Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions
Abstract
:1. Introduction
- What are the characteristics of family mealtimes?
- What are the correlates of family mealtimes?
- What outcomes, if any, are family mealtimes associated with?
- Are interventions aimed at promoting family mealtimes effective?
2. Materials and Methods
2.1. Eligibility Criteria and Information Source
- Systematic reviews with or without meta-analysis and/or meta-synthesis;
- Systematic reviews of studies whose participants included families comprising children and/or adolescents aged from birth to 18 years (PICO Population);
- Systematic reviews that reported at least one aspect of family mealtimes (characteristics, correlates, outcomes or interventions) (PICO Intervention, Comparison and Outcome);
- Peer-reviewed;
- English Language.
- Systematic reviews of studies whose participants were restricted to adults aged >18 years;
- Systematic reviews of studies in which only non-family meals were investigated e.g., eating at school;
- Systematic reviews of studies investigating breakfast consumption if the focus was exclusively on the nutrition associated with consuming breakfast rather than breakfast as a family mealtime;
- Systematic reviews of studies whose participants were families with children/adolescents with a medical condition that may affect their eating, for example, Type 1 or Type 2 diabetes; eating disorders (e.g., anorexia); feeding or food intake disorders or difficulties; Autism Spectrum Disorder (ASD); Attention Deficit Hyperactivity Disorder (ADHD);
- Systematic reviews of studies where participants were restricted to adolescents/children who were overweight;
- Systematic reviews of studies in which participants were restricted to parents with eating disorders;
- Primary studies reporting original data;
- Non-systematic reviews e.g., scoping reviews;
- Commentaries, editorials, position papers.
2.2. Search Selection
- Exclusion of systematic reviews that focused on families with children/adolescents with a medical condition that may affect their eating (see exclusion criteria for detail);
- The inclusion of “review” as a search term in the title but not in the abstract; doing so resulted in the inclusion of articles that described reviewing the literature but were not reviews. Meta-analysis and meta-synthesis were searched for in both the title and the abstract.
2.3. Data Extraction
- Authors and year of publication;
- Key search criteria: dates of review; age of participants; designs included/excluded;
- Systematic review question(s);
- Conceptualisation, definition and/or operationalisation of family mealtimes and other constructs relevant to the article;
- Key systematic review characteristics: design; number of articles/studies; quality;
- Key findings and limitations relevant to family mealtime research.
2.4. Assessment of Quality and Risk of Bias
2.5. Data Synthesis
- Characteristics of family mealtimes;
- Correlates of family mealtimes;
- Outcomes predicted by family mealtimes;
- Interventions aimed at promoting family mealtimes.
3. Results
3.1. Search Results
3.2. Characteristics of the Included Systematic Reviews
3.2.1. Constructs Assessed
3.2.2. Overlap
3.2.3. Quality and Risk of Bias
- All reviews described their research question and inclusion criteria;
- While some reviews were pre-registered (6) or explicitly stated the review methods were established in advance (11), most had not pre-registered or made an explicit statement (24);
- Few reviews (3) explained their rationale for their selection of study designs;
- In almost all reviews, at least two databases (40) were searched and most reported keywords (37); however, few reviews provided a full rationale for their search limitations (34). In total, only 5 reviews described their literature search strategy comprehensively;
- Approximately half (19) of reviews described at least two reviewers independently agreeing on eligible articles, and approximately one third (15) described at least two reviewers agreeing on the extracted data;
- None of the reviews provided a list of excluded studies or justified exclusions;
- A majority of reviews described the studies included in partial (11) or full (19);
- Reviews that assessed the risk of bias of the original studies also accounted for risk of bias when interpreting their results; however, most reviews (22) did not describe a satisfactory technique for assessing the risk of bias in original studies;
- Most reviews discussed any heterogeneity in the results;
- None of the reviews reported the sources of funding for the original studies that were included;
- A majority of reviews (29) reported potential sources of conflict (including funding); however, reporting may be an artifact of the journal in which the review was published as some require this to be reported while others do not. Of the fourteen that received funding, ten received institutional grants or scholarships, three received industry grants and one did not specify.
3.3. Characteristics of Family Mealtimes
3.4. Correlates of Family Mealtimes
3.4.1. Correlates of Family Meal Frequency
3.4.2. Correlates of Other (Non-Frequency) Aspects of Family Meals
3.5. Outcomes Associated with Family Mealtimes
3.5.1. Family Mealtimes as a Predictor of Eating Behaviours/Nutrition
3.5.2. Family Meals as a Predictor of Weight-Status
3.6. Family Mealtimes as a Predictor of Psychosocial Outcomes
3.7. Moderators of the Relationship between Family Mealtimes and Outcomes
3.8. Interventions Aimed at Promoting Family Mealtimes
3.9. Heterogeneity of Results
4. Discussion
4.1. What Are the Characteristics of Family Mealtimes?
4.2. What Are the Correlates of Family Mealtimes?
4.3. What Outcomes Are Associated with Family Mealtimes?
4.4. Are Interventions Aimed at Promoting Family Mealtimes Effective?
4.5. Strengths and Limitations of Systematic Reviews
4.6. Strengths and Limitations of Umbrella Review
4.7. Implications for Practice, Policy and Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Reference | Authors (Year of Publication) | Review Question(s) Pertinent to Family Mealtimes | Review Design | Key Findings Pertinent to Family Mealtime Research |
---|---|---|---|---|
[1] | McCullough et al., (2016) | How has the family meal environment been characterised in the existing literature? |
| All studies reported ≥ 1 of the structural characteristics; most reported one, none reported all four.
|
[2] | Martin-Biggers et al., (2014) |
|
| A range of definitions of family meals was used across studies, with some specifying the number of people who must be present and meal type (dinner). Parents experiences of family meals:
|
[3] | Glanz et al., (2021) |
|
| Factors associated with more frequent in-home eating:
|
[4] | Duriancik & Goff (2015) | Are children living in a single-parent household at risk of obesity? |
| Two studies investigated family meals. One investigated family meal frequency and found that children from single-mother homes had higher odds of infrequent family meals. The other investigated shared meals as a possible mechanism to explain the association between family structure and children’s higher risk of obesity but found it non-significant. Key limitation(s) pertinent to family mealtimes: Most studies were cross-sectional and causality could not be determined. |
[5] | Burrows et al., (2017) | What are the effects of dietary intakes and behaviours on the academic achievement of school aged children? |
| One study reviewed assessed the frequency of family meals and found eating family meals ≥5 days per week was not associated with academic achievement. Key limitation(s) pertinent to family mealtimes: studies focused on household routines with few examining broader components of the home environment. |
[6] | Skeer & Ballard (2013) | What mechanisms contribute to the protective effect against adolescent risk behaviour afforded by family meal frequency? |
|
|
[7] | Dwyer et al., (2015) |
|
| Six intervention studies evaluating multiple session programmes delivered to families (3) or children/adolescents (3). Of the 6, 4 demonstrated a positive effect on family meal frequency while 2 were not significantly related to family meals. Non-intervention articles showed:
|
[8] | Fulkerson et al. (2014) | What are the associations between family meal frequency and children and adolescents’ dietary/weight outcomes? |
|
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[9] | Tosatti et al., (2017) | Do family mealtimes have a protective effect on obesity and good eating habits in young people? |
|
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[10] | Woodruff et al., (2008) |
|
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[11] | Robson et al., (2020) | What is the direction and magnitude of the exposure to family meals and:
|
| Dietary Outcomes:
Evidence of a positive association between family meal/family dinner frequency and family functioning. Key limitation(s) pertinent to family mealtimes: lack of definitions and standardised measure for family meals. |
[12] | Verhage et al., (2018) | Are characteristics of the family meal associated with outcomes in terms of health benefits in infants and toddlers? |
| Nine studies investigated the family meal frequency and parents’ perceptions of sharing meals: Most children had regular meals at the age of three.Mothers perceived mealtimes as a valuable moment to socialise.Family meals were more frequent among families that were Hispanic and non-Hispanic white compared to non-Hispanic black.
Interventions to promote family meals (2 studies):
|
[13] | Middleton et al., (2020) | What impact does the family meal have on the health and wellbeing of the family? |
| Intervention Studies:
|
[22] | Hammons & Fiese (2011) | What is the strength of the relationship between the frequency of shared family mealtimes and children’s nutritional health? |
|
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[23] | Pearson et al., (2009) | What are the correlates of the family environment associated with children’s and adolescent’s breakfast behaviour? |
|
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[24] | Scaglioni et al., (2018) | How does the family environment influence children’s eating behaviours? |
|
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[25] | van der Horst et al., (2017) |
|
| Three studies reported findings relating to family meals:
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[26] | Cislak et al., (2012) | What is the evidence for relationships between family variables, weight-related behaviours and body weight in children and adolescents? |
| Of two reviews examining frequency of family meals (breakfast/dinner), both found that a higher frequency was positively associated with healthy diet in children/adolescents. Key limitation(s) pertinent to family mealtimes: none reported. |
[27] | Dallacker et al., (2019) |
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[28] | Dallacker et al., (2018) |
|
|
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[29] | Harrison et al., (2015) | What is the relationship between family meals and psychosocial outcomes in children and adolescents and are their differences between males and females? |
|
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[30] | Rahill et al., (2020) |
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[31] | Fraser et al., (2011) | In relation to children’s weight gain, overweight and obesity:
|
| One qualitative study identified two themes relating to family mealtimes: mealtime rituals and routines; tension during mealtimes and found a variety of strategies are required to establish healthy eating patterns and consistent routines. Key limitation(s) pertinent to family mealtimes: small, unrepresentative samples. |
[32] | Liu et al., (2009) | How does the family influence adolescent eating habits in terms of knowledge, attitudes and practices? |
|
|
[33] | Valdés et al., (2013) | What is the relationship between the frequency of family meals and the risk of overweight in children and adolescents? |
| While several studies found an inverse relationship between frequency of family meals and BMI/overweight, the association became non-significant once adjustments were made for potentially confounding variables (age, gender, socio-economic status, diet, physical activity). Key limitation(s) pertinent to family mealtimes: lack of definition of family meal and scarce information about the characteristics of family meals. |
[34] | Khandpur et al., (2014) |
|
|
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[35] | Berge et al., (2009) | What are the familial correlates of child and adolescent obesity? |
| Correlates of family meal frequency:
|
[36] | Vollmer & Mobley (2013) | What is the relationship between parenting and/or feeding styles on child body weight and/or child obesogenic behaviours? |
| One of five studies examining the role of family meal characteristics found an authoritative parenting style was positively associated with family meal frequency. Key limitation(s) pertinent to family mealtimes: None reported. |
[37] | Jenkins & Horner (2005) | What are the barriers that influence eating behaviours in adolescence? |
|
|
[38] | Titis (2022) | What are parents’ perspectives of the impact of the COVID-19 lockdown on the family food environment and food-related activities? |
| Changes arising from the COVID-19 lockdown were associated with parents having more time, greater interest in health and nutrition, increased motivation to eat more healthily. Specifically:
|
[39] | Do Amaral e Melo et al., (2020) | What is the association between family meals frequency and food consumed and/or children’s, adolescents’ and young adults’ nutritional status? |
| Studies varied in the operationalisation of meal frequency, assessing the frequency of meals in general, dinner/supper/evening meal, dinner only, all three main meals (breakfast, lunch, and dinner), breakfast only, breakfast and dinner, lunch and dinner with most assessing meal frequency over a 1-week period. Association between family meal frequency and nutritional status:
|
[40] | Krølner et al., (2011) | What are children/adolescents’ views and experiences regarding determinants of their intake of fruit and vegetables? |
| Children/adolescents perceived that family dinner at home is the only appropriate time to eat vegetables. Key limitation(s) pertinent to family mealtimes: none reported. |
[41] | Pearson et al., (2008) | What are the correlates of the family environment associated with children’s and adolescent’s fruit and vegetable intake? |
|
|
[42] | Rasmussen et al., (2006) | What are the determinants of fruit and vegetable consumption in children and adolescents? |
| Five of six papers investigating the influence of shared family meals found a positive association with children’s consumption of fruit and/or vegetables. The sixth paper found no association. Key limitation(s) pertinent to family mealtimes: many studies were based on small, non-representative samples; the validity of instruments used to assess constructs was reported either superficially or not at all. |
[43] | Smith et al., (2022) | What are the child/adolescent level correlates of mealtime emotional climate? |
|
|
[44] | Avery et al., (2017) | What are the associations between watching TV during a meal or while consuming a snack, and children’s diet quality? |
| Having the TV on during the family meal was associated with poorer diet quality in terms of adolescents’ consumption of fried foods (girls), soft drinks, grains, calcium-rich foods, and vegetables. Key limitation(s) pertinent to family mealtimes: none reported. |
[45] | Bates et al., (2018) | What relations exist between the organisation of the family home environment and child obesity? |
| 10/16 studies found a significant relation between meal routines and child weight, 70% of which was in the expected direction. Less likelihood of obesity if:
|
[46] | Psaltopoulou et al., (2019) | What is the observational and/or interventional evidence for nutritional, physical activity and behavioural factors preventing and/or treating child and adolescent obesity? |
| One meta-analysis investigated the frequency of family meals and childhood obesity and found that children having ≥3 family meals per week were 12% less likely to become obese compared to children who had <3 family meals per week. Key limitation(s) pertinent to family mealtimes: none reported. |
[47] | Beckers et al., (2021) | What are the prospective links between food parenting practices and children’s weight outcomes? |
| Nine studies (six independent datasets) examined the association between meal routines and weight outcomes.
|
[48] | Goldfarb et al., (2015) | What role does the family meal play in adolescent risk behaviours? |
|
|
[49] | Dolor-Beauroy-Eustache & Mishara (2021) | What factors influence the impact of cyberbullying on suicidal and self-harm behaviours among children and adolescents? |
| A single study investigating the role of family meals showed that family dinners moderated the relationship between cyberbullying and internalising problems (including self-harm, suicide attempts and ideation). Key limitation(s) pertinent to family mealtimes: Most studies were cross-sectional so direction/causality could not be determined; studies used different instruments and conceptualisations to measure cyberbullying and suicidal and self-harm behaviours. |
Reference | Author (Year of Publication) | Constructs (n) | Characteristics of Investigated Family Mealtimes (11 Reviews) | Correlates of Investigated Family Mealtime Characteristics (18 Reviews) | Investigated Outcome(s) that Family Mealtimes Predict (33 Reviews) | Interventions Promoting Family Mealtimes (4 Reviews) |
---|---|---|---|---|---|---|
[1] | McCullough et al., (2016) | 1 | location; duration; presence of family members | |||
[2] | Martin-Biggers et al., (2014) | 3 | parents’ experiences | socio-demographics; meal structure, location, TV on; barriers/facilitators | BMI/weight status; psychosocial | |
[3] | Glanz et al., (2021) | 3 | previous family meal frequency; ethnicity | BMI/weight status | 4 interventions evaluated | |
[4] | Duriancik & Goff (2015) | 2 | single-mother homes | BMI/weight status | ||
[5] | Burrows et al., (2017) | 1 | psychosocial | |||
[6] | Skeer & Ballard (2013) | 1 | psychosocial | |||
[7] | Dwyer et al., (2015) | 3 | parents’ experiences | socio-demographics; barriers/facilitators | 6 interventions evaluated | |
[8] | Fulkerson et al., (2014) | 2 | meal frequency; TV | nutrition; BMI/weight status | ||
[9] | Tosatti et al., (2017) | 2 | meal frequency | eating behaviour; nutrition; BMI/weight status | ||
[10] | Woodruff et al., (2008) | 3 | meal frequency; TV | socio-demographics | nutrition | |
[11] | Robson et al., (2020) | 2 | family functioning | nutrition; psychosocial | ||
[12] | Verhage et al., (2018) | 3 | meal frequency; location; TV; presence of parent | ethnicity; feeding approach | eating behaviour; nutrition | 2 interventions evaluated |
[13] | Middleton et al., (2020) | 3 | meal frequency; parents’ motivations, perceptions, strategies | barriers/facilitators | 9 interventions evaluated | |
[22] | Hammons & Fiese (2011) | 2 | meal frequency | nutrition | ||
[23] | Pearson et al., (2009) | 1 | nutrition | |||
[24] | Scaglioni et al., (2018) | 2 | socio-demographics | eating behaviour; nutrition; psychosocial | ||
[25] | van der Horst et al., (2017) | 2 | single-mother homes | eating behaviours; nutrition | ||
[26] | Cislak et al., (2012) | 1 | nutrition | |||
[27] | Dallacker et al., (2019) | 1 | nutrition; BMI/weight status | |||
[28] | Dallacker et al., (2018) | 1 | nutrition | |||
[29] | Harrison et al., (2015) | 3 | meal frequency | socio-demographics | psychosocial | |
[42] | Rasmussen et al., (2006) | 1 | nutrition | |||
[30] | Rahill et al., (2020) | 2 | parents’ roles | |||
[31] | Fraser et al., (2011) | 1 | fathers’ experiences | |||
[32] | Liu et al., (2009) | 2 | atmosphere at home | eating behaviours | ||
[33] | Valdés et al., (2013) | 1 | nutrition; BMI/weight status | |||
[34] | Khandpur et al., (2014) | 2 | food parenting practices | BMI/weight status | ||
[35] | Berge et al., (2009) | 2 | prioritisation of family meals; family connectedness | nutrition; BMI/weight status | ||
[36] | Vollmer & Mobley (2013) | 1 | parenting style | |||
[37] | Jenkins & Horner (2005) | 2 | mothers’ employment | nutrition | ||
[38] | Titis (2022) | 1 | COVID-19 pandemic restrictions | |||
[39] | Do Amaral e Melo et al., (2020) | 1 | nutrition | |||
[40] | Krølner et al., (2011) | 1 | eating behaviours | |||
[41] | Pearson et al., (2008) | 1 | eating behaviours | |||
[43] | Smith et al., (2022) | 1 | eating behaviour; nutrition; BMI/weight status | |||
[44] | Avery et al., (2017) | 1 | nutrition | |||
[45] | Bates et al., (2018) | 1 | BMI/weight status | |||
[46] | Psaltopoulou et al., (2019) | 1 | BMI/weight status | |||
[47] | Beckers et al., (2021) | 1 | nutrition | |||
[48] | Goldfarb et al., (2015) | 1 | psychosocial | |||
[49] | Dolor-Beauroy-Eustache & Mishara (2021) | 1 | psychosocial |
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Snuggs, S.; Harvey, K. Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions. Nutrients 2023, 15, 2841. https://doi.org/10.3390/nu15132841
Snuggs S, Harvey K. Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions. Nutrients. 2023; 15(13):2841. https://doi.org/10.3390/nu15132841
Chicago/Turabian StyleSnuggs, Sarah, and Kate Harvey. 2023. "Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions" Nutrients 15, no. 13: 2841. https://doi.org/10.3390/nu15132841
APA StyleSnuggs, S., & Harvey, K. (2023). Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions. Nutrients, 15(13), 2841. https://doi.org/10.3390/nu15132841