The Village Effect: How Face-to-Face Contact Can Make Us Healthier and Happier (18 page)

Still, one of the most surprising findings about regular family meals is their capacity to transform teenagers, particularly teenage girls. One 2008 study surveyed eight hundred Minnesota teenagers about their eating habits when they were twelve and their substance use five years later (other factors, such as financial status, were held constant). The results showed that twelve-year-old girls who regularly ate with their families at the beginning of middle school had half the odds of other kids their age of drinking, smoking, and regularly using marijuana when they were seventeen.
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The meals seemed to work as a protective umbrella for the girls, though not for the boys. And this wasn’t an isolated finding. Another study, published the same year, of more than 2,500 adolescent boys and girls surveyed over a five-year span, revealed that girls who regularly ate
family meals were less likely to develop eating disorders years later.
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(Given that so few boys develop eating disorders in the first place, family meals are not particularly predictive on that score.)

Not only are women more sensitive to their friends’ and sisters’ food habits than men, but at an early age they’re also more affected by the transformative power of social meals. The researchers explain this peculiar finding as follows: “Females may be more attuned to subtle emotional support offered during family meals, resulting in a more profound protective effect for females than for males.”
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A few years earlier, this same research group had looked into the lives of almost five thousand American teens and found that a third of them rarely, if ever, ate meals with their families. Compared to those who did eat with their families, the girls who didn’t were almost twice as likely to attempt suicide. And that finding surfaced after the researchers accounted for the protective effect of having a close-knit family. The less often these teenagers—boys and girls—ate with their families, the higher their odds of getting low grades, becoming depressed, smoking cigarettes, using drugs, and thinking about or attempting suicide.
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But why? Clearly something transformative is happening at the dinner table, though we don’t know exactly what. Almost all the studies about food and social relationships are correlations: they document the way two separate phenomena are yoked together, but they don’t plumb the reasons.
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Do kids who regularly eat meals with their parents and siblings turn out to be clean-livers—more psychologically stable and academically more successful—because parental support is part of what goes on at the dinner table? Or is it more about the children? Perhaps the types of kids who eat regularly with their parents are better conversationalists to begin with, or less angry at the world. If a parent is working spirit-draining hours just to keep the fridge full or to pay into the kids’ college fund, he or she might not be keen to eat dinner every weeknight with a sullen pothead who sees school as a waste of time. “If they can’t stand each
other, they won’t eat together,” is how my son Carl put it. “Sharing food is all about the absence of conflict.”

Peace in the valley can lead to communal dinners, that’s true. Or a shared feast can jumpstart a feeling of cooperation, as was suspected of the Natufian funeral barbecue—or its modern equivalent, block parties intended to instill solidarity among neighbors.
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The only real way to answer this chicken-and-egg question is to randomly assign children at birth to different types of meals—with family, with friends, with both, or alone—and then watch what happens to them as they grow. That can’t happen, of course. One of the best alternatives is a longitudinal study, which asks lots of questions about people’s habits and then tracks what happens to them over time (as we’ve seen in the Framingham study, as well as the nurses study on breast cancer).

One recent such study, led by University of Minnesota’s Ann Meier and Cornell’s Kelly Musick, tracked eighteen thousand American adolescents. After ruling out other causes, they found that face-to-face interaction is what’s protective about family dinners, not shared meals per se. Eating together is simply a focused—often the only—way many parents connect with their kids; the more engaged and less embattled the parenting, the stronger the connection between eating together and reduced rates of depression, delinquency, and substance abuse later.
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Looking at food habits in particular, the American psychologist and eating disorder expert Debra Franko and her colleagues followed nearly 2,400 girls between the ages of nine and nineteen. They found that more frequent family meals in the first three years of the study neatly predicted greater family cohesion and more salubrious personal habits in years seven and eight. So, when it comes to all these positive outcomes, in many ways family meals
do
come first. Specifically, girls who said they “never or almost never” ate with their parents from the ages of nine to eleven (about 10 percent of the sample) were more likely than other kids to
become teenagers who were stressed-out smokers with weird attitudes toward food. Social contact around the dinner table seemed to promote family cohesion and “problem-focused coping,” the authors write, which probably reduced the girls’ risky antics later.
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I’m not suggesting that children need sit-down dinners with their families every night of the week, complete with lively mealtime banter, in order to avoid turning into anorexic dropouts or insensitive brutes. That would be preposterous, especially as different cultures feature different styles of table talk. For example, Catherine Snow and Oslo psychologist Vibeke Grover Aukrust matched Norwegian and American families with preschoolers of the same age and compared their mealtime conversations. The researchers discovered that Americans relate half as many stories at mealtimes as Norwegians do, but they explain things twice as often. And when they do, they like it to be dramatic. (
Norwegian preschooler
: Nils wore a green sweater to preschool today.
American preschooler
: Johnny threw up today and it was orange.)
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What’s common to both statements is that they invite parents to respond—to throw the ball back to the child, who will likely toss it back again, keeping the volley going.

That’s why I am suggesting that shared meals offer a head start for picking up the subtleties of language and social interaction. They also help us feel that we belong somewhere.

THE CHANGE THAT CHANGES OTHERS

As a newspaper columnist I’ve watched book sections and venerable broadsheets come and go (actually, mostly go), but among the survivors there is one change that’s here to stay: weekly columns on dieting by dieters. I saw it first in my local paper, where a newsroom administrator attempting to lose weight was asked to write her “diary of a fat girl” in a column called “Shaping Up.” Then came one called “How I Lost It” in one of the national papers. The section’s editors asked readers to write in with their weight-loss stories, which it published along with before-and-after photos. The
point is to inspire others. But does reading about strangers’ experiences really spur people to change their own behavior?

There’s no evidence that it does, though it would certainly be a handy solution to a health problem that affects three-quarters of North America. Just about the only commercial approach to weight loss that works is Weight Watchers, which exploits the powerful social features of eating. Studies that randomly assign overweight people to various programs show that none can compete with Weight Watchers’ record of sustained moderate weight loss.
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The critical factor seems to be that Weight Watchers requires members not just to keep track of every ingested morsel but to attend weekly meetings. There they get weighed, and for every few pounds they’ve shed since the previous meeting, they receive applause and, at certain milestones, even a token gift.

I signed on to Weight Watchers in March 2011, along with three companions, to see how it worked. “I think the social support is huge. If you look around, everyone’s in twos and threes,” said one of my friends at the meeting, who maintains a “svelting” thread on a writers’ email list to help cheer on fellow dieters and “hold each other accountable.” This type of vocabulary makes sense in 12-step-like programs such as Weight Watchers. After all, these movements began with the assumption that overindulgence is a moral failure that requires, as Dr. Franklin Nathaniel Daniel Buchman, one of AA’s missionary founders put it, “confession as a prerequisite to change,” not to mention a social responsibility to experience a “change that must change others.”
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Overbearing zealots though they were, these self-control missionaries were right about one thing. When it comes to changing human habits around consumption, social pressure—especially from people you admire—works.

THE REAL GOD OF 12-STEP

In January 2009, the
New York Times Magazine
ran a profile of Dr. Drew Pinsky, an addictions specialist and the star of the reality TV
shows
Sober House
and
Celebrity Rehab with Dr. Drew
. Pinsky’s decision to pursue addiction medicine as a career—his “burning bush moment,” as he called it—came while he was a medical resident providing care to recovering alcoholics and addicts at a Pasadena hospital. “I watched these people—these young people—go from dying to better than they ever knew they could be. And I was like, ‘Whoa.’ In medicine you go from dying to chronically ill. You don’t go from dying to better than you ever knew you could be. That just doesn’t happen,” he said.

Pinsky soon evolved into the camera-ready therapist who could challenge, on air, the hidden demons of celebrity substance abusers like Rodney King and Heidi Fleiss, which earned him their public gratitude and the moniker “the God of 12-step.” The title is a reference to the first therapeutic group to exploit peer support to help people exert self-control: Alcoholics Anonymous. In a profile in the
New York Times
, Chris Norris points out how Pinsky connects through non-verbal cues:

That basic human contact—so crucial to addicts’ and alcoholics’ ability to kick their habits, according to Pinsky—was also one of the catalysts that started them drinking or doing drugs in the first place. As anyone who has watched
The Wire
knows, ghetto kids use and Baltimore cops drink, in large part because all their friends do. It takes outsized self-control to resist peer pressure. Make that iron-clad
discipline when one’s entire social network has taken on a bad habit, whether it’s downing three drinks before dinner, sniffing glue at recess, or toking up at noon. Your mother may have warned you about the dangers of hanging out with the wrong crowd, and it turns out your mother was right: research confirms that as your friends change, so do your ideas about what’s acceptable, whether it’s what you’re eating, drinking, smoking, or putting up your nose.
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Those who drink too much could be drowning their sorrows or mirroring their friends. If it’s the latter, they’re simply playing bit parts in the “human superorganism,” as Fowler and Christakis call it. Social contagion spurs boozing and smoking much the way it transmits obesity. If we are wired to communicate our feelings and proclivities through language and nonverbal signals alike (think of menstrual synchrony, or the fertility contagion described in the previous chapter), then the same mechanisms can also promote bad habits.

On that score, Niels Rosenquist, a Harvard-based psychiatrist, mined the Framingham data to show that the alcohol a person downs a day is tied to how much his or her friends drink. They found that if someone’s buddy drinks a glass or two of wine a day, then he or she is 50 percent more likely to do the same, compared to what their drinking habits would be if they were suddenly parachuted into some random, computer-generated social network. Being surrounded by “heavy drinkers” (oddly, the study defines “heavy” as one or more drinks a day for women, two or more for men) increased people’s reported alcohol consumption by 70 percent. Conversely, being surrounded by abstainers halved it. Again, women played a much more powerful role in swaying people’s drinking habits than did men, whether it was to drink more or to drink less.
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The scientists didn’t observe the drinking itself, but what people said they were drinking. Still, how much you admit you drink is also colored by your peers. In some social circles drinking is shameful, while in others it’s a point of pride. “A bum who ain’t drunk by midnight ain’t trying,” was what Toots Shor, owner of the eponymous
New York watering hole told patrons like Frank Sinatra and Ernest Hemingway in the 1950s.
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Booze and bonhomie are still considered inseparable, so it’s not surprising that what people say they drink is fairly accurate.

And as with obesity, the social effect diminishes with each step away from the personal connection. If a close friend of yours drinks heavily, he or she increases your alcohol consumption by 50 percent, the consumption of a friend of hers by 35 percent, and of a friend of a friend of a friend by 8 percent. Like secondhand smoke, the effect dissipates; after three degrees of separation, your influence on friends and family is no different from that of any stranger.

WOMEN AND BOOZE

Interestingly, the female effect shows up yet again with alcohol. Given that men’s social lives are often so closely linked to drinking, one might expect that contagion would work best within male social circles. But the Framingham data show that female contacts are far more influential in the spread—or censure—of boozing. Whether subtly or overtly, it seems that women’s influence on men’s consumption is a powerful vector of change.