How Food Rules at Home Influence Independent Adolescent Food Choices

Purpose: The prevalence of unhealthy dietary behaviors among adolescents is high. We examined the effect of having health-oriented food rules at home on the healthiness of adolescents' independent food choices, and the necessity of parental oversight for such rules to be effective. Methods: We surveyed a socioeconomically and racially diverse San Francisco Bay Area public high school in May 2017 (N = 1,246). We used ordinal logistic regressions to assess the relationships between adolescent-reported presence of health-oriented food rules at home and the healthiness of snacks selected by adolescents in a raffle, which included a randomized controlled experiment to manipulate the level of parental approval students needed to pick up their snacks. Results: Adolescents reporting at least one health-oriented food rule at home were significantly more likely to choose healthier snacks in the raffle (adjusted odds ratio, 1.85; 95% confidence interval [CI] 1.41-2.45). Telling adolescents that a parent needed to approve the snacks did not have a significant effect on snack choice healthiness relative to a no-approval baseline condition (adjusted odds ratio, 1.01; 95% CI .55-1.86). Post hoc analyses suggest that rules may affect adolescent food-related attitudes and perceptions of parental reactions; for example, adolescents with rules reported that their parents would be more disappointed (adjusted mean difference on five-point scale, .5; 95% CI .36-.64) if they made an unhealthy food choice. Conclusions: Having health-oriented food rules at home is associated with healthier snack choices. Findings suggest that adolescents with rules also hold beliefs that may correspond to healthier independent dietary choices. (C) 2018 Society for Adolescent Health and Medicine. All rights reserved.