title: Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA.
abstract: Although existing evidence links breakfast frequency to better dietary quality, little is known specifically in regard to the benefits associated with eating breakfast together with one's family. The present study describes the prevalence and experience of having family meals at breakfast among rural families and examines associations between meal frequency and adolescent diet quality.
  
  
  
  Data were drawn from Project BreakFAST, a group-randomized trial aimed at increasing school breakfast participation in rural Minnesota high schools, USA. Linear mixed models were used to examine associations between student reports of family breakfast frequency and Healthy Eating Index 2010 (HEI-2010) scores while accounting for clustering within schools, demographics and household food security.
  
  
  
  Adolescent students from sixteen schools completed online surveys, height and weight measurements, and dietary recalls at baseline in 2012-2014.
  
  
  
  The sample included 827 adolescents (55·1 % girls) in grades 9-10 who reported eating breakfast on at most three days per school week.
  
  
  
  On average, adolescents reported eating breakfast with their family 1·3 (sd 1·9) times in the past week. Family breakfast meals occurred most frequently in the homes of adolescents who reported a race other than white (P=0·002) or Hispanic ethnicity (P=0·02). Family breakfast frequency was directly associated with adolescent involvement in preparing breakfast meals (P<0·001) and positive attitudes (P≤0·01) about mealtime importance, interactions and structure. Family breakfast frequency was unrelated to most diet quality markers.
  
  
  
  Family meals may be one important context of opportunity for promoting healthy food patterns at breakfast. Additional research is needed to better inform and evaluate strategies.
authors.affiliation: 1Division of Epidemiology and Community Health,School of Public Health,University of Minnesota,1300 South Second Street,Suite 300,Minneapolis,MN 55454,USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Larson
authors.affiliation: 2Biostatistical Design and Analysis Center,Clinical and Translational Science Institute,University of Minnesota,Minneapolis,MN,USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: 3Department of Family Medicine & Community Health,Program in Health Disparities Research,University of Minnesota,Minneapolis,MN,USA.
authors.forename: Jerica M
authors.initials: JM
authors.lastname: Berge
authors.affiliation: 3Department of Family Medicine & Community Health,Program in Health Disparities Research,University of Minnesota,Minneapolis,MN,USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Shanafelt
authors.affiliation: 3Department of Family Medicine & Community Health,Program in Health Disparities Research,University of Minnesota,Minneapolis,MN,USA.
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Nanney
mesh_terms: D000293:Adolescent; D062408:Breakfast; D003430:Cross-Sectional Studies; D004032:Diet; D005190:Family; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota; D012424:Rural Population
keywords: Adolescents; Dietary intake; Family meals; Rural