Happy and healthy: How family mealtime routines relate to child nutritional health.

Children eat most of their meals in a family context, making family meals a key environment in which to learn about healthy food. What makes a family meal "healthy"? This diary study examined the practice of seven family mealtime routines (e.g., positive mealtime atmosphere, parental modeling, and longer meal duration) and their predictive value for children's healthier nutrition focusing on everyday family meal settings. Over 7 consecutive days, parents from N = 310 families (Mage = 42 years) described their most important family meal of the day and food intake for an index child (Mage = 9 years) and indicated what mealtime routines were practiced during the family meal. On average, each parent responded to 5.6 (SD = 1.4) of seven daily surveys. Mean correlations between mealtime routines were small (rs between -0.14 and 0.25), suggesting independent and distinct routines. Creating a positive atmosphere and turning TV and smartphones off were reported most often (on average, 91.2% and 90.5%, respectively). Parent's fruit and vegetable intake and creating a positive mealtime atmosphere were the strongest predictors for children's higher nutritional quality (i.e., higher vegetable and fruit intake; ps < .001). Findings indicate that mealtime routines obtained from independent meta-analyses represent distinct routines. Families practiced these independent and distinct routines to different degrees. Parental modeling and a positive mealtime atmosphere were most predictive of healthier child nutrition in daily family meal settings. More experimental research is needed to better understand causality and provide a better basis for effective interventions.

Parents' considerable underestimation of sugar and their child's risk of overweight.

High sugar intake is associated with an increased risk of overweight. For parents, as their children's nutritional gatekeepers, knowledge about sugar is a prerequisite for regulating sugar consumption. Yet little is known about parental ability to estimate the sugar content of foods and beverages and how this ability is associated with children's body mass index (BMI). In 305 parent-child pairs, we investigated to what extent parents systematically under- or overestimate the sugar content of foods and beverages commonly found in children's diets as well as potential associations with children's z-BMI. Parents considerably underestimated the sugar content of most foods and beverages (e.g., 92% of parents underestimated the sugar content of yogurt by, on average, seven sugar cubes). After controlling for parental education and BMI, parental sugar underestimation was significantly associated with a higher risk of their child being overweight or obese (odds ratio = 2.01). There was a small dose-response relationship between the degree of underestimation and the child's z-BMI. These findings suggest that providing easily accessible and practicable knowledge about sugar content through, for instance, nutritional labeling may improve parents' intuition about sugar. This could help curtail sugar intake in children and thus be a preventive measure for overweight.

Autobiographical Memory in Bipolar Disorder and Its Link to Neuropsychological Functioning.

OBJECTIVE: The aim of this study was to examine the specificity of autobiographical memory (AM) in bipolar disorder (BD) and to investigate the association between AM and neuropsychological functions. METHOD: Twenty bipolar patients and 22 matched healthy controls (HCs) were included in this study. AM was assessed with an extended version of the Autobiographical Memory Test (AMT) including rejection cue words. A neuropsychological test battery was used to examine verbal memory, executive functions, and attention. RESULTS: Across both groups, the number of specific memories in the AMT was significantly smaller in response to rejection cue words and positive cue words than in response to negative cue words. Participants with BD and HCs did not differ significantly in neuropsychological measures. Across both groups, scores of verbal memory, executive functions, and attention were significantly correlated with specificity of retrieved memories. LIMITATIONS: Although our clinical sample consisted of clinically stable outpatients, 6 out of 20 patients were not rated as euthymic but as mildly depressed. All BD patients were medicated. CONCLUSION: Contrary to previous results, patients with BD did not differ in the number of specific memories compared to an HC group. Our findings suggest that neuropsychological functioning is associated with AMT specificity. Further research is required to gain a better understanding of the underlying mechanisms which may influence the ease of memory retrieval.

Social nature of eating could explain missing link between food insecurity and childhood obesity.

We suggest that social factors are key to explain the missing link between food insecurity and obesity in children. Parents and public institutions are children's nutritional gatekeepers. They protect children from food insecurity by trimming down their consumption or by institutional support. To gauge children's food insecurity, evaluations across the different nutritional gatekeepers need to be integrated.

Effect of Longer Family Meals on Children's Fruit and Vegetable Intake: A Randomized Clinical Trial.

Importance: Family meals are a formative learning environment that shapes children's food choices and preferences. As such, they are an ideal setting for efforts to improve children's nutritional health. Objective: To examine the effect of extending the duration of family meals on the fruit and vegetable intake in children. Design, Setting, and Participants: This randomized clinical trial used a within-dyad manipulation design and was conducted from November 8, 2016, to May 5, 2017, in a family meal laboratory in Berlin, Germany. Included in the trial were children aged 6 to 11 years who did not follow a special diet or have food allergies and adult parents who served as the nutritional gatekeeper in the household (ie, the family member responsible for at least half of the food planning and preparation). All participants underwent 2 conditions: control, defined as regular family mealtime duration, and intervention, defined as 50% longer mealtime duration (10 minutes longer on average). Participants were randomized to the condition they would complete first. Statistical analyses of the full sample were conducted between June 2 and October 30, 2022. Interventions: Participants had 2 free evening meals under different conditions. In the control or regular condition, each dyad ate in the same amount of time as their reported regular mealtime duration. In the intervention or longer condition, each dyad had 50% more time to eat than their reported regular mealtime duration. Main Outcomes and Measures: The primary outcome was the number of pieces of fruits and vegetables eaten by the child during a meal. Results: A total of 50 parent-child dyads participated in the trial. Parents had a mean (range) age of 43 (28-55 years) years and were predominantly mothers (36 [72%]). Children had a mean (range) age of 8 (6-11) years and included an equal number of girls and boys (25 [50%]). Children ate significantly more pieces of fruits (t49 = 2.36, P = .01; mean difference [MD], 3.32 [95% CI, 0.96 to ∞]; Cohen d = 0.33) and vegetables (t49 = 3.66, P < .001; MD, 4.05 [95% CI, 2.19 to ∞]; Cohen d = 0.52) in the longer condition than in the regular mealtime duration condition. Consumption of bread and cold cuts did not significantly differ between conditions. The children's eating rate (bites per minute over the regular mealtime duration) was significantly lower in the longer than in the regular condition (t49 = -7.60, P < .001; MD, -0.72 [95% CI, -0.56 to ∞]; Cohen d = 1.08). Children reported significantly higher satiety after the longer condition (V = 36.5, P < .001). Conclusions and Relevance: Results of this randomized clinical trial suggest that the simple, low-threshold intervention of increasing family mealtime duration by approximately 10 minutes can improve the quality of children's diet and eating behavior. The findings underscore the potential for such an intervention to improve public health. Trial Registration: ClinicalTrials.gov Identifier: NCT03127579.

Quality matters: A meta-analysis on components of healthy family meals.

OBJECTIVE: A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children. However, the effect sizes are small, and it remains unclear which qualitative components of family meals contribute to these positive health outcomes. This meta-analysis synthesizes studies on social, environmental, and behavioral attributes of family meals and identifies components of family meals that are related to better nutritional health in children. METHOD: A systematic literature search (50 studies; 49,137 participants; 61 reported effect sizes) identified 6 different components of healthy family mealtimes. Separate meta-analyses examined the association between each component and children's nutritional health. Age (children vs. adolescents), outcome type (BMI vs. diet quality), and socioeconomic status (SES; controlled vs. not controlled for SES) were examined as potential moderators. RESULTS: Positive associations consistently emerged between 5 components and children's nutritional health: turning the TV off during meals (r = .09), parental modeling of healthy eating (r = .12), higher food quality (r = .12), positive atmosphere (r = .13), children's involvement in meal preparation (r = .08), and longer meal duration (r = .20). No moderating effects were found. CONCLUSIONS: How a family eats together shows significant associations with nutritional health in children. Randomized control trials are needed to further verify these findings. The generalizability of the identified mealtime components to other contexts of social eating is also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Lower parental numeracy is associated with children being under- and overweight.

BACKGROUND: In adults, lower numeracy is associated with poorer nutrition label comprehension and higher BMI. It remains unclear whether parental numeracy also impacts children's body weight. PURPOSE: We examined the relationship between parental numeracy and children's BMI z-scores and analyzed whether weight-related numerical information processing skills-specifically, portion-size estimation skills, comprehension of nutrition labels, and comprehension of growth charts-mediated that relationship. DESIGN AND METHODS: Numeracy, portion-size estimation skills, comprehension of nutrition labels, and comprehension of growth charts were assessed in face-to-face interviews with 320 parents of children aged 6-12 years in Germany. Parent and child body weight were measured; parents reported both their own height and that of their children. RESULTS: Lower parental numeracy was significantly associated with having a child who was either underweight (ß = 0.126, P = 0.048) or overweight (ß = -0.299, P < 0.001). Lower parental numeracy was also associated with poorer portion-size estimation skills (r = -0.08, P = 0.023) and inferior comprehension of growth charts (r = 0.33, P < 0.001) and nutrition labels (r = 0.26, P < 0.001). However, these weight-related numerical information processing skills did not mediate the association between parental numeracy and children's BMI. CONCLUSION: This study is the first to find lower parental numeracy to be a risk factor for children being either over- or underweight. However, portion-size estimation skills, comprehension of nutrition labels, and comprehension of growth charts did not mediate the association between parental numeracy and children's BMI. The present findings thus winnow down the set of mechanisms potentially underlying this association. Parental numeracy is an as yet largely overlooked factor that can be targeted when developing interventions to prevent and treat malnutrition and to achieve and maintain a healthy body weight in children.