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Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers

Published online by Cambridge University Press:  20 July 2020

Kathryn Walton*
Affiliation:
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, CanadaN1G 2W1 Translational Medicine, The Hospital for Sick Children, Toronto, ON, CanadaM5G 0A4
Andrea Breen
Affiliation:
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, CanadaN1G 2W1
Julia Gruson-Wood
Affiliation:
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, CanadaN1G 2W1
Kira Jewell
Affiliation:
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, CanadaN1G 2W1
Emma Haycraft
Affiliation:
School of Sport, Exercise and Health Sciences, Loughborough University, LoughboroughLE11 3TU, Leicestershire, UK
Jess Haines
Affiliation:
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, CanadaN1G 2W1
*
*Corresponding author: Email kathryn.walton@sickkids.ca
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Abstract

Objective:

Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents’ perceptions of family meals in order to understand how parents’ past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children.

Design:

Semi-structured qualitative interviews.

Setting:

In-person interviews were conducted in participants’ homes.

Participants:

Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years.

Results:

Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents’ own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families’ approaches to mealtimes.

Conclusions:

Parents’ own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.

Type
Research paper
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

Family meals promote healthy eating and well-being among both children and adolescents(Reference Hammons and Fiese1). Those who frequently share meals with family members have healthier dietary intakes(Reference Hammons and Fiese1Reference Swanson, Power and Crombie7) and a lower prevalence of disordered eating(Reference Ackard and Neumark-Sztainer8Reference Neumark-Sztainer, Eisenberg and Fulkerson11) in comparison with children and adolescents who do not have regular family meals. The benefits extend beyond nutrition, as frequent family meals are associated with lower levels of substance abuse(Reference Fulkerson, Story and Mellin9,Reference Eisenberg, Olson and Neumark-Sztainer12,Reference Goldfarb, Tarver and Locher13) , depressive symptoms(Reference Eisenberg, Olson and Neumark-Sztainer12,Reference Fulkerson, Kubik and Story14) and improved academic outcomes(Reference Eisenberg, Olson and Neumark-Sztainer12,Reference Snow and Beals15,Reference Beals, Dickinson and Tabors16) . However, the frequency of shared meals typically declines linearly beyond the preschool years(Reference McCullough, Robson and Stark17,Reference Miller, Waldfogel and Han18) . Despite this decline, to date, few family meal interventions have been tested(Reference Dwyer, Oh and Patrick19). Of the ten existing interventions(Reference DeBar, Stevens and Perrin20Reference Haines, McDonald and O’Brien29), only six present statistically significant intervention effects specific to family meal frequency(Reference DeBar, Stevens and Perrin20Reference Utter, Denny and Farrant24,Reference Haines, McDonald and O’Brien29) , the majority of which target adolescents(Reference DeBar, Stevens and Perrin20,Reference Sepúlveda, Lu and Sill21,Reference Rosenkranz and Dzewaltowski23,Reference Utter, Denny and Farrant24) or were tested among a small sample of families(Reference Rosenkranz and Dzewaltowski23,Reference Utter, Denny and Farrant24) .

Given the equivocal findings of the small body of existing research, many opportunities exist for the development of new approaches to increase family mealtimes and, by extension, improve child health and well-being. Findings from the HOME Plus family meal intervention developed by Fulkerson and colleagues(Reference Fulkerson, Friend and Flattum26) suggest that family meal interventions may be more efficacious in impacting health-related outcomes such as weight status among younger, pre-pubescent children. The preschool years may be a particularly important window of opportunity as research suggests that health-related behaviours are established early in life and track into adolescence and adulthood(Reference Savage, Fisher and Birch30Reference Skinner, Carruth and Wendy33). Thus, to guide the development of effective family meal interventions that sustain frequent family meals beyond the preschool years, we need to understand the context of family meals among families with preschoolers and what motivates or influences parents to establish family meal routines.

Beyond the well-known barriers to family meals, including a lack of time, conflicting schedules and picky eaters(Reference Martin-Biggers, Hongu and Worobey34Reference Martin-Biggers, Spaccarotella and Berhaupt-Glickstein36), recent nutrition research highlights the importance of intergenerational influences on family meal routines(Reference Watts, Berge and Loth37Reference Friend, Fulkerson and Neumark-Sztainer42). This small body of literature emphasizes that both positive and negative childhood mealtime experiences influence how and whether parents engage in mealtimes with their own families(Reference Trofholz, Thao and Donley38,Reference Malhotra, Herman and Wright39,Reference Loth, Uy and Winkler41) . For example, Loth and colleagues(Reference Loth, Uy and Winkler41) described from a nutrition perspective, how parents who participated in frequent family meals from adolescence to adulthood experienced more positive early life experiences and supports (related to cooking skills, family togetherness and relationships), as compared with those who had inconsistent family meal patterns across time.

Social scientists have long examined eating and family meal practices from a variety of disciplinary perspectives. For example, sociologists have been concerned with understanding how social locations and roles are formed through, and shaped by, eating rituals(Reference Ashley, Hallows and Jones43,Reference Cairns and Johnson44) . In the context of the family, eating practices have been shown to organise family life and structure the family as a social institution(Reference DeVault45,Reference Ristovski-Slijepcevic, Chapman and Beagan46) . Family meals are significant biographical and cultural occasions woven into the fabric of our self-understanding and kinship ties. By bridging the gap between social science and nutrition education research, we are able to interpret the act of eating family dinners as both a ‘meaningful social practice’(Reference Crawford47) and a clinically beneficial activity linked to improved health outcomes.

We aim to extend this previous research by understanding the context in which families with preschoolers participate in family meals and use life course theory(Reference Elder, Moen, Elder and Luscher48,Reference Elder, Johnson, Mortimer and Shanahan49) as a framework from which to understand this phenomenon. Life course theory is an integrative approach to understanding the lives of people over time, emphasising both personal agency in constructing one’s life and the constraints of socio-cultural and historical contexts(Reference Elder, Moen, Elder and Luscher48,Reference Elder, Johnson, Mortimer and Shanahan49) . Life course theory emphasises ‘linked lives’; the notion that our lives are lived interdependently with others in our family, community and cultural contexts(Reference Elder, Johnson, Mortimer and Shanahan49). It posits that early life experiences and critical life transitions, such as the transition to parenthood, influence future behaviours(Reference Elder, Moen, Elder and Luscher48Reference Wethington and Johnson-Askew50). Employing life course theory to understand the phenomenon of family mealtimes may be particularly useful for enhancing intervention effectiveness(Reference Wethington and Johnson-Askew50). Life course theory would suggest that major life transitions and the emergence of new social roles may impact family dietary habits and routines more significantly than incremental or gradual changes in responsibility(Reference Elder, Moen, Elder and Luscher48,Reference Wethington and Johnson-Askew50) . Thus, intervention effects may be stronger when interventions are timed to coincide with life transitions and developmental periods that observational studies have associated with an increased interest or likelihood of behaviour change(Reference Wethington and Johnson-Askew50).

By approaching families with young children using life course theory, we aim to elucidate how the world of memories, feelings, resources, practices and actions that comprised the eating practices of parents in their childhood years influence the relational dynamics and experiences of their current family meals. Considering the variations with which families’ think about and approach family meals is a method for learning how to maintain family mealtime practices over time. The results will help inform whom to target, as well as the timing and content of family meal interventions aimed at helping families sustain frequent family meal participation beyond the preschool years.

Methods

Sample and study design

This study was a qualitative sub-study of the Family Mealtime Observation Study (FaMOS), which aimed to explore mealtimes and food parenting practices among seventy-seven families with preschool-aged children(Reference Walton, Haycraft and Jewell51). Families were eligible to participate in FaMOS if: (1) they had a child aged between 18 months and 5 years, (2) it was typical for the family to eat together and (3) parents could speak and understand English. A sub-set of twenty-one families were invited to participate in this qualitative sub-study via email using purposeful, maximum-variation sampling(Reference Patton52,Reference Palinkas, Horwitz and Green53) . Specifically, we purposefully aimed to recruit families that would provide a broad range of family experiences and mealtime perspectives including both single- and dual-headed families and ethnically diverse families. Recruitment ended when we reached theoretical saturation(Reference Saunders, Sim and Kingstone54,Reference Sobal55) .

Parents were asked to participate in an in-home, semi-structured interview (guide developed by the authors; Table 1). Interviews lasted approximately 45 min. In dual-headed families, both parents were invited to participate in a joint interview and all questions were posed to each parent individually. Following the interview, we sent notes outlining parents’ responses to each question to allow for clarification or additional thoughts. We transcribed interviews verbatim and noted clarifications derived from the member-checking process. We collected demographic information including family structure, mothers’ and fathers’ ethnicity and educational attainment (university education v. less than university education), child gender, household income and family dinner frequency as part of FaMOS. Household income was dichotomized using the 2016 Canadian low-income cut-offs, which consider total household income before tax and account for population of residence and family size(56). We defined family dinner frequency as the number of times family members eat dinner or supper together: every day (7 d/week), most days (4–6 d/week), a few days (1–3 d/week) or never/rarely (<1 d/week).

Table 1 Semi-structured interview guide exploring parent feeding practices and family meal experiences

Data analysis

There were three distinct phases to our qualitative analysis, which followed an inductive approach to thematic analysis(Reference Braun and Clarke57Reference Braun and Clarke60). First, we immersed ourselves in the data by reviewing each transcript, noting emerging ideas and patterns. Two subsequent audio-recorded meetings were conducted to discuss and create initial codes; detailed notes were recorded to document our discussion and decisions(Reference Mays and Pope61). In these discussions, we found that our participants’ orientation to family meals was governed by one of the following three orientations: meals for (1) Togetherness, (2) Nutrition Messaging and (3) Necessity. Importantly, the mealtime orientations describe the family-level approach to mealtimes. While parents tended to align themselves primarily with one of the three orientations we identified, they often incorporated the other two orientations into their responses in a complex manner. Individual parent perspectives among dual-headed families did exist, and in cases where parents described discordance in their perspectives and experiences, the parents’ discussion and interaction during the interview still situated the family unit towards an over-arching mealtime orientation. We began conducting initial analysis while data collection was occurring and concluded data collection when no new ideas were generated beyond what had been provided in earlier interviews; this occurred after twenty families(Reference Saunders, Sim and Kingstone54). Next, two analysts (KW and KJ) independently coded the transcripts to compare the mealtime orientations. Segments of data (codes developed during phase 1) were coded using qualitative software (NVivo 11; QSR International Pty Ltd). Inter-rater reliability calculated by the software revealed a high level of agreement (94 %) between the two analysts; the two resolved any coding discrepancies(Reference Braun and Clarke60). Finally, we met to review the coding and collate themes(Reference Braun and Clarke60). We developed four main themes and reviewed them against the data to ensure fidelity throughout the data set(Reference Braun and Clarke60). We organised our themes hierarchically with ‘mealtime orientation’ serving as the overarching framework to understand families’ approaches to mealtimes over the life course. The first two themes relate to parents’ historical experiences with family meals: (1) early life meals matter, and (2) stability and change. The remaining themes relate to current meals: (3) mealtime messages and (4) mealtime challenges.

Results

Twenty-one families were invited to participate and twenty families (twenty-one mothers and fifteen fathers) agreed. In two of the dual-headed families, one parent was unable to participate due to work conflicts; thus, in sixteen families, both parents were interviewed together and in four families, the mother was interviewed alone. Table 2 displays demographics of the participating families. We identified that families fell predominantly into one of three overarching mealtime orientations (see Table 3), which shape families’ approach to meals: (1) Togetherness (n 7), (2) Nutrition Messaging (n 8) and (3) Necessity (n 5). Briefly, parents in the ‘Meals for Togetherness’ orientation described that the focus of the family meal is to bring family members together and to connect socially. These parents discussed how social interaction during the meal is more important than the food provided. Parents in the ‘Meals for Nutrition Messaging’ orientation described that the focus of the family meal is to support healthful eating and discussed how eating together at mealtimes is driven by a desire to ensure their child eats well. Mealtimes are also an opportunity to teach their child about nutrition and portion sizes. Finally, parents in the ‘Meals for Necessity’ orientation described that having family meals is a required role of parenting and that their mealtimes are very functional. These parents described how meals ensure their child eats regularly and serve as a time to teach manners. The two families who reported not participating in family meals every day had a ‘Nutrition Messaging’ orientation. Both single-parent families described a ‘Necessity’ orientation. The five families that reported low income fell into either the ‘Necessity’ or ‘Togetherness’ orientations, suggesting that socio-economic status can be a critical factor in shaping parents’ mealtime orientation.

Table 2 Demographics of participating families

* One same-sex couple.

Among the eighteen dual-headed families, two fathers were unable to participate in the interviews.

Table 3 Description of the family mealtime orientations and the corresponding messages/goals parents have for children about mealtimes, food and eating

Parents’ historical mealtime experiences

Early life meals matter

Our findings expand the literature on the life course by demonstrating the complex ways that parents’ perceptions of family meals and their family’s current routines are influenced significantly by their early life family meals. Parents who described approaching meals with a ‘Togetherness’ orientation emphasized the social aspects of their childhood meals and remembered childhood mealtimes as full of conversation and connection whereby interactions were warm and family members enjoyed each other’s company. For example, ‘Rob’ described how dinner was the centrepiece of his family life: it was the ‘time of: “this is our family.”’ Dinner was when family members would ‘catch up’ and talk about ‘any problems.’ (F10, Togetherness).

In contrast to parents with a ‘Togetherness’ orientation, parents with a ‘Nutrition Messaging’ or ‘Necessity’ orientation remember a lack of connection or pleasure during their childhood mealtimes, but in different ways. For example, ‘Ian’ described dinnertime as ‘interrogation time,’ with the ‘main goal’ being to ‘get in and out as quickly as possible’ (F16, Nutrition), while ‘Tyler’ recollected that his family did not engage in conversation over dinner time, rather they ‘just start[ed] digging for food’ (F8, Necessity). While the first description highlights the complicated and negative family dynamics expressed and tied up in Ian’s family meals, Tyler’s excerpt illuminates a mealtime environment focused on the pragmatic task of eating. In both orientations, mealtimes were routinely not a place of enjoyment or connection within the family home.

Participants who described a ‘Nutrition Messaging’ orientation often discussed receiving messages about weight, body size and body composition during their childhood meals that continue to impact their relationship with food and family mealtimes. For example, ‘Shannon’ described being told by her parents that healthy foods like ‘spinach’ would make her ‘strong like’ ‘Popeye’ (F19, Nutrition). ‘George’ summed up his parents’ mealtime communication as ‘eat everything but why are you so fat?’ (F18, Nutrition). Within the ‘Nutrition Messaging’ orientation, memories of food also seem to have moral qualities which may stem from intergenerational challenges or fixations on body image and dieting. For example, one mother, ‘Judy’ recalled ‘watching’ her mother go on ‘many fad diets’ and learning ‘a lot of messages’ linking ‘self-control’ with ‘good body type’ (F16, Nutrition). These messages about body image seem to be one of the reasons many of the parents in this orientation approach meals with a lens towards nutrition. This orientation transition is evident in Judy’s case as she now works to cultivate a ‘healthy relationship with food’ by talking about ‘consumption’ with her daughters through the lens of ‘nutrition.’

Parents in the other orientations did not report memories of nutrition messaging or dieting. Notably, however, parents in the ‘Necessity’ orientation described their childhood mealtimes as marked by pressure to consume food as a functional requirement of survival. ‘Jeff’ describes his childhood meals as a time to get fed and move on to other activities: ‘[Meals were] more just like ’feed the family’ instead of trying to eat particularly healthy food.’ (F5, Necessity). Similarly, ‘Kristen,’ a mother with a ‘Necessity’ orientation describes having no memory of her parents ‘saying anything about healthy or unhealthy eating,’ it was just: ‘was there food?’ She continued to describe memories of ‘having cereal with no milk for breakfast’ and ‘eating cheese and salad dressing because that’s all there was’ (F17). Kristen explained how she tries to balance out being ‘a little more inclusive of food groups’ with her children while ‘trying to live within a really strict budget.’ She described this balancing act as making it ‘a little bit more difficult to be health conscious all the time.’ Here, lack of financial resource created a particular orientation towards food that, along with economic status, has been passed down intergenerationally. The ability to focus on the nutritional value of food is a privilege, and the ‘Necessity’ orientation highlights how socio-economic status may impact the development of mealtime orientations.

Our results demonstrate the importance of early life on the trajectory of mealtime orientations and routines. Parents who currently approach meals for family connection remembered their childhood mealtimes in the same positive light and seemed to have a more positive relationship with eating in relation to their self-development and body image. The others shared elements of disconnection, stemming from complicated family dynamics, diet culture and the impact of food insecurity.

Stability and change

For most parents, their childhood mealtime orientations tracked as a stable trajectory into adulthood, providing lifelong context for their eating habits and mealtime experiences. The ‘Togetherness’ orientation seemed to be the most stable, with almost all parents currently approaching meals from this orientation also describing their childhood meals as a time for family connection. However, consistent with life course theory, there were major points in life where mealtime orientations changed(Reference Elder, Moen, Elder and Luscher48,Reference Wethington and Johnson-Askew50,Reference Setterstein62,Reference Elder, Mortimer and Shanahan63) . For parents whose childhood meal orientations did not track into adulthood, there seemed to be two major transitions that impacted their current orientation: (1) forming adult relationships and being immersed in their partner’s food culture and (2) the transition to parenthood. Parents reported that these life events created deep, fundamental and lasting changes to their mealtime routines. For example, ‘Claire’ described liking the social aspect of her husband’s family mealtimes. She contrasted this with her childhood mealtime experiences which were marked by her father wanting everyone to be ‘quiet’ while eating. (F10, Togetherness). Judy described the ‘clash of cultures’ between her history with family meals and that of her husband. While her own parents offered only ‘homemade’ dinners, her husband grew up on ‘processed’ food. She pronounced: ‘I won that battle,’ to which her husband, Ian responded, ‘I guess so. There wasn’t really [that] sort of messaging about […] food’ (F16, Nutrition). These quotes illustrate how as partners, parents negotiated and were influenced by each other’s experiences and orientations towards shared meals. In these examples, both Claire and Ian’s childhood mealtime orientations were altered to align with those of their partner. Notably, this was not the case for all dual-headed families like ‘Vicky’ and ‘Owen’s’ family, where parents’ trajectories remained stable and they ‘agreed to be different’ while mostly defaulting towards one parent’s approach (F4, Togetherness). Vicky explains, ‘well it doesn’t work that we have different, um, philosophies. […] like I said [mealtimes are] family time’, while Owen says, ‘we sit together to get fed’ (F4). This process of negotiating, compromising or disagreeing on approaches to family mealtimes highlights the importance of considering the perspectives of both parents in dual-headed homes and further demonstrates how eating rituals are shaped by social roles, as both a partner and a parent.

While mealtime practices shift throughout the life course, parents still seemed to orient to their childhood mealtime practices – even if as a counterpoint – in defining their current family mealtimes. While family practices may diminish during early adulthood, in the context of major life transitions such as becoming a parent, latent influences such as where meals should be eaten, remerged. For example, ‘Mia’ (F14, Nutrition) described how before having kids she used to eat dinner in front of the TV with her spouse. Having children motivated her to create a space to sit together for meals. Similarly, Mia’s husband ‘Lucas’ started having regular family meals for the first time after becoming a father; he describes how as a child he would grab dinner and ‘go to my room and watch TV by myself and eat like on my bed’ (F14). ‘Jeff’ said that when he became a father, he purposefully chose to avoid pressuring his son to eat, which is a pointed counteraction to his childhood. He described ‘everything’ around mealtime being ‘a power struggle,’ during his own childhood which resulted in the resolution to never ‘force’ his child to eat when ‘he says he’s not hungry’ (F5, Necessity).

For other families – particularly ‘Nutrition Messaging’ – the transition to parenthood seemed to negatively impact the mealtime orientation. This transition seemed to be associated with anxiety, to the point at which their orientation towards meals shifted from Togetherness to Nutrition. Mia describes ‘obsessing’ about the food her daughter eats, which contrasts with the positive relationship she had with food as a child. She described her childhood as enabling her the freedom of ‘consum[ing] as much food’ as she ‘wanted’ yet in her adult years she has become ‘consumed’ and ‘obsessed’ with her own, and her daughter’s, intake (F14, Nutrition). Judy reflects on how having three kids and coming from a ‘very long line of body shaming women’ has caused her to develop a relationship with food that centres around body image concerns (F16, Nutrition).

To this end, having a child created positive mealtime changes for some and negative changes for others. Some described a mix of both positive and negative influences on their mealtime routines including starting to have mealtimes but becoming more worried about the types of foods to serve and wondering whether their child was eating enough. Whether the transition to parenthood had positive or negative implications on mealtime orientation seemed to stem from the parents’ early life experiences, with latent expectations or challenges remerging.

Impact of historical meal experiences on current family meal context

Mealtime messages

Parents’ experiences with family meals throughout life influenced their mealtime orientation which included the food and eating practices that they currently share with their children. The mealtime orientation of the parent participants interviewed served as the contextual foreground for the way they ‘do’ food and family meals. Embedded in parents’ orientations are larger family dynamics (see Table 3).

Mealtime challenges

Consistent with life course theory, we found that not only do mealtime routines shift and change as the family unit evolves (Reference Elder, Moen, Elder and Luscher48,Reference Elder, Mortimer and Shanahan63) but also do the challenges that parents experience when sharing mealtime messages with their children. All families noted some challenges; however, the main challenges and their impact differed across orientations.

‘Togetherness’ families reported few challenges in sharing their message of connection but noted that this may change as their child gets older and other activities (e.g. extra-curriculars and part-time jobs) contest family meals. ‘Nicole’ reflected how, as her children age, the family ‘might not be sitting together at the table’ leading to concern about ‘finding time, to have those really important conversations.’ (F1).

‘Nutrition Messaging’ families reported feelings of general frustration towards mealtimes, which challenged their ability to focus on enjoyment during meals. For example, ‘Alex’ described supper as not ‘always having a positive feeling’ and stated that she ‘blame[d] her children for that’ (F19), while ‘Emily’ described dinner as just such a fraught thing…’ (F2). Some of these challenges may be related to parents’ reports of wanting to control their child’s intake during mealtimes. Mia described the importance of providing ‘good portion control’ to her toddler and the push back she received from her partner who ‘doesn’t think’ toddlers require this form of regulation (F14). Later, in the interview, Mia explicitly expressed concern that her daughter might follow her habit of linking food to self-image. She described wanting her daughter to be able to ‘think about [eating] in a positive way, that reflects a good self-image’ and not wanting food to be ‘so tied to physical appearance’ but struggled to model this herself.

Parents with a ‘Necessity’ orientation not only talked about wanting mealtimes to provide structure to their child’s day and to have their children eat healthy, but also reported difficulties in modelling these healthy behaviours. For example, ‘Brittany’ described making breakfast for her son and then realising hours later that she had not eaten yet (F11). Kristen described a desire to be ‘health conscious’ while also choosing fast food in ‘certain situations’ because ‘it’s cheap and fast’ (F17). These parents also reported scheduling changes to be disruptive to their participation in family meals due to busyness with appointments and after school activities as described by ‘Diane’: ‘[We] grab something on the road because of a lack of time.’ (F8, Necessity)

Challenges were the most prevalent among families with a ‘Nutrition Messaging’ or ‘Necessity’ orientation. Parents with a ‘Nutrition Messaging’ orientation discussed frustration towards mealtimes stemming from their responsibility of providing healthy meals and desire for control over their children’s diets. Parents with a ‘Necessity’ orientation discussed wanting family meals to provide structure to their children’s days, but found it challenging to model because they often prioritise feeding their children over themselves.

Discussion

Across all mealtime orientations, we found that parents’ early life meal routines and experiences informed the trajectory and context of their current family meals. Similar to our findings, Malhotra and colleagues(Reference Malhotra, Herman and Wright39) found that mothers’ childhood experiences informed their perceptions of the benefits and barriers to family meals with preschoolers. Trofholz(Reference Trofholz, Thao and Donley38) found that the lessons mothers learned about family meals from their parents influenced the lessons they shared with their school-aged children. Loth and colleagues(Reference Loth, Uy and Winkler41) recently described the intergenerational transmission of mealtime routines based on the frequency of participation using three different longitudinal trajectories from adolescence to adulthood: maintainers, starters and inconsistent. Those who were considered maintainers of regular family meals reported many of the same mealtime supports that were discussed by parents with a ‘Togetherness’ orientation, including positive childhood memories about family meals and having a partner who shared a similar upbringing with family meal participation or who also valued family meals. Our study extends previous research by considering how other significant life changes impact these experiences, and in such a way as to form particular orientations that shape everyday practice.

Using life course theory to frame our exploration of the family mealtime context led to important insights useful for the development of future interventions aimed at sustaining frequent family meal participation beyond the preschool years. We determined that, for many parents, childhood mealtime routines and orientations seemed to track into parenthood, illustrating the importance of intervening among families with young children to impact the intergenerational transmission of this routine. However, we also found that major life transitions, for example, partnership/marriage or parenthood, appear to impact the family’s mealtime routines and orientation(Reference Wethington and Johnson-Askew50). For some, life transitions may cause changes to these practices; dietary routines and behaviours are fluid which signals important windows of opportunity for establishing family meals(Reference Moura and Aschemann-Witzel64). Examining parent’s mealtime practices and beliefs from a life course perspective provides a deeper understanding of factors underlying mealtime supports or barriers. For example, ‘Nutrition Messaging’ parents described frustration towards mealtimes, but our use of life course theory provided the understanding that, in some cases, this frustration may stem from transgenerational struggles with body image and a resultant internal pressure to ensure meals are healthy. Further, while families leaned towards an overarching mealtime orientation, there was some discordance among some dual-headed families. This finding highlights the importance of considering the perspective of both parents. Among dual-headed families, planning effective family meal interventions requires an understanding of the complex perspectives and values each partner brings towards shared meals. Future research should explore these mealtime orientations over time to understand how co-parenting with different mealtime philosophies impacts the frequency of family meals and the mealtime environment. It is possible that over the life course, differing orientations may dominate the family’s approach to family meals depending on context and life demands at particular points in time.

Our results underscore that grounding in social science theory, specifically life course theory, may help clinicians and practitioners to understand the constellation of parents’ beliefs, experiences and practices with respect to mealtimes. This understanding will help to create interventions that are grounded in understanding parents’ specific mealtime orientations and provide tailored support.

Implications for practice and research

Like in previous research, the preschoolers in this study participated in frequent family meals(Reference Wyse, Campbell and Nathan5,Reference Miller, Waldfogel and Han18,Reference Litterbach, Campbell and Spence65Reference Le Heuzey and Turberg-Romain67) . Our results extend this by highlighting important variations in the mealtime environments and philosophies among families who participate in frequent family meals. Our results suggest that it is important to understand why families eat together to properly understand the challenges they may face and to provide tailored supports. Interventions should be aimed at sustaining this high frequency of participation throughout childhood and into adolescence. Effective intervention programmes may require learning and responding to each family’s mealtime orientation. To further explain, we will now turn to a focused discussion of the implications of each mealtime orientation and the specific intervention messages and considerations for healthcare professionals.

Meals for togetherness

Almost all participants who embodied this orientation maintained it throughout their lives, despite life transitions. Parents who adopt this orientation appear to focus on the importance of the social aspects of family meals, which sets the context for relaxed mealtimes and reduced anxiety towards their children’s intake. While their children are small, they do not seem to struggle with finding time for mealtimes but acknowledge that this may be a challenge in the future. These families can be encouraged to continue eating together for family bonding and reminded that their modelling during this time will set their children up for positive psychosocial development(Reference Martin-Biggers, Spaccarotella and Berhaupt-Glickstein36) and lifelong healthy eating(Reference Hammons and Fiese1,Reference Patrick and Nicklas68) . To continue having family meals as their children age, these families may benefit from being reminded that any meal counts in terms of providing benefits to their children. Because parents with this orientation described strong intergenerational stability in their meal routines, these families may not need to be the focus of intervention or supports aimed at sustaining family meals over time.

Meals for nutrition messaging

Parents with this orientation tended to describe mealtimes as a source of anxiety and frustration due to their concern about their family’s nutritional intake. Our finding that the two families who identified that they do not have family meals every day both identified with a ‘Nutrition Messaging’ orientation may suggest that this frustration may already impact the frequency with which families within this orientation eat together. Alternatively, given the internal pressure that these parents seem to place on themselves, they may not count meals that do not meet certain criteria in quantitative reports of shared meals, despite the benefits they still have for child well-being. However, our data cannot determine the direction of this effect, and it is also possible that this lower frequency of shared meals is contributing to parents’ frustration. This orientation seems to have been particularly vulnerable to increased mealtime anxiety during the transition to parenthood. Healthcare professionals should acknowledge the family’s participation in shared meals as an excellent way to promote healthy eating habits. However, given their less favourable perception of and anxiety towards family meals, these families may struggle to continue the practice of eating together as children gain independence; mealtimes may also be fraught with power struggles surrounding eating. Harris and colleagues(Reference Harris, Ria-Searle and Jansen69) suggest the importance of identifying families that have concerns early (regardless of the presence of an actual feeding or growth problem), before escalating parental worry during feeding interactions negatively impacts the food parenting practices used (more pressuring tactics, including control) and the resultant mealtime environment. These families may benefit from support to take a more relaxed approach to family meals that focuses on the social benefits and enjoyment of family meals with a reduced focus specifically on nutrition. Given parents reported desire to control their child’s intake during meals, and their challenges with body image, some may benefit from counselling supports for their own food challenges.

Meals for necessity

Parents with this orientation describe family meals as necessary to accomplish the task of child feeding. They also noted mealtimes as important for providing structure to their children’s day, but noted many challenges associated with the routine. Families with this orientation should be encouraged that mealtimes are an excellent way to create routine and structure to their child’s day; research strongly supports the benefits of routines in young children’s development(Reference Haines, McDonald and O’Brien29,Reference Spagnola and Fiese70) . These families may struggle to continue the tradition of eating together as children age and no longer require supervision during meals, especially among single-headed families where scheduling may be more challenging. Health professionals are encouraged to reiterate to families that these routines and structure are also beneficial for children as they grow up. Families in this orientation reported struggling to find time to eat together and reported that this routine is interrupted when other life responsibilities arise. Health professionals can also help families to problem solve through challenges when they arise and provide supports for making the process easier (i.e. quick and easy recipes, reminders that any meal eaten together counts). Given our results that ‘Necessity’ families had lower household income, these families will likely benefit from support surrounding meal planning on a budget and, where possible, financial and systematic supports to make healthy food more accessible. The parents with this orientation also acknowledged challenges in modelling healthful eating habits for their children related to a lack of time, resources and in some cases, nutrition knowledge. While positive dietary modelling is beneficial for children(Reference Pearson, Biddle and Gorely71), before creating an intervention, it is important to understand how these barriers shape parents articulated challenges with modelling healthy eating. While some parents may benefit from dietary counselling to support their own behaviour change, the socio-economic barriers to parents’ healthful eating habits must not be lost from view. Particularly for families that have experienced food insecurity – currently or in the past, the topic of healthy eating may be particularly loaded. Rather than narrowing in on modelling or nutrition education per se, building on parents’ current goals and focusing on additional benefits like family bonding while providing supports tailored to individual family challenges will be constructive in supporting healthful shared meals long-term.

Strengths and limitations

By acknowledging nutrition as a socially inflected category, we were able to examine the nutritional practices of family meals in a sociological manner to enhance both clinical nutrition practice and the development of family meal interventions. To our knowledge, this is the first study of this kind within Canada, which is important as family meal and parenting expectations may vary across cultures and countries(Reference Moura and Aschemann-Witzel64,Reference Bornstein72) . Our study also provides a dual-parent perspective for a more complete understanding of the family meal context. However, there are limitations to note. Families signed up to participate in a study about mealtimes and, as such, may have more interest in mealtimes and food than families that did not sign up. While we found diversity in the mealtime orientations described, the orientations may not extend to those outside the study, to families with older children or to families that share fewer meals or do not participate in family meals at all. The majority of families participating in this study had fairly high income and educational attainment and the majority of parents identified as ‘white’; thus, results may not be generalisable to other populations. However, owing to our purposeful, maximum-variation sampling technique, the families participating in this qualitative sub-study were more ethnically diverse than the full study(Reference Walton, Haycraft and Jewell51). Future research should explore our mealtime orientations among more diverse populations and longitudinally across the lifespan.

Conclusions

In this study, we explored parents’ perceptions and experiences of family meals. Understanding how people make sense of eating and how their relationship with food intertwines lived experiences in family and socio-cultural contexts across the life course provides the knowledge required to create effective interventions geared to sustaining frequent family meals beyond the preschool years. Accordingly, we found participating families to primarily embody one of three overarching mealtime orientations that informed the context of their meals, the messages they share with their children during meals, and the challenges they experienced with mealtimes. Results suggest that understanding why families eat meals together has important implications for the intergenerational transmission of mealtime practices, as well as the intervention strategies that are likely to be beneficial to help families sustain the routine as their children age. While meal orientations often track throughout the life course, they are also fluid and vulnerable to life transitions. Future research should focus on understanding these orientations in more diverse populations and testing their ability to inform practice in a variety of settings including dietetic counselling and intervention planning.

Acknowledgements

Acknowledgements: The authors would like to thank the families who participated in FaMOS and that generously welcomed us into their homes to allow us to learn from their mealtimes. The authors would also like to thank the anonymous reviewers’ whose constructive comments significantly improved this manuscript. Conflict of interest: The authors declare that they have no competing interests. Funding: Funding provided by the Canadian Foundation for Dietetic Research (CFDR). Authorship: K.W., E.H. and J.H. obtained study funding and conceptualised the study design along with A.B. K.W. conducted study interviews and drafted the manuscript. K.W., A.B., J.G.W., K.J. and J.H. analysed the data. A.B. and J.G.W. provided expertise in qualitative methods. All authors interpreted results and reviewed and approved the final manuscript. Ethics of human subject participation: The study was conducted according to the guidelines laid down by the Declaration of Helsinki, and all study protocols were approved by the University of Guelph Research Ethics Board (REB# OC14033). Written informed consent was obtained from all participants.

References

Hammons, AJ & Fiese, BH (2011) Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics 127, e15651574.CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D, Hannan, PJ, Story, M et al. (2003) Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents. J Am Diet Assoc 103, 317322.CrossRefGoogle ScholarPubMed
Cooke, LJ, Wardle, J, Gibson, EL et al. (2004) Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children. Public Health Nutr 7, 295302.CrossRefGoogle ScholarPubMed
Fitzpatrick, E, Edmunds, LS & Dennison, BA (2007) Positive effects of family dinner are undone by television viewing. J Am Diet Assoc 107, 666671.CrossRefGoogle ScholarPubMed
Wyse, R, Campbell, E, Nathan, N et al. (2011) Associations between characteristics of the home food environment and fruit and vegetable intake in preschool children: a cross-sectional study. BMC Public Health 11, 938.CrossRefGoogle ScholarPubMed
Woodruff, SJ & Hanning, RM (2008) A review of family meal influence on adolescents’ dietary intake. Can J Diet Pract Res 69, 1422.CrossRefGoogle ScholarPubMed
Swanson, V, Power, KG, Crombie, IK et al. (2011) Maternal feeding behaviour and young children’s dietary quality: a cross-sectional study of socially disadvantaged mothers of two-year old children using the theory of planned behaviour. Int J Behav Nutr Phys Act 8, 65.CrossRefGoogle Scholar
Ackard, DM & Neumark-Sztainer, D (2001) Family mealtime while growing up: associations with symptoms of bulimia nervosa. Eat Disord 9, 239249.Google ScholarPubMed
Fulkerson, JA, Story, M, Mellin, A et al. (2006) Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors. J Adolesc Health 39, 337345.CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D, Wall, M, Story, M et al. (2004) Are family meal patterns associated with disordered eating behaviors among adolescents? J Adolesc Health 35, 350359.CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D, Eisenberg, ME, Fulkerson, JA et al. (2008) Family meals and disordered eating in adolescents: longitudinal findings from project EAT. Arch Pediatr Adolesc Med 162, 1722.CrossRefGoogle ScholarPubMed
Eisenberg, ME, Olson, RE, Neumark-Sztainer, D et al. (2004) Correlations between family meals and psychosocial well-being among adolescents. Arch Pediatr Adolesc Med 158, 792796.CrossRefGoogle ScholarPubMed
Goldfarb, SS, Tarver, WL, Locher, JL et al. (2015) A systematic review of the association between family meals and adolescent risk outcomes. J Adolesc 44, 134149.CrossRefGoogle ScholarPubMed
Fulkerson, JA, Kubik, MY, Story, M et al. (2009) Are there nutritional and other benefits associated with family meals among at-risk youth? J Adolesc Health 45, 389395.CrossRefGoogle ScholarPubMed
Snow, CE & Beals, DE (2006) Mealtime talk that supports literacy development. New Dir Child Adolesc Dev 111, 5166.CrossRefGoogle Scholar
Beals, D (2001) Eating and reading: links between family conversations with preschoolers and later language and literacy. In Beginning Literacy With Language: Young Children Learning at Home and School [Dickinson, D & Tabors, P, editors]. Baltimore, MD: Brookes Publishing.Google Scholar
McCullough, MB, Robson, SM & Stark, LJ (2016) A review of the structural characteristics of family meals with children in the united states. Adv Nutr 7, 627640.CrossRefGoogle ScholarPubMed
Miller, DP, Waldfogel, J & Han, WJ (2012) Family meals and child academic and behavioral outcomes. Child Dev 83, 21042120.CrossRefGoogle ScholarPubMed
Dwyer, L, Oh, A, Patrick, H et al. (2015) Promoting family meals: a review of existing interventions and opportunities for future research. Adolesc Health Med Ther 6, 115131.Google ScholarPubMed
DeBar, LL, Stevens, VJ, Perrin, N et al. (2012) A primary care-based, multicomponent lifestyle intervention for overweight adolescent females. Pediatrics 129, e611620.CrossRefGoogle ScholarPubMed
Sepúlveda, MJ, Lu, C, Sill, S et al. (2010) An observational study of an employer intervention for children’s healthy weight behaviors. Pediatrics 126, e11531160.CrossRefGoogle ScholarPubMed
Johnson, DB, Birkett, D, Evens, C et al. (2006) Promoting family meals in WIC: lessons learned from a statewide initiative. J Nutr Educ Behav 38, 177182.CrossRefGoogle ScholarPubMed
Rosenkranz, RR & Dzewaltowski, DA (2009) Promoting better family meals for girls attending summer programs. J Nutr Educ Behav 41, 6567.CrossRefGoogle ScholarPubMed
Utter, J, Denny, S, Farrant, B et al. (2019) Feasibility of a family meal intervention to address nutrition, emotional wellbeing, and food insecurity of families with adolescents. J Nutr Educ Behav 51, 885892.CrossRefGoogle ScholarPubMed
Ayala, GX, Elder, JP, Campbell, NR et al. (2010) Longitudinal intervention effects on parenting of the Aventuras para Niños study. Am J Prev Med 38, 154162.CrossRefGoogle ScholarPubMed
Fulkerson, JA, Friend, S, Flattum, C et al. (2015) Promoting healthful family meals to prevent obesity: HOME plus, a randomized controlled trial. Int J Behav Nutr Phys Act 12, 154.CrossRefGoogle ScholarPubMed
Fulkerson, JA, Rydell, S, Kubik, MY et al. (2010) Healthy home offerings via the mealtime environment (HOME): feasibility, acceptability, and outcomes of a pilot study. Obesity (Silver Spring) 18, Suppl. 1, S69S74.CrossRefGoogle ScholarPubMed
White, AA, Colby, SE, Franzen-Castle, L et al. (2019) The icook 4-h study: an intervention and dissemination test of a youth/adult out-of-school program. J Nutr Educ Behav 51, S2S20.CrossRefGoogle ScholarPubMed
Haines, J, McDonald, J, O’Brien, A et al. (2013) Healthy habits, happy homes: randomized trial to improve household routines for obesity prevention among preschool-aged children. JAMA Pediatr 167, 10721079.CrossRefGoogle ScholarPubMed
Savage, JS, Fisher, JO & Birch, LL (2007) Parental influence on eating behavior: conception to adolescence. J Law Med Ethics 35, 2234.CrossRefGoogle Scholar
Birch, L & Fisher, J (1998) Development of eating behaviors among children and adolescents. Pediatrics 101, 539549.Google ScholarPubMed
Birch, L (1999) Development of food preferences. Annu Rev Nutr 19, 4162.CrossRefGoogle ScholarPubMed
Skinner, JD, Carruth, BR, Wendy, B et al. (2002) Children’s food preferences: a longitudinal analysis. J Am Diet Assoc 102, 16381647.CrossRefGoogle ScholarPubMed
Martin-Biggers, J, Hongu, N, Worobey, J et al. (2013) Family meal behaviors and cognitions among parents of preschoolers. FASEB J 27, 367.3367.3.Google Scholar
Quick, BL, Fiese, BH, Anderson, B et al. (2011) A formative evaluation of shared family mealtime for parents of toddlers and young children. Health Commun 26, 656666.CrossRefGoogle ScholarPubMed
Martin-Biggers, J, Spaccarotella, K, Berhaupt-Glickstein, A et al. (2014) Come and get it! A discussion of family mealtime literature and factors affecting obesity risk. Adv Nutr 5, 235247.CrossRefGoogle ScholarPubMed
Watts, A, Berge, JM, Loth, K et al. (2018) The transmission of family food and mealtime practices from adolescence to adulthood: longitudinal Findings From Project EAT-IV. J Nutr Educ Behav 50, 141147.e141. CrossRefGoogle ScholarPubMed
Trofholz, AC, Thao, MS, Donley, M et al. (2018) Family meals then and now: a qualitative investigation of intergenerational transmission of family meal practices in a racially/ethnically diverse and immigrant population. Appetite 121, 163172.CrossRefGoogle Scholar
Malhotra, K, Herman, AN, Wright, G et al. (2013) Perceived benefits and challenges for low-income mothers of having family meals with preschool-aged children: childhood memories matter. J Acad Nutr Diet 113, 14841493.CrossRefGoogle ScholarPubMed
Berge, JM, Miller, J, Watts, A et al. (2018) Intergenerational transmission of family meal patterns from adolescence to parenthood: longitudinal associations with parents’ dietary intake, weight-related behaviours and psychosocial well-being. Public Health Nutr 21, 299308.CrossRefGoogle ScholarPubMed
Loth, KA, Uy, MJA, Winkler, MR et al. (2019) The intergenerational transmission of family meal practices: a mixed-methods study of parents of young children. Public Health Nutr 22, 12691280.Google ScholarPubMed
Friend, S, Fulkerson, JA, Neumark-Sztainer, D et al. (2015) Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents. J Fam Psychol 29, 136140.CrossRefGoogle ScholarPubMed
Ashley, B, Hallows, J, Jones, S et al. (2004) Food and Cultural Studies. London & New York: Routledge.CrossRefGoogle Scholar
Cairns, K & Johnson, J (2015) Food And Femininity. New York, NY: Bloomsbury Academic.Google Scholar
DeVault, M (1991) Feeding the Family: The Social Organization of Caring as Gendered Work, Women in Culture aand Society. Chicago and London: University of Chicago Press.Google Scholar
Ristovski-Slijepcevic, S, Chapman, GE & Beagan, BL (2010) Being a ‘good mother’: dietary governmentality in the family food practices of three ethnocultural groups in Canada. Health (London) 14, 467483.CrossRefGoogle ScholarPubMed
Crawford, R (2006) Health as a meaningful social practice. Health (London) 10, 401420.CrossRefGoogle ScholarPubMed
Elder, J (1995) The life course paradigm: social changes and individual development. In Examining Lives In Context, pp. 101139 [Moen, P, Elder, GJ & Luscher, K, editors]. Washington, DC: American Psychological Association.Google Scholar
Elder, GJ, Johnson, M, Crosnoe et al. (2003) The emergence and development of life course theory. In Handbook of the Life Course, pp. 319 [Mortimer, J & Shanahan, M, editors]. New York: Kluwer.CrossRefGoogle Scholar
Wethington, E & Johnson-Askew, WL (2009) Contributions of the life course perspective to research on food decision making. Ann Behav Med 38, Suppl. 1, S74S80.CrossRefGoogle ScholarPubMed
Walton, K, Haycraft, E, Jewell, K et al. (2019) The family mealtime observation study (FaMOS): exploring the role of family functioning in the association between Mothers’ and Fathers’ Food Parenting Practices and Children’s Nutrition risk. Nutrients 11, 630644.CrossRefGoogle ScholarPubMed
Patton, M (1990) Designing qualitative studies. In Qualitative Evaluation and Research Methods pp. 169186. Beverly Hills, CA: Sage.Google Scholar
Palinkas, LA, Horwitz, SM, Green, CA et al. (2015) Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health 42, 533544.CrossRefGoogle ScholarPubMed
Saunders, B, Sim, J, Kingstone, T et al. (2017) Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant 52, 18931907.CrossRefGoogle Scholar
Sobal, J (2001) Sample extensiveness in qualitative nutrition education research. J Nutr Educ 33, 184192.CrossRefGoogle ScholarPubMed
Statistics Canada (2016) Table  11-10-0241-01 Low income cut-offs (LICOs) before and after tax by community size and family size, in current dollars. Ottawa, Canada.Google Scholar
Braun, V & Clarke, V (2006) Using thematic analysis in psychology. Qual Res Psychol 3, 77101.CrossRefGoogle Scholar
Vaismoradi, M, Turunen, H & Bondas, T (2013) Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci 15, 398405.CrossRefGoogle ScholarPubMed
Hsieh, HF & Shannon, SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15, 12771288.CrossRefGoogle ScholarPubMed
Braun, V & Clarke, V (2013) Successful Qualitative Research: A Practical Guide for Beginners. Thousand Oaks, CA: Sage.Google Scholar
Mays, N & Pope, C (1995) Rigour and qualitative research. BMJ 311, 109112.CrossRefGoogle ScholarPubMed
Setterstein, R (1999) Lives in Time and Place: The Problems and Promises of Developmental Science. Amityville: Baywood.Google Scholar
Elder, J (2003) The emergence and development of life course theory. In Handbook of the Life Course, pp. 319 [Mortimer, E & Shanahan, M, editors]. New York: Kluwer.CrossRefGoogle Scholar
Moura, AF & Aschemann-Witzel, J (2020) A downturn or a window of opportunity? How Danish and French parents perceive changes in healthy eating in the transition to parenthood. Appetite 150, 104658.CrossRefGoogle ScholarPubMed
Litterbach, EV, Campbell, KJ & Spence, AC (2017) Family meals with young children: an online study of family mealtime characteristics, among Australian families with children aged six months to six years. BMC Public Health 17, 111.CrossRefGoogle ScholarPubMed
Berge, JM, Truesdale, KP, Sherwood, NE et al. (2017) Beyond the dinner table: who’s having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children? Public Health Nutr 20, 32753284.CrossRefGoogle ScholarPubMed
Le Heuzey, M & Turberg-Romain, C (2015) Nutri bébé 2013 Study Part 3/Behaviours of mothers and young children during feeding. Archives de Pediatrie 22, 10S2010S29.CrossRefGoogle Scholar
Patrick, H & Nicklas, TA (2005) A review of family and social determinants of children’s eating patterns and diet quality. J Am Coll Nutr 24, 8392.CrossRefGoogle ScholarPubMed
Harris, HA, Ria-Searle, B, Jansen, E et al. (2018) What’s the fuss about? Parent presentations of fussy eating to a parenting support helpline. Public Health Nutr 21, 15201528.CrossRefGoogle ScholarPubMed
Spagnola, M & Fiese, B (2007) Family routines and rituals: a context for development in the lives of young children. Infant Young Child 20, 284299.CrossRefGoogle Scholar
Pearson, N, Biddle, SJ & Gorely, T (2009) Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr 12, 267283.CrossRefGoogle ScholarPubMed
Bornstein, MH (2012) Cultural approaches to parenting. Parent Sci Pract 12, 212221.CrossRefGoogle ScholarPubMed
Figure 0

Table 1 Semi-structured interview guide exploring parent feeding practices and family meal experiences

Figure 1

Table 2 Demographics of participating families

Figure 2

Table 3 Description of the family mealtime orientations and the corresponding messages/goals parents have for children about mealtimes, food and eating