The Benefits of the Family Table

American College of Pediatricians – May 2014

Abstract: Research demonstrates many benefits of the family meal, especially in protecting adolescents from negative, high-risk behaviors. Unfortunately, families today are less likely to enjoy meal times together 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 eat one or two meals a week at most 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, Smartphone apps, text messaging, and telephone conversations.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 kids. Most wish they had more family dinners.3

Evaluating the Literature
When evaluating the scientific research on the effect of ”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 weight, healthy eating patterns, and less disordered eating are found when families eat at least three meals per week together.4

It is also difficult to differentiate the effect of overall quality of childrearing of 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.5

Benefits of the Family Table
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 to 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.

Academic

  • Teens that have frequent family dinners are likelier to get better grades in school.
    • “Teens who have dinner with their families seven times a week are almost 40 percent 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 percent vs. 45 percent).”6
  • Language development is enhanced.
    • Mealtimes offer unique opportunities for children to learn as they hear longer discussions 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

Family discussion

More family talk occurs during mealtime than during any other activity, including playing with toys and storybook reading.10

Healthy nutrition

  • Children ages nine to fourteen 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 micro-nutrients.11
    • Children are 35% less likely to engage in disordered eating.12
    • Children are 24% more likely to eat healthier foods.13
  • 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.14
      • Children are 12% less likely to become obese just by eating family meals.15
  • Adolescents from homes where the family regularly eats meals together (more than five meals per week) have a much lower likelihood of disordered eating (weight control tactics: self-induced vomiting, laxative use, diet pills, fasting, eating very little food, using food substitutes, skipping meals, and smoking.)16,17
  • Teens that eat with the family eat more vegetables, fruits, and dairy products.18

Less television viewing

  • Teens having fewer family dinners report more TV watching during meals and less talk during dinner, and express that the meals do not last long enough.19

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.20
  • Decreased alcohol use
      • Teens who have infrequent family dinners are twice as likely to use alcohol.21
  • Decreased nicotine use
      • Teens who have infrequent family dinners are four times more likely to use tobacco.22
  • 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.23
  • 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 marijuana.24
      • Teens who have infrequent family meals are twice as likely to know a friend who uses Ecstasy.25
      • Teens who have infrequent family meals are 80% more likely to know a friend who abuses prescription drugs.26

Decreased other high risk behaviors

  • Teens who had more frequent family dinners were less likely to engage in sexual activity.27
  • Teens who had more frequent family dinners were less likely to experience depression.28

Improved family relations

  • 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.29
      • Twice as likely to have an excellent relationship with father.30
      • Twice as likely to have an excellent relationship with sibling(s).31
  • 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.32

Less emotional stress

  • 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.33
      • 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.

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.

Primary Author: Jane Anderson, MD, FCP and Den Trumbull, MD, FCP
May 2014

The American College of Pediatricians is a national association of licensed physicians and healthcare professionals who specialize in the care of infants, children, and adolescents. The mission of the College is to enable all children to reach their optimal physical and emotional health and well-being.

A PDF of this statement is available here, The Benefits of the Family Table.

View the Patient Handout, How to Have a Healthy Family Table, on the website.

Visit the Family Table page for more information and to purchase posters for your exam rooms.

References

1. Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among adolescents. Arch of Pediatr Adolesc Med. 2004; 158: 792-796.

2. Share the Table: The Barilla Family Dinner Project. http://www.sharethetable.com/docs/BenefitsofTheFamilyDinnerWhitePaper.pdf accessed April 1, 2014.

3. The Family Dinner Table and the Health of Our Children Traditional Wisdom and New Data. William J. Doherty, Ph.D. University of Minnesota: http://www.ksre.ksu.edu/humannutrition/DesktopModules/ViewDocument.aspx?DocumentID=8481 accessed February 20, 2014.

4. 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.

5. Musick K, Meier A. Assessing causality and persistence in associations between family dinners and adolescent well-being. J Marriage Fam. 2012; 74(3): 476-493.

6. The importance of family dinners II. The National Center on Addiction and Substance Abuse at Columbia University Web site. http://casafamilyday.org/familyday/files/themes/familyday/pdf/Family-Dinners-II.pdf. Published September 2005. Accessed February 10, 2014.

7. Snow CE, Beals DE. Mealtime talk that supports literacy development. New Dir Child Adolesc Dev. Spring 2006; 111: 51-66.

8. Neumark-Sztainer D, Story M. A perspective on family meals: do they matter? Nutr Today. 2005; 40 (6): 261-266.

9. Snow CE, Beals DE. Mealtime talk that supports literacy development. New Dir Child Adolesc Dev. Spring 2006; 111: 51-66.

10. Ibid. Share the Table.

11. Gillman MW, Rifas-Shiman SL, Frazer AL, et al. Family dinner and diet quality among older children and adolescents. Arch Fam Med 2000; 9: 235-240. http://triggered.edina.clockss.org/ServeContent?issn=1063-3987&volume=9&issue=3&spage=235. Accessed April 21, 2014.

12. 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.

13. Ibid.

14. Anderson SE, Whitaker RC. Household routines and obesity in US preschool-aged children. Pediatrics. 2010; 125: 420-428.

15. 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.

16. Neumark-Sztainer D. Eating among teens: do family mealtimes make a difference for adolescents’ nutrition? New Dir Child Adolesc Dev. 2006; 111: 91-104.

17. 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.

18. 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.

19. The importance of family dinners II. The National Center on Addiction and Substance Abuse at Columbia University Web site. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2005. Published September 2005. Accessed February 10, 2014.

20. The importance of family dinners VII. The National Center on Addiction and Substance Abuse at Columbia University Web site. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2011. Published September 2011. Accessed February 10, 2014.

21. Ibid. The importance of family dinners VII.

22. Ibid.

23. Ibid.

24. Ibid.

25. Ibid. The importance of family dinners II.

26. Ibid.

27. Ibid.

28. 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.

29. Ibid. The importance of family dinners VII.

30. Ibid. The importance of family dinners VII.

31. Ibid. The importance of family dinners VII.

32. The importance of family dinners VII. The National Center on Addiction and Substance Abuse at Columbia University Web site. http://www.casacolumbia.org/addiction-research/reports/importance-of-family-dinners-2011. Published September 2011. Accessed February 10, 2014.

33. Elgar, FJ, Craig W, Trites SJ. Family dinners, communication, and mental health in Canadian adolescents. J Adolesc Health. 2013; 52: 433-438.