The family meal, a ritual frozen in time; an Australian grounded theory study

Family meals are recognized as an opportunity to promote the health of families. Popular discourse posits that changes to contemporary family life have made family meals harder to achieve and promotion of the 'traditional' family meal may be adding pressures to contemporary families. While research has been conducted on family meals over the last three decades, there is no explicit investigation of the experiences and practices of family meals over this time. Understanding the evolution of family meal practices across time is important for developing achievable expectations in relation to this ritual. Qualitative interviews were conducted with a diverse population of South Australian parents in the 1990s (n = 32) and with a separate population of parents in 2020 (n = 22) to gather their experiences of family meal practices. A comparative analysis, informed by grounded theory, was undertaken to identify similarities and differences in experiences across these two time periods. The results indicated stability in many family meal experiences across time, particularly in their value and significance in family life. Negotiations balancing time, cost, food preferences and responsibility persisted. The stability of family meal values and practices is important to consider when making recommendations, designing interventions and creating services targeting the family meal.

Parenting Styles, Food Parenting Practices, Family Meals, and Weight Status of African American Families

Parents influence adolescents' weight status through different strategies used in the home environment, including parenting styles (PSs), food parenting practices (FPPs), and family meal frequency. As the prevalence of obesity is higher among African American adolescents, investigation of which parental strategies serve as an adjustable factor for the prevention of obesity is critical. First, this study aims to examine the relationship between the different parenting influences and obesity statuses of both parents and 10-17-year-old adolescents among African American families. Second, it aims to examine the correlation between PSs and FPPs and frequency of family meals. A total of 211 parent-adolescent dyads completed an online survey using Qualtrics. Four PSs (i.e., authoritative, authoritarian, setting rules/expectations, and neglecting) and four FPPs (i.e., monitoring, reasoning, copying, and modeling) were identified for this study, along with family meal frequency. Body mass index (BMI) percentile and BMI were used to assess the obesity status of the adolescents and parents, respectively. No correlation was found between the adolescents' and parents' obesity status and the PSs and FPPs, while the adolescents' BMI percentile was significantly correlated with parental BMI. However, a higher number of family meals decreased the likelihood of obesity among the adolescents to some extend and depended on the type of BMI used. An authoritative PS was the only style related to family meal frequency, while three FPPs, namely, monitoring, reasoning, and modeling, were related to a greater number of family meals in African American families. The findings of this study can be used in the development of parental education workshops/sessions, with consideration of the cultural differences in African American families, and can help parents to adopt the best parenting strategy to promote the healthy weight status of their adolescents.

The Relationship between Family Meals and Mental Health Problems in Japanese Elementary School Children: A Cross-Sectional Study

The relative burden of mental health problems in children is increasing worldwide. Family meals have attracted attention as an effective modifiable factor for preventing children’s mental health problems. We examined the relationship between family meals and mental health problems in Japanese elementary schoolchildren. A cross-sectional, self-administered questionnaire survey was conducted with guardians of children aged 7 to 12 years in Gifu Prefecture, Japan. Frequency of family meals and with whom the child eats breakfast, lunch, and dinner were assessed separately for weekdays and weekends/holidays. Mental health was assessed using the Japanese version of the parent-reported Strengths and Difficulties Questionnaire. Multivariate adjusted odds ratios (ORs) for borderline/abnormal mental health status were calculated using logistic regression analysis. Of the 678 children, 24.9% had borderline/abnormal mental health status. Children eating breakfast with their family less than once a week (adjusted OR, 4.79; 95% confidence interval (CI), 1.51–15.25) and those eating weekend breakfast alone (adjusted OR, 3.61; 95% CI, 1.42–9.23) had a higher prevalence of borderline/abnormal mental health status compared to those eating breakfast seven times a week and weekend breakfast with their family, respectively. These results suggest that family meals, especially breakfast, might be positively associated with better mental health in children.

Associations of Family Meals with Adolescent Perception of Family Relationship and Compliance with Parental Guidance in Hong Kong: Results of a Representative Cross-Sectional Survey

Family meals are beneficial for adolescent development, but evidence from Chinese populations has been limited. This study aimed to examine the associations between family meal frequency and adolescent perception of family relationship and compliance with parental guidance in Hong Kong. During the period from October to December 2016, a stratified random sample of 3359 students were recruited from 25 secondary schools in Hong Kong. Students completed questionnaires about family characteristics, relationship quality, and meal frequency by paper-and-pencil in class. Multiple regression analyses were conducted to examine the associations between family meal frequency and perceived family relationship and compliance with parental guidance overall and by subgroups. After adjusting for sociodemographic and school confounders, family breakfast and dinner frequency were significantly associated with adolescent compliance (breakfast: B = 0.07, p < 0.001; dinner: B 0.07, p < 0.001) and perception of family relationship (breakfast: B = 0.10, p < 0.001; dinner: B = 0.25, p < 0.001). Risk factors for infrequent family meals included older age, not born in Hong Kong, less educated fathers, and unmarried parents. Our findings support the associations of regular family meals with adolescent perception of high family bond and compliance with parental guidance. Interventions are needed to enhance quality family meal interactions in disadvantaged families.

Beyond the Normative Family Meal Promotion: A Narrative Review of Qualitative Results about Ordinary Domestic Commensality

There exists a normative representation of family meals in contemporary Western societies which is promoted as imperative through public health programs, larger discourses and by some studies in the nutritional and public health research fields. Family meals, also called domestic commensality, are represented as convivial events and are associated with positive health and wellbeing outcomes but there is minimal evidence to show they are beneficial for family members and it is not known which aspect of the family meal could be responsible for these alleged benefits. This normative family meal image is based on a representation of the family as a peaceful unit exempt from external constraints. This narrative literature review of qualitative studies of family meals seeks to put forward the underlying premises of this representation and compare it with reports about actual practices. The results emphasize that eating together is still practiced and remains valued by family members, which is in contrast to discourses lamenting the decline of the family meal. However, the valorisation and recurrence of family meals depends on class, gender and cultural positions. There is a gap between the norm of healthy or convivial and achievable family meals, which can reinforce the so-called "mental load" and "emotion work" of those in charge of feeding the family and heighten inequalities within the household. In fact, there are many challenges to family meals which originate from external constraints or are inherent aspects of family life. The results from this review suggest that we should focus on family meals by taking into account the food work surrounding it and focussing on the interactional aspects of family meals. Ethnographic methods allow the researcher to observe the diversities and complexities of commensality as well as family dynamics and, in doing so, could provide more realistic representations of eating within the family.

Feasibility of a Family Meal Intervention to Address Nutrition, Emotional Wellbeing, and Food Insecurity of Families With Adolescents

OBJECTIVE

To assess the feasibility of a family meal intervention to address indicators of parent and adolescent nutrition and well-being and household food security.

METHODS

Nine adolescents and a parent/caregiver were recruited from a youth health clinic. Families were provided with meal plans, recipes, and ingredients for 5 meals weekly for 4 weeks. Participants completed baseline and follow-up surveys and open-ended interviews.

RESULTS

Overall, fidelity to the intervention was high among families; the frequency of family meals increased by approximately 2 meals/wk. Both parent/caregivers and adolescents reported improvements to nutrition (4 of 9 increased vegetable consumption for both) and most reported improvements to mental well-being. Household food insecurity also reduced during the intervention (means of 8.2 and 0.2 at baseline and follow-up, respectively).

CONCLUSIONS AND IMPLICATIONS

Providing families with meal plans, recipes, and ingredients is an acceptable way to increase weekly frequency of family meals. Future research may consider the family meal as a way to engage with families about broader concerns.

Factors Influencing Children's Eating Behaviours

Relevant factors involved in the creation of some children’s food preferences and eating behaviours have been examined in order to highlight the topic and give paediatricians practical instruments to understand the background behind eating behaviour and to manage children’s nutrition for preventive purposes. Electronic databases were searched to locate and appraise relevant studies. We carried out a search to identify papers published in English on factors that influence children’s feeding behaviours. The family system that surrounds a child’s domestic life will have an active role in establishing and promoting behaviours that will persist throughout his or her life. Early-life experiences with various tastes and flavours have a role in promoting healthy eating in future life. The nature of a narrative review makes it difficult to integrate complex interactions when large sets of studies are involved. In the current analysis, parental food habits and feeding strategies are the most dominant determinants of a child’s eating behaviour and food choices. Parents should expose their offspring to a range of good food choices while acting as positive role models. Prevention programmes should be addressed to them, taking into account socioeconomic aspects and education.

The frequency of family meals and nutritional health in children: a meta-analysis

Findings on the relationship between family meal frequency and children's nutritional health are inconsistent. The reasons for these mixed results have to date remained largely unexplored. This systematic review and meta-analysis of 57 studies (203,706 participants) examines (i) the relationship between family meal frequency and various nutritional health outcomes and (ii) two potential explanations for the inconsistent findings: sociodemographic characteristics and mealtime characteristics. Separate meta-analyses revealed significant associations between higher family meal frequency and better overall diet quality (r = 0.13), more healthy diet (r = 0.10), less unhealthy diet (r = -0.04) and lower body mass index, BMI (r = -0.05). Child's age, country, number of family members present at meals and meal type (i.e. breakfast, lunch or dinner) did not moderate the relationship of meal frequency with healthy diet, unhealthy diet or BMI. Socioeconomic status only moderated the relationship with BMI. The findings show a significant relationship between frequent family meals and better nutritional health - in younger and older children, across countries and socioeconomic groups, and for meals taken with the whole family vs. one parent. Building on these findings, research can now target the causal direction of the relationship between family meal frequency and nutritional health.

Family Meals and Adolescent Emotional Well-Being: Findings From a National Study

OBJECTIVE

To describe the relationship between family meals and adolescent mental health and determine whether the relationship differs by sex.

DESIGN

Secondary analyses of a cross-sectional survey.

PARTICIPANTS

A total of 8,500 nationally representative students.

MAIN OUTCOME MEASURES

Reynolds Adolescent Depression Scale; Strengths and Difficulties Questionnaire; World Health Organization Well-being Index.

ANALYSIS

Multiple regression models determined the relationships between family meals and mental health indicators; sociodemographic variables and family connection were included as covariates.

RESULTS

Approximately 60% of adolescents shared family meals ≥5 times in the previous week, whereas 22% reported that they shared ≤2 meals in the previous week. Greater frequency of family meals was associated with fewer depressive symptoms (P < .001), fewer emotional difficulties (P < .001) and better emotional well-being (<.001). These relationships between family meals and depressive symptoms were attenuated by sex; the relationship was stronger for females than for males.

CONCLUSIONS AND IMPLICATIONS

Frequent family meals may have a protective effect on the mental health of adolescents, particularly for depressive symptoms in girls. Interventions that aim to increase the frequency of family meals are needed to evaluate whether family meals alone can have an emotional benefit for adolescents.

Supporting Families to Cook at Home and Eat Together: Findings From a Feasibility Study

OBJECTIVE

The current study tested the feasibility and acceptability of an intervention that provided families with meal plans, recipes, and ingredients to cook meals at home.

METHODS

Ten diverse families (1 adolescent, 1 parent) were provided with the resources to prepare 5 family dinners/wk for 8 weeks. Process data were collected by weekly telephone calls. Outcome data were collected by open-ended interviews with parent or caregiver and adolescents, separately.

RESULTS

Most of the meals provided were prepared (86%) and a high proportion of meals prepared were eaten together by families (96%). Both parents and adolescents reported that the intervention was acceptable, particularly the opportunity to try new foods. Families reported multiple benefits to participation, including eating healthier, feeling better, and having improved relationships.

CONCLUSIONS AND IMPLICATIONS

Providing families with resources for home cooking appears to be an acceptable and well-enjoyed intervention. Further research measuring the health and social impacts of this intervention is warranted.

A Review of the Structural Characteristics of Family Meals with Children in the United States

Family meals are associated with a range of positive outcomes among children and adolescents. There is inconsistency, however, in the way in which studies have defined and measured family meals. Therefore, a systematic review of the literature was conducted to determine how studies describe family meals with the use of structural characteristics. The current review focused on studies in the United States that included children ages 2-18 y. A total of 33 studies were identified that characterized family meals with the use of ≥1 of the following structural features: frequency or mean number of family meals per week, length of family meal, people present at meal, and where meals occurred. No study characterized family meals by using all 4 family meal features, whereas most studies (81%) characterized family meals by using frequency or mean number of meals per week. Findings not only provide an initial understanding of the structural features used to define family meals but also point to the importance of developing a more comprehensive, sensitive assessment that can accurately capture the complex and multidimensional nature of family meals.

How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment

OBJECTIVE

To examine the range and frequency of parental mealtime strategies used during the family meal session of Family-Based Treatment (FBT) for adolescent anorexia nervosa, and to explore the relationships between parental mealtime strategies, mealtime emotional tone and parental 'success' at encouraging adolescent food consumption.

METHOD

Participants were 21 families with a child aged between 12 and 18 years receiving FBT for adolescent anorexia nervosa. Video recordings of the family meal session (FBT session two) were coded using the Family Mealtime Coding System adapted in this study for use with adolescents (FMCS-A) to identify frequency of parental strategies, emotional tone of the meal (measured by adolescent positive and negative vocalisations) and frequency of prompted mouthfuls consumed by the adolescent (measured by the number of mouthfuls consumed by the adolescent immediately following parental interactions).

RESULTS

A range of parental mealtime strategies were in use. Those used repeatedly included direct eating prompts, non-direct eating prompts, physical prompts, and providing information or food-related choices. Several parental mealtime strategies (direct and non-direct eating prompts) were found to be consistently associated with the tone of adolescents' vocalisations and the number of mouthfuls consumed in response to a parental prompt.

DISCUSSION

Despite associations with negativity from the adolescent, the use of food-related prompts (both verbal and physical) seems to be associated with increased eating. This indicates the potentially important role of parental control of eating. Following replication, these findings might provide a focus for therapists when supporting and coaching parents during the family meal session.

Just one more bite: a qualitative analysis of the family meal in family-based treatment for anorexia nervosa

OBJECTIVE

The family meal is an integral component of Maudsley family-based treatment for anorexia nervosa. The aim of this study was to determine whether there are different types of family meal, as suggested in the treatment manual, and whether within session processes differ according to meal type.

METHOD

Thirty video-recorded family meal sessions from a randomised controlled trial were transcribed and analysed using thematic analysis.

RESULTS

Analyses revealed two types of family meal. In the first, the patient ate one mouthful more than they were willing to eat. This meal type was characterised by processes that were consistent with the Maudsley model. In the second, the patient ate what was asked of them with little to no difficulty. Therapist and family avoidance differentiated this meal type from the first.

DISCUSSION

The current findings, along with the existing theory, suggest that avoidance may have reduced the therapeutic impact of the meal for many families. Strategies to challenge therapist and family avoidance are suggested. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.