Scientific Report of the 2015 Dietary Guidelines Advisory Committee

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Part D. Chapter 3: Individual Diet and Physical Activity Behavior Change

Family Shared Meals

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Data from cross-sectional studies suggest that when families share meals, they achieve better diet quality and improved nutrient intake, and to some extent, are better able to maintain appropriate body weight.30-36 The definition of family shared meals in the literature varies, with some defining it as the number of a specific meal eaten together (e.g., dinner), or any meal, prepared at home or outside of home, that is shared among individuals living in the same household.37 Family mealtime may act as a protective factor for many nutritional health-related problems. For example, they provide an opportunity for parents to model good eating behaviors and create a positive atmosphere by providing time for social interaction and thus a sense of social support for all members.38, 39 Shared meals may be important in every stage of the lifecycle to support healthy growth, development, and weight, though the evidence for adults is mixed. The importance of the family in supporting positive behaviors is clearly part of the life course approach embodied in the DGAC’s conceptual model (see Part B. Chapter 2: 2015 DGAC Themes and Recommendations: Integrating the Evidence). As a result, the Committee decided to explore the relationship between family shared meals and dietary intake as well as weight outcomes from high-quality epidemiological studies to determine if there is a cause and effect association.

Question 2: What is the relationship between frequency/regularity of family shared meals and measures of dietary intake in U.S. population groups?

Source of evidence: NEL systematic review

Conclusion

Insufficient evidence on the association between frequency of family shared meals and measures of dietary intake is available to draw a conclusion. DGAC Grade: Grade not assignable

Implications

The DGAC determined that a grade was not assignable due to the insufficient evidence for this question. Therefore, no implications were developed.

Review of the Evidence

Two studies in the United States with the duration of 5 to 10 years from one prospective cohort examined the relationship between frequency/regularity of family meals and measures of dietary intake in U.S. population groups.40, 41 The studies included adolescents transitioning from early to middle adolescence (middle school to high school)40 and adolescents transitioning to early adulthood.41 These studies found more frequent consumption of family meals was associated with improved dietary intake, specifically an increase in fruits and/or vegetables, and calcium-rich or milk-based foods.40, 41 Given that the evidence is limited to these two studies using data from the same cohort at two time points, the Committee could not assign a grade.

For additional details on this body of evidence, visit: http://NEL.gov/conclusion.cfm?conclusion_statement_id=250455

Question 3: What is the relationship between frequency/regularity of family shared meals and measures of body weight in U.S. population groups?

Source of evidence: NEL systematic review

Conclusion

Limited evidence from prospective studies shows inconsistent relationships between the number of family shared meals and body weight of children and adolescents. DGAC Grade: Limited

Implications

The very limited evidence available on the relationship between family shared meals and measures of body weight precludes developing implications for this question. Shared meals may be important in every stage of the lifecycle to support healthy growth, development, and weight; however, more studies are warranted to determine if there is a direct effect. In the absence of such studies, meal times may still be an optimal time for parents to provide role modeling behaviors in terms of what foods to eat and, for the elderly encouragement to eat given the social support of other individuals.

Review of the Evidence

Six studies, which included one randomized control trial (RCT)42 and five prospective cohort studies (4 cohorts)43-47 examined the relationship between frequency/regularity of family meals and measures of body weight in U.S. populations. The study duration for the RCT was 6 months42 and the prospective cohort studies43-47 ranged in duration from 1 to 5 years. The study population was children and adolescents ages 4 to 15 years.

Three out of four prospective cohort studies found no significant association between the frequency of family shared meals, BMI, or overweight status. Evidence from one prospective study (two articles) showed that an increase in the frequency of family shared meals lowered the likelihood of becoming overweight or the persistence of overweight. One study found that among overweight children, eating more family breakfast and dinner meals was associated with lower likelihood of becoming overweight or remaining overweight over a 4-year period. Another article reported children who typically ate more breakfast meals with their families had a lower rate of increase in BMI over 5 years. The number of dinner meals eaten with the family was not associated with a change in BMI.

One RCT included an intervention that simultaneously focused on four household routines, including family shared meals.42 Although a reduction in body weight occurred, family meal frequency did not change.42

This body of evidence had several limitations, including that studies did not use a standard definition for family shared meals, two studies assessed only family dinners, two studies assessed breakfast and dinner meals, and two studies assessed all meals. No study assessed the quality or source of meals consumed.

For additional details on this body of evidence, visit: http://NEL.gov/conclusion.cfm?conclusion_statement_id=250460

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