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Family Meals for Better Health

By Lisa Andrews, MEd, RD, LD

As the pandemic rages on, family meal planning continues to take a hit, as many parents are working from home while their children are learning remotely. Parents have the added responsibility of becoming their child’s teacher’s aide, IT expert, and math tutor. Thus, timing of meals has been disrupted and frequent snacking is on the rise. Now more than ever, it’s important to reestablish family meal time.

Why Eat Together?
Research has shown that families that dine together have improved diet quality and overall health. A systematic review and meta-analysis of more than 203,000 subjects in 57 studies evaluated the connection between family meal frequency and nutritional health outcomes, including BMI, consumption of fruits and vegetables, and overall diet quality. In younger and older children across several countries, researchers saw a significant relationship between frequency of family meals and nutritional health. Age of the child, country, family members in attendance at meals, and which meal (breakfast, lunch, or supper) didn’t impact the relationship of meal frequency with healthful or unhealthful diet or BMI. Benefits were seen whether one or more parents were present at meals, and socioeconomic status was the best predictor of BMI.1

When families are experiencing stress or differences of opinion, family meals still make a difference. A 2018 study found that families with teens that have dinner with each other are more likely to make healthful food choices regardless of whether parents and children have problems talking or connecting emotionally. The report in JAMA Network Open found that even when families had trouble juggling daily routines or weren’t exceptionally close to one another, more frequent family dinners were linked with more healthful eating among teens and young adults.2

The researchers discovered that the more frequently teens and young adults ate dinner with their parents, the more often their overall diets contained fruits and vegetables, less fast food, and fewer sweetened beverages. The differences in healthful food intake were statistically significant despite being small.2

Reduced Obesity and Heart Disease
According to the Centers for Disease Control and Prevention, more than 18% of children aged 2 to 19 are considered to have obesity, with rates being slightly higher in middle-income families (19.9%), Hispanics (25.8%), and non-Hispanic African Americans (22%).3

A longitudinal study of more than 2,100 racially and socioeconomically diverse adolescents evaluated whether family meals protected them against becoming overweight or obese as young adults within 10 years. The Project Eating and Activity in Teens-III found that frequency of meals at baseline (one to two, three to four, or greater than five family meals per week) during the teen years significantly reduced the odds of having overweight or obesity as young adults. Family meals had a stronger impact in Black vs white young adults. This study showed that eating even a few family meals per week made a difference.4

Managing obesity in childhood aids in preventing adulthood obesity and potential chronic illness. A systematic review and meta-analysis evaluated 37 studies and found that high childhood BMI was linked with increased development of diabetes, coronary heart disease (CHD), and certain cancers. In children with overweight or obesity, 31% developed diabetes and 22% had risk of hypertension and CHD. However, the majority of adult chronic disease occurs in those who were at a healthy weight as children.5

Fewer Mental Health Issues
Not only is there a decrease in overweight, obesity, and heart disease among those who partake in family meals, but participants also have fewer mental health issues.

There’s no denying that the risk of childhood and teen suicide is on the rise. According to the Centers for Disease Control and Prevention, the rate of suicide among those aged 10 to 24 has increased 60% between 2007 and 2018.6 Stressors such as economic recession, moving to new schools and losing friends, and social media are cited as reasons for the rise in depression and suicide rates. These stressors have become even more pressing during the pandemic.

A systematic review on the impact of family meal frequency and psychosocial outcomes showed that frequent family meals were positively related to increased self-esteem and school success and inversely related to alcohol and substance use, violent behavior, feelings of depression, thoughts of suicide, and disordered eating.7

Family meals not only benefit children; they also benefit parents. A 2018 study examining whether family meals improved nutrition indicators, family relationships, and mental health was conducted in 889 US adults (mean age 31). Factors were controlled for demographic and household differences. Results showed that reports of frequent family meals were linked with higher family functioning, improved self-esteem, and reduced levels of stress and depression. Greater fruit and vegetable intake also were reported with more frequent family meals.8

Financial Health and Wealth
Cooking and eating meals at home also aids in financial health and confidence. A program known as Cooking Matters for Adults teaches low-income adults to shop and cook healthful meals with hands-on meal preparation, interactive grocery tours, and facilitated discussions. At the conclusion of the six-week program, which met twice per week, food resource management, cooking skills, and self-confidence all improved compared with controls who didn’t participate in the program. Participants also had less fear that food would run out before they had money to purchase more.9

A recent study showed that meals cooked at home were linked with better diet quality at no extra cost. The Seattle Obesity Study found that frequent dinners made at home were associated with marriage status, unemployment, larger families, the presence of children younger than 12, and lower frequency of dining out, but not related to income or education. Meals more frequently made at home were associated with less per capita food expenditure ($330/month in low cooking vs $273/month among high cooking groups) without a significant increase in at-home food costs. Home-cooked meals were associated with better dietary compliance than those eaten away from home.10

Getting People to Cook
As dietitians, we are uniquely poised to educate clients and consumers on the multiple benefits of frequent family meals. Use of social media or sites such as Pinterest can offer simple, inexpensive recipes. We also can reach people via Facebook Live, Instagram Stories, or online cooking classes.

When communities begin to open back up, faith-based cooking classes, classes in recreation centers, libraries, or after-school facilities also may be opportunities for us to teach important cooking and food budget skills, especially to higher-risk groups with health disparities.

— Lisa Andrews, MEd, RD, LD, is the owner of Sound Bites Nutrition, where she provides nutrition education through freelance writing, teaching, and cooking demos. She’s the creator of Lettuce Beet Hunger, food pun swag, and a consultant dietitian and freelance writer with Dietitian Pros Premier Nutrition Staffing. Dietitian Pros provides class-leading nutrition staffing services across the United States and recruits RDs to serve in temporary, part-time, or full-time positions.

References
1. Dallacker M, Hertwig R, Mata J. The frequency of family meals and nutritional health in children: a meta-analysis. Obes Rev. 2018;19(5):638-653.

2. Walton K, Horton NJ, Rifas-Shiman SL, et al. Exploring the role of family functioning in the association between frequency of family dinners and dietary intake among adolescents and young adults. JAMA Netw Open. 2018;1(7):e185217.

3. Prevalence of childhood obesity in the United States. Centers for Disease Control and Prevention website. https://www.cdc.gov/obesity/data/childhood.html. Updated June 24, 2019.

4. Berge JM, Wall M, Hsueh TF, Fulkerson JA, Larson N, Neumark-Sztainer D. The protective role of family meals for youth obesity: 10-year longitudinal associations. J Pediatr. 2015;166(2):296-301.

5. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17(1):56-67.

6. Hedegaard H, Curtin SC, Warner M. Centers of Disease Control and Prevention. Suicide rates in the United States continue to increase. https://www.cdc.gov/nchs/data/databriefs/db309.pdf. Published June 2018.

7. Harrison ME, Norris ML, Obeid N, Fu M, Weinstangel H, Sampson M. Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Can Fam Physician. 2015;61(2):e96-e106.

8. Utter J, Larson N, Berge JM, Eisenberg ME, Fulkerson JA, Neumark-Sztainer D. Family meals among parents: associations with nutritional, social and emotional wellbeing. Prev Med. 2018;113:7-12.

9. Pooler JA, Morgan RE, Wong K, Wilkin MK, Blitstein JL. Cooking matters for adults improves food resource management skills and self-confidence among low-income participants. J Nutr Educ Behav. 2017;49(7):545-553.e1.

10. Tiwari A, Aggarwal A, Tang W, Drewnowski A. Cooking at home: a strategy to comply with U.S. dietary guidelines at no extra cost. Am J Prev Med. 2017;52(5):616-624.