Eating together is a wellness tool

The family meal institution is an endangered species. Losing this important practice is worrisome, since family meals are linked with better nutrition, improved social skills, healthier eating habits, improved family connections and with lower obesity rates.

A meta-analysis in Pediatrics including 17 studies found that shared meals are linked with better nutritional health in kids – healthier weight, healthier choices and fewer eating disorders. Another meta-analysis, published in Obesity Reviews, including 57 studies with over 200,000 participants, finds that family meals are associated with lower risk of overweight, a healthier diet, and fewer unhealthy diet habits.

These pooled studies are correlational, but one can intuitively see why family meals could actually cause better habits: Family meals are usually composed of more nutritious foods, eating together enables role modeling of good habits by caregivers, it nurtures spending time and interacting with others, and it encourages slower, more mindful eating.

Frequent family meals, however, are likely more common in more organized homes, in homes with a higher socioeconomic status – homes with better eating habits and less obesity anyway.

The researchers therefore controlled for socioeconomic status in the meta-analysis, and even when controlling for socioeconomic status, more frequent family meals were correlated with better nutrition and weight status.

But whether eating together conclusively causes better nutrition or not, eating in company is a very good idea. The family meal offers a great opportunity to lead by example, communicate good habits and to bond.

Yet only about half of US households with two or more people eat meals together regularly.

Bringing families together – what works?

With busy and demanding schedules and the availability of processed and prepared foods increasing family meal frequency is challenging.

Which interventions support family meals? 

A new study in the journal Appetite looks at which interventions work best to improve the frequency and healthfulness of family meals especially among low-income families. Six different interventions were put to the test in different combinations, with 2 of the 6 intervention components tested together in each experiment, which makes for 64 different combinations. The interventions were:

• Cooking/Serving Resources: All the tools you need for cooking and serving a meal, including pots, pans, utensils, dishes etc.
• Meal Delivery: Prepared meals once a week , ready to warm up and serve.
• Ingredient Delivery: Delivery of ingredients to supply one meal a week.
• Community Kitchen: Participants were invited to a weekly group session in which you prepare one main dish to take home.
• Nutrition Education Classes: Participants were invited to attend a weekly group nutrition class that included food prep and tastings.
• Cooking Demos: Participants were invited to attend weekly group cooking lessons that included tastings.

These were tried with about 400 families recruited through Head Start, the age of children at the start of the trial was 3-4 years, and the interventions were tested for 8 weeks each.

The families were asked: “How many nights a week out of 7 did you and your child eat dinner together in the same place at home (such as around the table) for most of the meal?”. Families were also asked how many evening a week dinner was made mostly from scratch, how many nights a week dinner was cooked mostly or only from ready made foods (such as canned soup or boxed macaroni), how many nights food was from ready made dinners (such as frozen meals), and how many nights the parent/s or kid/s ate fast food (such as KFC, McDonalds) either at home or on premise.

The combination of Cooking/Serving Resources and Meal Delivery performed best and increased family meal frequency, cooking dinner from scratch, and prioritization of family meals; it also decreased the use of ready made and fast foods.

As you might imagine, supplying cooking and serving utensils, and supplying meals or ingredients garnered good participation. But getting busy parents to take part in weekly nutrition and cooking classes and demos was more challenging, and only 13-15 percent attended. Participation was so low that the researchers couldn’t even test the effectiveness of this intervention.

Eat with pleasure

Gathering around the table works even better to foster normal weight and health benefits when the atmosphere is positive. A study published in Pediatrics looks at key risk and protective factors for childhood obesity in the home, and includes 120 low–income kids and families from the Minneapolis/St Paul area, recording family meals at home for 8 days. These were all families that regularly shared meals, and told that the study focuses on “modern day” dinner, and to just eat as they always do. The video recordings were analyzed for interpersonal and food related behaviors. 

The researchers found that the atmosphere around the table matters: Families that enjoyed the meal, had warm, calm and positive conversations around the meal, had a higher frequency of normal weight. These results held true even after they were adjusted for parental weight.

On the other hand, hostility, frequent criticism, yelling, food lecturing (“children in other countries are starving”) and indulgent and inconsistent parenting were associated with heavier kids. Overweight kids also sat at the table for significantly shorter times.

Sharing meals with the people in your life depends on physical preconditions, such as arranging the time, space, utensils and food. These are barriers that may not be trivial, but well worth overcoming.

A virtuous cycle in which family members await this time to connect, talk and enjoy food and company – and reap the benefits – depends on making mealtimes as pleasurable as possible. 

Dr. Ayala