Quality Matters: A Meta-Analysis on Components of Healthy Family Meals

Objective: A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children. However, the effect sizes are small, and it remains unclear which qualitative components of family meals contribute to these positive health outcomes. This meta-analysis synthesizes studies on social, environmental, and behavioral attributes of family meals and identifies components of family meals that are related to better nutritional health in children. Method: A systematic literature search (50 studies; 49,137 participants; 61 reported effect sizes) identified 6 different components of healthy family mealtimes. Separate meta-analyses examined the association between each component and children's nutritional health. Age (children vs. adolescents), outcome type (BMI vs. diet quality), and socioeconomic status (SES; controlled vs. not controlled for SES) were examined as potential moderators. Results: Positive associations consistently emerged between 5 components and children's nutritional health: turning the TV off during meals (r = .09), parental modeling of healthy eating (r = .12), higher food quality (r = .12), positive atmosphere (r = .13), children's involvement in meal preparation (r = .08), and longer meal duration (r = .20). No moderating effects were found. Conclusions: How a family eats together shows significant associations with nutritional health in children. Randomized control trials are needed to further verify these findings. The generalizability of the identified mealtime components to other contexts of social eating is also discussed.