Abstract
A growing body of research suggests that children and adolescents who share frequent meals with their families report better nutrition indicators, family relationships and mental health. Yet, little research has examined whether parents who share meals with their families report the same indicators of wellbeing. The current paper addresses this question using population-based survey data and a sample of parents in the United States (n=889, mean age 31 years) that responded to the fourth wave of the Project EAT study in 2015–16. Multiple regression models were used to examine associations between frequency of family meals and indicators of nutritional, social and emotional wellbeing, controlling for demographic and household characteristics. Analyses also examined if associations were moderated by sex, as mothers tend to be more responsible for household and childcare tasks. Results suggested that parent report of frequent family meals was associated with higher levels of family functioning, greater self-esteem, and lower levels of depressive symptoms and stress (p-value for all <0.001). Frequency of family meals was also related to greater fruit and vegetable consumption (both p<0.05), but was unrelated to other indicators of parent body size and nutritional wellbeing. Associations between frequency of family meals and parent wellbeing were similar for both mothers and fathers. Findings from the current study suggest that frequent family meals may contribute to the social and emotional wellbeing of parents. Future strategies to promote family meals should consider the potential impacts on the health and wellbeing of the whole family.
Introduction
A growing body of research suggests that frequent family meals support the healthy development of children and young people1–3. Family meals are opportunities for families to prepare and share healthy foods. Children and young people who frequently share meals with their families report better nutrition and eating behaviors like eating more vegetables and less fast food4–7.
Family meals also provide opportunities for communication, sharing of values and family bonding. Research suggests that adolescents who have frequent family meals report greater family connection and parental monitoring and communication8–10. These findings may explain, in part, existing evidence that suggests family meals are protective against adolescent participation in health risk behaviors and promote emotional wellbeing8,9,11–13.
Less is known about the potential nutritional, social and emotional benefits of family meals for parents. Findings from a nationally representative survey in the US found a small, but significant, association between frequent family meals and lower body mass index among parents14. Another study conducted by our research team found that parents who had frequent family meals ate more fruits and vegetables, fathers ate less fast food, and mothers engaged in fewer dieting behaviours15. Particularly little research has explored the social and emotional benefits of family meals for parents. As noted above, family meals provide opportunities for family communication and positive engagement. For parents, this may be a useful opportunity to discuss family issues, allocate household jobs or simply engage with family members in a positive way. As such, it is possible that frequent family meals may promote social and emotional wellbeing for parents, as well as children.
It is alternatively possible that frequent family meals come at a cost to parent wellbeing and increase stress, as preparing meals requires time and resources that many parents may not have. This may be particularly true for mothers as women still spend more time doing housework and child care than men16. Moreover, more than half of mothers say they find it difficult to balance work and family life16. Reducing time spent in preparing meals may be one strategy mothers use to cope17, 18. Adults who are employed spend less time on home food preparation and place a higher value on convenience foods19.
The aim of the current study is to expand what is already known about the relationship between family meals and the health and wellbeing of parents. Specifically, the current research will explore associations between family meals and parental indicators of nutritional, social and psychosocial wellbeing. As women assume more responsibility for household chores, such as meal preparation, the current analyses will also examine whether the associations between family meals and nutritional, social and emotional wellbeing vary by parent sex.
Methods
Data for this cross-sectional analysis were drawn from the fourth wave of the population-based Project EAT (Eating and Activity in Teens and Young Adults) longitudinal study of dietary intake, physical activity, weight control behaviors, weight status and factors associated with these outcomes among young adults. At the original assessment (1998-1999), a total of 4,746 junior and senior high school students at 31 public schools in the Minneapolis-St. Paul metropolitan area of Minnesota, US completed surveys and anthropometric measures20, 21. In 2015-2016, original participants who responded to at least one previous follow-up survey were mailed letters inviting them to complete the Project EAT-IV survey and a food frequency questionnaire (FFQ)22, 23 with the offer of 50 dollars for survey completion.
Complete follow-up survey data were collected online, by mail, or by phone from 66% of those for whom correct contact information was available (N=2,770) for a final sample of 1,830 young adults. Of the 1830 participants in EAT-IV, 49% (n=889) reported that they had at least one child and were retained for the current analyses. All study protocols were approved by the University of Minnesota’s Institutional Review Board Human Subjects Committee.
Measures
Family meal frequency was assessed with the question, “During the past seven days, how many times did all, or most, of the people living in your house eat a meal together?” Participants could select one of six response options ranging from “never” to “more than 7 times” (Test-retest r=0.64). The response options were re-categorized to create three categories (0 to 2 times, 3 to 6 times, and 7 times or more) based on distribution within in the sample.
Indicators of social wellbeing
Six items were drawn from the general functioning scale of the Family Assessment Device24,25 to measure overall family functioning. Previous research has shown high validity (r = 0.92) and test-retest reliability (r = 0.71) for the general functioning scale with racially/ethnically and socio-economically diverse populations.26 The 6-item scale on the EAT-IV survey assessed family communication, acceptance of family members, expressing feelings, getting along, decision making and trust. Possible EAT-IV family functioning scores ranged from 6-24, with higher scores indicating greater family functioning (Cronbach’s α=0.72, test-retest reliability r=0.71).
Partner relationship strength was assessed with the emotional intimacy subscale of the Personal Assessment of Intimacy in Relationships27 among participants who reported that they currently had a significant other. The instrument contains six items assessing intimacy within a relationship, such as listening and sharing feelings with significant other. Responses were selected from a four-point Likert scale. Possible scores ranged from 6–24, with higher scores indicating greater relationship strength (Cronbach’s α = 0.88; test-retest r=0.80).
Indicators of emotional wellbeing
Depressive mood was assessed with a six item instrument asking how often participants were troubled by symptoms such as feeling hopeless over the past 12 months28 (not at all, somewhat very much). The items were summed to get a depression score that ranged from 6 to 18, with higher scores indicating more depressive symptoms (Crohnbach’s α=0.85; test-retest r=0.77).
Self-esteem was assessed with the Rosenberg Self-esteem Scale29 which asks about multiple dimensions of self-image and wellbeing. Possible scores ranged from 6-24, with higher scores indicating greater self-esteem. The scale was found to have good internal consistency (Crohnbach’s α=0.85) and reliability (test-retest r=0.81) in the EAT sample.
A stress index was measured with two items asking, on a scale of one to ten, about overall level of stress and ability to manage stress. An index was then created by dividing the number for perceived stress score by the managing stress score30. Possible scores ranged from 0.1 to 10, with scores above 1.0 indicating unmanaged greater stress (test-retest r=0.78).
Indicators of nutritional wellbeing
Body mass index (BMI) was calculated as weight (kg)/ height (m)2, drawing on self-reported height and weight. In a validation study among a sub-sample of 127 Project EAT-III young adult participants, the correlation between measured and self-reported BMI values was r = 0.9531. In the current sample, the mean BMI for males was 28.2 (68% overweight) and for females 28.0 (62% overweight).
Fast food intake was assessed with the item, “In the past week, how often did you eat something from a fast food restaurant (like McDonald’s, Burger King, etc.)?” with six response options ranging from never to more than 7 times. Usual past year intake of fruit, vegetables, and sugar sweetened beverages was assessed with a semi-quantitative food frequency questionnaire32. A daily serving was defined as the equivalent of one-half cup for fruit and vegetables or as the equivalent of one glass, bottle, or can for sugar-sweetened beverages. For analyses, all food consumption variables (including fast food) were treated as continuous items.
Age, sex, and race/ethnicity were all based on self-report measures with strong reliability (test-retest percent agreement: 74-100%). Socioeconomic indicators included household income, educational attainment (highest level of education completed by participant or spouse)33, and current level of employment (full-time or part-time/ not working). Participants were also asked to report on their number of children, age of their children, whether children live in the household, and if they have a significant other. Participants were considered to be living with their children if they reported having one or more children in their home at least 50% of the time.
Analysis
All analyses were conducted using the SAS software package (v9.4, Cary, NC). Our main analyses were restricted to those who were parents at EAT-IV. Prevalence estimates were derived to describe the socio-demographic characteristics of participants and to describe the bivariate relationship between variables of interest (e.g. the relationship between socio-demographic variables and frequency of family meals). Multiple regression models were conducted to determine the relationship between frequency of family meals and indicators of social, emotional and nutritional wellbeing. All regression analyses controlled for the socio-demographic variables. A separate set of regression models was generated to determine if the relationships between family meals and indicators of social, emotional and nutritional wellbeing were moderated by sex. This was done by including an interaction term (family meal*sex) as a covariate in the regression models.Tests for trend were used to determine statistical significance between the frequency of family meals and indicators of social, emotional and nutritional wellbeing in multivariate models.
Results
The socio-demographic characteristics of parents participating in EAT-IV are described in Table 1. The mean age of parents was 31 years. There were slightly more females (62%) than males and slightly more participants identifying as white (68%) than non-white. Approximately 50% of participants reported their household income at $75,000 or greater (43% of mothers, 56% of fathers) and their maximum household educational attainment at university degree or higher (49% of mothers, 63% of fathers). Full-time employment was reported by 64% of mothers and 91% of fathers, while 26% of participants were not employed in full-time work. Parents reported they had, on average, 2.0 children with a mean age of 4.6 years. Nearly 90% of parents (90% of mothers, 87% of fathers) reported living with their children 50% of the time or more and over 90% of parents reported that they had a significant other.
Table 1.
Socio-demographic characteristics of parents participating in Project EAT-IV
| Total | Mothers | Fathers | |||||
|---|---|---|---|---|---|---|---|
| n | % or mean | n | % or mean | n | % or mean | p-value | |
| Age | |||||||
| Mean | 889 | 31.4 | 552 | 31.3 | 337 | 31.5 | 0.016 |
| Race/ ethnicity | |||||||
| White | 593 | 67.5% | 338 | 62.2% | 255 | 75.9% | |
| Non-white | 286 | 32.5% | 205 | 37.8% | 81 | 24.1% | <0.001 |
| Household Income | |||||||
| Less than $34,999 | 133 | 15.2% | 102 | 18.8% | 31 | 9.4% | |
| $35,000–$74,999 | 323 | 37.0% | 207 | 38.1% | 116 | 35.0% | |
| $75,000 or more | 418 | 47.8% | 234 | 43.1% | 184 | 55.6% | <0.001 |
| Household Educational Attainment | |||||||
| High school graduate or equivalent | 132 | 14.9% | 93 | 16.9% | 39 | 11.6% | |
| Some university | 267 | 30.1% | 188 | 34.1% | 79 | 23.6% | |
| Four year university degree | 306 | 34.5% | 174 | 31.6% | 132 | 39.4% | |
| Graduate or Professional degree | 181 | 20.4% | 96 | 17.4% | 85 | 25.4% | <0.001 |
| Level of Employment | |||||||
| Full-time work | 655 | 73.8% | 350 | 63.5% | 305 | 90.8% | |
| Not full-time work | 232 | 26.2% | 201 | 36.5% | 31 | 9.2% | <0.001 |
| Number of children | |||||||
| Mean | 889 | 2.0 | 552 | 2.1 | 337 | 1.9 | 0.003 |
| Age of children | |||||||
| Mean | 828 | 4.6 | 518 | 5.0 | 310 | 3.9 | <0.001 |
| Live with children | |||||||
| 50% of the time or more | 790 | 88.9% | 497 | 90.0% | 293 | 86.9% | |
| Less than 50% of the time | 99 | 11.1% | 55 | 10.0% | 44 | 13.1% | 0.16 |
| Relationship Status | |||||||
| Significant other | 819 | 92.1% | 498 | 90.2% | 321 | 95.3% | |
| No significant other | 70 | 7.9% | 54 | 9.8% | 16 | 4.7% | 0.007 |
Approximately 50% of parents reported frequent family meals (7 or more times per week), while 12% of parents reported family meals twice a week or less often (Table 2). Frequent family meals were more common among participants who identified as white, with higher levels of education, with household incomes of greater than $75,000, who were living with their children 50% of the time or more often, with younger children, and who had a significant other.
Table 2.
Frequency of family meals by socio-demographic characteristics of participants
| Frequency of family meals | |||||||
|---|---|---|---|---|---|---|---|
| 0-2 times a week | 3–6 times | 7 times or more | |||||
| n | % | n | % | n | % | p-value | |
| Total | 104 | 11.7% | 315 | 35.6% | 467 | 52.7% | |
| Age | |||||||
| Mean | 104 | 31.4 | 315 | 31.3 | 467 | 31.4 | 0.51 |
| Gender | |||||||
| Male | 42 | 12.5% | 119 | 35.5% | 174 | 51.9% | |
| Female | 62 | 11.3% | 196 | 35.6% | 293 | 53.2% | 0.84 |
| Race/ ethnicity | |||||||
| White | 57 | 9.6% | 200 | 33.8% | 335 | 56.6% | |
| Non-white | 46 | 16.2% | 112 | 39.4% | 126 | 44.4% | <0.001 |
| Household Income | |||||||
| Less than $34,999 | 25 | 18.9% | 54 | 40.9% | 53 | 40.2% | |
| $35,000-$74,999 | 47 | 14.6% | 113 | 35.1% | 162 | 50.3% | |
| $75,000 or more | 31 | 7.4% | 147 | 35.2% | 240 | 57.4% | <0.001 |
| Household Educational Attainment | |||||||
| High school graduate or equivalent | 30 | 23.1% | 54 | 41.5% | 46 | 35.4% | |
| Some university | 39 | 14.6% | 102 | 38.2% | 126 | 47.2% | |
| Four year university degree | 27 | 8.8% | 106 | 34.6% | 173 | 56.5% | |
| Graduate or Professional degree | 8 | 4.4% | 51 | 28.2% | 122 | 67.4% | <0.001 |
| Level of Employment | |||||||
| Full-time work | 76 | 11.6% | 248 | 37.9% | 330 | 50.5% | |
| Not full-time work | 28 | 12.2% | 67 | 29.1% | 135 | 58.7% | 0.052 |
| Number of children | |||||||
| Mean | 104 | 2.2 | 315 | 1.9 | 467 | 2.0 | 0.29 |
| Age of children | |||||||
| Mean | 91 | 5.6 | 302 | 5.3 | 435 | 3.9 | <0.001 |
| Children living in the household | |||||||
| 50% of the time or more | 80 | 10.1% | 281 | 35.6% | 429 | 54.3% | |
| Less than 50% of the time | 24 | 25.0% | 34 | 35.4% | 38 | 39.6% | <0.001 |
| Relationship Status | |||||||
| Significant other | 93 | 11.3% | 282 | 34.5% | 442 | 54.1% | |
| No significant other | 11 | 15.9% | 33 | 47.8% | 25 | 36.2% | 0.017 |
Increasing frequency of family meals was associated with multiple indicators of parental social and emotional wellbeing of parents (Table 3). Specifically, greater frequency of family meals was associated with greater family functioning (p<0.001) and greater relationship strength (among participants with a significant other, p<0.001). Likewise, having more frequent family meals was associated with lower levels of depressive symptoms, lower stress index, and greater self-esteem (all p<0.001). The relationships between frequency of family meals and indicators of social and emotional wellbeing were similar for mothers and fathers (all interactions p>0.05; data not shown.) Given that the direction of the relationship between family meals and emotional wellbeing is unknown (e.g. it is possible that poor emotional wellbeing of parents may make it difficult for families to eat together and vice versa), supplemental analyses adjusting for previous emotional well-being were conducted. Additional regression models were generated to include the depressive symptoms and self-esteem as measured five years earlier as covariates in the models where the dependent variables were depressive symptoms and self-esteem. These two indicators were selected because they reflect both positive and negative dimensions of emotional wellbeing and the same measures were assessed in both the EAT-III and EAT-IV surveys. The overall findings were unaffected (p<0.001 for both; data not shown).
Table 3.
Indicators of social and emotional wellbeing of parents by frequency of family meals
| Family meals | ||||||||
|---|---|---|---|---|---|---|---|---|
| 0–2 times a week | 3–6 times | 7 times or more | ||||||
| n | LS mean1 | CI2 | LS mean | CI | LS mean | CI | p-value3 | |
| Family functioning | 807 | 19.6 | 18.7,20.5 | 20.6 | 19.9,21.3 | 21.6 | 20.9,22.3 | <0.001 |
| Relationship strength4 | 745 | 17.5 | 15.5,19.6 | 18.3 | 16.5,20.1 | 19.5 | 17.7,21.4 | <0.001 |
| Depressive symptoms | 807 | 11.6 | 10.6,12.6 | 11.0 | 10.1,11.8 | 10.4 | 9.5,11.2 | <0.001 |
| Self?esteem | 807 | 18.8 | 17.9,19.8 | 19.2 | 18.4,20.0 | 20.4 | 19.6,21.1 | <0.001 |
| Stress index | 790 | 1.4 | 1.1,1.7 | 1.2 | 0.9,1.5 | 0.9 | 0.7,1.2 | <0.001 |
Least squared mean
95% confidence interval for the mean
Test for trend between frequency of family meals and social and emotional wellbeing variables, controlling for gender, age, household income, household education, race/ ethnicity, level of employment, number of children, age of children, children living in the household, and relationship status
Asked only of participants reporting they had a significant other
The relationships between frequency of family meals and indicators of nutritional wellbeing are shown in Table 4. Parents reporting frequent family meals ate significantly more fruits (p=0.045) and vegetables (p=0.048). There were no significant relationships between frequency of family meals and BMI, fast food consumption or daily servings of sugar sweetened beverages. The relationships between frequency of family meals and indicators of nutritional wellbeing were similar for mothers and fathers (all interactions p>0.05; data not shown), with the exception of servings of fruit (p=0.012). The positive relationship between frequency of family meals and servings of fruit appeared to be stronger for mothers, than fathers. Mothers reporting frequent family meals reported 3.2 servings of fruit per day, compared to 2.5 servings among those having family meals 3-6 times a week, and 2.5 servings among those having infrequent family meals. For fathers, consumption of fruit was 2.2, 2.5 and 2.4 servings, respectively.
Table 4.
Body mass index (BMI) and eating behaviors of parents by frequency of family meals
| Family meals | ||||||||
|---|---|---|---|---|---|---|---|---|
| 0–2 times a week | 3–6 times | 7 times or more | ||||||
| n | LS mean1 | CI2 | LS mean | CI | LS mean | CI | p-value3 | |
| BMI | 752 | 28.9 | 26.7,31.2 | 28.4 | 26.4,30.3 | 27.9 | 26.1,29.7 | 0.16 |
| Fast food, frequency per week | 807 | 1.9 | 1.7,2.1 | 1.8 | 1.7,2.0 | 1.8 | 1.6,1.9 | 0.09 |
| Daily servings of vegetables | 701 | 3.9 | 2.7,5.1 | 4.3 | 3.2,5.4 | 4.5 | 3.3,5.6 | 0.045 |
| Daily servings of fruit | 701 | 2.4 | 1.6,3.1 | 2.4 | 1.8,3.0 | 2.8 | 2.1,3.4 | 0.048 |
| Daily servings of sugar sweetened beverages | 700 | 0.7 | 0.3,1.1 | 0.8 | 0.4,1.1 | 0.6 | 0.2,0.9 | 0.21 |
Least squared mean
95% confidence interval for the mean
Test for trend between frequency of family meals and nutrition indicators, controlling for gender, age, household income, household education, race/ ethnicity, level of employment, number of children, age of children, children living in the household, and relationship status
Discussion
The aim of the current paper was to explore the relationship between family meals and indicators of nutritional, social and emotional wellbeing for parents. We found that parents who reported frequent meals with their families also reported better family functioning, stronger relationships and better mental health, but few relationships with better nutrition. These findings are novel, as to date, the majority of research addressing the potential health effects of family meals has focused on children and adolescents1–3.
Findings from the current study suggest that frequent family meals are associated with better social and emotional health for parents. Previous research has documented these relationships for adolescents3, 5, 34, but we are aware of only one other population-based study35 (from our research team) to report these relationships for parents. Berge et al.35 found that parents who had maintained regular family meals from adolescence or who had started regular family meals with their own children had better self-esteem and fewer depressive symptoms than parents who did not have family meals. Meal times present families with the opportunity for communication and engagement, on a regular basis. Adolescents who report frequent family meals also report greater family connection, parental monitoring and that they feel they can talk to their parents about their concerns9. Thus it follows that parents may also benefit from greater communication and engagement with their children and other family members and that mealtimes may create an opportunity for this to happen. Frequent family meals may also serve as a family routine and ritual. A long-standing body of evidence suggests that family routines and rituals are associated with better health and wellbeing for all family members, as well as feelings of parenting competence and marital satisfaction36. As the current study is cross-sectional, the direction of the relationships between family meals and psychosocial indicators remain unknown. It is possible that infrequent family meals are the result of greater stress on parents as parents with busy working schedules may trade-off family meals as a coping strategy17. It is also possible that family meals are a characteristic or function of family wellbeing, rather than the cause of it. However, in the supplemental analyses we accounted for background levels of emotional health and our results were unchanged. In addition, findings from a feasibility study of a family meal intervention found that parents reported improvements to family relationships as a result of participating in the intervention37.
In general, the current study found few relationships between frequent family meals and better nutrition for parents. Though the current study did find a relationship between family meals and greater fruit and vegetable consumption among parents, there were no relationships observed for BMI or consumption of fast food or sugar sweetened beverages. It was of interest that frequency of fast food consumption was similar across the frequency categories of family meals. This may be due to families having fast food for family meals or may reflect that fast food was consumed at times when young adult parents do not typically eat with their families (e.g. lunch). Our findings on are consistent with a few other studies in this area15,38. At least one study has reported a relationship between frequent family meals and lower BMI among parents14, though it is notable that the mean age of parents in that study was 50 years. The lack of associations with BMI specifically, may reflect that the parents in the current study were younger the previous study and that the types of foods served at family meals may change as parents (and their children) get older.
Strengths of the current study lie in its large, diverse population-based sample, inclusion of established scales and measures, wide range of health indicators and timeliness of the data. Though, the current study has a few limitations worth considering when interpreting the findings. First, the sample is derived from a longitudinal study. Attrition from the original sample, and non-response for the current survey, may have affected the results. Since we have no way of knowing which participants lost to follow-up became parents we were unable to construct appropriate inverse probability weights to account for the potential retention bias. In addition, participants in the current study had higher household incomes and achieved higher levels of education than general population of adults in Minnesota39the For example, in the current study 55% of participants completed a university degree, compared to 34% of adults in Minnesota. Therefore, findings from this study may not be generalizable to other more diverse populations. Second, the measure of family meals is only a measure of frequency. Other aspects of the family meal may be important to measure in future studies (such as nutritional quality of the meal and type and quality of communication) to better understand these relationships. Previous research has suggested that psychosocial factors of adults (work-life stress, depressive symptoms) is inversely associated with the healthiness of meals served at family dinners.40 Future research may explore the mediating roles of healthiness of meals, positive atmosphere of family meals, and communication during meals in the relationship between frequency of family meals and nutritional and emotional wellbeing. Future research may also explore the how family meals influences the health and wellbeing of parents over time.
Conclusions
Findings from the current study suggest that parents who have frequent family meals are better off in terms of social and emotional wellbeing. These findings are significant as it is well known that parent mental wellbeing affects the health and wellbeing of their children. Future interventions to promote family meals should consider measuring a wide range of potential impacts on the health and wellbeing of the whole family. Given the direction of the relationship with emotional wellbeing remains unknown, future interventions to increase family meals may consider that the emotional health of parents may make it more difficult for families to prepare meals and eat together. Conversely, if family meals do improve wellbeing, then the current research offers health professionals and interventionists and tangible and feasible mechanism for working with families.
Acknowledgements:
This study was supported by Grant Number R01HL116892 from the National Heart, Lung, and Blood Institute (PI: Dianne Neumark-Sztainer). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.
Footnotes
Conflicts of Interest:
All authors declare that they have no conflicts of interest to disclose
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