green and orange vegetables), whole grains, calcium rich foods and soft drinks. They also assessed calories, total and saturated fat, and calcium and mineral intake.

While in middle school, 38% of the students reported regular family meals. Five years later only 8% reported regular family meals and only 2% reported regular family meals during both middle school and high school. The late adolescent group revealed that teens who had had regular family meals in middle school, were more likely to eat breakfast, lunch and dinner as older teens. Males who reported regular family meals in middle school reported fewer fast food meals later on. Regular family meals in middle school were positively associated with daily intake of vegetables, calcium, fiber, and nutrient rich foods five years later, though the diets, while better than their peers, still did not always meet recommended standards.

Because the family eating experience in middle school continued to be influential five years later, even in the face of declining family meals, this study suggests that parents and doctors should consider the family meal as a potentially influential tool, especially in early to middle adolescence when the normal conflicts associated with adolescents' autonomy are less intrusive into family dynamics. Families can easily overcome the barriers to the family meal by designating certain nights as family nights, turning off the television, not taking phone calls during meals, and making a concerted effort to create the eating experience that was taken for granted in the past.

Parents can use these family meals to take the opportunity to discuss menu choices, food preparation and perhaps explore with their teens how they can continue to make good choices when they are away from home. These lessons, in addition to the family meal itself, are all worth considering because they may help reduce the health risks our teens are facing with their current nutritional practices. Unless addressed, these risks will produce a huge personal and societal burden of health problems down the road.

Many restaurants, including fast food restaurants, now post caloric and fat content of foods. Teaching teens to read labels, showing them comparisons, and teaching them that healthy food and tasty food are not mutually exclusive nor difficult to buy or prepare are all ways parents can promote the future health of their children.
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