Meals around the family dinner table is something many health professionals have been trying to push these days, considering numerous studies in the past have linked the activity to children eating more nutritious foods and getting quality face-time with their parents and siblings.

But according to a University of Illinois scientist, eating meals together as a family could be even more beneficial for children suffering from chronic asthma, as long as those meals contain three ingredients in the right amounts.

"Family mealtimes, when they're done right, are linked to many benefits for children, including a reduced risk of substance abuse, eating disorders, and obesity. In this study, we've put these mealtimes under a microscope so we can see minute by minute which factors deliver these healthy outcomes," said Barbara H. Fiese, director of the U of I's Family Resiliency Center.

Which three ingredients make such a big difference? Fiese said it’s as easy to remember as ABC:

  • Action, which includes eliminating such distractions as cell phones and the TV;
  • Behavior control, which involves discipline that isn't harsh and also teaches manners; and
  • Communication that shows genuine interest and concern about what's going on in each others' lives.

And, because any good recipe is specific about the amounts of each ingredient, Fiese has issued some guidelines.

"Communication is by far the most important ingredient. The average family meal takes 18 minutes, and I'd allot about 2 minutes to action, 4 minutes to behavior control, and 12 minutes to positive communication that affirms kids' importance, helps them resolve troublesome issues, and reminds them to take their medicine or write a thank-you note," she said.

Fiese and her colleagues videotaped 200 families that included children aged 5 to 12 with persistent asthma, observing and coding their actions during family meals.


Caregivers filled out a questionnaire assessing the severity of the child's symptoms, and a respiratory therapist checked the kids' lung functioning. The researchers controlled for adherence to medication.

The kids filled out a 23-item asthma-specific questionnaire assessing their quality of life, rating such items as the degree to which they worried about their symptoms and how well they were able to take part in everyday activities.

"When children were part of families that 'followed the recipe,' their asthma symptoms were less severe and they were more apt to take their medicine. They also tended to worry less about their symptoms, and they were able to engage more fully in activities at school and after school," said Fiese.

And when mealtimes had more distractions, Fiese said the children’s asthma symptoms were more pronounced.

"In families headed by a single parent or when the primary caregiver had less education, we found that mealtimes contained more disruptions, including watching TV and talking on cell phones, and less time talking about the day's events. If there's a lot of confusion, it's hard for family members to follow conversations," she said.

Single parents and those with less education also spent more time controlling behavior and were likely to use harsher methods to restore order to the family table.

However, being a single parent or having lower levels of education doesn’t necessarily cause more disruptions during mealtimes,  but rather the disruptions could stem from families having fewer resources, having more difficulty managing their time, and needing more assistance.

Thrive on routine 

According to Fiese, children thrive on routine, and disorganized meals are related to poorer health for the children who participate in them. These children are believed to be at highest risk for poorly controlled asthma and are most likely to use the emergency room for health care.

"We need to pay attention to the chronic stress that compromises health in low-income families that have few resources," she said.

Fiese notes recent research suggesting poor organization -- a lot of chaos in the family environment -- disrupts learning and predicts poor social and emotional development.

"Family mealtimes that follow these ABC guidelines are an important ritual that parents can use to counter that trend," she said.

The study was published in the January/February 2011 issue of Child Development.

Co-authors are Marcia A. Winter of the University of Rochester Medical Center and Joanna C. Botti of Upstate Medical Center in Syracuse, New York.