Not screens but their context of use impact cognitive development: a commentary on Yang et al. (2023).

There have been extensive debates about the impact of the digital transformation on human development. A recent study by Yang and colleagues highlights the importance of considering context of use, beyond amount of use. In their study, children from parents who reported having TV-on during family meals when they were 2 years old showed poorer cognitive development at age 3.5 as compared to those with TV-off during family meals. This highlights the importance of considering the context of use when studying effect of screen use. While Yang et al. discuss the distracting effects of TV-on sensory processing, we propose an alternative - and not mutually exclusive - interpretation based on TV induced deprivation of family interactions. On a more practical note, this should encourage to preserve screen-free time, especially during structured time such as family meals, in order to maintain family interactions known to be critical to development.

Mothers' experiences of reducing family mealtime screen use in Australian households with young children.

OBJECTIVE: Screen use at mealtimes is associated with poor dietary and psychosocial outcomes in children and is disproportionately prevalent among families of low socio-economic position (SEP). This study aimed to explore experiences of reducing mealtime screen use in mothers of low SEP with young children. DESIGN: Motivational interviews, conducted via Zoom or telephone, addressed barriers and facilitators to reducing mealtime screen use. Following motivational interviews, participants co-designed mealtime screen use reduction strategies and trialled these for 3-4 weeks. Follow-up semi-structured interviews then explored maternal experiences of implementing strategies, including successes and difficulties. Transcripts were analysed thematically. SETTING: Australia. PARTICIPANTS: Fourteen mothers who had no university education and a child between six months and six years old. RESULTS: A range of strategies aimed to reduce mealtime screen use were co-designed. The most widely used strategies included changing mealtime location and parental modelling of expected behaviours. Experiences were influenced by mothers' levels of parenting self-efficacy and mealtime consistency, included changes to mealtime foods and an increased value of mealtimes. Experiences were reportedly easier, more beneficial and offered more opportunities for family communication, than anticipated. Change required considerable effort. However, effort decreased with consistency. CONCLUSIONS: The diverse strategies co-designed by mothers highlight the importance of understanding why families engage in mealtime screen use and providing tailored advice for reduction. Although promising themes were identified, in this motivated sample, changing established mealtime screen use habits still required substantial effort. Embedding screen-free mealtime messaging into nutrition promotion from the inception of eating will be important.

Foodservice: Serafico Institute Experience.

BACKGROUND: Foodservice has an important role in health care: it is an indispensable tool for the prevention and treatment of diseases related to an impaired state of nutrition. The foodservice must reach an optimal level for nutritional and sensory quality, fundamental aspects for preparations aimed at users with physical and intellectual disabilities. The Serafico Institute in Assisi (SA) is a health care facility that houses disabled users and is concerned with their rehabilitation and with guaranteeing them an optimal quality of life. Our food model of reference is the Mediterranean Diet: widely studied and validated for the prevention of chronic degenerative diseases. Dietary proposals change throughout the year following the alternation of seasons, holidays and religious festivities. SUBJECTS: The SA currently houses 82 resident and 27 semi-resident users. Residents range in age from 11 to 52 and are housed in 5 different dwellings, eating all meals internally: breakfast, lunch, dinner and one or two snacks according to personal needs. Semi-residents attend SA only during daytime hours are divided into two groups according to their age: infancy and adult. They do not all attend for the whole week. They only consume lunch internally. RESULTS: The goal of our foodservice experience is to protect the sensory and nutritional quality of our users to ensure their adequate living and health conditions.Meals provided must first and foremost guarantee the requirements of food safety and food security, adapting the definitions themselves to the context, considering them an irreplaceable complement to the pathways of prevention and treatment. They represent an indispensable tool in the prevention and treatment of many diseases. Malnutrition by default or excess has a high impact on health management of individual users, representing often the "disease within a disease." The repercussion on their quality of life and care costs is known and therefore it is to be managed carefully and by promoting as much as possible the culture of prevention. CONCLUSIONS: Food is nourishment for the soul and the body. Celebrating anniversaries, birthdays, celebrating every single day becomes an opportunity to give dignity to each of our youngsters, recognizing their physiological and emotional needs, the need to share the experience with others. Mealtime is an important time for every real or acquired family; it is a privileged relationship occasion in which we have the opportunity to develop numerous aspects central to the growth of each of us. We strongly believe that the dignity of each and every one of our yongsters also comes from the care we take in their nutrition and the way it is administered.

Comer en familia: su relación con la comunicación familiar y la agresividad de los adolescentes / Family meals: its relationship with family communication and adolescent aggression

La sociedad postmoderna ha transformado muchas conductas familiares, entre ellas, la comunicación familiar y el hábito de comer en familia, práctica que ha disminuido en España en las últimas décadas, al tiempo que han aumentado la agresividad y las conductas violentas en adolescentes. El objetivo principal de este trabajo fue determinar la relación de la frecuencia de comidas en familia con la comunicación familiar y con la agresividad en población adolescente. Participaron 1117 adolescentes (51.1% mujeres y 48.9% varones), entre 14 y 18 años (M = 16.20; DT = 1.31), procedentes de 23 centros educativos, 10 grados universitarios y 18 centros específicos de menores de Castilla y León (España). Se utilizó el Cuestionario de Agresividad de Buss y Perry (BPAQ) y la Escala de Comunicación Familiar (FCS). Los resultados muestran que la ausencia de comidas en familia está asociada con un descenso de la comunicación familiar y un aumento de la agresividad física, la ira y la hostilidad del adolescente. Si comer en familia va acompañado de comunicación familiar, una mayor frecuencia de comidas en familia se relaciona con una disminución de las tres dimensiones mencionadas de la agresividad. Sin embargo, si se deja al margen la influencia de la comunicación familiar, comer frecuentemente en familia se relaciona con una reducción de la agresividad (física, ira y hostilidad), pero comer siempre en familia está asociado con un nuevo incremento de la agresividad física y hostilidad. Los hallazgos revelan la importancia de potenciar las comidas en familia y la comunicación familiar. (AU)

Postmodern society has modified many family behaviors, among them, family communication and the habit of eating together as a family, a practice that has decreased in Spain in the last decades while aggressiveness and violent behaviors in adolescents have increased. The main objective of the present study was to determine the relationship between the frequency of family meals with family communication and with aggression in adolescent population. 1117 adolescents (51.1% female and 48.9% male), aged between 14 and 18 years (M = 16.20; SD = 1.31), from 23 educational centers, 10 university grades, and 18 specific juvenile centers in Castilla y León (Spain) participated in the study. The Buss and Perry Aggression Questionnaire (BPAQ) and the Family Communication Scale (FCS) were used. The results show that the absence of family meals is associated with a decrease in family communication and an increase in adolescent physical aggression, anger, and hostility. If family meals are accompanied by family communication, a higher frequency of family meals is associated with a decrease in the three aforementioned dimensions of aggression. However, if the influence of family communication is left out, eating frequently as a family is related to a reduction in physical aggression, anger and hostility, but always eating as a family is associated with a new increase in physical aggression and hostility. Findings reveal the importance of enhancing family meals and family communication. (AU)

The contribution of Australian fathers in getting food on the table among families with young children.

OBJECTIVE: To explore how fathers with young children contributed to healthy home food provisioning and the factors enabling or inhibiting their involvement in family food tasks. DESIGN: Cross-sectional study using purpose-designed online survey. The survey assessed the level of responsibilities and practices in family food tasks, food agency (Cooking and Food Provisioning Action Scale), and use of resources to support involvement in family food tasks. Data collection took place over 3 weeks in November-December 2020 when various COVID-19-related restrictions were in place. Descriptive and regression analyses were used to assess psychosocial factors influencing responsibilities in family food tasks and food agency. SETTING: Online survey. PARTICIPANTS: Included in the analysis were 435 Australian fathers with children aged under 5 years. RESULTS: Between 75 and 77 % of fathers in this study reported having at least half of the responsibilities in meal planning, shopping, and cooking. Health was frequently considered when deciding what to eat, but few used nutrition or food labels when shopping, tried new recipes or modified recipes to make them healthier. Involvement in family food tasks was promoted by a higher food agency, but time spent in employment was a significant barrier to reported food agency and greater involvement in food tasks. There was a high interest in resources to support healthy home food provisioning. CONCLUSIONS: The findings suggest the need to consider father-specific strategies to overcome time barriers and opportunities to enhance their capabilities for healthy home food provisioning.

Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions.

Systematic reviews have examined the multitude of studies investigating family mealtimes and their importance to child/adolescent health and psychosocial outcomes, but the focus of each is limited to specific aspects of family meals (e.g., frequency) and/or specific outcomes (e.g., nutrition). Their findings require synthesis and so a systematic umbrella review was undertaken. Databases were searched to identify systematic reviews (with or without meta-analysis/meta-synthesis) addressing at least one of the following questions: what are the characteristics and/or correlates of family mealtimes; what outcomes are associated with family mealtimes; are interventions aimed at promoting family mealtimes effective? Forty-one eligible reviews were retrieved. Their findings demonstrate that families with children/adolescents typically eat together at least a few days each week. More frequent family meals are predicted by a more positive mealtime environment, more positive attitudes towards family meals, the presence of younger children, and families having more time. Greater family meal frequency protects children/adolescents against a poorer diet, obesity, risk behaviours, poorer mental health and wellbeing, and poorer academic outcomes. Findings from interventions seeking to promote family mealtimes are mixed. This umbrella review provides a comprehensive and integrated understanding of research into family mealtimes, establishing where evidence is sound and where further research is needed.

Leveraging ecological momentary assessment to understand variability in food parenting practices within a low-income racially/ethnically diverse sample of parents of preschoolers.

Children's eating behaviors are shaped significantly by their home food environment, including exposure to food parenting practices. The current study leveraged ecological momentary assessment (EMA) to describe how food parenting practices used to feed preschoolers (n = 116) differed across contextual factors around eating, including type of eating occasion (i.e., meals vs. snacks), day of the week (i.e., weekend vs. weekday), who initiated the meal (parent vs. child), emotional climate of the eating occasion. Parent perceptions of how well the eating occasion went, including how well the child ate and whether the food parenting practices worked as intended were also explored. Parent use of specific food parenting practices, situated within four higher-order domains (i.e., structure, autonomy support, coercive control, indulgent), was found to differ by type of eating occasion; parents engaged in a higher proportion of structure practices at meals than at snacks. Use of specific food parenting practices differed by mealtime emotional climate; parent use of structure and autonomy support was associated with eating occasions described as relaxed, enjoyable, neutral, and fun. Finally, parent perception of how well the child ate differed by use of specific food parenting practices; during eating occasions when parent's felt their child ate "not enough", they used less autonomy support and more coercive control compared to eating occasions where the child ate "enough and a good balance." Leveraging EMA allowed for increased understanding of the variability in food parenting practices and contextual factors. Findings may be utilized to inform the development of larger-scale studies seeking to understand why parents choose specific approaches to feeding their children, as well as the impact of various approaches to child feeding on child health outcomes.

The effect of adverse childhood experiences on family mealtime frequency: Examining racial and ethnic differences.

Eating meals as a family is associated with multiple positive nutritional and emotional outcomes for parents and children. Although the benefits of mealtimes extend to all families, families of color and those in poverty face disproportional barriers to eating frequent meals together. No previous study has properly attended to the heterogeneity of racial and ethnic groups in the United States when assessing mealtime barriers. Focusing on adverse childhood experiences (ACEs), our analyses tested whether an increased number of adversities, and particular types of adversities, were associated with a decrease in mealtime frequency for different racial/ethnic families in the United States. Utilizing a large, nationally representative sample of families (n = 59,963), results showed that higher cumulative ACE scores reduced the number of days a family eats meals together in a given week. For specific ACE items, seven out of nine individual ACE items were associated with decreased mealtimes (excluding parental death and racial discrimination). Stratification resulted in varied associations between accumulated and individual ACE items and mealtime frequency depending on racial/ethnic group. Asian families in particular had greater odds of infrequent meals than other families, while Native American, Alaskan Native, Pacific Islander, and other racial/ethnic families were unaffected by increased ACEs. Results indicate that a family's accumulation of multiple adversities may impede mealtimes by either forcing families to prioritize the management of other stressors or by depleting the physical and mental resources needed to establish a routine. Focusing on family cultural traditions as protective factors may be an area of future intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Alone but together: Cloud-based commensality benefits physical and mental health.

Cloud-based commensality refers to an eating scenario in which people are eating and videoconferencing with remote co-diners. We report two experiments designed to investigate whether cloud-based commensality can exert a positive effect on individuals' physical and mental health. In Experiment 1, the participants were asked to rate their expectations concerning their feelings when eating in the context of cloud-based commensality or solitary eating and to make food choices in each eating scenario. In Experiment 2, romantic couples were recruited to have meals in different eating scenarios in the laboratory and were asked to rate their emotions and close relationships. The results of the two experiments revealed that when engaging in cloud-based commensality, participants reduced their intake of meat dishes but did not increase their choices of meat dishes compared to solitary eating. Moreover, the results suggest that cloud-based commensality can alleviate negative feelings and promote positive emotions during periods of quarantine or non-quarantine and enhance close relationships for romantic couples. These findings demonstrate that cloud-based commensality is beneficial for individuals' physical and mental health and provide practical implications for utilizing social eating to promote healthy eating.

Adding mini meals to a nasogastric refeeding protocol for patients with eating disorders can be achieved on general hospital wards.

BACKGROUND: Treatment of medically compromised patients with eating disorders is difficult in general hospital wards. There is currently no consensus on the best feeding method; however, previous research has demonstrated the safety of using enteral feeding. Because an oral diet has benefits on psychological and behavioural pathways, concurrent feeding requires further investigation. The present study aimed to examine acceptability and safety of implementing mini meals to a previously nil-by-mouth 7-day enteral feeding protocol. METHODS: This was mixed methods research including a retrospective observational study and participant survey. Patients admitted to a tertiary hospital in Brisbane, Australia, between July 2020 and March 2021 were eligible. Eligible participants were provided mini meals from day 5. Type and quantity of meals consumed alongside clinical incident data were collected. The survey examined acceptability of mini meals. Descriptive statistics were used to interpret findings. Content analyses were conducted on survey responses. RESULTS: Sixty-four participants (95%, n = 57/60 female, 25.2 ± 8.9 years; 75%, n = 45/60 diagnosed with anorexia nervosa) were included. At least half of the participants consumed some or all of the mini meals at each meal period. No clinical incidents were reported. Twenty-six (50%, n = 26/52) surveys were returned. Half (54%, n = 14/26) agreed-strongly agreed that mini meals improved their experience. Eleven participants desired more choice in menu items. CONCLUSIONS: The present study found that introducing mini meals into an enteral feeding protocol is acceptable and safe for patients with eating disorders. Participants reported benefits in returning to eating; however, some items on the menu require reconsideration to enable increased consumption.

Are family meals and social eating behaviour associated with depression, anxiety, and stress in adolescents? The EHDLA study.

OBJECTIVE: This study examined the association between family meals and social eating behaviour with depression, anxiety and stress symptoms among Spanish adolescents. METHODS: This was a cross-sectional study with data obtained from a representative sample of adolescents aged 12-17 years from Valle de Ricote, Murcia, Spain. Emotional symptomatology was evaluated with the Depression, Anxiety and Stress Scale. The frequency of family meals and social eating behaviour were self-reported. RESULTS: Each additional point in social eating behaviour decreased the probability of having a higher number of depressive (OR = 0.83; 95% CI, 0.75-0.92), anxiety (OR = 0.88; 95% CI, 0.80-0.97) and stress (OR = 0.90; 95% CI, 0.82-0.99) symptoms. CONCLUSIONS: Higher social eating behaviour was associated with lower probabilities of higher number of depressive, anxiety and stress symptoms.

Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic.

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural-urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults.

Hospital Services to Improve Nutritional Intake and Reduce Food Waste: A Systematic Review.

BACKGROUND AND AIMS: Patients' nutritional intake is a crucial issue in modern hospitals, where the high prevalence of disease-related malnutrition may worsen clinical outcomes. On the other hand, food waste raises concerns in terms of sustainability and environmental burden. We conducted a systematic review to ascertain which hospital services could overcome both issues. METHODS: A systematic literature search following PRISMA guidelines was conducted across MEDLINE, Web of Science, and Scopus for randomised controlled trials (RCTs) and observational studies comparing the effect of hospital strategies on energy intake, protein intake, and plate/food waste. The quality of included studies was assessed using the Newcastle-Ottawa Scale for cohort studies and the Cochrane Risk of Bias tool from the Cochrane Handbook for Systematic Reviews of Interventions for RCTs. RESULTS: Nineteen studies were included, assessing as many hospital strategies such as food service systems-including catering and room service-(n = 9), protected mealtimes and volunteer feeding assistance (n = 4), food presentation strategies (n = 3), nutritional counseling and education (n = 2), plant-based proteins meal (n = 1). Given the heterogeneity of the included studies, the results were narratively analysed. CONCLUSIONS: Although the results should be confirmed by prospective and large sample-size studies, the personalisation of the meal and efficient room service may improve nutritional intake while decreasing food waste. Clinical nutritionist staff-especially dietitians-may increase food intake reducing food waste through active monitoring of the patients' nutritional needs.

Experiences of mealtime assistance delivered by volunteers: an extended literature review.

Trained mealtime volunteers are ideally situated to provide mealtime assistance to older patients in general hospital settings. Older patients are at risk of becoming undernourished and dehydrated while in hospital as a result of various factors, such as cognitive impairment and lack of mealtime assistance. This article details an extended literature review that was conducted to explore the lived experiences of older patients, staff, relatives and volunteers of mealtime assistance provided by volunteers. The findings suggest that continual use of mealtime volunteers in practice could improve the quality of care. Mealtime volunteers could be educated on the importance of communicating information pertaining to patients' food and fluid intake to enhance patient monitoring. Furthermore, additional training for mealtime volunteers could be streamlined and standardised to improve patient care and safety.

'It stopped you thinking about food' - The experiences of mealtimes and attending a post-meal support group for young people with anorexia nervosa.

Anorexia nervosa presents as an international public health concern as it is the mental health problem with the greatest risk of mortality, and the average age of onset is decreasing. For those experiencing anorexia nervosa, mealtimes have long been recognized as a difficult and distressing time when young people need additional support. However, the post mealtime period can be associated with even greater distress, yet there is little research on interventions to support young people in this vulnerable time, and even less on how young people experience these interventions. This study, therefore, explores young peoples' perceptions of mealtimes and a post mealtime support group. Using a qualitative descriptive design, telephone interviews were conducted with a purposive sample of six young people who participated in a post-meal support group while an inpatient in a Child and Adolescent Mental Health Unit. Using a semi-structured interview guide, participants were asked about their experiences of this support group and their perceptions of how to improve this intervention. Content analysis resulted in the development of three themes: 'The Challenges of Mealtimes and Post Mealtimes', 'The Benefits of Post-meal Support Groups', and 'Improving Unhelpful Aspects of Post-meal Support Groups'. Findings are reported in accordance with COREQ guidelines and suggest that for young people experiencing anorexia nervosa, post mealtimes are often more distressing than the meal itself and that participants found post-meal support groups to be a helpful intervention in reducing post-mealtime distress. Post-meal support groups can be improved by ensuring a consistent approach from staff and providing staff with the training and knowledge required to support those affected by eating disorders.

Daytime eating prevents mood vulnerability in night work.

Shift workers have a 25 to 40% higher risk of depression and anxiety partly due to a misalignment between the central circadian clock and daily environmental/behavioral cycles that may negatively affect mood and emotional well-being. Hence, evidence-based circadian interventions are required to prevent mood vulnerability in shift work settings. We used a stringently controlled 14-d circadian paradigm to assess mood vulnerability during simulated night work with either daytime and nighttime or daytime-only eating as compared with simulated day work (baseline). Simulated night work with daytime and nighttime eating increased depression-like mood levels by 26.2% (p-value adjusted using False Discovery Rates, pFDR = 0.001; effect-size r = 0.78) and anxiety-like mood levels by 16.1% (pFDR = 0.001; effect-size r = 0.47) compared to baseline, whereas this did not occur with simulated night work in the daytime-only eating group. Importantly, a larger degree of internal circadian misalignment was robustly associated with more depression-like (r = 0.77; P = 0.001) and anxiety-like (r = 0.67; P = 0.002) mood levels during simulated night work. These findings offer a proof-of-concept demonstration of an evidence-based meal timing intervention that may prevent mood vulnerability in shift work settings. Future studies are required to establish if changes in meal timing can prevent mood vulnerability in night workers.

Children's experiences of meals after obesity treatment: a qualitative follow-up four years after a randomized controlled trial.

BACKGROUND: The practice of eating together, commensality, is rarely explored in the context of childhood obesity treatment. This is noteworthy given long-standing debates about the physical, psychosocial, and societal benefits of meals, especially family meals. Moreover, as children with obesity experience weight bias and stigma both within and outside the home, it is important to examine meals as a locus of social exchange around food and the body. Our study is based on the premises that eating together (i) matters and (ii) occurs in different environments with diverse social organization, where food-related interactions create varying arrangements of individuals, groups, their statuses, and their actions. METHOD: The study explores children's experiences of meals in different social contexts. Thirty-two children (age 8-10 years) living in Sweden were interviewed, 4 years after they entered an obesity intervention trial. Thematic analysis was applied to the data. RESULTS: We thematized three meal types, with each meal type having two subthemes: (i) "The family meal", with "Shared routines, rituals, and rules" and "Individual solutions and choices"; (ii) "The school meal", with "Rules and norms of the school" and "Strategies of the child"; and (iii) "The friend meal", with "Handling food that was disliked" and "Enjoyment of food". These three different meal types carried different experiences of and knowledge about how they were socially organized. CONCLUSIONS: While the children spoke about the family and school meals as meaningful, the friend meal stood out as particularly positive. Contrary to our expectations, the children did not express experiences of weight bias or obesity stigma around meals, nor did they speak negatively about parental control of their food intake. Our findings, especially regarding the friend meal, have implications for further research into commensality and social influences on eating among children with obesity, from early childhood into adolescence.

"Just sit and eat." Adult and Child Mealtime Responsibilities in Early Care and Education Centers During COVID-19 in Florida.

Most young children in the United States attend early care and education (ECE) programs, in which they eat 3-4 times daily. 'Division of responsibility' between adult and child means the adults are responsible for what, when and where, and the child is responsible for whether, what and how much to eat. A balanced division of responsibility can support children's development of healthy eating competency. This paper aims to describe division of responsibility during mealtimes during COVID-19 in Florida using a cross-sectional, mixed methods design. Questions were developed based on Trust Model and Social Cognitive Theory. A survey was completed by 759 ECE directors and 431 teachers, and 29 teachers completed in-depth interviews. COVID-19 increased teacher mealtime responsibilities. Most (95%+) ECE teachers provided meals at the same time and place daily (when and where). Children determined what and how much they ate, but did not serve or handle food. Implications include modifying mealtime routines to minimize the risk of COVID-19 and support healthy eating with a balanced division of responsibility.

Family mealtime emotions and food parenting practices among mothers of young children: Development of the Mealtime Emotions Measure for Parents (MEM-P).

Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self-report measure to assess parents' emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM-P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three-factor solution comprising both positive and negative emotion subscales: MEM-P Efficacy; MEM-P Anxiety; MEM-P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food-based interactions.

Feasibility of Implementing a Food Skills Intervention.

BACKGROUND: Food skills are defined as meal planning, preparation, shopping, budgeting, resourcefulness, and label reading/consumer awareness. To date, food skills have not been tested in intervention-based studies. OBJECTIVE: To evaluate the feasibility of implementing a food skills intervention. DESIGN: This was an 8-week prospective food skills intervention. Study measures were completed through questionnaires provided before the start of the intervention and after the intervention was completed. For questionnaires, the web platform REDCap was used. PARTICIPANTS AND SETTING: Thirty parents (aged 18 years or older) with at least one child (aged 2 to 12 years), attended weekly virtual intervention sessions via Zoom. The intervention took place from August to October 2020 with assessment measures collected within 2 months of the start and end date of the intervention. Participants were from the mid-Atlantic region of the United States INTERVENTION: A food skills intervention based on behavior modification strategies from the Social Cognitive Theory was implemented. Intervention goals included meal planning (six of seven dinner meals per week), meal plan implementation (at least four of six planned dinner meals), and always using a grocery list when shopping. MAIN OUTCOME MEASURES: Feasibility was evaluated based on parent attendance, number of self-monitoring booklets completed, adherence to goals, implementation fidelity, and qualitative responses to interviews. Change in food skills confidence and nutrition knowledge were also assessed. STATISTICAL ANALYSIS: Descriptive statistics and qualitative responses were used to describe feasibility. Paired t tests were used to evaluate change in food skills confidence and nutrition knowledge from baseline to 8 weeks. RESULTS: Parents attended a mean of 7.6 ± 1.0 (out of eight) sessions and completed a mean of 6.2 ± 1.7 (out of seven) self-monitoring booklets. Parents planned a mean of 6.1 ± 1.5 dinners per week and implemented a mean of 4.7 ± 1.6 of the six planned dinners, achieving the intervention goals. Of the mean 1.2 ± 0.6 trips/week to the grocery store reported, grocery lists were used a mean of 1.1 ± 0.6 times. Mean food skills confidence score increased significantly from baseline to 8 weeks (baseline = 86.5 ± 18.0; 8 weeks = 101.4 ± 15.3; P < 0.001). Mean nutrition knowledge score also significantly increased (baseline = 64.1 ± 7.2; 8 weeks = 69.1 ± 6.6; P < 0.001). Parents reported on a scale of zero ("easy") to 10 ("difficult") a mean difficulty rating of 2.4 ± 2.4 for meal planning, a mean of 2.1 ± 2.1 for meal plan implementation, and a mean of 1.0 ± 1.7 for always using a grocery shopping list indicating acceptability of goals. CONCLUSIONS: Feasibility of a food skills intervention was demonstrated by high session attendance, high numbers of self-monitoring booklets turned in, high achievement of intervention goals, parent acceptability, and high ratings of implementation fidelity. There was an increase in food skill confidence and nutrition knowledge. Future research should examine the efficacy of changing food skill behaviors on dietary intake.