The Benefits of the Family Table
American College of Pediatricians - February 2021
ABSTRACT
The custom of regularly eating together as a family is common to most cultures. There are proven benefits to every member when mealtime is a family affair. Families today, however, are less likely to gather at meal times than in the past. Given the protective factors that are conveyed to children and adolescents, pediatricians should encourage parents to make every effort to regularly gather around the “Family Table” for meals.
Introduction
Over the past three decades, family time at the dinner table and family conversation, in general, has declined by more than 30%. Families with children under age 18 report having family dinners three to four times per week. One third of families with 11- to 18-year-olds only eat one or two meals a week together. Only one fourth eat seven or more family meals per week.1
The experience at the meal table has also declined in quality with the increase in distractions, such as television watching, text messaging, phone conversations and social media.2 Barriers to family meals cited by parents include: too little time, child and adult schedule challenges, and food preparation. Most parents, however, say they place a high value on family meals, ranking them above every other activity (including vacations, playing together and religious services) in helping them connect with their families and children. Most wish they had more family dinners.
Evaluating the Literature
When evaluating the scientific research on the effects of the “Family Table,” it is important to take into consideration the number of family members present and the frequency of the family meals, as well as the type of study (cross-sectional versus longitudinal). Studies have found that benefits such as maintenance of normal body weight, healthy eating patterns, and less disordered eating are found when families eat at least three meals per week together.3
It is also difficult to differentiate the effect of overall quality of childrearing by parents who practice family meals from the benefits of the family meal itself. However, even the most rigid research demonstrates the benefits to be specific to the family table, especially for adolescents who are less likely to experience depressive symptoms if there are more family meals.4
Researchers have attempted to define the characteristics of family meals that are the most beneficial. One meta-analysis of 50 studies found six components to be consistently associated with the nutritional benefits for the children.5 These characteristics are: turning off the television, parental modeling of healthy eating, higher food quality, a positive atmosphere, children’s assistance with food preparation, and longer meal duration.
Definition / Description of the Family Table
The term “Family Table” obviously describes the situation in which the family shares time together while eating a meal, but it is much more than that. It is a time of open communication in a relaxed setting, allowing all family members to share ideas and experiences.
Implementation of the Family Table
Every family will choose to implement the family table in a unique way that fits the lifestyle and culture of the members. Here are some guidelines to consider:
Allow your children to help you with food preparation, whenever possible.
Eat together as a family whenever you can, even if just two of you are home at the time.
Designate a location in your home for most of your family meals.
Turn off the television, computer, and all personal digital devices.
During the meal encourage pleasant and respectful conversation
To encourage conversation, consider utilizing a technique such as sharing a “rose, thorn, bud” - something during the day that was happy (rose), sad (thorn), and bud (something the person is looking forward to)
Other conversation ideas can be found at The Family Dinner Project https://thefamilydinnerproject.org/
Serve a variety of healthy foods during the week.
Ideally, serve the same foods to all family members, thus avoiding “short-order cooking” and encouraging variety in the diet.
Require that everyone stay at the table until all family members have finished.
Enjoy the moment - don’t rush the meal or conversation.
Benefits of the Family Table
As early as 1943, researchers were discussing the benefits of the Family Table from a sociological and cultural viewpoint. “Family table talk is an essential part of the process whereby the family inducts the child into the life of society."6 Family meals allow the parents to impart values and traditions, as well as demonstrate appropriate relationships, communication techniques, and problem solving skills.
Family meals are powerful for many reasons. First, meal times impact all of our senses – the sight, touch, taste, and smell of food, as well as listening to family conversation. Family meals offer the opportunity to spend time together, reconnect after a busy day, communicate with and listen to each other, share values and ideas, and problem solve.
Family meals also contribute to traditions that tie families together. A special food for a birthday celebration, a favorite place to eat for special occasions, a cultural or ethnic food unique to the family’s heritage – these become traditions that provide meaning and context for children as they grow.
Family meals provide structure for the day, allowing children to feel more secure and safe, knowing what to expect. They also permit parental monitoring of children’s moods, behavior, and activities, providing parents with insight into the emotional well-being of their children. When extended to neighbors and friends, family meals allow children to learn and appreciate social interactions, understand the importance of community, and experience different ideas while under the guidance of their parents.
The family table is one of the very few places that children can observe their parents interact, negotiate, solve problems, express emotions and treat one another with respect. A child’s world is mostly spent with peers and teachers; the family table gives them a chance to see how adults interact and cooperate.
Improved Academics
Language development is enhanced.
Mealtimes offer unique opportunities for children to learn as they have a greater likelihood of hearing conversations that include explanations and narratives.7
Children expand their vocabularies as they hear new words used in conversations.8
There is a connection between children’s language experiences during their preschool years and their future literacy skills in grade school and high school.9
Teens who have frequent family dinners are more likely to obtain better grades in school.10
“Teens who have dinner with their families seven times a week are almost 40% likelier to say they receive mostly A’s and B’s in school compared to teens who have dinner with their families two or fewer times a week (62%vs. 45%).”11
Improved family relationships/socialization
Teens having frequent family dinners are more likely to report having excellent relationships with their family.
One-and-a-half times more likely to have an excellent relationship with their mother.12
Twice as likely to have an excellent relationship with father.13
Twice as likely to have an excellent relationship with sibling(s).14
Teens surveyed state they like family mealtimes.
71% of teenagers in one survey said that they consider talking/catching up, and spending time with family members as the best part of family dinners.15
Parents and adolescents agree that sharing meals has a positive influence on the family16
More family talk occurs during mealtime than during any other activity, including playing with toys and storybook reading.17
Family meals benefit all children, including those with disabilities, by helping them improve their social skills.18
Improved nutrition / decreased obesity
Children ages nine to 14 who have more regular dinners with their families have more healthful dietary patterns, including eating more fruits and vegetables, less saturated and trans fat, fewer fried foods and sodas, lower glycemic load, and more vitamins and other micronutrients.19
Children are 35% less likely to engage in disordered eating.20
Children are 24% more likely to eat healthier foods21
Toddlers demonstrate less fussy eating behaviors and eat more nutrient-dense food during family meals.22
Even preschool children have improved intake of fruits and vegetables when they participate in family meals.23
Preschool-aged children exposed to the three household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had a 40% lower prevalence of obesity than those exposed to none of these routines. These household routines may be promising targets for obesity-prevention efforts in early childhood.24
Children are 12% less likely to become obese just by eating family meals.25
Children especially benefit when family meals include more positive interpersonal interactions with warmth and positive reinforcement.
In one study, low-income minority families experienced a significant decrease in childhood obesity when family meals (that were videotaped and coded by researchers) demonstrated nurturing relationships.26 This was true even though the average meal lasted only 16 minutes.
Adolescent females from homes where the family regularly ate meals together more than five meals per week had a much lower likelihood of disordered eating (e.g. less: self-induced vomiting, laxative use, diet pill ingestion, fasting, eating very little food, using food substitutes, skipping meals).27,28,29
Teens who ate with the family ate more vegetables, fruits, and dairy products.30, 31
Adolescents who participate in family meals have a more positive body image.32
Adolescents who eat meals with their families benefit from long term effects. Those adolescents who ate meals with their families were significantly less likely to be overweight 10 years later, even if they only ate 1 - 2 meals per week together.33
This protective effect was found to be stronger in black versus white youths.
A systematic review and meta-analysis of 57 international studies found improved quality of diet and lower body mass index in children who participated in family meals.34
Decreased screen time, television viewing
Teens having fewer family dinners report more TV watching during meals, less talk during dinner, and express that the meals do not last long enough.35
Decreased risk of drug, alcohol, and nicotine use
Decreased marijuana use:
Teens who have infrequent family dinners (fewer than three per week) are two and a half times more likely to use marijuana.36
Decreased alcohol use:
Teens who have infrequent family dinners are twice as likely to use alcohol37
Decreased nicotine use:
Teens who have infrequent family dinners are four times more likely to use tobacco.38
Decreased overall substance abuse (alcohol, nicotine, and marijuana), especially in female adolescents.39,40,41
Decreased access to prescription drugs:
Teens who have infrequent family dinners are more likely to have access to prescription drugs in order to get high.42
Decreased likelihood that friends use drugs:
Teens who have infrequent family meals (fewer than two meals per week) are three times more likely to report that at least half of their friends use marijuana43
Teens who have infrequent family meals are twice as likely to know a friend who uses Ecstasy.44
Teens who have infrequent family meals are 80% more likely to know a friend who abuses prescription drugs.45
Decreased other high-risk behaviors
Teens who had more frequent family dinners were less likely to engage in sexual activity.46
Even after controlling for family connectedness and other family activities, teens who had more frequent family dinners were less likely to engage in “problem behaviors” such as physical violence, property destruction, stealing, and running away from home. (Studies sometimes find different benefits for males versus females.)47
Improved mental health / emotional well being
The more frequent the family meals, the better the emotional health of the adolescent, according to a study of more than 26,000 Canadian teens between 11 and 15 years of age.48
Teens with more frequent family meals had fewer emotional and behavioral problems.
Teens were more trusting and had more helpful behaviors toward others.
Teens had higher life satisfaction regardless of family economics.
Children whose family had positive family meal experiences at age 6 years were less likely to demonstrate physical aggression, oppositional behavior, nonaggressive delinquency and reactive aggression when assessed four years later.49
Family meals may help protect adolescents from the harmful effects of cyberbullying50
Teens who had more frequent family dinners were less likely to experience depression.51,52
Teens who ate 7 or more meals each week with their families were less likely to report a suicide attempt53.
Parents also benefit from family meals!
Both mothers and fathers who had more frequent family meals were less likely to describe depressive symptoms, had a lower stress index, and had greater self-esteem.54
Conclusion
When families regularly share meals together, everyone benefits ─ the children, parents and even the community. Making the “Family Table” a priority from an early age can serve as a “vaccine” against many of the harms that come to children from a hurried lifestyle. Pediatricians should inform parents of the benefits of the Family Table and regularly encourage its implementation. In a day when digital distractions are rampant, the simplicity of this concept can be refreshing and encouraging to parents.
Principal Authors: Jane E. Anderson, MD, FCP and Den Trumbull, MD, FCP
February 2021
The American College of Pediatricians (ACPeds) is a national association of licensed physicians and healthcare professionals who specialize in the care of infants, children, and adolescents. The mission of the ACPeds is to enable all children to reach their optimal physical and emotional health and well-being.
A PDF of this statement is available by clicking here: The Benefits of the Family Table
Additional Resources:
See the Patient Handout: Family Table on the website www.ACPeds.org.
See The Family Dinner Project by Harvard University for more ideas https://thefamilydinnerproject.org/
References
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3. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011; 127 (6): e1565-1574.
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10. Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among adolescents. Arch Pediatr Adolesc Med 2004;158(8):792-6.
11. The importance of family dinners II. The National Center on Addiction and Substance Abuse at Columbia University Website. http://casafamilyday.org/familyday/files/themes/familyday/pdf/Family-Dinners-II.pdf. Published September 2005. Accessed February 10, 2014.
12. Ibid. The importance of family dinners VII.
13. Ibid. The importance of family dinners VII.
14. Ibid. The importance of family dinners VII.
15. The importance of family dinners VII. The National Center on Addiction and Substance Abuse at Columbia University Website. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2011. Published September 2011. Accessed February 10, 2014.
16. Fulkerson JA, Neumark-Sztainer D, Story M. Adolescent and parent views of family meals. J Am Diet Assoc. 2006; 106:526 - 532.
17. Share the Table: The Barilla Family Dinner Project. http://www.sharethetable.com/docs/BenefitsofTheFamilyDinnerWhitePaper.pdf accessed April 1, 2014.
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20. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011; 127 (6): e1565-1574.
21. Ibid.
22. Verhage CL, Gillebaart M, van der Veek SMC, Vereijken CMJL. The relation between family meals and health of infants and toddlers: A review. Appetite. 2018; 127:97-109.
23. Caldwell AR, Terhorst L, Skidmore R, and Bendixen RM. Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis. J Hum Nutr Diet. 2018; 31:505-512.
24. Anderson SE, Whitaker RC. Household routines and obesity in US preschool-aged children. Pediatrics. 2010; 125: 420-428.
25. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011; 127 (6): e1565-1574.
26. Berge JM, Rowley S, Trofholz A, et al. Childhood obesity and interpersonal dynamics during family meals. Pediatrics. 2014; 134:923-932.
27. Neumark-Sztainer D. Eating among teens: do family mealtimes make a difference for adolescents’ nutrition? New Dir Child Adolesc Dev. 2006; 111: 91-104.
28. Neumark-Sztainer D, Wall M, Story M, Fulkerson JA, et al. Are family meal patterns associated with disordered eating behaviors among adolescents? J Adolesc Health. 2004; 35: 350-359.
29. Neumark-Sztainer D, Eisenberg M, Fulkerson JA, et al. Family meals and disordered eating in Adolescents. Arch Pediatr Adolesc Med. 2008; 162(1):17 - 22.
30. Dieticians of Canada. EatRight Ontario http://www.eatrightontario.ca/en/Articles/Adolescents-teenagers/Parent-and-Caregivers-Influence-on-Children%E2%80%99s-Eating-Habits.aspx#.U1VnvfldWSo. Accessed April 21, 2014.
31. Walton K, Horton NJ, Rifas-Shiman SL, et al. Exploring the role of family functioning in the association between frequence of family dinners and dietary intake among adolescents and young adults. JAMA Network Open. 2018:1(7)e185217.
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33. Berge JM, Wall M, Hsueh TF, et al. The protective role of family meals for youth obesity: 10-year longitudinal associations. J Pediatrics. 2015; 166:296-301.
34. Dallacker M, Hertwig R, and Mata J. The frequency of family meals and nutritional health in children: a meta-analysis. Obesity Reviews. 2018; 29: 638 - 653.
35. The importance of family dinners II. The National Center on Addiction and Substance Abuse at Columbia University Website. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2005. Published 2005. Accessed February 10, 2014.
36. The importance of family dinners VII. The National Center on Addiction and Substance Abuse at Columbia University Website. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2011. Published September 2011. Accessed February 10, 2014.
37. Ibid. The importance of family dinners VII.
38. Ibid. The importance of family dinners VII.
39. Eisenberg ME, Neumark-Sztainer D, Fulkerson JA, Story M. Family meals and substance use: is there a long-term protective association? J Adolesc Health 2008;43(2):151-6.
40. Harrison ME, Norris ML, Obeid N, et al. Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian Family Physician. 2015; 61:e96-106.
41. Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among ado- lescents. Arch Pediatr Adolesc Med 2004;158(8):792-6.
42. Ibid. The importance of family dinners VII.
43. Ibid. The importance of family dinners VII.
44. Ibid. The importance of family dinners II.
45. Ibid. The importance of family dinners II.
46. Ibid. The importance of family dinners II.
47. Sen, B. The relationship between frequency of family dinner and adolescent problem behaviors after adjusting for other family characteristics. J of Adolescence. 2010; 33:187-196.
48. Elgar, FJ, Craig W, Trites SJ. Family dinners, communication, and mental health in Canadian adolescents. J Adolesc Health. 2013; 52: 433-438.
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50. Elgar FJ, Napoletano A, Saul G, et al. Cyberbullying Victimization and Mental Health in Adolescents and the Moderating Role of Family dinners. JAMA Pediatr. 2014; 168(1):1015-1022.
51. Fulkerson JA, Story M, Mellin A, Leffert N, Neumark‐Sztainer D, French SA. Family dinner meal frequency and adolescent development; relationships with developmental assets and high-risk behaviors. J Adolesc Health. September 2006; 39(3): 337-45.
52. Utter J, Denny S, Robinson E, et al. Family meals and the well-being of adolescents. J Paediatr Child Health. 2013; 49:906-911.
53. Eisenberg ME, Olson RE, Newmark-Sztainer D, et al. Correlations between family meals and psychosocial well-being among adolescents. Arch Pediatr Adolesc Med. 2005; 158:792-796.
54. Utter J, Larson N, Brege JM, et al. Family meals among parents: Associations with nutritional, social and emotional wellbeing. Prev Med. 2018; 113:7-12.