Family Meal Frequency, Diet, and Family Functioning: A Systematic Review With Meta-analyses

Published:January 23, 2020DOI:



      To examine the direction and magnitude of the relation between family meal frequency and dietary and family functioning outcomes in children (aged 2–18 years).


      Systematic literature review with meta-analysis.


      Independent electronic searches, 1 for each outcome of interest, were conducted across 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and PsycINFO. Studies were included if they were peer-reviewed and published in English in the US through December 2018.

      Main Outcome Measures

      Diet and family functioning.


      Dietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There was less clear evidence of this relation in snacks, fast food, and desserts. A positive association was found between family meal frequency or dinner family meal frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs.

      Conclusions and Implications

      There is some evidence to show a positive relation between family meal frequency and dietary outcomes. There is stronger evidence for the relation with family functioning outcomes. Most articles included in the systematic reviews were excluded from meta-analysis owing to inadequate data and high methodological diversity across exposure and outcome variables.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.


      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hammons AJ
        • Fiese BH.
        Is frequencyof shared family meals related to the nutritional health of children and adolescents?.
        Pediatrics. 2011; 127: e1565-e1574
        • Dwyer L
        • Oh A
        • Patrick H
        • Hennessy E
        Promoting family meals: a review of existing interventions and opportunities for future research.
        Adolesc Health Med Ther. 2015; 6: 115-131
        • Berge JM
        • Truesdale KP
        • Sherwood NE
        • et al.
        Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
        Public Health Nutr. 2017; 20: 3275-3284
        • Horning ML
        • Fulkerson JA
        • Friend SE
        • Neumark-Sztainer D
        Associations among nine family dinner frequency measures and child weight, dietary, andpsychosocial outcomes.
        J Acad Nutr Diet. 2016; 116: 991-999
        • Eisenberg ME
        • Neumark-Sztainer D
        • Fulkerson JA
        • Story M
        Family meals and substance use: is there a long-term protective association?.
        J Adolesc Health. 2008; 43: 151-156
        • Utter J
        • Denny S
        • Peiris-John R
        • Moselen E
        • Dyson B
        • Clark T
        Family meals and adolescent emotional well-being: findings from a national study.
        J Nutr Educ Behav. 2017; 49: 67-72
        • Skeer MR
        • Ballard EL
        Are family meals as good for youth as we think they are? A review of the literature on family meals as they pertain to adolescent risk prevention.
        J Youth Adolesc. 2013; 42: 943-963
        • Neumark-Sztainer D
        • Eisenberg ME
        • Fulkerson JA
        • Story M
        • Larson NI
        Family meals and disordered eating in adolescents: longitudinal findings from project EAT.
        Arch Pediatr Adolesc Med. 2008; 162: 17-22
        • Goldfarb SS
        • Tarver WL
        • Locher JL
        • Preskitt J
        • Sen B
        A systematic review of the association between family meals and adolescent risk outcomes.
        J Adolesc. 2015; 44: 134-149
        • Berge JM
        • Wall M
        • Hsueh TF
        • Fulkerson JA
        • Larson N
        • Neumark-Sztainer D
        The protective role of family meals for youth obesity: 10-year longitudinal associations.
        J Pediatr. 2015; 166: 296-301
        • Fiese BH
        • Schwartz M
        • Reclaiming the family table
        Mealtimes and child health and wellbeing.
        Soc Res Child Dev. 2008; 42: 3-9
        • Barlow SE
        • Expert Committee
        Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.
        Pediatrics. 2007; 120: S164-S192
        • Woodruff SJ
        • Hanning RM
        A review of family meal influence on adolescents’ dietary intake.
        Can J Diet Pract Res. 2008; 69: 14-22
        • Eccleston C
        • Fisher E
        • Law E
        • Bartlett J
        • Palermo TM
        Psychological interventions for parents of children and adolescents with chronic illness.
        Cochrane Database Syst Rev. 2015; CD009660
        • Leeman J
        • Crandell JL
        • Lee A
        • Bai J
        • Sandelowski M
        • Knafl K
        Family functioning and the well-being of children with chronic conditions: a meta-analysis.
        Res Nurs Health. 2016; 39: 229-243
        • Moens E
        • Braet C
        • Soetens B
        Observation of family functioning at mealtime: a comparison between families of children with and without overweight.
        J Pediatr Psychol. 2007; 32: 52-63
        • Patton SR
        • Piazza-Waggoner C
        • Modi AC
        • Dolan LM
        • Powers SW
        Family functioning at meals relates to adherence in young children with type 1 diabetes.
        J Paediatr Child Health. 2009; 45: 736-741
        • Langdon-Daly J
        • Serpell L
        Protective factors against disordered eating in family systems: a systematic review of research.
        J Eat Disord. 2017; 5: 12
        • Berge JM
        A review of familial correlates of child and adolescent obesity: what has the 21st century taught us so far?.
        Int J Adolesc Med Health. 2009; 21: 457-483
        • Berge JM
        • Wall M
        • Neumark-Sztainer D
        • Larson N
        • Story M
        Parenting style and family meals: cross-sectional and 5-year longitudinal associations.
        J Am Diet Assoc. 2010; 110: 1036-1042
        • Stroup DF
        • Berlin JA
        • Morton SC
        • et al.
        Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.
        JAMA. 2000; 283: 2008-2012
      1. The Cochrane Collaboration. Cochrane handbook for systematic review of interventions. 2011. Accessed November 25, 2019.

      2. US Department of Health and Human Services, National Heart, Lung, and Blood Institute. Study quality assessment tools. Accessed November 25, 2019.

        • von Hippel PT
        The heterogeneity statistic I(2) can be biased in small meta-analyses.
        BMC Med Res Methodol. 2015; 15: 35
      3. Deeks JJ, Higgins JPT, Altman DG, editors. Analysing data and undertaking meta-analyses. In: Deeks JJ, Higgins JPT, Altman DG, Cochrane Statistical Methods Group, eds. Cochrane Handbook for Systematic Review of Interventions. Version 5.1.0. London, UK: The Cochrane Collection; 2011.

        • DerSimonian R
        • Laird N
        Meta-analysis in clinical trials.
        Control Clin Trials. 1986; 7: 177-188
        • Egger M
        • Davey Smith G
        • Schneider M
        • Minder C
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Ranjit N
        • Evans AE
        • Springer AE
        • Hoelscher DM
        • Kelder SH
        Racial and ethnic differences in the home food environment explain disparities in dietary practices of middle school children in Texas.
        J Nutr Educ Behav. 2015; 47: 53-60
        • Neumark-Sztainer D
        • Hannan PJ
        • Story M
        • Croll J
        • Perry C
        Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents.
        J Am Diet Assoc. 2003; 103: 317-322
        • Larson N
        • MacLehose R
        • Fulkerson JA
        • Berge JM
        • Story M
        • Neumark-Sztainer D
        Eating breakfast and dinner together as a family: associations with sociodemographic characteristics and implications for diet quality and weight status.
        J Acad Nutr Diet. 2013; 113: 1601-1609
        • Larson NI
        • Neumark-Sztainer D
        • Hannan PJ
        • Story M
        Family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood.
        J Am Diet Assoc. 2007; 107: 1502-1510
        • Demissie Z
        • Eaton DK
        • Lowry R
        • et al.
        The association of meal practices and other dietary correlates with dietary intake among high school students in the United States, 2010.
        Am J Health Promot. 2015; 29: e203-e213
        • Cutler GJ
        • Flood A
        • Hannan P
        • Neumark-Sztainer D
        Multiple sociodemographic and socioenvironmental characteristics are correlated with major patterns of dietary intake in adolescents.
        J Am Diet Assoc. 2011; 111: 230-240
        • Burgess-Champoux TL
        • Larson N
        • Neumark-Sztainer D
        • Hannan PJ
        • Story M
        Are family meal patterns associated with overall diet quality during the transition from early to middle adolescence?.
        J Nutr Educ Behav. 2009; 41: 79-86
        • Befort C
        • Kaur H
        • Nollen N
        • et al.
        Fruit, vegetable, and fat intake among non-Hispanic black and non-Hispanic white adolescents: associations with home availability and food consumption settings.
        J Am Diet Assoc. 2006; 106: 367-373
        • Bauer KW
        • Neumark-Sztainer D
        • Fulkerson JA
        • Hannan PJ
        • Story M
        Familial correlates of adolescent girls’ physical activity, television use, dietaryintake, weight, and body composition.
        Int J Behav Nutr Phys Act. 2011; 8: 25
        • Koszewski W
        • Behrends D
        • Nichols M
        • Sehi N
        • Jones G
        Patterns of family meals and food and nutrition intake in limited resource families.
        Fam Con Sci Res J. 2011; 39: 431-441
        • Videon TM
        • Manning CK
        Influences on adolescent eating patterns: the importance of family meals.
        J Adolesc Health. 2003; 32: 365-373
        • Surjadi FF
        • Takeuchi DT
        • Umoren J
        Racial and ethnic differences in longitudinal patterns of family mealtimes: link to adolescent fruit and vegetable consumption.
        J Nutr Educ Behav. 2017; 49: 244-249
        • Feldman S
        • Eisenberg ME
        • Neumark-Sztainer D
        • Story M
        Associations between watching TV during family meals and dietary intake among adolescents.
        J Nutr Educ Behav. 2007; 39: 257-263
        • Appelhans BM
        • Waring ME
        • Schneider KL
        • Pagoto SL
        Food preparation supplies predict children's family meal and home-prepared dinner consumption inlow-income households.
        Appetite. 2014; 76: 1-8
        • Fulkerson JA
        • Kubik MY
        • Story M
        • Lytle L
        • Arcan C
        Are there nutritional and other benefits associated with family meals among at-risk youth.
        J Adolesc Health. 2009; 45: 389-395
        • Ayala GX
        • Baquero B
        • Arredondo EM
        • Campbell N
        • Larios S
        • Elder JP
        Association between family variables and Mexican American children's dietary behaviors.
        J Nutr Educ Behav. 2007; 39: 62-69
        • Lipsky LM
        • Haynie DL
        • Liu D
        • et al.
        Trajectories of eating behaviors in a nationally representative cohort of U.S. adolescents during the transition to young adulthood.
        Int J Behav Nutr Phys Act. 2015; 12: 138
        • Larson N
        • Wang Q
        • Berge JM
        • Shanafelt A
        • Nanney MS
        Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA.
        Public Health Nutr. 2016; 19: 1565-1574
        • Kornides ML
        • Nansel TR
        • Quick V
        • et al.
        Associations of family meal frequency with family meal habits and meal preparation characteristics among families of youth with type 1 diabetes.
        Child Care Health Dev. 2014; 40: 405-411
        • Ranjit N
        • Wilkinson AV
        • Lytle LM
        • Evans AE
        • Saxton D
        • Hoelscher DM
        Socioeconomic inequalities in children's diet: the role of the home food environment.
        Int J Behav Nutr Phys Act. 2015; 12: S4
        • Andaya AA
        • Arredondo EM
        • Alcaraz JE
        • Lindsay SP
        • Elder JP
        The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children.
        J Nutr Educ Behav. 2011; 43: 308-315
        • Erinosho TO
        • Beth Dixon L
        • Young C
        • Brotman LM
        • Hayman LL
        Caregiver food behaviours are associated with dietary intakes of children outside the child-care setting.
        Public Health Nutr. 2013; 16: 1263-1272
        • Larson N
        • Miller JM
        • Eisenberg ME
        • Watts AW
        • Story M
        • Neumark-Sztainer D
        Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents.
        Appetite. 2017; 112: 23-34
        • Welsh EM
        • French SA
        • Wall M
        Examining the relationship between family meal frequency and individual dietary intake: does family cohesion play a role?.
        J Nutr Educ Behav. 2011; 43: 229-235
        • Watts AW
        • Loth K
        • Berge JM
        • Larson N
        • Neumark-Sztainer D
        No time for family meals? Parenting practices associated with adolescent fruit and vegetable intake when family meals are not an option.
        J Acad Nutr Diet. 2017; 117: 707-714
        • Granner ML
        • Evans AE
        Variables associated with fruit and vegetable intake in adolescents.
        Am J Health Behav. 2011; 35: 591-602
        • Fink SK
        • Racine EF
        • Mueffelmann RE
        • Dean MN
        • Herman-Smith R
        Family meals and diet quality among children and adolescents in North Carolina.
        J Nutr Educ Behav. 2014; 46: 418-422
        • Caldwell AR
        • Terhorst L
        • Skidmore ER
        • Bendixen RM
        Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis.
        J Hum Nutr Diet. 2018; 31: 505-512
        • Berge JM
        • Wall M
        • Larson N
        • Forsyth A
        • Bauer KW
        • Neumark-Sztainer D
        Youth dietary intake and weight status: healthful neighborhood food environments enhance the protective role of supportive family home environments.
        Health Place. 2014; 26: 69-77
        • Loth K
        • Wall M
        • Choi CW
        • et al.
        Family meals and disordered eating in adolescents: are the benefits the same for everyone?.
        Int J Eat Disord. 2015; 48: 100-110
        • Fulkerson JA
        • Pasch KE
        • Stigler MH
        • Farbakhsh K
        • Perry CL
        • Komro KA
        Longitudinal associations between family dinner and adolescent perceptions of parent-child communication among racially diverse urban youth.
        J Fam Psychol. 2010; 24: 261-270
        • Musick K
        • Meier A
        Assessing causality and persistence in associations between family dinners and adolescent well-being.
        J Marriage Fam. 2012; 74: 476-493
        • Franko DL
        • Thompson D
        • Affenito SG
        • Barton BA
        • Striegel-Moore RH
        Whatmediates the relationship between family meals and adolescent health issues.
        Health Psychol. 2008; 27: S109-S117
        • Berge JM
        • Wall M
        • Larson N
        • Loth KA
        • Neumark-Sztainer D
        Family functioning: associations with weight status, eating behaviors, and physical activity in adolescents.
        J Adolesc Health. 2013; 52: 351-357
        • Lawrence SD
        • Plisco MK
        Family mealtimes and family functioning.
        Am J Fam Ther. 2017; 45: 195-205
        • Martin-Biggers J
        • Quick V
        • Zhang M
        • Jin Y
        • Byrd-Bredbenner C
        Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours.
        Matern Child Nutr. 2018; 14: e12540
        • Eisenberg ME
        • Olson RE
        • Neumark-Sztainer D
        • Story M
        • Bearinger LH
        Correlations between family meals and psychosocial well-being among adolescents.
        Arch Pediatr Adolesc Med. 2004; 158: 792-796
        • Fulkerson JA
        • Story M
        • Mellin A
        • Leffert N
        • Neumark-Sztainer D
        • French SA
        Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors.
        J Adolesc Health. 2006; 39: 337-345
        • Martin-Biggers J
        • Spaccarotella K
        • Berhaupt-Glickstein A
        • Hongu N
        • Worobey J
        • Byrd-Bredbenner C
        Come and get it! A discussion of family mealtime literature and factors affecting obesity risk.
        Adv Nutr. 2014; 5: 235-247
        • Fulkerson JA
        • Strauss J
        • Neumark-Sztainer D
        • Story M
        • Boutelle K
        Correlates of psychosocial well-being among overweight adolescents: the role of the family.
        J Consult Clin Psychol. 2007; 75: 181-186
        • Eisenberg ME
        • Neumark-Sztainer D
        • Feldman S
        Does TV viewing during family meals make a difference in adolescent substance use.
        Prev Med. 2009; 48: 585-587
        • Neumark-Sztainer D
        • Wall M
        • Story M
        • Fulkerson JA
        Are family meal patterns associated with disordered eating behaviors among adolescents?.
        J Adolesc Health. 2004; 35: 350-359
        • Mitchell M
        • Piazza-Waggoner C
        • Modi A
        • Janicke D
        Examining short-term stability of the Mealtime Interaction Coding System (MICS).
        J Pediatr Psychol. 2009; 34: 63-68
        • Fulkerson JA
        • Neumark-Sztainer D
        • Story M
        Adolescent and parent views of family meals.
        J Am Diet Assoc. 2006; 106: 526-532
        • Neumark-Sztainer D
        • Larson NI
        • Fulkerson JA
        • Eisenberg ME
        • Story M
        Family meals and adolescents: what have we learned from Project EAT (Eating Among Teens)?.
        Public Health Nutr. 2010; 13: 1113-1121
        • Berge JM
        • MacLehose RF
        • Loth KA
        • Eisenberg ME
        • Fulkerson JA
        • Neumark-Sztainer D
        Family meals. Associations with weight and eating behaviors among mothers and fathers.
        Appetite. 2012; 58: 1128-1135