Family Medicine Vital Signs

Sakineh Najmabadi

There is great advantage from a public health perspective for a known economic and easy-to- adopt family activity–family meals–that may help achieve a reduction in risk behaviors and risk behavior inequalities among the entire population.₁ However, rapid cultural, social, economic, and technical changes have imposed increasing stress on family structure and the ability to adapt to new environments.₂  Given the greater risk for poor health outcomes among low income families, the widening gap in the frequency of family meals between youth from low and high socioeconomic backgrounds is concerning.₃  Reviving the fading daily ritual of family meals can play an essential role in healthy family functioning, by meeting both physical and mental needs of family members through developmental transitions. Family as society’s primary agency in satisfying common needs for survival, a sense of loving and belonging, status, self-esteem, and self-realization, provides for the child’s biological needs and simultaneously directs its development toward becoming an integrated person capable of living in society.₄

The positive role of family meals, and in particular the influence on children’s dietary intake and its subsequent impact on overweight and obesity prevention, has been discussed by several researchers. _{5 6 7}   There is no single solution to the multifactorial childhood obesity epidemic in the U.S., with increased coordination among various sectors such as child care facilities, communities, and schools being required to fully address the issue.₈

Family meals also play an important role in obesity prevention through developing healthy lifestyle and diet. Controlling for demographic characteristics, physical activity, sedentary behaviors, energy intake, and baseline overweight status, the extent of family meals’ impact on overweight and obesity prevention depends on the frequency of family meals, quality and quantity of foods served, time cost in food preparation, and parents’ diet as a healthy role model._{9 10}

Communication affecting interpersonal involvement at family meals is not only seen to be significantly associated with lower adolescent body mass index and higher vegetable intake, ₁₁ but family meals may also help to reduce or eliminate inequalities in adolescent risk behaviors.

It seems that changing family structure and fluctuating family patterns within a given family are associated with increased smoking, drinking, cannabis use, unsafe sexual practices, and violence. However, the likelihood of all risk behaviors among girls, and all but fighting and sexual practices among boys, may have a significant inverse association with the frequency of eating family meals.₁₂  Family meals encourage healthy family functioning, which seems to have a positive impact over and above that of family structure.₁₃  The protective association between family meals and academic performance and learning, however, have not been statistically significant.

Despite controversy in the current literature about some protective aspects of family meals, undoubtedly home environment and family meals as an indicator of healthy family functioning play an important role in developing health behaviors. It is not yet clear to what extent this daily ritual can affect lifelong health. However the majority of current literature indicates a significant positive impact.

Sakinah Najmabadi, is a 3rd year PhD student in Public Health (focusing on reproductive health). She has an MPH from the university of Utah and a Masters in Midwifery from Iran.  She currently works as a research assistant for The Utah Women and Girl program.