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How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 55509

Special Issue Editor


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Guest Editor
Department of Nutrition, Harvard T.H. Chan School of Public Health, Bldg 2655 Huntington Ave, Boston, MA 02115, USA
Interests: evaluating teaching kitchens; culinary medicine; culinary nutrition; lifestyle medicine and integrative medicine programs for their impact on behaviours; clinical outcomes; costs and the training of future health care professionals

Special Issue Information

Dear Colleagues,

Diet-related diseases account for the majority of deaths in the US and an increasing proportion of morbidity and mortality worldwide. Increasing rates of obesity, diabetes, food and nutrition insecurity pose challenges to health authorities and governments globally. Existing strategies focusing primarily on disease diagnosis and treatment are insufficient.

In May 2022 the US House of Representatives passed the bipartisan Resolution 1118 (https://www.congress.gov/bill/117th-congress/house-resolution/1118/text) calling for medical schools, graduate medical education programs, and other professional training programs to provide meaningful physician and health professional education on nutrition and diet, and demonstrate competencies in advising patients about enhanced food choices, or risk the discontinuation of $10.3 billion in federal funding for the training of future health professionals. In October 2022, the White House National Strategy on Hunger, Nutrition and Health set the bold strategy to end hunger and increase healthy eating and physical activity by 2030, so that fewer Americans experience diet-related diseases such as diabetes, obesity, and hypertension.

In October 2022, the Teaching Kitchen Research Conference (https://tkresearchconference.org) showcased the rapid growth of multidisciplinary programs to respond to these calls. Individuals, families, and communities need to be able to afford, access, and learn to select and prepare delicious and nutritious foods and receive evidence-based, culturally sensitive guidance about diet and lifestyle. Proponents of Teaching Kitchens, Culinary Medicine, Culinary Nutrition, Lifestyle Medicine, Integrative Medicine, Food as Medicine, and Whole Person Health Programs have developed strategies which include nutrition education alongside hands-on cooking instruction, often in association with evidence-based instruction in lifestyle, e.g., movement, exercise, and sleep; mindfulness training; motivational interviewing, health coaching, and additional behaviour change strategies. Teaching kitchens are increasingly being built as educational classrooms and translational research laboratories to deliver this evidence-based instruction across a range of populations and settings worldwide.

For this Special Issue, we invite manuscripts that formally describe, contrast, and evaluate the impact of health and wellness promotion strategies which include nutrition education alongside hands-on cooking on (a) health risk behaviours; (b) clinical outcomes; (c) biomarkers; (d) costs; (e) access to nutritious foods; and (f) the training of future health professionals.

We welcome submissions that (a) provide evidence that these programs show behavioural, clinical and/or educational impact; (b) highlight and recommend strategies to improve programming; (c) suggest or demonstrate the financial impact, return on investment, and financial sustainability of these programs; (d) provide evidence of impact for at-risk populations; (e) summarize relevant data tracking tools to be used across comparable studies; (f) recommend future wellness care team “ensembles” and training programs; (g) describe relevant competencies and credentialing requirements for those providing such programs.

For a list of additional manuscript topics relevant to this Special Series, see LINK BELOW.

https://res.mdpi.com/data/nutrients_special-issue_topics.docx.pdf

Dr. David Miles Eisenberg
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • teaching kitchens
  • culinary medicine
  • culinary nutrition
  • lifestyle medicine
  • integrative medicine
  • food as medicine
  • whole person health
  • precision nutrition
  • nutrition insecurity
  • nutrition education
  • nutrition education for health professionals
  • hands-on cooking instruction
  • food literacy
  • cooking self-efficacy
  • food knowledge
  • interprofessional education
  • multidisciplinary care
  • house of representatives resolution 1118
  • preventative health
  • learning environment
  • interprofessional nutrition education
  • behaviour change
  • health and wellness
  • mindfulness
  • dietary behaviour
  • interdisciplinary care
  • multidisciplinary care
  • movement and exercise
  • value-based care
  • food agency
  • cooking self-efficacy
  • food skills
  • food knowledge
  • nutrition knowledge
  • food attitude
  • social determinants of health
  • socio-cultural influences and eating practices

Published Papers (35 papers)

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7 pages, 218 KiB  
Communication
Nourishing Conversations: Using Motivational Interviewing in a Community Teaching Kitchen to Promote Healthy Eating via a Food as Medicine Intervention
by Sara Temelkova, Saria Lofton, Elaine Lo, Jeannine Wise and Edwin K. McDonald IV
Nutrients 2024, 16(7), 960; https://doi.org/10.3390/nu16070960 - 27 Mar 2024
Viewed by 601
Abstract
It is well known that dietary choices impact both individual and global health. However, there are numerous challenges at the personal and systemic level to fostering sustainable healthy eating patterns. There is a need for innovative ways to navigate these barriers. Food as [...] Read more.
It is well known that dietary choices impact both individual and global health. However, there are numerous challenges at the personal and systemic level to fostering sustainable healthy eating patterns. There is a need for innovative ways to navigate these barriers. Food as Medicine (FM) and Culinary Medicine (CM) are approaches to helping individuals achieve healthier diets that also recognize the potential to alleviate the burden of chronic diseases through healthy eating. Teaching kitchens, which offer an interactive environment for learning nutrition and cooking skills, are valuable educational tools for FM and CM interventions. Motivational interviewing (MI), a type of person-centered counseling, facilitates behavior change and may enhance FM and CM programs involving teaching kitchens. In this commentary, we share our experience with using MI in a community-based CM program at a teaching kitchen. In demonstrating our application of MI principles, we hope to offer an additional strategy for improving dietary quality and delivering nutrition education. Full article
20 pages, 1142 KiB  
Article
Cultivating Healthier Habits: The Impact of Workplace Teaching Kitchens on Employee Food Literacy
by Richard Daker, Ghislaine Challamel, Chavanne Hanson and Jane Upritchard
Nutrients 2024, 16(6), 865; https://doi.org/10.3390/nu16060865 - 16 Mar 2024
Viewed by 756
Abstract
This research explores the impact of workplace teaching kitchen cooking classes on participants’ food literacy and identifies key predictors of employee engagement. Aligning with the existing literature, we demonstrate that a workplace teaching kitchen program, with hands-on cooking classes, effectively enhances food skills [...] Read more.
This research explores the impact of workplace teaching kitchen cooking classes on participants’ food literacy and identifies key predictors of employee engagement. Aligning with the existing literature, we demonstrate that a workplace teaching kitchen program, with hands-on cooking classes, effectively enhances food skills and intrinsic motivation—core aspects of food literacy. Importantly, our results reveal that even a single class can have a measurable impact. Teaching kitchens can successfully engage employees, particularly those with low food skills, showcasing their broad appeal beyond individuals already engaged in wellness or seeking social connection. Awareness emerges as the most influential predictor of participation, emphasizing the crucial role of marketing. Virtual classes prove as effective as onsite ones, offering the potential to increase access for employees. Recognizing employee wellness as a strategic opportunity for employers and a sought-after benefit for top talent, we underscore the importance of practical nutrition education to support individuals in shifting food choices within lifestyle constraints. Workplace teaching kitchens emerge as an effective and scalable solution to address this need. Future research should prioritize exploring the lasting impacts of teaching kitchen education on employee eating habits and health, contributing to ongoing strategy refinement. Full article
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16 pages, 289 KiB  
Article
Evaluation of the Effectiveness of a Bilingual Nutrition Education Program in Partnership with a Mobile Health Unit
by Madeleine L. French, Joshua T. Christensen, Paul A. Estabrooks, Alexandra M. Hernandez, Julie M. Metos, Robin L. Marcus, Alistair Thorpe, Theresa E. Dvorak and Kristine C. Jordan
Nutrients 2024, 16(5), 618; https://doi.org/10.3390/nu16050618 - 23 Feb 2024
Viewed by 1130
Abstract
There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. [...] Read more.
There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. The purpose of this paper is to report on the development, implementation, and evaluation of Journey to Health, a program designed for community implementation using the RE-AIM planning and evaluation framework. Reach and effectiveness were the primary outcomes. Regarding reach, 507 individuals registered for the program, 310 participants attended at least one nutrition class, 110 participants completed at least two biometric screens, and 96 participants attended at least two health coaching appointments. Participants who engaged in Journey to Health realized significant improvements in body mass index, blood pressure, and triglycerides. For higher risk participants, we additionally saw significant improvements in total and LDL cholesterol. Regarding dietary intake, we observed a significant increase in cups of fruit and a decrease in sugar sweetened beverages consumed per day. Our findings suggest that Journey to Health may improve selected biometrics and health behaviors in low-income and underrepresented minority participants. Full article
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12 pages, 1457 KiB  
Article
Culinary Medicine or Culinary Nutrition? Defining Terms for Use in Education and Practice
by Sharon Croxford, Emma Stirling, Julia MacLaren, John Wesley McWhorter, Lynn Frederick and Olivia W. Thomas
Nutrients 2024, 16(5), 603; https://doi.org/10.3390/nu16050603 - 22 Feb 2024
Viewed by 1424
Abstract
Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these [...] Read more.
Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these terms across work areas and disciplines. Thirty leading practitioners, academics, and researchers in the fields of food and nutrition across Australia, the United States, Canada, United Kingdom, Europe, and Asia were approached by investigators via email to submit definitions of key terms using a Qualtrics survey link. Further participants were reached through snowball recruitment. Initial emails were sent in October and November 2021 with subsequent reminders between November 2021 and March 2022. Two researchers undertook content analysis of the text answers for each of the terms and generated definitions for discussion and consensus. Thirty-seven participants commenced the survey and twenty-three submitted one or more definitions. Agreed definitions fell into two categories: practice concepts and practitioners. Further discussion amongst investigators led to the creation of a visual map to demonstrate the interrelationship of terms. Culinary nutrition science underpins, and interprofessional collaboration characterizes practice in this area, however, further work is needed to define competencies and model best practice. Full article
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12 pages, 252 KiB  
Article
Impact of a Food Skills Course with a Teaching Kitchen on Dietary and Cooking Self-Efficacy and Behaviors among College Students
by Caitlin D. French, Alexander Gomez-Lara, Arianna Hee, Akshara Shankar, Nayoung Song, Monserrath Campos, Mikelle McCoin and Susana L. Matias
Nutrients 2024, 16(5), 585; https://doi.org/10.3390/nu16050585 - 21 Feb 2024
Viewed by 1109
Abstract
College students may face barriers to eating healthy foods. Educational interventions providing practical knowledge and skills may help students to overcome financial barriers or other barriers to acquiring, preparing, and consuming healthy foods. We evaluated the association between participation in a semester-long food [...] Read more.
College students may face barriers to eating healthy foods. Educational interventions providing practical knowledge and skills may help students to overcome financial barriers or other barriers to acquiring, preparing, and consuming healthy foods. We evaluated the association between participation in a semester-long food skills course with an interactive teaching kitchen and dietary and cooking self-efficacy and behaviors. Participants were recruited from course enrollees (intervention) and the general student population (comparison). We assessed differences in pre–post changes in the outcomes between groups using the propensity score weighting and mixed effects linear or Poisson regression. Course participation was associated with improved self-efficacy around cooking (group × time β-coefficient [SE]: 3.25 [0.57], p < 0.0001) and fruit (6.33 [1.19], p < 0.0001), vegetable (5.43 [1.42], p = 0.0002), and whole grain (5.83 [1.40], p < 0.0001) consumption. Course participants reported smaller pre–post decreases in vegetable consumption compared to non-participants (0.35 [0.16], p = 0.03), increased cooking frequency (0.22 [0.10], p = 0.03) and a decreased frequency of skipping meals (−0.47 [0.16], p = 0.003). There were no changes associated with the intervention in the consumption of fruit or whole grains, or in eating out frequency. Participation in a semester-long, personal food skills course with a teaching kitchen may improve self-efficacy, cooking, and vegetable consumption among college students. Full article
11 pages, 490 KiB  
Article
Promoting Nutrition and Food Sustainability Knowledge in Apprentice Chefs: An Intervention Study at The School of Italian Culinary Arts—ALMA
by Cinzia Franchini, Beatrice Biasini, Francesca Giopp, Alice Rosi and Francesca Scazzina
Nutrients 2024, 16(4), 537; https://doi.org/10.3390/nu16040537 - 15 Feb 2024
Viewed by 796
Abstract
Chefs’ decisions can greatly improve the quality of food provided and positively guide diners’ choices. Culinary students’ knowledge of healthy and sustainable nutrition is still scarcely investigated and is limited to the nutritional aspect of the diet, without considering food sustainability or the [...] Read more.
Chefs’ decisions can greatly improve the quality of food provided and positively guide diners’ choices. Culinary students’ knowledge of healthy and sustainable nutrition is still scarcely investigated and is limited to the nutritional aspect of the diet, without considering food sustainability or the environmental impact of foods. This study aims to determine the effectiveness of an educational program designed for apprentice chefs. Two questionnaires were administered twice to each student who followed dedicated lectures about nutrition and food sustainability and to other students enrolled as the control group. A total of 264 and 252 apprentice chefs of The School of Italian Culinary Arts—ALMA were enrolled in the control and intervention groups, respectively. At baseline, both groups showed a good level of nutrition knowledge, whereas food sustainability knowledge was lower in all students, regardless of the group. This educational intervention proved to be effective in improving knowledge about nutrition and the environmental impact of food production and consumption. However, a small but significant improvement in nutritional knowledge was also found over time in the control group. Finally, a food sustainability knowledge questionnaire was developed and validated for this study, providing interesting results to be treated as a guide for future developments. Full article
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16 pages, 1148 KiB  
Article
University Students as Change Agents for Health and Sustainability: A Pilot Study on the Effects of a Teaching Kitchen-Based Planetary Health Diet Curriculum
by Nicola Rosenau, Uwe Neumann, Stacey Hamblett and Thomas Ellrott
Nutrients 2024, 16(4), 521; https://doi.org/10.3390/nu16040521 - 13 Feb 2024
Viewed by 1425
Abstract
Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of [...] Read more.
Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of their degree paths, all university students, in their role as potential future experts and leaders in their fields, can serve as important change agents in society. In this paper, we (a) introduce a university curriculum in a teaching kitchen setting that is based on the planetary health diet (PHD) of the EAT-Lancet Commission, (b) investigate its feasibility, and (c) analyze its effects on the planetary health diet literacy of a pilot cohort of university students enrolled in various degree programs. We developed seven flipped classroom teaching kitchen sessions based on social cognitive theory (SCT), each consisting of a one-hour seminar with student presentations on various nutrition- and sustainability-related key topics, followed by corresponding two-hour hands-on cooking classes. To assess feasibility, specific questions from the official teaching evaluation of the University of Göttingen were analyzed. Changes in self-assessed planetary health diet literacy were measured using a pre- and post-survey. During the pilot phase, 26 students successfully completed the course. A total of 25 participants responded to the teaching evaluation and expressed high satisfaction with the course, the learning outcomes, and the level of demand. A total of 26 participants completed the pre- and post-survey. At the post-intervention, the students rated their planetary health diet literacy as 21 to 98% higher than before their course participation. The findings of this pilot study indicate that the curriculum was well-received and feasible with the target group, and they demonstrate that the course participation increased the university students’ self-assessed ability to disseminate strategies for more sustainable and healthy diets. Through replication at other universities worldwide, the teaching kitchen-based planetary health diet curriculum might foster a social shift towards healthier and more climate-friendly food systems. Full article
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13 pages, 773 KiB  
Article
Effect of the Emory Healthy Kitchen Collaborative on Employee Health Habits and Body Weight: A 12-Month Workplace Wellness Trial
by Sharon H. Bergquist, Danyang Wang, Rokhaya Fall, Jonathan P. Bonnet, Krystyna R. Morgan, Dominique Munroe and Miranda A. Moore
Nutrients 2024, 16(4), 517; https://doi.org/10.3390/nu16040517 - 13 Feb 2024
Viewed by 1133
Abstract
Introduction: Teaching kitchens are being used to facilitate lifestyle changes with a focus on culinary and nutrition programs to improve health behaviors. Less is known regarding their use as a worksite wellness program and their influence on employees’ quality of life, body weight, [...] Read more.
Introduction: Teaching kitchens are being used to facilitate lifestyle changes with a focus on culinary and nutrition programs to improve health behaviors. Less is known regarding their use as a worksite wellness program and their influence on employees’ quality of life, body weight, and adoption of healthy behaviors. We evaluated changes in self-reported healthy behaviors, overall health, and weight during a one-year multidisciplinary teaching kitchen program. Methods: Thirty-eight benefits-eligible employees were recruited, screened based on a priori eligibility criteria that prioritized elevated body mass index (BMI), co-morbid conditions, and high levels of motivation to make lifestyle changes, and consented to participate in The Emory Healthy Kitchen Collaborative. This 12-month program included a 10-week didactic and experiential curriculum followed by continued support and access to health coaching implemented in an academic health system university hospital workplace between 2019 and 2020. Comparative statistics, paired t-test, Mcnemar’s tests, and Wilcoxon signed-rank tests were used to assess changes at four time points. Results: Participants improved diet quality (p ≤ 0.0001), increased confidence in tasting new foods (p = 0.03), and increased mindful eating habits (p = 0.00002). Significant changes were seen in physical activity levels; aerobic activities (p = 0.007), strength resistance activities (p = 0.02), and participation in yoga (p = 0.002). Most participants weighed within 5 lbs. of their starting weight at 3 months (p = 0.57). Conclusions: A teaching kitchen intervention is an innovative model for improving employee health behaviors and general health self-perception. Full article
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18 pages, 2252 KiB  
Article
Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention
by Nicole Farmer, Ralph Tuason, Kimberly R. Middleton, Assumpta Ude, Gladys Tataw-Ayuketah, Sharon Flynn, Narjis Kazmi, Alyssa Baginski, Valerie Mitchell, Tiffany M. Powell-Wiley and Gwenyth R. Wallen
Nutrients 2024, 16(3), 463; https://doi.org/10.3390/nu16030463 - 05 Feb 2024
Viewed by 1094
Abstract
Background: Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may [...] Read more.
Background: Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may aid in designing community-tailored interventions. Methods: A sequential mixed methods study was conducted to determine the prospective acceptability of a planned community-located cooking intervention among African American adults living in a low food access area and with at least one cardiovascular disease risk factor. A semi-structured guide was used to conduct five virtual focus groups. Qualitative data were analyzed using thematic analysis and validated through participant check-in interviews. Survey responses were analyzed based on descriptive data. Geospatial analysis of participant locations that were reported for food shopping was conducted to show food environment utilization. Results: Focus groups with study participants (n = 20, all female, mean age 60.3, SD 9.3, mean cooking frequency per week 4.0, food insecure n = 7) were conducted between March and April, 2021. Thematic analysis of the focus group transcripts identified five main themes as follows: (A) Barriers to Cooking (family and caregiving, transportation, COVID-19 pandemic, time availability, household composition); (B) Motivators for Cooking (family, caregiving, health, enjoyment, COVID-19 pandemic); (C) Strategies (food shopping, social support, social media, meal planning); (D) Neighborhood (gentrification, perceived safety, stigmatization, disparities in grocery stores); (E) and Acceptability of the Intervention (reasons to participate, barriers, recruitment, intervention delivery). Participant validation interviews confirmed the themes and subthemes as well as the illustrative quotes. Geospatial analysis showed a majority of locations were outside of the participants’ residential areas. Conclusions: Prospective acceptability of a community-tailored cooking intervention found that the planned intervention could be modified to address individual level factors, such as caregiving and health, community contextual factors, such as perceived safety, and the general health needs of the community. Full article
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7 pages, 1964 KiB  
Communication
Development of a Culinary Medicine Curriculum to Support Nutrition Knowledge for Gastroenterology Fellows and Faculty
by Karen L. Lindsay, Jennifer Kennedy, Daniel Kim, Ankush Kalra and Nimisha K. Parekh
Nutrients 2024, 16(3), 404; https://doi.org/10.3390/nu16030404 - 30 Jan 2024
Viewed by 805
Abstract
Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine [...] Read more.
Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1–4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice. Full article
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11 pages, 260 KiB  
Article
Addressing the Gap of Nutrition in Medical Education: Experiences and Expectations of Medical Students and Residents in France and the United States
by Solenn Thircuir, Nancy N. Chen and Kristine A. Madsen
Nutrients 2023, 15(24), 5054; https://doi.org/10.3390/nu15245054 - 09 Dec 2023
Viewed by 1714
Abstract
Distinct pedagogical approaches within medical curricula in France and in the U.S. reflect a growing recognition of the importance of nutrition to address major public health challenges. However, recent generations of medical students have expressed mixed opinions regarding nutrition education. What pedagogical approach [...] Read more.
Distinct pedagogical approaches within medical curricula in France and in the U.S. reflect a growing recognition of the importance of nutrition to address major public health challenges. However, recent generations of medical students have expressed mixed opinions regarding nutrition education. What pedagogical approach may improve nutrition education? Despite different medical systems, students from both France and the U.S. share similar concerns and expectations, that nutrition knowledge must be embedded in the curriculum and must be engaging. Hands-on, system-based, epistemological, and multidisciplinary approaches need better articulation to forge a robust medical curriculum. In the rapidly changing contexts of medicine and public awareness, social science research may facilitate recommendations for improved nutrition education. Full article
10 pages, 241 KiB  
Article
Eat to Treat: The Methods and Assessments of a Culinary Medicine Seminar for Future Physicians and Practicing Clinicians
by Kate Donovan, Olivia W. Thomas, Ty Sweeney, Tyler J. Ryan, Sonja Kytomaa, Molly Zhao, Wayne Zhong, Michelle Long, Iniya Rajendran, Suzanne Sarfaty and Carine Lenders
Nutrients 2023, 15(22), 4819; https://doi.org/10.3390/nu15224819 - 17 Nov 2023
Viewed by 1194
Abstract
Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled “Eat to Treat: A Nutrition Course for Future Clinicians” that teaches culinary skills, nutrition science, [...] Read more.
Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled “Eat to Treat: A Nutrition Course for Future Clinicians” that teaches culinary skills, nutrition science, and counseling techniques to improve clinical nutrition management. The seminar was offered in-person to first-year medical students in a medical school-based teaching kitchen from 2017 to 2019. A virtual three-session course was also offered to practicing clinicians in 2020. Voluntary self-efficacy questionnaires were collected at the beginning of the first and last sessions of the student seminar, and paired t-tests determined the course’s effect on survey items. A total of 53 first-year medical students attended the program over five semesters, and 39 students (73.6%) completed both surveys. All except one measure of self-efficacy were significantly higher at session 6 than session 1 (p < 0.05). A post-course survey was utilized for the clinician seminar and of the 31 participants, 14 completed the surveys; 93% and 86% of respondents agreed the course was clinically relevant and improved their confidence, respectively. We developed a CM curriculum that improved nutrition knowledge and confidence among a professionally diverse cohort and may represent a scalable education model to improve nutrition education in US medical schools. Full article
14 pages, 1230 KiB  
Article
Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign
by Marianna S. Wetherill, Lacey T. Caywood, Nicholas Hollman, Valarie P. Carter, Joshua Gentges, Ashli Sims and Carrie Vesely Henderson
Nutrients 2023, 15(20), 4417; https://doi.org/10.3390/nu15204417 - 18 Oct 2023
Viewed by 2018
Abstract
Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential [...] Read more.
Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of “food is medicine” interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed “food is medicine” guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time. Full article
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13 pages, 534 KiB  
Article
Enhancing Chronic-Disease Education through Integrated Medical and Social Care: Exploring the Beneficial Role of a Community Teaching Kitchen in Oregon
by Jacob P. Tanumihardjo, Heidi Davis, Mengqi Zhu, Helen On, Kayla K. Guillory and Jill Christensen
Nutrients 2023, 15(20), 4368; https://doi.org/10.3390/nu15204368 - 14 Oct 2023
Cited by 2 | Viewed by 1779
Abstract
Teaching kitchens (TKs) are rapidly being utilized as models to integrate culinary education and chronic-disease education into healthcare settings. Our observational study details the structure and organizational processes (e.g., referral, services, medical and social care integration) of the Community TK at Providence Milwaukie [...] Read more.
Teaching kitchens (TKs) are rapidly being utilized as models to integrate culinary education and chronic-disease education into healthcare settings. Our observational study details the structure and organizational processes (e.g., referral, services, medical and social care integration) of the Community TK at Providence Milwaukie Hospital in Portland, OR. We utilize electronic medical-record data from engaged TK participants (n = 3077) to evaluate between the association of engagement and clinical outcomes (e.g., HbA1c, blood pressure, weight and cholesterol). Mean baseline HbA1c of Highly Engaged TK patients with diabetes (n = 88) reduced from 9.8% to 8.6% at 6 months (p < 0.0001) and sustained significant reductions at 12, 18, 24, 30, and 36 months (p < 0.05). Highly Engaged patients with hypertension (n = 152) had significant, sustained reductions in blood pressure (p < 0.0001). Engaged patients in the same high-risk groups also had significant improvements in HbA1c and blood pressure. Both engagement subgroups had moderate improvements in weight change and cholesterol. This study shows promising associations of TK services that promote chronic-disease self-management with improved clinical outcomes among higher risk patients (e.g., high blood pressure, high HbA1c, high low-density lipoprotein) with different medical issues (e.g., diabetes, obesity) and social barriers (e.g., food insecurity). Full article
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23 pages, 3306 KiB  
Article
Characteristics of Current Teaching Kitchens: Findings from Recent Surveys of the Teaching Kitchen Collaborative
by Christina Badaracco, Olivia W. Thomas, Jennifer Massa, Rachel Bartlett and David M. Eisenberg
Nutrients 2023, 15(20), 4326; https://doi.org/10.3390/nu15204326 - 10 Oct 2023
Viewed by 1430
Abstract
Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) [...] Read more.
Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) to enhance the health and wellness of patients, staff, youth, and the general community. Although implementation of TKs is becoming more common, best practices for starting and operating programs are limited. The present study aims to describe key components and professionals required for TK operations. Surveys were administered to Teaching Kitchen Collaborative (TKC) members and questions reflected seven primary areas of inquiry: (1) TK setting(s), (2) audiences served, (3) TK model(s), (4) key lines of operations, (5) team member who manages or directs the TK, (6) team member(s) who performs key operations and other professionals or partnerships that may be needed, and (7) the primary funding source(s) to build and operate the TK (among various other topics). Findings were used to articulate recommendations for organizations seeking to establish a successful TK as well as for TKs to expand their collective reach, research capacity, and impact. Full article
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14 pages, 801 KiB  
Article
Comparison of Effectiveness regarding a Culinary Medicine Elective for Medical Students in Germany Delivered Virtually versus In-Person
by Selina Böttcher, Louisa Josefa Schonebeck, Laura Drösch, Anna Manuela Plogmann, Can Gero Leineweber, Seraphina Puderbach, Charlotte Buhre, Christoph Schmöcker, Uwe Neumann and Thomas Ellrott
Nutrients 2023, 15(19), 4281; https://doi.org/10.3390/nu15194281 - 08 Oct 2023
Cited by 1 | Viewed by 1563
Abstract
(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum [...] Read more.
(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum was either delivered virtually (2021) or in-person (2022/2023). Changes in teaching effectiveness were evaluated. (2) Methods: The elective included seven modules in the teaching kitchen for 3 h each. It consisted of a short introduction and a hands-on interactive cooking part illustrating important dietary principles in different disease groups. The elective was conducted virtually in 2021 in a fully interactive setup using videoconference tools. Students in this cohort attended from their private kitchens whereas students in the in-person cohort (2022/2023) attended the same classes in the teaching kitchen. Standardized comparative self-assessment questionnaires on counselling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5) before and after the elective were used to determine teaching effectiveness. Paired and unpaired t-tests were performed to evaluate results. (3) Results: A total of 70 students (mean semester 6.3) were included in the virtual cohort, and 80 students (mean semester 6.3) were in the in-person cohort. In both, counselling competencies on 25 nutrition and lifestyle medicine topics increased significantly. Significant changes also occurred in most nutrition knowledge categories. Subjective well-being as well as personal attitudes towards nutrition counselling in medical practice improved significantly during the elective. Healthy eating habits improved in both groups as students ate significantly less unfavourable foods. There were no significant differences between the two groups apart from minor differences in nutrition knowledge. (4) Conclusions: The elective in Culinary Medicine improved students counselling competencies, nutrition knowledge, attitudes, well-being, and eating habits with no relevant difference between virtual and in-person teaching. Full article
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13 pages, 1033 KiB  
Article
Standard Patient History Can Be Augmented Using Ethnographic Foodlife Questions
by June Jo Lee, John Wesley McWhorter, Gabrielle Bryant, Howard Zisser and David Miles Eisenberg
Nutrients 2023, 15(19), 4272; https://doi.org/10.3390/nu15194272 - 06 Oct 2023
Viewed by 1371
Abstract
The relationship between what and how individuals eat and their overall and long-term health is non-controversial. However, for decades, food and nutrition discussions have often been highly medicalized. Given the significant impact of poor nutrition on health, broader discussions about food should be [...] Read more.
The relationship between what and how individuals eat and their overall and long-term health is non-controversial. However, for decades, food and nutrition discussions have often been highly medicalized. Given the significant impact of poor nutrition on health, broader discussions about food should be integrated into routine patient history taking. We advocate for an expansion of the current, standard approach to patient history taking in order to include questions regarding patients’ ‘foodlife’ (total relationship to food) as a screening and baseline assessment tool for referrals. We propose that healthcare providers: (1) routinely engage with patients about their relationship to food, and (2) recognize that such dialogues extend beyond nutrition and lifestyle questions. Mirroring other recent revisions to medical history taking—such as exploring biopsychosocial risks—questions about food relationships and motivators of eating may be essential for optimal patient assessment and referrals. We draw on the novel tools of ‘foodlife’ ethnography (developed by co-author ethnographer J.J.L., and further refined in collaboration with the co-authors who contributed their clinical experiences as a former primary care physician (D.M.E.), registered dietitian (J.W.M.), and diabetologist (H.Z.)) to model a set of baseline questions for inclusion in routine clinical settings. Importantly, this broader cultural approach seeks to augment and enhance current food intake discussions used by registered dietitian nutritionists, endocrinologists, internists, and medical primary care providers for better baseline assessments and referrals. By bringing the significance of food into the domain of routine medical interviewing practices by a range of health professionals, we theorize that this approach can set a strong foundation of trust between patients and healthcare professionals, underscoring food’s vital role in patient-centered care. Full article
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10 pages, 226 KiB  
Article
Cooking up Change: DEIB Principles as Key Ingredients in Nutrition and Culinary Medicine Education
by Melinda Ring, David Ai, Geeta Maker-Clark and Raeanne Sarazen
Nutrients 2023, 15(19), 4257; https://doi.org/10.3390/nu15194257 - 05 Oct 2023
Cited by 1 | Viewed by 1504
Abstract
The integration of diversity, equity, inclusion, and belonging (DEIB) principles into healthcare education is essential to ensure culturally sensitive and equitable healthcare delivery. In the domain of nutrition, food, and health, these principles are particularly vital, as diet and food choices are strongly [...] Read more.
The integration of diversity, equity, inclusion, and belonging (DEIB) principles into healthcare education is essential to ensure culturally sensitive and equitable healthcare delivery. In the domain of nutrition, food, and health, these principles are particularly vital, as diet and food choices are strongly linked to cultural identities and socioeconomic conditions. Despite a growth of DEIB initiatives in undergraduate and graduate medical education, there is a significant gap regarding guidelines for implementing DEIB principles in education around nutrition and food, including that for dietitians, allied health and medical professionals. A literature review was conducted, analyzing peer-reviewed articles and current practices in academic medical education to understand DEIB in nutrition, food, and health. The outcome was the creation of a three-tiered checklist titled “Checklist for Culturally Competent Education in Nutrition”. It serves as a roadmap to cultivate culturally competent, equitable, and inclusive healthcare professionals that emphasizes avoiding bias, enhancing awareness, and building practical skills for DEIB implementation around nutrition. Full article
11 pages, 256 KiB  
Article
Impact of a Teaching Kitchen Curriculum for Health Professional Trainees in Nutrition Knowledge, Confidence, and Skills to Advance Obesity Prevention and Management in Clinical Practice
by Christine K. Thang, Alma D. Guerrero, Cambria L. Garell, Janet K. Leader, Erica Lee, Kevin Ziehl, Catherine L. Carpenter, Shanika Boyce and Wendelin Slusser
Nutrients 2023, 15(19), 4240; https://doi.org/10.3390/nu15194240 - 30 Sep 2023
Cited by 1 | Viewed by 999
Abstract
Nutrition knowledge, confidence, and skills are thought to be important elements in the role of healthcare professionals in obesity prevention and management. The Upstream Obesity Solutions curriculum goes upstream with a multidisciplinary approach to supplement nutrition education among health professional trainees. Educational strategies [...] Read more.
Nutrition knowledge, confidence, and skills are thought to be important elements in the role of healthcare professionals in obesity prevention and management. The Upstream Obesity Solutions curriculum goes upstream with a multidisciplinary approach to supplement nutrition education among health professional trainees. Educational strategies of didactics, teaching kitchens, and service-based learning were employed for medical, dental, and nursing students and resident physicians. Pre/post participation surveys assessed knowledge, attitude, and practices; lifestyle habits; and culinary skills among 75 trainees in this cross-sectional descriptive study. There was variability in statistically significant improvement in knowledge, attitudes, and practices about obesity management and nutrition education, lifestyle habits, and culinary skills among learner groups. Full article
14 pages, 1517 KiB  
Article
Empowering Future Physicians and Communities on Chicago’s South Side through a 3-Arm Culinary Medicine Program
by Geeta Maker-Clark, Ashley McHugh, Hannah Shireman, Valeria Hernandez, Megha Prasad, Tiffany Xie, Arianna Parkhideh, Carlin Lockwood and Sonia Oyola
Nutrients 2023, 15(19), 4212; https://doi.org/10.3390/nu15194212 - 29 Sep 2023
Cited by 2 | Viewed by 1044
Abstract
The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in [...] Read more.
The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in the study. Data were obtained using pre- and post-course surveys and qualitative interviews from September 2021–July 2023. Results show increased confidence in medical students’ ability to provide nutrition counseling, with a high significance in their ability to provide counseling regarding chronic conditions. Participants managing chronic conditions demonstrated significant increases in self-reported confidence in their understanding of overall chronic disease management and care and in their kitchen skills, with participants who attended five or more classes having significantly higher means. Qualitative feedback from middle school students highlights their knowledge and willingness to try new foods after engaging with the curriculum. Findings add to the growing literature on culinary medicine and provide insight into the effectiveness of culinary medicine programming to increase knowledge and promote positive changes among future healthcare professionals and community members. However, more extensive research across a longer time span is needed to confirm the potential for sustained change. Full article
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12 pages, 547 KiB  
Article
Survivors Overcoming and Achieving Resiliency (SOAR): Mindful Eating Practice for Breast Cancer Survivors in a Virtual Teaching Kitchen
by Sherri Huang, Diane Riccardi, Sonya Pflanzer, Laura S. Redwine, Heewon L. Gray, Tiffany L. Carson, Marc McDowell, Zachary Thompson, Jesse J. Hubbard and Smitha Pabbathi
Nutrients 2023, 15(19), 4205; https://doi.org/10.3390/nu15194205 - 29 Sep 2023
Cited by 1 | Viewed by 1434
Abstract
The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen [...] Read more.
The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen intervention called Survivors Overcoming and Achieving Resiliency (SOAR). SOAR engaged participants through weekly cooking classes that also taught multiple domains of mindfulness. Participants (n = 102) were breast cancer survivors and completed the Mindful Eating Questionnaire (MEQ) prior to and after completion of the intervention. Linear regression analyses examined relationships between the aspects of mindful eating and body mass index (BMI). Wilcoxon (paired) rank sum tests evaluated the significance of the change in the MEQ total sum and subscales scores. A total of 102 participants completed both the pre- and post-intervention surveys. The mean change between the pre- and post-SOAR MEQ summary scores was 0.12 (sd = 0.30; Wilcoxon p-value = 0.0003). All MEQ subscale scores significantly increased with the exception of the distraction subscale. The MEQ summary scores increased for participants across both BMI stratifications. The SOAR teaching kitchen represents one of the first interventions that is tailored for breast cancer survivors and combines behavioral strategies from mindful eating training to nutritional knowledge and culinary medicine pedagogy in a virtual teaching kitchen. Further research is needed to examine whether mindful eating practices among cancer survivors result in sustainable healthy eating behaviors and food choices consistent with the cancer risk reduction guidelines. Full article
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14 pages, 295 KiB  
Article
Examination of an Online Cooking Education Program to Improve Shopping Skills, Attitudes toward Cooking, and Cooking Confidence among WIC Participants
by Dena R. Herman, Rachel Kimmel, Skye Shodahl and Jose H. Vargas
Nutrients 2023, 15(19), 4177; https://doi.org/10.3390/nu15194177 - 27 Sep 2023
Cited by 1 | Viewed by 1253
Abstract
The present study examined if adapting the Cooking Matters (CM) curriculum to be used in an online format would improve participants’ shopping skills, attitudes toward cooking, and feelings of cooking confidence, similar to the traditionally offered method, which is conducted in person. Results [...] Read more.
The present study examined if adapting the Cooking Matters (CM) curriculum to be used in an online format would improve participants’ shopping skills, attitudes toward cooking, and feelings of cooking confidence, similar to the traditionally offered method, which is conducted in person. Results from factor analyses indicated that the online CM program demonstrated construct and content reliability compared to in-person (Cronbach’s α ≥ 0.70). Repeated-measures ANOVA revealed a decrease in shopping skills overall (F = 5.91; p ≤ 0.05), consistent across age groups (F = 3.2; p ≤ 0.05) and food security status (F = 7.48; p < 0.01), with larger impacts on the food insecure (FI). Positive cooking attitudes increased with income (F = 2.86; p ≤ 0.05), especially among the <$20,000 and $30–39,000 income brackets. Cooking confidence increased post-intervention (F = 27.2, p < 0.001), with an interaction effect for food security status (F = 7.45; p ≤ 0.01), with greater improvement for households with food insecurity. These findings provide evidence to program and policymakers that virtual nutrition and cooking education services for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) should continue to be supported beyond the pandemic as they reduce barriers to receiving program benefits, nutrition education, and may lead to reductions in household food insecurity. Full article
18 pages, 2612 KiB  
Article
“Zoom”ing to the Kitchen: A Novel Approach to Virtual Nutrition Education for Medical Trainees
by Justin A. Charles, Nathan I. Wood, Stephanie Neary, Jorge O. Moreno, Lindsey Scierka, Benjamin Brink, Xiwen Zhao and Katherine A. Gielissen
Nutrients 2023, 15(19), 4166; https://doi.org/10.3390/nu15194166 - 27 Sep 2023
Cited by 2 | Viewed by 2018
Abstract
While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included [...] Read more.
While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included plant-based nutrition, dietary history-taking and counseling, and culinary medicine. Students were surveyed before, immediately after, and four weeks after the curriculum to assess changes to nutrition-related knowledge, attitudes, confidence, and personal dietary behaviors. Seventy-three PA students (91%) completed the pre-survey, 76 (95%) completed the post-survey, and 42 (52.5%) completed the delayed post-survey. Knowledge scores increased immediately post-intervention (48.9% to 78.9%; p < 0.001) and persisted four weeks later (78.9% to 75.8%; p = 0.54). Post-intervention, students felt more confident in dietary history-taking (55% vs. 95%; p = 0.001) and nutrition counseling (53% vs. 84%; p = 0.003) and agreed that dietary changes alone could reverse type 2 diabetes (74% vs. 97%; p = 0.027) and coronary artery disease (66% vs. 92%; p = 0.039). Curricula using virtual teaching kitchens may be a scalable approach to nutrition education for medical trainees. Full article
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17 pages, 1301 KiB  
Article
Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy
by Britta Retzlaff Brennan, Katherine A. Beals, Ryan D. Burns, Candace J. Chow, Amy B. Locke, Margaret P. Petzold and Theresa E. Dvorak
Nutrients 2023, 15(19), 4157; https://doi.org/10.3390/nu15194157 - 26 Sep 2023
Cited by 1 | Viewed by 1244
Abstract
Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated [...] Read more.
Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated the impact of an interprofessional CM course for medical and health professional students who experienced the hands-on cooking component in person or a in mixed-mode format (in-person and via Zoom) at the University of Utah from 2019–2023 (n = 84). A factorial ANOVA assessed differences between educational environment and changes between pre- and post-course survey responses related to diet and lifestyle counseling, interprofessional communication, and health behaviors and advocacy. Qualitative comments from post-course surveys were analyzed on a thematic level. Students rated themselves as having greater confidence and competence in diet and lifestyle counseling (p < 0.05) and increased ability to prepare eight healthy meals (p < 0.05). Additionally, a Mann–Whitney two-sample rank-sum test was used to compare data from exit survey responses from medical students who took the CM course (n = 48) and did not take the CM course (n = 297). Medical students who took CM were significantly more likely to agree that they could counsel patients about nutrition (p < 0.05) and physical activity (p < 0.05). CM courses may improve students’ confidence to provide diet and lifestyle counseling. Full article
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12 pages, 1053 KiB  
Article
Cooking Skills, Eating Habits and Nutrition Knowledge among Italian Adolescents during COVID-19 Pandemic: Sub-Analysis from the Online Survey COALESCENT (Change amOng ItAlian adoLESCENTs)
by Silvia Marconi, Loredana Covolo, Monica Marullo, Barbara Zanini, Gaia Claudia Viviana Viola, Umberto Gelatti, Roberto Maroldi, Nicola Latronico and Maurizio Castellano
Nutrients 2023, 15(19), 4143; https://doi.org/10.3390/nu15194143 - 25 Sep 2023
Cited by 1 | Viewed by 1548
Abstract
Background: Cooking skills (CS) have the potential to improve self-care behaviours and healthy development among adolescents. The COVID-19 pandemic has affected lifestyles worldwide, and the present study aims to investigate the level of CS after the pandemic, as well as its associations with [...] Read more.
Background: Cooking skills (CS) have the potential to improve self-care behaviours and healthy development among adolescents. The COVID-19 pandemic has affected lifestyles worldwide, and the present study aims to investigate the level of CS after the pandemic, as well as its associations with nutrition knowledge and eating behaviours among a cohort of Italian adolescents. Methods: We submitted an online survey about lifestyle changes to students aged 13–21 years during the pandemic. Based on overall culinary abilities, we divided respondents into high, medium and low CS. Worsening or improvement in diet quality was detected by assigning an eating habit index (EHI; 0–54). Results: Out of the 1686 questionnaires collected, 21.5%, 63.6% and 14.9% reported high, medium and low CS, respectively. The EHI scores were statistically higher among students who were able to cook more than 20 recipes compared to those reporting no cooking abilities (30.2 ± 5.9 vs. 26.6 ± 5.7; p = 0.0001). High CS significantly correlated with better EHI (OR 1.44; p = 0.009), lower consumption of ultra-processed food (OR 1.80; p < 0.0001) and better nutrition knowledge (OR 1.42; p = 0.007). Conclusions: Adolescents with good CS showed better nutrition knowledge and healthier eating habits, including lower consumption of ultra-processed foods. Projects aimed to improve CS in adolescents can therefore promote healthier development. Full article
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16 pages, 421 KiB  
Article
Redesigning Recruitment and Engagement Strategies for Virtual Culinary Medicine and Medical Nutrition Interventions in a Randomized Trial of Patients with Uncontrolled Type 2 Diabetes
by Molly F. McGuire, Patricia M. Chen, Carolyn Smith-Morris, Jaclyn Albin, Milette D. Siler, Miguel Angel Lopez, Sandi L. Pruitt, Vincent C. Merrill and Michael E. Bowen
Nutrients 2023, 15(19), 4124; https://doi.org/10.3390/nu15194124 - 25 Sep 2023
Viewed by 1435
Abstract
In-person culinary medicine (CM) can improve health behaviors, but its translation to virtual platforms and impact on diabetes outcomes are not well described. We designed a pragmatic trial comparing the effectiveness of virtual CM (eCM) to Medical Nutrition Therapy on diabetes outcomes among [...] Read more.
In-person culinary medicine (CM) can improve health behaviors, but its translation to virtual platforms and impact on diabetes outcomes are not well described. We designed a pragmatic trial comparing the effectiveness of virtual CM (eCM) to Medical Nutrition Therapy on diabetes outcomes among patients with uncontrolled diabetes within a safety-net healthcare system. All participants were provided cooking equipment and food from a food pantry. Due to low initial eCM participation, recruitment was paused, and eight semi-structured interviews were conducted to solicit feedback on study appeal, operations, and barriers to participation. Rapid thematic analysis was used to modify study operations. We found that participants were interested in the study and motivated by health concerns. While they valued food distribution and cooking equipment, they highlighted transportation barriers and conflicts with the pick-up time/location. Some eCM participants expressed discomfort with the virtual platform or preferred to observe rather than cook along. Study operations were modified by (1) moving supply pick-up to a familiar community clinic and diversifying food pick-up locations; (2) offering an in-person orientation to the program to increase comfort with the virtual platform; (3) emphasizing the credibility and relatability of the eCM instructor and encouraging participation of family members. This redesign led to the recruitment of 79 participants, of whom 75% attended at least one class. In conclusion, participant feedback informed pragmatic changes in study operations that increased engagement in this ongoing trial and may inform future eCM program design. Full article
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13 pages, 290 KiB  
Article
Cross-Sector Partnerships for Improved Cooking Skills, Dietary Behaviors, and Belonging: Findings from a Produce Prescription and Cooking Education Pilot Program at a Federally Qualified Health Center
by Kelly R. Ylitalo, Kathryn M. Janda, Reanna Clavon, Sheri Raleigh-Yearby, Catherine Kaliszewski, Jade Rumminger, Burritt Hess, Katie Walter and Wendy Cox
Nutrients 2023, 15(19), 4098; https://doi.org/10.3390/nu15194098 - 22 Sep 2023
Cited by 2 | Viewed by 1183
Abstract
Participant engagement, psychosocial factors, and dietary behaviors are important components of “Food as Medicine” and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons [...] Read more.
Participant engagement, psychosocial factors, and dietary behaviors are important components of “Food as Medicine” and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons (2022–2023), patients participated in four or six weekly 1.5 h hands-on cooking classes with shared meals, education, and produce delivery. Pretest–posttest surveys assessed sociodemographic information, health, psychosocial factors, and dietary behaviors; follow-up assessed group cohesion/sense of community in classes. Survey data were described using means and proportions. Across four cohorts, participants (n = 33; mean age: 45 ± 16 years) were 30% Hispanic/Latino, 18% non-Hispanic Black, and 52% non-Hispanic White; on average, participants attended 66% of sessions. Increases in cooking self-efficacy (p < 0.001) and diet-related self-management strategies (p < 0.001) were observed for those with follow-up data (n = 16); further, 44% reported increased vegetable consumption. All participants (100%) reported feeling like a valued member of their cooking group and 94% reported high levels of belonging. In a diverse community health center serving low-income patients, provision of produce and cooking education classes supported strategies to improve diet-related confidence, skills, and behavior. Cross-sector partnership within a health care setting may help patients and physicians prioritize nutrition and food access. Full article
13 pages, 580 KiB  
Article
A Specific Carbohydrate Diet Virtual Teaching Kitchen Curriculum Promotes Knowledge and Confidence in Caregivers of Pediatric Patients with Inflammatory Bowel Disease
by Nancy Rivera, Kaylie Nguyen, Venus Kalami, Feifei Qin, Maya B. Mathur, Rebecca Blankenburg and Ann Ming Yeh
Nutrients 2023, 15(18), 3999; https://doi.org/10.3390/nu15183999 - 15 Sep 2023
Cited by 1 | Viewed by 1526
Abstract
Diet-based approaches such as the Specific Carbohydrate Diet (SCD) have proposed health benefits for patients with Inflammatory Bowel Disease (IBD). Despite its potential effectiveness, patients and caregivers identified barriers towards implementing the SCD, and a majority expressed interest in formal education surrounding the [...] Read more.
Diet-based approaches such as the Specific Carbohydrate Diet (SCD) have proposed health benefits for patients with Inflammatory Bowel Disease (IBD). Despite its potential effectiveness, patients and caregivers identified barriers towards implementing the SCD, and a majority expressed interest in formal education surrounding the SCD. This study aimed to determine the impact of a virtual teaching kitchen curriculum on caregivers’ knowledge and perspectives on implementing the SCD. Inclusion criteria included pediatric patients with IBD aged 3–21 years and their caregivers. Participants should have fewer than 12 months of experience with the SCD or have no experience with the SCD but with an interest in learning it. Twenty-three caregivers took part in a 90-min virtual teaching kitchen curriculum and completed pre- and post-session surveys. Caregivers had statistically significant increases in total curriculum scores (p < 0.0001) as well as increases in all curricular elements post-curriculum teaching. Caregivers indicated that they plan to apply the newly acquired recipes and cooking concepts and appreciated the encouragement and support they received during the course. Curricular strengths identified included the innovative multimodal curriculum structure and professional and community support. IBD centers can use this pilot study to create or expand SCD and other nutritional curricula for the IBD community. Full article
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13 pages, 2622 KiB  
Article
Experiential Culinary, Nutrition and Food Systems Education Improves Knowledge and Confidence in Future Health Professionals
by Katherine Shafto, Natalie Vandenburgh, Qi Wang and Jenny Breen
Nutrients 2023, 15(18), 3994; https://doi.org/10.3390/nu15183994 - 15 Sep 2023
Viewed by 1440
Abstract
The food system plays a crucial role in the relationship between environmental, population and individual health. While leading healthcare and environmental organizations call for urgent action to address climate–planetary–human health crises, it is often challenging for healthcare organizations to respond at a systems [...] Read more.
The food system plays a crucial role in the relationship between environmental, population and individual health. While leading healthcare and environmental organizations call for urgent action to address climate–planetary–human health crises, it is often challenging for healthcare organizations to respond at a systems level to these concerns. Additionally, there is little consensus and limited research exploring how future health professionals should be trained in order to work at both the individual and systems level to address or prevent the negative health impacts related to the current food system. The intervention of a 6-week, hands-on cooking and nutrition course for graduate health professional students which examines these intersections and equips students with clinically applicable skills was examined using matched pre- and post-course surveys and thematic analysis of reflective assignments. Results indicate improved knowledge and confidence in areas including understanding the food system, guiding patients through dietary change, working interprofessionally, and applying basic nutrition concepts to clinical practice. Full article
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17 pages, 1871 KiB  
Article
Feasibility of a Community Healthy Eating and Cooking Intervention Featuring Traditional African Caribbean Foods from Participant and Staff Perspectives
by Sally G. Moore, Aashna Kundra, Peter Ho, Esther Bissell and Tanefa Apekey
Nutrients 2023, 15(17), 3758; https://doi.org/10.3390/nu15173758 - 28 Aug 2023
Viewed by 1464
Abstract
Culturally appropriate healthy eating resources are intended to help people from different ethnic backgrounds consume diets reflecting government dietary recommendations, yet evidence on use in the target groups is lacking. This study evaluated the feasibility of a new brief culturally appropriate community intervention [...] Read more.
Culturally appropriate healthy eating resources are intended to help people from different ethnic backgrounds consume diets reflecting government dietary recommendations, yet evidence on use in the target groups is lacking. This study evaluated the feasibility of a new brief culturally appropriate community intervention that aimed to introduce food-based healthy eating and recipe resources featuring African Caribbean foods, which were recently co-developed with people from these ethnic backgrounds. Working with a community organization in the UK, a single-arm study was used to collect verbal data from participants and staff on the acceptability of intervention whilst knowledge, skills and behaviours related to healthy eating were evaluated using pre-, post- and follow-up questionnaires. A total of 30 participants were recruited, and 22 completed all three questionnaires; who were mostly female aged 55 years+ (n = 17) and of African Caribbean ethnicity (45%, n = 10), with 32% (n = 7) reporting no educational attainment. At post-intervention and follow-up, most participants reported high satisfaction (n = 21, 95%) with the intervention sessions and high levels of confidence in using the resources at home within budget. The number of participants who were familiar with the healthy eating guidance featuring Caribbean foods increased from pre- (36%, n = 8) to post-intervention/follow-up (n = 22, 100%) (p < 0.05). Findings suggest the intervention is feasible in a community setting and could help increase awareness and use of culturally appropriate healthy eating guidance amongst a diverse group. Full article
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11 pages, 264 KiB  
Article
Expectations from a Home Cooking Program: Qualitative Analyses of Perceptions from Participants in “Action” and “Contemplation” Stages of Change, before Entering a Bi-Center Randomized Controlled Trial
by Rani Polak, Adi Finkelstein, Maggi A. Budd, Brianna E. Gray, Hanni Robinson, Julie K. Silver, Mark D. Faries and Amir Tirosh
Nutrients 2023, 15(9), 2082; https://doi.org/10.3390/nu15092082 - 26 Apr 2023
Viewed by 2282
Abstract
Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person’s genes; yet, behavioral factors, such as participant “readiness” to make a change, may also impact treatment [...] Read more.
Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person’s genes; yet, behavioral factors, such as participant “readiness” to make a change, may also impact treatment preferences and outcomes. The purpose is to explore the expectations of participants in different stages of change from a home cooking intervention. Participants were recruited to a randomized controlled trial evaluating the impact of a home cooking intervention on weight. Stage of change assessed by a validated University of Rhode Island Change Assessment scale and expectations through an open-ended questionnaire. Sixteen (21%) participants were in the action stage of change, and 59 (79%) were in the contemplation stage. Participants from both groups shared similar expectations to achieve healthy eating and lifestyle goals and to adopt sustainable change. However, action group expectations also included expanding existing culinary knowledge and change of habits; the contemplation group expectations also included acquiring culinary knowledge, improving self-regulatory skills, and obtaining guidance and support. While action group participants were looking to expand existing knowledge and techniques, contemplation group participants were focusing on acquiring culinary knowledge and skills. This can potentially contribute to developing effective, personalized nutrition interventions. Full article

Review

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19 pages, 324 KiB  
Review
The Role of Agricultural Systems in Teaching Kitchens: An Integrative Review and Thoughts for the Future
by Alexis Cole, Jennifer Pethan and Jason Evans
Nutrients 2023, 15(18), 4045; https://doi.org/10.3390/nu15184045 - 18 Sep 2023
Cited by 1 | Viewed by 1703
Abstract
Diet-related chronic disease is a public health epidemic in the United States. Concurrently, conventional agricultural and food production methods deplete the nutritional content of many foods, sever connections between people and the origin of their food, and play a significant role in climate [...] Read more.
Diet-related chronic disease is a public health epidemic in the United States. Concurrently, conventional agricultural and food production methods deplete the nutritional content of many foods, sever connections between people and the origin of their food, and play a significant role in climate change. Paradoxically, despite an abundance of available food in the US, many households are unable to afford or attain a healthful diet. The linkages between agriculture, health, and nutrition are undeniable, yet conventional agriculture and healthcare systems tend to operate in silos, compounding these pressing challenges. Operating teaching kitchens in collaboration with local agriculture, including farms, community gardens, vertical farms, and urban agriculture, has the potential to catalyze a movement that emphasizes the role of the food system in promoting human and planetary health, building resilient communities, and encouraging cross-disciplinary collaboration. This paper reviews the current state of agricultural systems, food is medicine, consumer behavior, and the roles within these sectors. This is followed by a series of case studies that fill the gaps between TKs and agriculture. The authors summarize opportunities to combine the knowledge and resources of teaching kitchens and agriculture programs, as well as challenges that may arise along the way. Full article
12 pages, 1826 KiB  
Review
Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research
by David M. Eisenberg, Lorena S. Pacheco, Auden C. McClure, John W. McWhorter, Kate Janisch and Jennifer Massa
Nutrients 2023, 15(13), 2859; https://doi.org/10.3390/nu15132859 - 24 Jun 2023
Cited by 15 | Viewed by 3636
Abstract
There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. [...] Read more.
There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies. Moreover, TKs can be used as revenue-generating research sites in universities and hospitals performing sponsored research, and, potentially, as instruments of cost containment when placed in accountable care settings and self-insured companies. Thus, TKs can be considered for inclusion in future health professional training programs, and the recently published Biden–Harris Administration Strategy on Hunger, Nutrition and Health echoes this directive. Recent innovations in the ability to provide TK classes virtually suggest that their impact may be greater than originally envisioned. Although the impact of TK curricula on behaviors, outcomes and costs of health care is preliminary, it warrants the continued attention of medical and public health thought leaders involved with Food Is Medicine initiatives. Full article
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14 pages, 2168 KiB  
Commentary
Teaching Kitchens and Culinary Gardens as Integral Components of Healthcare Facilities Providing Whole Person Care: A Commentary
by Angela M. Fals and Andrea M. Brennan
Nutrients 2023, 15(19), 4162; https://doi.org/10.3390/nu15194162 - 27 Sep 2023
Cited by 1 | Viewed by 1054
Abstract
Child and adult obesity continue to be major health concerns in the United States and can contribute to the development of chronic diseases. Culinary medicine, which incorporates teaching kitchens and gardens, may be a useful strategy for preventing and/or treating obesity-related disease by [...] Read more.
Child and adult obesity continue to be major health concerns in the United States and can contribute to the development of chronic diseases. Culinary medicine, which incorporates teaching kitchens and gardens, may be a useful strategy for preventing and/or treating obesity-related disease by providing the knowledge and skills that encourage consumption of whole plant-based foods prepared at home. Though emerging research describes the benefits of culinary medicine-based programming, examples of teaching kitchens and culinary gardens being integrated into current clinical practice is minimal. Here, we describe the development of innovative, community-centered culinary medicine programming borne from interdisciplinary collaboration at a leading healthcare system. Preliminary outcomes suggest improvements in anthropometrics, cardiometabolic risk factors, and participation in healthy lifestyle behaviors in pediatric weight management patients, as well as improved confidence, knowledge, and likelihood to prepare whole food, plant-based meals in healthcare employees following participation in culinary medicine workshops. Hospitals and culinary medicine partners can support each other through shared knowledge, vision, and resources to provide value-based care to patients in the community. Collaboration among gardeners, chefs, architects, educators, and healthcare professionals can transfer traditional physician-driven care to patients, empowering them with the tools, resources, and confidence to improve health and wellbeing. Full article
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8 pages, 617 KiB  
Brief Report
Culinary Medicine eConsults Pair Nutrition and Medicine: A Feasibility Pilot
by Jaclyn L. Albin, Milette Siler and Heather Kitzman
Nutrients 2023, 15(12), 2816; https://doi.org/10.3390/nu15122816 - 20 Jun 2023
Cited by 3 | Viewed by 2243
Abstract
The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital [...] Read more.
The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital innovation in the delivery of nutrition-based clinical care. Aligning with an existing eConsult infrastructure in the institutional electronic health record (EHR), a physician–dietitian team developed a novel Culinary Medicine eConsult. During a pilot phase, the service was introduced to primary care clinicians, and a response algorithm for eConsults was created. During the 12-month pilot phase, the Culinary Medicine team completed 25 eConsults from 11 unique primary care clinicians with a 76% (19/25) insurance reimbursement rate. Topics varied from dietary strategies for preventing and managing common metabolic diseases to specific dietary influences on microbiome health and disease flares. Requesting clinicians reported time saved in their clinic encounters and high patient satisfaction with expert nutrition guidance. EConsults in Culinary Medicine promote the integration of interprofessional nutrition care into existing clinical structures and empower enhanced access to the vital domain of dietary health. EConsults deliver timely answers to clinical questions and create opportunities for further innovation in care delivery as communities, health systems, and payors seek solutions to the growing burden of diet-sensitive diseases. Full article
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