Sample descriptives stratified by race are shown in . The majority of the children were non-Hispanic White (71.7%). FMF was high in all children; on average, Hispanics reportedly had family meals 5.6 days/week, non-Hispanic Whites 5.2 days/week, and non-Hispanic Blacks 5.0 days/week. Slightly less than half of non-Hispanic white children were overweight or obese (43.0%) compared with almost two-thirds of the Hispanic (60.3%) and non-Hispanic Black children (63.3%).
Sample Weighted Characteristics of Non-Hispanic White, Non-Hispanic Black, and Hispanic Children (n=16,770): National Survey of Children’s Health, 2003–2004
This is the first study to investigate racial differences in the association between FMF and weight status among children. Referring to , FMF was inversely associated with being obese in non-Hispanic White children only. Compared to non-Hispanic Whites who ate none or few family meals (0–2 per week), the odds of being obese were 33% less in non-Hispanic Whites who ate family meals almost everyday. In addition, having family meals everyday or on some days marginally lowered the odds of being obese by ~19%. No significant associations were observed for overweight. These findings corroborate previous research conducted with adolescents (13
Association Between Family Meal Frequency (FMF) and Weight Status Among Non-Hispanic White (n=13,271), Non-Hispanic Black (n=1,847), and Hispanic (n=1,652) Children: National Survey of Children’s Health, 2003–2004a
To our knowledge, this is the first study to investigate individual, familial, and socioeconomic moderators in the relationship between family meals and weight status. Sex marginally moderated the relation between FMF and weight status in non-Hispanic Blacks (P=0.07). The odds of being overweight or obese marginally decreased as FMF increased in non-Hispanic Black boys (simple slope, B=−0.15, P=0.08; OR=0.89, 95% CI: 0.73 to 1.02); whereas no association was found in non-Hispanic Black girls (P=0.45).
In Hispanics, two 3-way interactions were significant at P<0.10: FMF*family structure*gender (P=.02) and FMF*education*gender (P=0.07). Hispanic boys living in single-parent households were more likely to be overweight or obese if they reported greater FMF (simple slope, B=.27, P=0.098; OR=1.31, 95% CI: 0.95 to 1.80). Similarly, Hispanic boys living in low education households were more likely to be overweight or obese if they reported greater FMF (simple slope, B=0.33, P=0.06; OR=1.38, 95% CI: 0.98 to 1.95). No associations were observed for Hispanic girls living in single-parent or low education households (P>0.05), or boys or girls living in 2-parent or high education households (P>0.05). To assess whether the FMF*family structure*gender and FMF*education*gender interaction terms had unique effects on BMI in Hispanics, the main effects and interaction terms from both models were entered into one model. Results revealed that only FMF*education*gender remained statistically significant (P = .02). No significant interactions were observed in non-Hispanic Whites.
Findings from the current study highlight potential ethnic and contextual differences in the relation between family meals and weight status. There was a trend for non-Hispanic Black boys to be heavier when family meals were less frequent and for Hispanic boys living in low education households to be heavier if they consumed frequent family meals; in contrast, no relation was observed among their female counterparts. It is possible that parents within these ethnic populations used different child-feeding practices with their male and female children; previous research has shown this to be the case in other ethnic groups (26
). In one study, for instance, non-Hispanic White parents placed more foods within reach for boys than girls during family meals (29
). Future studies should examine cultural practices regarding mealtimes that may shed light on the gender differences that emerged in the current study
Further, mechanisms such as meal quality may account for the observed differences among racial groups. One study found that Hispanic parents were more likely to purchase fast food for family dinners than other ethnic groups (30
). Moreover, education level may play a role in the nutritional quality of family meals served in Hispanic households. In one study, for example, parents with low-incomes, which is influenced by education level, reported that they had little time to prepare meals or have family meals, and that they often purchased fast foods or prepared quick meals (31
). Such purchases may reflect an unhealthy food environment at home where high-calorie snack foods are readily available and fast food is regularly consumed. Thus, family meals may only be protective of obesity when they are healthful.
The current study has several limitations. The data are cross-sectional and thus causality cannot be determined. Children’s BMI was based on mother-reported height and weight, and thus may be subject to bias. Ten-percent of Hispanic children had missing BMI data and were not included in the current study. However, the data were nationally representative and thus the findings are generalizable. Some of the interaction terms approached statistical significance but did not reach it. Therefore, the authors further examined the extent to which design effects—a consequence of the study’s complex sampling design—inflated the standard errors of the interaction term parameters. Though acceptable, the design effects of these parameters ranged from 2.10 to 2.54, suggesting that the standard errors of the parameters were 2.1 to 2.5 times larger than they would have been if the sample were randomly sampled. Further, the design effects of the interaction parameters reduced the effective sample sizes of non-Hispanic Blacks to 473 and Hispanics to 300 in the moderation models. Though it is uncertain, the design effects may have made it difficult for the interaction terms to reach statistical significance. Lastly, the moderation analyses did not include children who consumed family meals everyday (45% of the sample) for reasons described previously. Although this limits the generalizability of the moderation findings to only those children who consume family meals 0 to 6 days per week, these findings overall highlight the complex nature of the relationship between family meals and weight status within minority populations.