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Glenn D. Braunstein, M.D. Headshot

The Family Meal: A Prescription for Healthier Kids and Adolescents

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In her recently published book, The Family Dinner, Laurie David writes about the virtues of having the family eat dinner together. The book is chock full of facts, recipes, interviews, and helpful tips to make dining together a positive, character-building experience that strengthens the family bonds and helps teach invaluable social skills to the children. But it was the chapter on the positive health aspects of dining together that sparked my curiosity. So, I did a quick search of the medical literature to see if the health claims in the book were true, and to my pleasant surprise, they were.

Most of the studies are epidemiological, in which children and adolescents who eat at least five meals a week with their family are compared to those who do not. The results show that regular family meals are associated with the intake of more fruits, vegetables, calcium-rich foods, protein, iron, folate, fiber, micronutrients and vitamins A, C, E and B6. The kids consume less fried foods, soda, salt, saturated and trans fats. The net result is a lower incidence of obesity.

Eating together also has other salutatory effects, such as lower incidences of dieting and extreme weight control behaviors such as purging, or use of laxatives, diuretics or diet pills. It's also been associated with a decrease in substance abuse, running away from home, physical violence, property destruction, stealing and early sexual intercourse. Additionally, there is data indicating kids perform better in school and are more "well-adjusted."

These findings have been noted in multiple studies on large numbers of individuals carried out at various institutions, which strengthens the conclusions. Epidemiological studies can uncover associations, but do not define a cause-and-effect relationship. Thus, it is not clear if the positive effects are only due to the family meal itself, or if there are also other factors that both contribute to these effects and the ability to consistently enjoy family meals. For instance, an increased frequency of family meals has been associated with the mother not working, high socioeconomic status, and being Asian American. Nevertheless, there are several reasons why the family meal itself might improve dietary intake and decrease the risk of disordered eating and risky behavior in adolescents. Parental modeling of healthy eating patterns at meals promotes similar behavior in the children. Additionally, it is likely that adolescents who eat with their family will be presented with healthier foods than they would eat on their own or with friends. Also, dining together provides an opportunity for parents to connect with their children through conversation, and promotes socialization. At the same time, the parents can monitor their children's eating behaviors and emotional health, and, therefore, be in a position to identify problems early and provide appropriate interventions.

In the past, the entire family would eat home-cooked meals together at the same time of the day. But times have changed and there exist multiple barriers that make it more difficult for families to eat a nutritious meal together today. To afford the American dream of a nice home, college educations, and even basic living expenses - including groceries - many households rely on two incomes. This is true in many regions of the country, and especially here in Los Angeles County where the median home price tops $363,000. Unfortunately, a household with two working parents often finds itself lacking the time, and certainly the energy, to prepare a meal, set the table and enjoy a leisurely dining experience.

After a long day at work, often paired with a long commute, the line at the drive-thru window is more inviting than the prospect of digging through the pantry to whip up a dinner. But the typical fast food combo meal - laden with salt, sugar and fat - cannot provide the same nutritional benefits of home-cooked meals.

Adolescents have notoriously busy schedules, which along with their desire for autonomy, may make it difficult to get them to the family table consistently. And, of course we have the ever-present distractions of TV, texting and computers. In fact, studies have shown that watching TV during a family meal lowers the intake of vegetables, calcium-rich foods, and grains, and increases the intake of soft drinks versus adolescents who do not watch TV during meals. However, watching TV during a family meal was still superior to not participating in regular family meals at all.

The importance of family meals has been recognized by the American Medical Association's Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity, the National Center on Addiction and Substance Abuse at Columbia University, Project Eating Among Teens (EAT) at the University of Minnesota, and multiple other centers and projects. Now, it is important that parents recognize the major return that they can reap, both for themselves and their children, by consciously establishing the family meal as a nightly ritual.