ABSTRACT. Objective. We examined relationships between the presence of television during meals and children's food consumption patterns to test whether children's overall food consumption patterns, including foods not normally advertised, vary systematically with the extent to which television is part of normal mealtime routines.Methods. Ninety-one parent-child pairs from suburbs adjacent to Washington, DC, recruited via advertisements and word of mouth, participated. Children were in the fourth, fifth, or sixth grades. Socioeconomic data and information on television use were collected during survey interviews. Three nonconsecutive 24-hour dietary recalls, conducted with each child, were used to construct nutrient and food intake outcome variables. Independent sample t tests were used to compare mean food and nutrient intakes of children from families in which the television was usually on during 2 or more meals (n ؍ 41) to those of children from families in which the television was either never on or only on during one meal (n ؍ 50). Multiple linear regression models, controlling for socioeconomic factors and other covariates, were used to test strength of associations between television and children's consumption of food groups and nutrients.Results. Children from families with high television use derived, on average, 6% more of their total daily energy intake from meats; 5% more from pizza, salty snacks, and soda; and nearly 5% less of their energy intake from fruits, vegetables, and juices than did children from families with low television use. Associations between television and children's consumption of food groups remained statistically significant in multiple linear regression models that controlled for socioeconomic factors and other covariates.Children from high television families derived less of their total energy from carbohydrate and consumed twice as much caffeine as children from low television families. There continued to be a significant association between television and children's consumption of caffeine when these relationships were tested in multiple linear regression models.Conclusion. The dietary patterns of children from families in which television viewing is a normal part of meal routines may include fewer fruits and vegetables and more pizzas, snack foods, and sodas than the dietary patterns of children from families in which television viewing and eating are separate activities. Pediatrics 2001;107(1). URL: http://www.pediatrics.org/cgi/content/full/107/1/e7; television, food consumption patterns, dietary patterns.ABBREVIATION. NKAN, nutrition knowledge, attitudes, and norms.