Profoundly, according to Project Eat
By Elizabeth Foy Larsen
It’s hard to believe that when Professor Diane Neumark-Sztainer came to the University of Minnesota’s School of Public Health in 1995, almost no one talked about teens’ attitudes about food. Today, childhood obesity and healthy eating are regular topics of public discourse, and even policy debates. That is due in no small measure to the path-breaking work of Neumark-Sztainer and her team of researchers at Project EAT, a longitudinal study through the Epidemiology and Community Health Division of the School of Public Health that identifies the influences of teens’ nutrition choices. Today, Project EAT’s findings—many of which are included in Neumark-Sztainer's book “I’m, Like, SO Fat!”: Helping Your Teen Make Healthy Choices About Eating and Exercise in a Weight-Obsessed World—have revolutionized our understanding of how our formative experiences with eating shape our relationship to weight and food.
According to your research, approximately one quarter of boys and girls are teased about their weight in middle and high school. How does that impact a person’s long-term associations with food?
The attitude about getting teased about your weight used to be “oh whatever, that’s just what happens.” But Project EAT showed that getting teased about your weight, whether it’s by friends or family members, predicts unhealthy weight control behaviors as you get older, including binge eating, skipping meals, using diet pills, and self-induced vomiting. It is also one of the strongest predictors for being overweight. We have learned that when adolescents feel worse about their bodies, it doesn’t motivate them to lose weight. Instead, it actually predicts weight gain over time because when you feel bad about your body, you engage in more unhealthy behaviors.
Project EAT has been a big player in conveying importance of family dinners. But for busy families, that can feel like yet another guilt trip. What’s your advice for parents when it comes to eating with their kids?
Family meals are about being together, so my advice is to keep it simple but healthy. You can serve carrot sticks and sandwiches or a bag salad and rotisserie chicken. And if your family isn’t eating together at all, just try and make gradual changes and don’t feel like you need to do it every day. Also, you want to avoid conflict at meals. Dinner isn’t the place to get down on your kid for not doing homework or chores.
Beyond family meals, are there other ways parents influence their kids’ attitudes about food?
Parents may think that they don’t matter as much as friends or peer pressure. But Project EAT has repeatedly shown they have a strong influence on what teenagers eat and that what is available at home matters when it comes to establishing eating habits. We have also found that when a parent is concerned about a child’s weight, talking to them about it and encouraging dieting backfires because it leads to all of the unhealthy eating behaviors that lead to weight gain over time. I tell parents to do more and talk less: Put out healthy food, do active things together, and leave weight out of the conversation. Don’t talk about your weight. Don’t talk about your child’s weight. Don’t talk about your aunt’s weight.
But what about the unhealthy foods so many of us eat? Should we urge our kids to avoid them?
Not always. We think it’s important for kids to see parents enjoying unhealthful food too. Instead of eating a piece of cake and worrying out loud that you blew your diet, it’s better if children experience adults enjoying many different types of food so that they don’t develop their own eating concerns.
Public health experts have done an excellent job getting the word out about the dangers of eating too much. But we know less about the issue of not having enough to eat. Has Project EAT addressed this issue?
In 2010, we did EAT 2010, which follows a new cohort of adolescents in the Minneapolis Public Schools. When we looked at the data and realized that 39 percent of the respondents reported some level of food insecurity—meaning that they had been hungry at some point because they didn’t have enough food—there was dead silence in the room. It was so sobering for everyone to know that is happening right here in our own community. And it has huge public health implications because in general, we find that food scarcity is also associated with higher levels of obesity because we live in a culture where food that is high in calories and low in nutrients is cheap.
What’s next on Project EAT’s research agenda?
We are just beginning to analyze our 15-year follow-up data and will be able to see how adolescent behaviors and family influences during adolescence continue into young adulthood, as our participants have their own families. Our long-term plans, which are contingent upon funding, are to follow our cohorts into adulthood to really learn about how these early influences contribute to long-term health so that we can guide public health interventions aimed at improving people’s quality of life. Our goal is always to translate our research into action.
Food for Thought
Since it began in 1997, Project EAT has conducted 250 research studies exploring teens’ attitudes and behaviors toward food. The ongoing research continues to deepen our understanding of how childhood experiences shape our relationship to food, weight, and body image. Here are some of the key findings.
- A high number of adolescent boys (38%) and girls (50%) use unhealthy weight control behaviors such as skipping meals, taking diet pills, and smoking cigarettes to lose or control their weight.
- Being teased about one’s weight in middle school or high school predicts poorer emotional well-being. It also leads to the use of unhealthy weight control behaviors in late adolescence and early young adulthood.
- Many adolescents skip breakfast and just 37% of participants in EAT 2010 reported eating breakfast daily.
- Participation in family meals varies widely among teens even though it’s associated with a number of positive outcomes, including better dietary intake, fewer unhealthy weight control behaviors, and better psychosocial health.
- Over the past decade, the ethnic and racial disparities in the prevalence of obesity increased, pointing to a need for more effective interventions to reach diverse populations.