key: cord-0738509-e1qo0ho3
authors: Barton, Jennifer M.
title: Food and beverage offerings by parents of preschoolers: A daily survey study of dinner offerings during COVID-19()
date: 2022-04-14
journal: Appetite
DOI: 10.1016/j.appet.2022.106047
sha: e6ef79c4d6463d4b1161b45a099ede254840cc3a
doc_id: 738509
cord_uid: e1qo0ho3

The COVID-19 pandemic is likely to have altered parents' daily feeding practices, including what and how much they feed their children, which may have negative implications for children's weight. The primary aim of this study was to examine patterns of and variation in parents' daily food and beverage offerings at dinner across 10 days during the COVID-19 pandemic using descriptive analysis and non-parametric tests. Ninety-nine parents (M(age) = 32.90, SD(age) = 5.60) of children ages 2–4 years (M = 2.82, SD = 0.78) completed an online baseline survey and 10 daily surveys (929 completed surveys) assessing their daily food and beverage offerings at dinner. On average, parents did not offer recommended foods and beverages on a daily basis; parents offered vegetables and protein most often across the 10 days, however, less than 50% of parents offered the recommended serving size for each group. The intraclass correlations and random sampling plots revealed considerable within-parent variation in food offerings. Eating dinner as a family, planning dinner in advance, and preparing a homemade dinner were associated with more vegetable and protein offerings, while processed, fast, or fried foods were offered less often when dinner was planned or homemade. Dairy, water, and refined grains were offered more often when dinner was homemade, while whole grains, processed, fast, or fried foods, and sugar-sweetened beverages were offered less often when dinner was homemade. The results provide documentation of parents' daily food and beverage offerings at dinner within the context of COVID-19 and point towards the importance of examining predictors and consequences of parents' daily feeding practices. (262/280 limit).

more autonomy (Phillipe et al., 2021). Parents' COVID-19-specific stress has also been linked to 1 offering less healthy food and snacks to children (Jansen et al., 2021) as well as to more 2 emotional eating among mothers (Wang et al., 2021) . Processed food sales (e.g., chips, popcorn, 3 candy) have also skyrocketed since the onset of the pandemic (Creswell, 2020; Skerrit et al., 4 2020), which may be linked with efforts to cope with stress, depression, or anxiety (Cummings et 5 al., 2021). For example, Wang and colleagues (2021) found that mothers reported using comfort 6 eating (e.g., candy, chips) as a way to cope with their COVID-19 stress and that mothers' 7 COVID-19 stress was marginally associated with emotional eating. 8

A positive consequence of the COVID-19 pandemic is that families spent more time 9

together and were likely to eat at home more often. Over 80% of U.S. parents reported feeling 10 grateful for the extra time they had with their children during the pandemic (APA, 2020b), and 11 more than half of U.S. adults reported that they were cooking at home more than pre-pandemic, 12

with 51% reporting that they would maintain their cooking habits after the pandemic (Hunter, 13 2020). Some reasons for increased cooking could be reduced access to restaurants and in-person 14 dining was discouraged to prevent transmission of COVID-19 (Luna, 2020 ; National Restaurant 15 Association Restaurant Law Center, 2020) as well as the misconception that COVID-19 could be 16 transmitted through food (International Food Information Council, 2020). Cooking at home is 17 associated with more healthful diets (Wolfson et al., 2016) , and increased cooking during the 18 pandemic may lead to healthier offerings in the future. The increase in cooking could also 19 suggest an increase in planning meals in advance, which is an effective strategy for engaging in 20 health behaviors (Anderson, 2020). Meal planning has been linked to healthier diets (Beck, 2007; 21 Neumark-Sztainer et al., 2014) and better physical and mental health outcomes (Fiese et al. , 22 2012) . Both cooking at home and meal planning may be important mechanisms for 23 J o u r n a l P r e -p r o o f understanding parents' feeding practices during the pandemic. However, current evidence is 1 limited; one study to date (Jansen et al. 2021) found that parents' snack planning during the 2 pandemic was associated with low-fat chip consumption, but snack planning was not 3 significantly associated with sweet snack or other savory snack consumption. Taken together, 4 further investigation is needed to document parents feeding practices during the COVID-19 5 pandemic. parents' food and beverage offerings within the context of a natural stressor, the COVID- 19 12 pandemic, is essential for documenting the potential for child overweight and obesity risk. foods and beverages for promoting healthy dietary patterns to promote health and prevent 18 disease (USDA, 2020). The primary recommended food groups, for adults and children above 19 age 2, include vegetables, fruit, protein, grains, dairy, and oils, and the primary recommended 20 beverages for children above age 2 include water, unsweetened milk (or unsweetened dairy 21 alternatives), and fruit juice without added sugar. Data from the NHANES 2013-2016 indicates 22

that most of the population (ages 1 and older) does not meet the recommended daily intakes for 23 J o u r n a l P r e -p r o o f vegetables, fruit, protein, grains, or dairy (USDA, 2020). According to the same USDA report, at 1 least 80% of the population does not meet the recommendations for vegetables, fruit, and dairy. 2 However, when considering only 2-to-4-year-olds, the average intake for fruits and protein are 3 within the recommended range, while vegetables and dairy are below the recommended range. 4

Another study using the NHANES data reported that 20% of children do not drink water on a 5

given day, and instead of water, they are more likely to consume beverages with sugar (Rosinger 6 et al., 2019) . 7

To capture day-to-day variation in parents' food and beverage offerings, a daily survey 8 (i.e., daily diary) approach must be employed. Unlike cross-sectional or traditional longitudinal 9 designs, daily surveys were created to examine everyday life experience in a natural context 10 (Bolger et al., 2003; Reis, 1994) . This type of design allows for daily variation in phenomena to 11 be captured, which is particularly useful for assessing changes in food and beverage offerings 12 across multiple days. This type of design has also been widely used in the psychological 13 parenting practices (i.e., coercive control, indulgence, structure, autonomy) before and during the 3 COVID-19 pandemic and reported reductions in structured and autonomy supportive practices 4 during the pandemic. In addition to how parents feed their children, it is important to capture 5 which foods and beverages parents offer to their children. 6

The aim of the current study was to describe patterns and variation in parents' food and 7 beverage offerings at dinner across 10 days of daily surveys during the COVID-19 pandemic. 8

Specifically, I examined how often parents offered both recommended (e.g., vegetables, fruit, 9

protein, dairy, whole grains, water) and non-recommended (e.g., refined grains, processed, fast, 10 or fried foods, sweets and desserts, sugar-sweetened beverages) foods and beverages at dinner, 11

and whether parents offered the recommended amounts of those items. I also examined whether 12 characteristics about dinner were associated with parents' food and beverage offerings, including 13 day of the week (weekday vs. weekend), having a shared family meal, planning dinner in 14 advance, and preparing a homecooked meal. Dinner was selected as the primary target for three 15 reasons: 1) to reduce participant burden so that parents would not have to recall all offerings 16 across the entire day; 2) parents may be more likely to personally feed their children dinner than 17 they would earlier meals and snacks, given that many young children may have returned to section. Based on previous research, I anticipated that the majority of parents would not offer the 1 recommended foods and beverages (e.g., vegetables, fruit, protein, dairy, whole grains, and 2 water) at dinner on a daily basis, and on days where parents do offer recommended foods and 3 beverages, they would offer less than the recommended serving size. However, due to the 4 exploratory nature of this aim, no further directional hypotheses were made. 5 Eighty-six percent of parents identified as being currently married, 49% of parents held a 13

Bachelor's degree, 41% of parents were considered to have a healthy body mass index and 59% 14 were considered overweight or to have obesity (for reference, roughly 73% of US adults are 15 considered overweight or having obesity using BMI; Fryar et al., 2020), and the median 16 household income was $82,500 (ranging from $3,000 to $325,000). Nineteen states in the U.S. Texas, Utah, Virginia, and Washington. The target children were 51% female (n = 51) and 20 averaged 2.82 years of age (SD = .78), with 52% (n = 51) of children having returned to school 21

in Fall 2020 and 9% (n = 9) having an identified food allergy. Twitter, to recruit 100 parents of 2-to 4-year-old children from September 2020 to November 2 2020 (no data collection occurred on holidays); a target sample size of 100 parents to complete 3 10 daily surveys was set to result in 1,000 observations, which should be sufficient to examine 4 within-person associations in future analyses (Nezlek, 2020) . To be eligible for inclusion, parents 5 had to be at least 18 years of age, have at least one child born between 2016-2018, be able to 6 complete the survey in English, be currently living in the U.S., be living with their child during 7 the stay-at-home orders in spring 2020, and be living with their child at the time of the study. All 8 parents were individually screened via email prior to enrollment, and following enrollment, 9

parents were sent a link to an online survey via Qualtrics (http://www.qualtrics.com/). 10

Using the baseline survey Qualtrics link, parents were presented an informed consent 11 page and then completed a tick-box indicating their consent to participate. The daily surveys 12 began 2-3 days after the baseline self-report survey was sent to parents and continued for 10 13 consecutive days; completion of the baseline survey was confirmed prior to beginning the daily 14

surveys. This length of time is comparable to typical daily survey studies ranging from 7 to 14 15 days (e.g., Maher et al., 2013; Santiago et al., 2016) . In the daily surveys, parents completed a 16 brief battery of measures related to their daily experiences and the food and beverages they 17 offered to their children for dinner. If parents had more than one child in the 2-to-4-year range, 18 parents were instructed to select their youngest child in that age range on whom to report. An 19 online text-messaging service, TextMagic (https://www.textmagic.com/), was used to send daily 20 text messages and reminder text messages to participants containing an electronic Qualtrics link 21 to complete the daily survey for 10 consecutive days. They were able to access the daily surveys 22

between 5 pm and 3 am to ensure that dinner for the respective day was captured and to reduce 23 J o u r n a l P r e -p r o o f errors in reporting. The daily surveys were accessible via a web-browser on both mobile devices 1 and laptop or desktop computers. The median completion time for the daily surveys was 9 2 minutes. Participants were compensated $10 for completion of the baseline survey, $30 for 3 completion of the daily surveys ($3/per day for 10 days), and $10 for completion of the entire 4 study. The study was approved by the Institutional Review Board at the University of Texas at 5

Austin (reference #: 2019-12-0029). 6

In each daily survey, parents were presented with a list of 33 foods and beverages and 9

were asked to indicate which foods and beverages they offered to their child for dinner that night beverages were categorized into the following food groups: vegetables (4 items), fruits (1 item), 12 protein (5 items; including alternative proteins commonly consumed by vegetarians), whole 13 grains (1 item), refined grains (2 items), dairy (4 items), processed, fast, or fried foods (5 items), 14 and sweets and desserts (2 items). Two beverage categories were created to assess water (1 item) 15 and sugar-sweetened beverages (2 items) were offered each night. The food and beverage groups 16 were selected to reflect the 2020-2025 Dietary Guidelines for Americans (USDA, 2020). 17

Example items include red or orange vegetables, dark green vegetables, white or sweet potatoes 18 (excluding French fries), fruit (any kind), refined grains (such as white bread, white rice, corn 19 products), whole grains (such as brown rice, wheat breads, quinoa), white meat or poultry 20 (excluding fried white meat), red meats (excluding hot dogs and bacon), pizza, chicken nuggets 21 or other fried chicken, candy/cake/pie/cookies, frozen treats (such as ice cream), soda or fruit 22 juice with sugar, water (any kind), and dairy milk. Parents were also given blank options if they 23 J o u r n a l P r e -p r o o f were not sure how to categorize the food or beverage offered, or if the food or beverage was not 1 reflected on the list provided. There were 61 days where parents used a blank option, and their 2 responses were assigned to the appropriate item. At the item-level, offered foods and beverages 3 were coded as "1" and non-offered foods and beverages were coded as "0". For food and 4 beverage groups with more than one item, if at least one item in that group was offered at dinner, 5 a score of "1" was assigned to that food or beverage group. If no items in that group were 6 offered, a score of "0" was assigned to that food or beverage group. As a result, all food and 7 beverage groups were dichotomized to indicate whether each group was offered at dinner or not. 8

For each food or beverage offered at dinner, parents were also asked to indicate the 9 serving size offered. Parents were presented with three serving size options for each of the 33 10 food and beverage items based on the 2020-2025 Dietary Guidelines (USDA, 2020) and the 11

American Academy of Pediatrics (2019). The serving size options were specific to children in 12 the targeted age range (2-to-4 years of age), and prior to survey administration, the serving sizes 13 were reviewed and validated by a panel of experts. For example, the recommended serving size 14 for red or orange vegetables for 2-to 4-year-old children is roughly ½ cup, and parents were 15 asked if they served less than ½ cup, equal to ½ cup, or more than ½ cup. Similarly, the 16 recommended serving size for white meat or poultry is 3 oz. filet (size of your palm), and parents 17 were asked if they served less than 3 oz. filet (size of your palm), equal to 3 oz. filet (size of your 18 palm) or more than 3 oz filet (size of your palm). The actual recommended serving size was not 19 revealed to parents in the instructions or response options, but the recommended serving size was 20 always the middle option. The response options were coded into three groups: less than the 21 recommended serving size, equal to the recommended serving size, and more than the 22 recommended serving size. 23 J o u r n a l P r e -p r o o f

Within-person daily characteristics included whether it was the weekday vs. weekend (1 2 = weekday), whether all or most of the family ate dinner together (1 = dinner together), whether 3 the dinner was planned in advance (1 = planned), and whether the dinner was homemade (1 = 4 homemade). 5

To address my primary aim, which was to examine patterns of and variation in parents' 7 food and beverage offerings across the 10 days of daily surveys, I conducted a visual inspection 8 of the data in two ways: proportion of food and beverage offerings by daily survey number and 9

average proportion of food and beverage offerings and serving size of offerings. I then estimated 10 random coefficients models for each food and beverage group to calculate intraclass correlations 11 (ICCs) indicating the amount of variability that is attributable to within-or between-subjects' 

Participants collectively completed a total of 929 daily surveys across the 10-day period, 19 averaging 9.38 daily surveys per participant (SD = 1.14). The 61 missing daily surveys, out of a 20 potential total of 990 equates to 6.16% total missing. Chi-square tests were conducted to 21 determine whether missing data were more likely to occur on weekdays vs. weekends; no 22 significant differences were found. This percent missing (6%) is considered inconsequential 23 J o u r n a l P r e -p r o o f (Bennett, 2001; Schafer, 1999) . Eighty-two percent of the time (i.e., 761 days), parents 1 personally fed their child dinner that night and there were 95 days on which parents knew what 2 was offered to their children for dinner even if they did not personally feed them. There were 22 3 days in which parents did not personally feed their child and did not know what their child was 4 offered for dinner; these 22 days were omitted from analysis, which resulted in 907 daily surveys 5 used for analysis. 6

Figure 1 depicts the proportion of the sample who offered at least one item from each 8 food or beverage group by daily survey number (i.e., day in study). The two most offered food 9 groups were protein and vegetables; between 53% and 70% of parents reported offering protein 10 and vegetables across the 10 days. Dairy, water, and refined grains offerings ranged from 42% to 11 59% of the time. The remaining food and beverage groups were offered less than 40% of the 12 time; fruit ranges from 25% to 40% of the time, processed, fast, or fried foods ranges from 26% 13 to 35%, sweets and desserts range from 12% to 25%, sugar-sweetened beverages range from 3% 14 to 16%, and whole grains ranges from 2% to 13%. Although there was some variability over 15 time, the general trend for each food and beverage group was relatively stable. 16 Figure 2 depicts the average proportion of food and beverage offerings at dinner across 17 the 10 days and, when offered, whether parents offered less than, more than, or equal to the 18 recommended serving size for each food and beverage group. Because processed, fast, or fried 19 foods, sweets and desserts, and sugar-sweetened beverages are not recommended groups, these 20 groups were only coded as "more than recommended size". 21

Parents offered protein and vegetables at dinner 60% to 62% of the time. On days that 22

parents offered protein or vegetables, 57% to 65% offered their children less than the 23 recommended serving size, 30% to 39% offered the recommended serving size, and 4% offered 1 more than the recommended serving size. Dairy and water were offered around 50% of the time. 2

When dairy was offered, the majority (53%) of parents offered less than the recommended 3 serving size, while 41% offered the recommended serving size, and 6% offered more than the 4 recommended serving size. Fifty-seven percent of water offerings were equal to the 5 recommended serving size, while 18% offered less than the recommended serving size and 25% 6 offered more than the recommended serving size. Whole grains were sparingly offered, and 7 when parents did offer whole grains, 49% did not offer enough and 51% did not offer the 8 recommended serving size nor more than the recommended serving size. This evidence suggests 9 that, in general, parents were not offering recommended food and beverages (i.e., vegetables, 10 fruits, protein, dairy, whole grains, water) to their children for dinner on a daily basis. 11

On average, refined grains (50%) were offered 42% more often at dinner than whole 12 grains (8%), and when refined grains were offered, 47% of parents offered the recommended 13 size, 39% offered less than the recommend serving size, and 14% offered more than the 14 recommended serving size. Compared to whole grains, refined grains were offered 6 times more 15 often. Processed, fast, or fried foods were offered 30% of the time, sweets and desserts 17% of 16 the time, and sugar-sweetened beverages 9% of the time; when each group was offered, 100% of 17 parents offered more than the recommended serving size. In other words, parents did not offer 18 processed, fast, or fried foods, sweets and desserts, or sugar-sweetened beverages greater than 19 30% of the time for dinner, or roughly equal to 3 days. .46 (sugar-sweetened beverages). These food and beverage groups are correlated .07-.60 across 8 days, indicating greater evidence of within-person variability, rather than between-person 9 variability, which suggests the ability to test future within-person associations. offerings within-and between-parents, which aligns with the ICCs presented above. 16

Chi-square tests were conducted to determine whether reports of parents' food and 18 beverage offerings at dinner differed by weekday vs. weekend, by whether all or most of the 19 family ate dinner together, by whether dinner was planned in advance, and by whether the dinner 20 was homemade (see Table 1 ). Vegetables and protein were offered more when the family ate 21 dinner together (χ 2 (1) = 34.65, p < .001, χ 2 (1) = 24.60, p < .001, respectively), when dinner was 22 (1) = 83.72, p < .001, χ 2 (1) = 59.40, p < .001). Processed, fast, or fried foods were offered less 1 often when the meal was planned (χ 2 (1) = 15.26, p < .001) or when dinner was homemade (χ 2 2

(1) = 102.50, p < .001). Dairy, water, and refined grains were offered more often when dinner 3 was homemade (χ 2 (1) = 15.27, p < .001, χ 2 (1) = 5.19, p < .05, χ 2 (1) = 15.17, p < .001, 4 respectively), while whole grains and sugar-sweetened beverages were offered less often when 5 dinner was homemade (χ 2 (1) = 11.58, p < .01, χ 2 (1) = 7.94, p < .01). No significant differences 6 emerged for weekdays vs. weekends. 7

Currently, there is limited research examining parents' feeding practices during the 9 COVID-19 pandemic. A key finding from this descriptive analysis of parents' food and beverage 10 offerings is that parents are not offering their children recommended foods and beverages, such 11 as vegetables, fruit, protein, whole grains, dairy, and/or water, on a daily basis for dinner during 12 the pandemic. Across the entire sample, parents' food and beverage offerings remained relatively 13 stable throughout the 10 days; protein, vegetables, dairy, water, and refined grains were the five 14 most offered food and beverage groups. However, most parents did not offer these recommended 15 food groups on a daily basis for dinner, and only offer vegetables and protein just over half of the 16 time and offer fruit, dairy, and water half of the time or less. This study was novel in exploring 17 patterns of and daily variation in parents' food and beverage offerings at dinner during the 18 pandemic and was conducted in a more ecologically valid framework than past research. 19

The trends identified in recommended food and beverage offerings were fairly consistent However, when non-recommended foods and beverages are requested by their children, parents 2 may use this opportunity to teach their children about which foods and beverages that can be 3 consumed "anytime" versus foods and beverages that should be consumed "sometimes" 4 Non-recommended foods and beverages, namely processed, fast, or fried foods, sweets 6 and desserts, and sugar-sweetened beverages, were offered less than 3 days per 10 days at dinner, 7

with the exception of refined grains, which were the primary grain source offered to children 8 across the 10 days. At the population-level prior to the COVID-19 pandemic, U.S. children were 9

exceeding the recommended limit of added sugars, saturated fat, and sodium intake, which 10 should be limited to 10% of total calories per day for added sugars and saturated fat and limited 11 to 1,200 mg for sodium (USDA, 2020). Alternatively, almost 100% of the U.S. population's 12 grain intake is from refined grains (USDA, 2020), which is consistent with 2-to-4 year-old's at 13 the population-level and this current study. Some possible explanations for these findings may be 14 that parents are limiting restaurant visits, that only dinner data was reported, or that parents' own 15 grain preferences influenced their offerings. Due to COVID-19 restrictions, parents may be less 16 likely to visit a restaurant to pick-up or dine-in for dinner, and instead, parents may opt to cook 17 dinner at home, which may be linked to healthier meals compared to restaurant meals (Lachat et cooking at home are associated with more healthful offerings to childrenboth in the current 5 study (during the pandemic) and the existing literature (prior to the pandemic)but continued 6

focus is needed to educate and encourage parents to eat together as a family, to plan meals in 7 advance, and to cook at home regularly. 8

The current study has several strengths and important implications for parents' feeding 9

practices during a naturally occurring stressful event, namely the COVID-19 pandemic. First, to 10 my knowledge, this is the first study to examine parents' food and beverage offerings at dinner 11 using a daily survey approach during the pandemic. Prior to the pandemic, several EMA studies 12 previous work by providing an initial glimpse into parents' daily offerings at dinner during the 18 pandemic; one caveat of these findings is that they are specific to the period of COVID-19 rather 19 than documenting changes in parents' feeding practices due to COVID-19. Second, I used daily 20 measures of parents' food and beverage offerings at dinner using a comprehensive checklist, 21

including estimated serving sizes for each offered item. There is a noticeable amount of variation 22

in parents' offerings across the 10 days, and few parents reported offering their child 23 J o u r n a l P r e -p r o o f recommended foods and beverages every day, which suggests that parents may not be 1 responding in a socially desirable manner (e.g., reporting offering vegetables every day). The 2 temporal window for reporting was small, which may also help reduce biased responding. 3

Parents received their daily surveys at 5 PM, a reminder at 9 PM, and was only available until 3 4 AM; thus, parents only had to recall the food and beverages they offered that evening. 5

Several limitations of this study need to be considered. First, the current study is 6 relatively homogenous with respect to parent sex, race, ethnicity, education, and income. This 7 sample may be less at risk for experiencing financial strain or food insecurity, in general, but also 8 may be less likely to have been negatively affected by the COVID-19 pandemic (e.g., loss of job, 9

loss of home). On a related note, there may be a potential selection effect; parents who are 10 having more difficulty during the pandemic may have declined to participate or the sampling 11 technique failed to reach these parents. Thus, the results of this study may not generalize well to 12 other populations and additional effort must be made to recruit a more diverse sample in the 13 future, which include partnering with programs such as Woman, Infants, and Children and the 14 Supplemental Nutrition Assistance Program. Second, the measure of parents' food and beverage 15 offerings is an approximation of child dietary intake. The standard method of measuring dietary 16 intake is repeated 24-hour dietary recalls (Gibson et al., 2017), which is an in-depth interview to 17 assess energy intake. Using this method, the researcher can ascertain more precise estimates of 18 food and beverage offerings and can be used to retrieve micronutrient estimates. However, this 19 would be too cumbersome for participants to complete for 10 consecutive days, and because 20 parents' behavior was the primary focus, a brief measure of daily food and beverage offerings 21 was created to determine if parents were, at the least, offering recommended foods and beverages 22

to their children at dinner. The current study could be extended by employing an EMA approach, 23 J o u r n a l P r e -p r o o f in which parents could be prompted throughout the day to provide information about their food 1 and beverage offerings from morning until evening to account for additional feeding 2 opportunities. A related concern is that parents may be unable to accurately estimate the serving 3 sizes offered to their children (Blake et al., 2015; More, 2013). For example, parents may not 4 know how much their child should eat or drink or may not be able to estimate the exact size 5 offered (e.g., ½ cup vs. 1 cup). Third, the inclusion criteria for participation in the study was 6 limited to one parent from each household, those who lived with their children full-time during 7

the stay-at-home orders, and those who currently live with their child full-time. Divorced (or 8 separated) families with were likely excluded from this study if their child did not live with them 9

full-time, and thus, parents would not be able to report what their child had for dinner for 10 10 consecutive days. 11

This study documented parents' food and beverage offerings at dinner on a daily basis 13 during the COVID-19 pandemic. On average, parents did not offer recommended foods and 14 beverages on a daily basis. Parents offered vegetables and protein most often across the 10 days, 15 however, less than 50% of parents are offered the recommended serving size for each group. The 16 intraclass correlations and random sampling plots revealed considerable within-person variation. 17

This study also demonstrates that the characteristics of dinner, such as eating together as a 18

family, planning meals in advance, and preparing homemade meals, are associated with greater 19 offerings of recommended foods and beverages. These characteristics may be important targets 20

for combatting daily barriers, such as parents' stress, and future analysis should test daily 21 associations between parents' stress, meal characteristics, and food and beverage offerings. COVID-19, volume one. https://www.apa.org/news/press/releases /stress/2020/report. Note. Protein included poultry or white meat (excluding fried poultry or white meat), red meats (excluding hot dogs, bacon), meat alternatives (e.g., tempeh, tofu), eggs, and legumes (e.g., lentils, chickpeas). Dairy included dairy milk (unflavored), cheese, other dairy products (e.g., yogurt), and milk alternatives (e.g., almond or soy milk). Note. Grains were divided into two groups: whole grains and refined grains. Whole grains included brown rice, wheat breads, ancient grains, and refined grains included white rice, white bread, and corn products. Pasta, such as spaghetti and macaroni, were included in the refined grains group. Water included still and/or sparkling water (e.g., tap, bottled, or canned). Note. Processed, fast, or fried foods included processed meats (e.g., hot dog, bacon), burgers (cheese or plain), breaded and fried chicken products (including nuggets), pizza (any kind), and other fried foods (e.g., French fries, chips). Sweets/desserts included frozen teats (e.g., ice cream, popsicles, milkshakes) and sweets and baked goods (e.g., candy, cookies, slice of cake). 

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