Background

Cross-sectional studies have suggested that when families share meals, they achieve better diet quality and improved nutrient intake, and to some extent are better able to maintain appropriate body weight. Family mealtime may act as a protective factor for many nutritional health-related problems. For example, they provide an opportunity for parents to model good eating behaviors and create a positive atmosphere by providing time for social interaction and thus a sense of social support for all members. This review focused on high-quality epidemiological studies to determine if there is an association between family shared meals and weight outcomes.

Conclusion statement

Limited evidence from prospective studies shows inconsistent relationships between the number of family and shared meals and body weight in children.

2015 DGAC Grade: Limited

Methods

Literature searches were conducted using PubMed, Embase and Cochrane databases to identify studies published in English in peer-reviewed journals from January 2004 to July 2014. Studies that met the following criteria were included in the review: randomized controlled trials (RCTs), prospective cohort studies; human subjects aged two years and older who were healthy or at elevated chronic disease risk; and studies conducted in the United States. The intervention or exposure was frequency or regularity of family and shared meals. The outcome was measures of diet intake including diet quality, foods and food groups and macronutrient intakes or proportions.

Data from each included article were extracted and risk of bias was assessed. The evidence was qualitatively synthesized, a conclusion statement was developed and the strength of the evidence (grade) was assessed using pre-established criteria that included evaluation of the quality and risk of bias, quantity, consistency, magnitude of effect and generalizability of available evidence.

Findings

• Three out of four prospective cohort studies found no association between frequency of family meals on body mass index (BMI) or overweight status
  • Evidence from one prospective study (two articles) showed that an increase in frequency of family meals lowered the likelihood of becoming overweight or the persistence of overweight
    • One study found that among overweight children, eating more family breakfast and dinner meals was associated with lower likelihood of becoming overweight or remaining overweight over a four-year period
    • Another article reported children who typically ate more breakfasts with their families had a reduced rate of increase in BMI over five years. The number of dinners eaten with family was not associated with change in BMI.
• One RCT included an intervention that simultaneously focused on four household routines including family meals. While there was a reduction of weight there was no change in family meal frequency
• Studies did not use a standard definition for family meals. Two studies assessed only family dinners, two studies assessed breakfast and dinner meals and two studies assessed all meals. No study assessed the quality of meals consumed or source of meals.

Limitations

• Studies described weekly frequency of family meals, but no studies described the quality of these meals
• There is no indication of food origin or location of consumption. Meals could have been purchased from restaurants or take-away establishments and brought home and consumed, or conversely, families could have consumed meals together at restaurant or other venue outside of the home.
• The only RCT was not able to assess the effect of family meal frequency on weight outcomes because the intervention failed to increase family meal frequency as intended.