Promoting healthful family meals to prevent obesity: HOME Plus, a randomized controlled trial

Abstract

BackgroundFamily meal frequency has been shown to be strongly associated with better dietary intake; however, associations with weight status have been mixed. Family meals-focused randomized controlled trials with weight outcomes have not been previously conducted. Therefore, this study purpose was to describe weight-related outcomes of the HOME Plus study, the first family meals-focused randomized controlled trial to prevent excess weight gain among youth.MethodsFamilies (n = 160 8-12-year-old children and their parents/guardians) were randomized to intervention (n = 81) or control (n = 79) groups. Data were collected at baseline (2011–2012), post-intervention (12-months post-baseline) and follow-up (21-months post-baseline). The intervention included ten monthly group sessions (nutrition education; hands-on meal and snack planning, preparation, and skill development; screen time reductions) and five motivational, goal-setting phone calls. The main outcome was child body mass index (BMI) z-score.ResultsGeneral linear models, adjusted for baseline values and demographics, showed no significant treatment group differences in BMI z-scores at post-intervention or follow-up; however, a promising reduction in excess weight gain was observed. Post-hoc stratification by pubertal onset indicated prepubescent children in the intervention group had significantly lower BMI z-scores than their control group counterparts.ConclusionsThe study used a strong theoretical framework, rigorous design, quality measurement and a program with high fidelity to test a family meals-focused obesity prevention intervention. It showed a modest decrease in excess weight gain. The significant intervention effect among prepubescent children suggests the intervention may be more efficacious among relatively young children, although more research with appropriately powered samples are needed to replicate this finding.Trial registrationThis study is registered at www.clinicaltrials.gov NCT01538615. Registered 01/17/2012.

Reasons Parents Buy Prepackaged, Processed Meals: It Is More Complicated Than “I Don't Have Time”

“…20 HOME Plus aimed to prevent excess childhood weight gain through a family intervention promoting family meal frequency, healthfulness of meals and snacks, and reduction in screen time. The University of Minnesota Institutional Review Board approved the trial and procedures and parent/guardian participants provided written informed consent.…”

“…20,21 Recruitment criteria included English fluency, not planning to move within 6 months of trial start, no medical conditions that would limit study participation (e.g., life threatening food allergies), the 8–12 year old child’s BMI percentile (age and gender adjusted) at or above the 50 th %, and the child must live with the participating parent/guardian most of the time. Recruitment strategies included (a) flyers, (b) site visits by study staff and staff at recreation centers, and (c) small group presentations about nutrition and family meals placed in and around community centers where interventions were held.…”

“…Intervention participants were invited to attend 10-monthly intervention sessions; parent/guardian participants also received 5 goal setting phone calls throughout the intervention. 20,21 …”

Family dinner frequency interacts with dinnertime context in associations with child and parent BMI outcomes.

“…The HOME Plus study was designed to prevent childhood obesity through a family-focused intervention promoting family meal frequency, the healthfulness of meals and snacks, and reductions in screen time at meals (Fulkerson et al, 2015). The study was approved by the Institutional Review Board at the University of Minnesota.…”

Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes

“…51 Baseline surveys were completed by 160 parent–child dyads in their homes during the summers of 2011 and 2012 (two cohorts). 50 All adults and children provided written consent and assent, respectively. Families received a $75 gift card for participating in baseline data collection.…”