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Child obesity risk reduced with family meals

Publish date: October 13, 2014

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Clinicians can promote healthy family dinners

The most striking finding in this study by Berge et al. is that if the reported relationships are even in part causal, truly simple changes to family meal structure may help families decrease their children’s risks of developing overweight and obesity, and speak to the incredible importance of our food and eating environment on our behaviors and choices. The implications of this study for both clinicians and parents are in the kitchen. For clinicians, this study highlights the importance of going beyond the typical medical history and taking more of a healthy living history, in which the structure, location, and attitudes around meals and cooking are explored.

Berge’s study further hammers home the need for clinicians to place a far greater focus on understanding the patient as a whole person and not simply as a collection of medical problems with a skeleton-bare scaffolding consisting of basic family, employment, and social vices histories. The presence or absence of health is no doubt rife with complexity, but there’s little doubt that gaining an understanding about the barriers patients and parents face trying to live a healthful lifestyle requires more digging and matters more than is generally taught in medical school.

According to the study, an ideal family meal takes place in the kitchen, is 18 minutes or longer in duration, has both parents present, is eaten along with an attentive, warm and supportive conversation, and food is discussed positively and not in the context of weight or good vs. bad. The main caveat is that we don’t yet know whether these results are the consequence of causality. Consequently, it’s impossible to say that changes to family meal time will in turn lead to changes in weight or prevention of weight gain. That said, given there’s no obvious harm associated with implementing more frequent, and more enjoyable family meals and that a glut of studies demonstrating potentially causal benefits to family meals exist, encouraging and exploring barriers to kitchen table love affairs should be a regular part of a primary care provider’s job.

Dr. Yoni Freedhoff is a family medicine physician at the University of Ottawa, medical director of the Bariatric Medical Institute there, and author of The Diet Fix: Why Diets Fail and How to Make Yours Work. These comments were made in an interview. Dr. Freedhoff reported no other disclosures except his book.

FROM PEDIATRICS

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Positive communication and warm interpersonal dynamics during family meals are necessary components for family meals to decrease the risk of obesity in children, according to a new study.

“This study identified characteristics of family meals (e.g., interpersonal and food-related dynamics) through direct observational methods that may help explain the inconsistencies found in previous studies regarding the frequency of family meal and childhood obesity status,” Jerica Berge and her colleagues at the University of Minnesota, Minneapolis, reported online (Pediatrics 2014 Oct. 13 [doi:10.1542/peds.2014-1936]).

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Children's obesity risk decreases if the family enjoys happy family meals together.

“Specifically, more positive measures (e.g., group enjoyment, relationship quality, warmth/nurture) were associated with reduced prevalence of child overweight/obesity, and more negative measures (e.g., hostility, indulgent/permissive, inconsistent discipline) were associated with increased prevalence of child overweight/obesity,” they wrote.

For example, the more warmth identified in more family relationships, the less likely it was that a child was overweight or obese, yet higher levels of hostility increased the likelihood of an overweight or obese child, after controlling for age, sex, and race/ethnicity. Findings were similar for family attitudes related to food: Positive food communication correlated with a lower prevalence of overweight/obesity, for example, though some food-related factors were less significant when parents’ body mass index was controlled for.

The researchers used multiple methods to observe the family meals of 120 low-income and/or minority children, average age 9 years, and years in the Minneapolis/St. Paul area over 8 days. Only families who typically ate at least three family dinners a week participated, and half the children were considered overweight (body mass index of 85th percentile or higher).

The researchers video-recorded the meals, inventoried food in the homes, interviewed the participants, and gathered three 24-hour dietary recalls for each child. Then they analyzed positive and negative variables during interactions between each arrangement of two family members over the meals (between the child and each other family member; between caregivers and between each caregiver and sibling).

Positive variables included group enjoyment, relationship quality, communication, parental influence, and positive reinforcement. Negative ones included hostility, lecturing/moralizing, silence, indulgence/permissiveness, inconsistent discipline, and intrusiveness/control.

Overweight/obese children’s family meals lasted an average 13.5 minutes, compared with an average 18.2 minutes for the family meals of the nonoverweight children. Also, 80% of nonoverweight children’s families ate in the kitchen, compared with 55% of overweight/obese children’s families. While only 18% of overweight/obese children had a father/stepfather at the meal, 52% of nonoverweight children did.

The study was supported by the National Institute of Diabetes, Digestive and Kidney Diseases. The authors reported no disclosures.

Child obesity risk reduced with family meals

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