Date Presented 4/19/2018
A systematic review was conducted to determine the influence of family meals on the health and well-being of family members. Results suggest that increased family meal frequency is associated with improved health and well-being outcomes for family members.
Primary Author and Speaker: Lauren Lange
Additional Authors and Speakers: Emily Katz, Karla Ausderau
PURPOSE: Family mealtime provides an opportunity for family members to spend time together and communicate. Because of decreased family emphasis on eating together and environmental barriers, participation in consistent family meals has decreased for many families. The purpose of this systematic review was to determine whether mealtime frequency improves the health and well-being of family members and to understand the benefits of participating in this occupation.
METHOD: The development and execution of this systematic review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), an evidence-based reporting standard. A systematic search was conducted in five databases: CINAHL Plus, PubMed, Scopus, OTseeker, and PsycINFO. Search terms related to meals, family mealtime, health outcomes, and family members were used across databases, yielding 3,103 studies. Studies were screened for inclusion and exclusion criteria by title first, resulting in 167 studies then screened by abstract. Sixty-two articles met inclusion criteria and were screened by full text. Twenty articles remained after full-text screening and were evaluated using the American Occupational Therapy Association’s levels of evidence. All levels of evidence were included in the review. To be included, studies needed to occur within the United States, be published in the past 10 years, have family mealtime frequency as the intervention, and assess outcomes related to family member health and well-being.
RESULTS: Using AOTA’s levels of evidence, 6 articles that used a longitudinal design were classified as Level III and 14 articles that used a cross-sectional design were classified as Level IV. Results of the articles were categorized into four outcome domains: weight, eating behaviors, psychosocial well-being, and family factors. Overall, limited evidence was available to support the effectiveness of frequent family meals in lowering family member body mass index (BMI) and overweight status, encouraging healthier food intake, decreasing depressive symptoms and high-risk behaviors, and improving family relationships. Because of variation in study design and inconsistent outcome measures, insufficient evidence was available to support the effectiveness of family mealtime in improving other analyzed health outcomes.
CONCLUSION: Overall, although not significant, increased frequency of family meals was associated with improved outcomes related to family member health and well-being. Specifically, family mealtime benefits family members by reducing BMI and risk of obesity, enhancing factors related to psychosocial well-being, leading to the consumption of a healthier diet, and improving overall family functioning. Although these associations were made, many studies lacked significance because of their low level of evidence and rigor of study design. Future research should address additional outcomes, examine the effects further in children and adults, and determine the optimal frequency of family mealtimes. Additionally, studies should use more rigorous designs, with greater control over and continuity across operational definitions of variables such as mealtime frequency.
IMPACT STATEMENT: Occupational therapy practitioners use a holistic approach to therapy, recognizing the importance of the family and the effect of family relationships on clients. With the acknowledgment of the benefits of family mealtime, occupational therapy practitioners can act as advocates for this important occupation in their clients’ lives. Practitioners can assist clients in recognizing the aspects of family mealtime that they find most meaningful and identifying other situations in which these characteristics can be incorporated.
References
Berge, J. M., MacLehose, R. F., Loth, K. A., Eisenberg, M. E., Fulkerson, J. A., & Neumark-Sztainer, D. (2012). Family meals: Associations with weight and eating behaviors among mothers and fathers. Appetite, 58, 1128–1135. https://doi.org/10.1016/j.appet.2012.03.008
Fink, S. K., Racine, E. F., Mueffelmann, R. E., Dean, M. N., & Herman-Smith, R. (2014). Family meals and diet quality among children and adolescents in North Carolina. Journal of Nutrition Education and Behavior, 46, 418–422. https://doi.org/10.1016/j.jneb.2014.05.004
Fulkerson, J. A., Story, M., Mellin, A., Leffert, N., Neumark-Sztainer, D., & French, S. A. (2006). Family dinner meal frequency and adolescent development: Relationships with developmental assets and high-risk behaviors. Journal of Adolescent Health, 39, 337–345. https://doi.org/10.1016/j.jadohealth.2005.12.026
