An examination of at-home food preparation activity among low-income, food-insecure women

How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.

Associations between cooking self-efficacy, attitude, and behaviors among people living alone: A cross-sectional survey analysis

Cooking-related literacy and attitudes may play important roles in preventing and reducing diet-related chronic diseases and nutrition disparities. People living alone are an under-researched but growing population who face above average food insecurity rates. This study's objectives were to 1) test how cooking self-efficacy and attitude are stratified demographically among a sample of people living alone, focusing on variations across gender, age, and food security, and 2) examine how cooking self-efficacy and attitude are associated with two indicators of cooking behavior - cooking frequency and convenience orientation. We draw from a cross-sectional survey analysis of 493 adults living alone in Illinois, USA with validated measures for cooking self-efficacy, attitude, frequency, convenience orientation, and demographic characteristics. Hierarchical linear regression models were used to examine demographic factors explaining variation in self-efficacy and attitude, with attention to interactions between gender, food insecurity, and age. Poisson and OLS linear regression models were used to examine associations between self-efficacy and attitude and cooking frequency and convenience orientation. We find cooking-related self-efficacy and attitude showed strong but distinct associations with cooking frequency and convenience orientation. Overall, food insecure groups had lower self-efficacy than those who were food secure; however, food insecure women had higher self-efficacy than men in similar positions, apart from older-adult women who held particularly low efficacy. Cooking attitudes varied in small ways, notably with food insecure younger and older women possessing more negative cooking attitudes than middle-aged women. This research highlights the importance of understanding the cooking-related orientations of single-living people, while demonstrating that this group's ability to prevent and manage food insecurity is not uniform. These results can inform targeted interventions around food and nutrition insecurity, cooking attitudes, and self-efficacy among single-living populations.

Outcomes of Cooking Matters for Diabetes: A 6-week Randomized, Controlled Cooking and Diabetes Self-Management Education Intervention

BACKGROUND

Diabetes self-management education and support is the cornerstone of diabetes care, yet only 1 in 2 adults with diabetes attain hemoglobin A1c (HbA1c) targets. Food insecurity makes diabetes management and HbA1c control more difficult.

OBJECTIVE

Our aim was to test whether a cooking intervention with food provision and diabetes self-management education and support improves HbA1c and diabetes management.

DESIGN

This was a waitlist-controlled, randomized trial.

PARTICIPANTS/SETTING

Participants were 48 adults with type 1 or type 2 diabetes.

INTERVENTION

Cooking Matters for Diabetes was adapted from Cooking Matters and the American Diabetes Association diabetes self-management education and support intervention into a 6-week program with weekly food provision (4 servings).

MAIN OUTCOME MEASURES

Surveys (ie, Summary of Diabetes Self-Care Activities; Medical Outcomes Study Short Form Health Survey, version 1; Diet History Questionnaire III; 10-item US Adult Food Security Survey Module; and Stanford Diabetes Self-Efficacy Scale) were administered and HbA1c was measured at baseline, post intervention, and 3-month follow-up.

STATISTICAL ANALYSIS

Mixed-effects linear regression models controlling for sex and study wave were used.

RESULTS

Mean (SD) age of participants was 57 (12) years; 65% identified as female, 52% identified as White, 40% identified as Black, and 19 (40%) were food insecure at baseline. Intervention participants improved Summary of Diabetes Self-Care Activities general diet score (0 to 7 scale) immediately post intervention (+1.51; P = .015) and 3 months post intervention (+1.23; P = .05), and improved Medical Outcomes Study Short Form Health Survey, version 1, mental component score (+6.7 points; P = .025) compared with controls. Healthy Eating Index 2015 total vegetable component score improved at 3 months (+0.917; P = .023) compared with controls. At baseline, food insecure participants had lower self-efficacy (5.6 vs 6.9 Stanford Diabetes Self-Efficacy Scale; P = .002) and higher HbA1c (+0.77; P = .025), and demonstrated greater improvements in both post intervention (+1.2 vs +0.4 Stanford Diabetes Self-Efficacy Scale score; P = .002, and -0.12 vs +0.39 HbA1c; P = .25) compared with food secure participants.

CONCLUSIONS

Cooking Matters for Diabetes may be an effective method of improving diet-related self-care and health-related quality of life, especially among food insecure patients, and should be tested in larger randomized controlled trials.

A latent class analysis to identify socio-economic and health risk profiles among mothers of young children predicting longitudinal risk of food insecurity

BACKGROUND

The purpose of the current study was to use a social determinants of health (SDOH) framework and latent class analysis (LCA) to identify risk classes among mothers with young children. The risk classes were then used to predict food insecurity severity and stability/change of food insecurity over time.

METHOD

The secondary data from the Fragile Families and Child Wellbeing Study (n = 2,368; oversampled for non-marital births) was used in this study. Household food insecurity was assessed using the 18-items USDA Food Security Survey. A seventeen-item inventory of educational, economic stability, incarceration (i.e. social context), neighborhood safety (i.e. neighborhood and built environment), health and health care, and substance use behaviors at baseline/Year-1 were included to identify SDOH risk indicators in the LCA. Covariate-adjusted multinomial logistic regression models were used to examine the relation between risk classes at Year-1 and the severity of food insecurity at Year-3 and stability/change of food insecurity between Year-3 and Year -5.

RESULTS

LCA identified five risk classes: High utility and medical hardship (Class 1), high housing and employment hardship, high substance use, and incarceration (Class 2), high housing and medical hardship, poor health, and health care (Class 3), high employment hardship and low-income (Class 4) and low-risk (Class 5). The Class 1, Class 2 and Class 3 had greater odds of low food security and very low food security at Year-3 compared to Class 4. In addition, compared to Class 4, Class 1, Class 2 and Class 3 had greater odds unstable food insecurity and persistent food insecurity over time.

CONCLUSIONS

LCA could be used to identify distinctive family system risk profiles predictive of food insecurity. The generated risk profiles could be used by health care providers as an additional tool to identify families in need for resources to ensure household food security.

Definitions and Assessment Methods of ‘Home Cooking’ in Studies with Dietary Variables: A Scoping Review

Home cooking is a complex idea that involves multiple skills and behaviors and can be interpreted differently. Using six databases (two of which were Japanese), this scoping review examined the definitions and methods used in studies investigating the relationship between home cooking and dietary variables. Of the 40 studies (2 in Japanese) included in this review, 8 provided definitions but did not specify the extent or level that convenience foods can be allowed in food preparation. The methods were classified into two categories, namely, perception-dependent (n = 29) if using a self-reported instrument, or perception-independent (n = 11) if based on investigators’ classification. Subsequently, indicators of home cooking were classified based on survey attributes (e.g., frequency, location). All but five studies used single indicators, primarily the preparation frequency (n = 18). Quality of analysis was also evaluated. Studies that used multiple indicators or perception-independent methods showed high or moderate overall quality. In contrast, studies that used single indicators based on perception-dependent methods tended to have a low overall quality. The consistency of the relationship between home cooking and dietary variables depended on study quality. In conclusion, the definitions of home cooking were inconsistent across studies, and lacked consensus for examining the association between dietary outcomes.

The acorn squash problem: a digestible conceptualisation of barriers to emergency food assistance

BACKGROUND

In common narratives of emergency food assistance, donors likely believe their efforts directly manifest as people consuming their donated food. For example, a person donating canned lima beans during a canned food drive may visualise someone eventually eating those lima beans. However, cultural and socio-economic barriers often exist that prevent people from accessing and consuming the donated food. These barriers are often complex and otherwise well-intentioned donors, volunteers and organisations may not initially consider them.

METHOD

This commentary article, which draws from existing US emergency food systems literature, uses the imagery of an acorn squash one might find at a US food pantry to conceptualise these barriers in a straightforward way.

RESULTS

Examining emergency food assistance through the lens of the acorn squash problem can help donors, volunteers and organisations better connect with food-insecure people. The lens of the acorn squash problem also allows for deeper critiques of some practices of emergency food systems.

Is It What They Eat or How Much They Eat That Matters More in Adults with Food Insecurity in a Wealthy-Country Context?

This study aimed to investigate whether dietary quantity and/or quality differ according to food security levels in the Korean adult population. Dietary adequacy and quality were evaluated by the Korean Dietary Reference Intake and the Korean Healthy Eating Index (KHEI) for adults, respectively, according to three food security levels, i.e., food security, low food security, and very low food security. A total of 7144 Korean adults (aged 19 to 64 years) were selected from cross-sectional data from the 2013-2015 Korean National Health and Nutrition Examination Surveys. The risk of inadequate nutrient intakes of protein (p trend = 0.021) and phosphorus (p trend = 0.002) increased according to food insecurity levels after adjustment for putative risk factors. The total KHEI scores (p < 0.001) as well as scores of having breakfast (p < 0.001) were lowest in the very low food security group. Among KHEI components, adults with food insecurity were less likely to get full scores from intakes of mixed grains (p trend = 0.016), total fruit (p trend = 0.039), fresh fruit (p trend = 0.043), and breakfast (p trend < 0.001). In addition, food-insecure adults were more likely to get zero score from intakes of fresh fruit (p trend = 0.020), milk and dairy products (p trend = 0.049), breakfast (p trend < 0.001), % of energy from sweets and beverages (p trend = 0.002), and total energy (p trend = 0.033). In conclusion, food security levels were associated with how much they ate, as well what they ate, in adults in South Korea. These results implied that the diet adequacy as well as moderation and balance could be carefully treated with food assistance or nutrition intervention once nutritional adequacy has mostly been met. In addition, targeted intervention programs tailored to diverse contexts for improving food insecurity may prevent unintended consequences due to easy access to inexpensive obesogenic foods in adults with food insecurity.

Food insecurity, food skills, health literacy and food preparation activities among young Canadian adults: a cross-sectional analysis

OBJECTIVE

To assess associations between household food security status and indicators of food skills, health literacy and home meal preparation, among young Canadian adults.

DESIGN

Cross-sectional data were analysed using logistic regression and general linear models to assess associations between food security status and food skills, health literacy and the proportion of meals prepared at home, by gender.

SETTING

Participants recruited from five Canadian cities (Vancouver (BC), Edmonton (AB), Toronto (ON), Montreal (QB) and Halifax (NS)) completed an online survey.

PARTICIPANTS

1389 men and 1340 women aged 16-30 years.

RESULTS

Self-reported food skills were not associated with food security status (P > 0·05) among men or women. Compared to those with high health literacy (based on interpretation of a nutrition label), higher odds of food insecurity were observed among men (adjusted OR (AOR): 2·58, 95 % CI 1·74, 3·82 and 1·56, 95 % CI 1·07, 2·28) and women (AOR: 2·34, 95 % CI 1·48, 3·70 and 1·92, 95 % CI 1·34, 2·74) with lower health literacy. Women in food-insecure households reported preparing a lower proportion of breakfasts (β = -0·051, 95 % CI -0·085, -0·017), lunches (β = -0·062, 95 % CI -0·098, -0·026) and total meals at home (β = -0·041, 95 % CI -0·065, -0·016). Men and women identifying as Black or Indigenous, reporting financial difficulty and with lower levels of education had heightened odds of experiencing food insecurity.

CONCLUSIONS

Findings are consistent with other studies underscoring the financial precarity, rather than lack of food skills, associated with food insecurity. This precarity may reduce opportunities to apply health literacy and undertake meal preparation.

Cooking for Health: a healthy food budgeting, purchasing, and cooking skills randomized controlled trial to improve diet among American Indians with type 2 diabetes

Background

The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging—which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes.

Methods

The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received.

Discussion

Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes – a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings.

Trial registration

This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10308-8.

Factors influencing engagement and dietary behaviour change of mothers and their children in a blog-delivered healthy eating intervention: a process evaluation of a randomised controlled trial

OBJECTIVE

A randomised controlled trial found no evidence of an impact of a blog written by a registered dietitian (RD) on vegetables and fruit and milk and alternatives (e.g. soya-based beverages, yogurt and cheese) consumption - two food groups included in the 2007 version of the Canadian Food Guide - in mothers and their children compared with a control condition. To investigate these null findings, the current study explored participants' perceptions of engagement with the blog and its influence on their dietary behaviours.

DESIGN

Mixed methods process evaluation using a post-intervention satisfaction questionnaire and a content analysis of mothers' comments on the blog (n 213 comments).

SETTING

French-speaking adult mothers living in Quebec City, Quebec, Canada (n 26; response rate = 61·9 % of the total sample randomised to exposure to the blog).

RESULTS

Most mothers (n 20/26; 76·9 %) perceived the blog useful to improve their dietary habits - with the most appreciated blog features being nutritional information and healthy recipes and interactions with fellow participants and the RD. Mothers reported several facilitators (e.g. meal planning and involving children in household food activities) and few barriers (e.g. lack of time and children's food preferences) to maternal and child consumption of vegetables and fruit and milk and alternatives. Lack of time was the principal reported barrier affecting blog engagement.

CONCLUSIONS

The findings from the current study suggest that blogs written by an RD may be an acceptable format of intervention delivery among mothers, but may not alleviate all the barriers to healthy eating and engagement in a dietary intervention.

Food Skills and Their Relationship with Food Security and Dietary Diversity Among Asylum Seekers Living in Norway

OBJECTIVE

To investigate the impact of food skills on food security and dietary diversity among asylum seekers living in Norwegian reception centers.

DESIGN

Cross-sectional study.

SETTING

Eight asylum reception centers.

PARTICIPANTS

A total of 205 asylum seekers (131 men and 74 women) recruited through convenience sampling.

MAIN OUTCOME MEASURES

Food skills were measured using questions from the Canadian Rapid Response on Food Skills and divided into cooking skills and shopping skills. Food security was measured with the 10-item version of the Radimer/Cornell Scale. The dietary diversity score was based on a 24-h recall.

ANALYSIS

Bivariate and multivariable logistic regression.

RESULTS

Cooking skills were associated with adequate dietary diversity (adjusted odds ratio, 2.12; 95% confidence interval, 1.04-4.31), but not with adult food insecurity (adjusted odds ratio. 0.63; 95% confidence interval, 0.26-1.53). Shopping skills were not associated with either measure of dietary diversity or adult food insecurity. Women had higher cooking skills than men, but there were no gender differences in shopping skills.

CONCLUSIONS AND IMPLICATIONS

Food skills had a limited association with food security and dietary diversity. Further research is needed to identify food skills beneficial for asylum seekers and to address the multiple causes of food insecurity.

Toward an Affective Political Ecology of Obesity

This article argues for an affective approach to obesity that destabilizes the conceptual boundaries between the biological and the social aspects of food, eating, and fatness. Its approach foregrounds visceral experience, attends to food both inside and outside the body, and explores how bodies labeled “obese” consume their political, economic, and material environments. This approach is termed affective political ecology. The authors’ aim is to draw attention to how the entanglements between the physiological and social aspects of eating tend to be absented from antiobesity public health rhetoric. By exploring a range of ethnographic examples in high-income countries, they illuminate how such interventions often fail to account for the complex interplays between subjective corporeal experience and political economic relations and contend that overlooking an individual’s visceral relationship with food counterproductively augments social stigma, stresses, and painful emotions. They demonstrate, then, how an approach that draws together political economic and biomedical perspectives better reflects the lived experience of eating. In so doing, the authors aim to indicate how attending to affective political ecologies can further our understanding of the consumption practices of those in precarious and stressful social contexts, and they offer additional insight into how the entanglement of the biological and the social is experienced in everyday life.

To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security

Issue addressed

Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home.

Methods

An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six‐item US Household Food Security Survey Module, 12 socio‐demographic variables and 32 questions related to elements of food literacy.

Results

Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre‐prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre‐packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking.

Conclusions

Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills.

So what?

This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in‐home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.

Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households

Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (β = −0.77; 95% CI: −0.88, −0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (β = −1.18; 95% CI: −1.45, −0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.

Industrially processed v. home-prepared dishes: what economic benefit for the consumer?

OBJECTIVE

To cope with the pressure of modern life, consumer demand for convenience foods has increased in the last decades. The current study set out to compare the costs of buying industrially processed dishes and of preparing them at home.

DESIGN

Direct purchase costs of industrially processed dishes frequently consumed in France (n 19) and of the ingredients needed for their home-prepared counterparts (n 86) were collected from four major food retailers' websites in Montpellier, France. Mean prices and energy density were calculated for four portions. Costs related to energy used by cooking appliances and time spent preparing dishes were further estimated.

SETTING

Montpellier, France.

PARTICIPANTS

Not applicable.

RESULTS

Based on the costs of ingredients and energy used for cooking, dishes prepared at home cost less (-0·60 € per four portions, P < 0.001) than industrially processed dishes, but when the cost of time was taken into account, the industrially processed dishes were much cheaper (-5·34 € per four portions, P < 0.001) than their home-prepared counterparts. There was no difference in energy density between industrially processed and home-prepared dishes.

CONCLUSIONS

Our findings suggest that industrially processed dishes are more profitable to consumers when the cost of time for preparing dishes at home is valued. Given the ever greater demands of everyday life, more account should be taken of the additional cost to consumers of the time they spend preparing meals at home.

A sales tax is better at promoting healthy diets than the fat tax and the thin subsidy

We analyze how a sales tax levied on all food products impacts the consumption of healthy food, unhealthy food, and obesity. The sales tax can stimulate the consumption of healthy meals by lowering the time costs of food preparation. Moreover, the sales tax lowers obesity under more general conditions than a tax on unhealthy food (fat tax) and a subsidy on healthy food (thin subsidy). We calibrate the model using recent consumption and time use data from the US. The thin subsidy is counterproductive and increases weight. While both the sales tax and the fat tax mitigate obesity, the former imposes a lower excess burden on consumers.

Home-prepared food, dietary quality and socio-demographic factors: a cross-sectional analysis of the UK National Diet and nutrition survey 2008-16

BACKGROUND

Evidence suggests eating home-prepared food (HPF) is associated with increased dietary quality, while dietary quality varies across socio-demographic factors. Although it has been hypothesised that variation in HPF consumption between population sub-groups may contribute to variation in dietary quality, evidence is inconclusive. This study takes a novel approach to quantifying home-prepared food (HPF) consumption, and describes HPF consumption in a population-representative sample, determining variation between socio-demographic groups. It tests the association between HPF consumption and dietary quality, determining whether socio-demographic characteristics moderate this association.

METHODS

Cross-sectional analysis of UK survey data (N = 6364, aged≥19; collected 2008-16, analysed 2018). High dietary quality was defined as 'DASH accordance': the quintile most accordant with the Dietary Approaches to Stopping Hypertension (DASH) diet. HPF consumption was estimated from 4-day food diaries. Linear regressions were used to determine the association between HPF consumption and socio-demographic variables (household income, education, occupation, age, gender, ethnicity and children in the household). Logistic regression was used to determine the association between HPF consumption and DASH accordance. Interaction terms were introduced, testing for moderation of the association between HPF consumption and DASH accordance by socio-demographic variables.

RESULTS

HPF consumption was relatively low across the sample (Mean (SD) % of energy consumption = 26.5%(12.1%)), and lower among white participants (25.9% v 37.8 and 34.4% for black and Asian participants respectively, p < 0.01). It did not vary substantially by age, gender, education, income or occupation. Higher consumption of HPF was associated with greater odds of being in the most DASH accordant quintile (OR = 1.2 per 10% increase in % energy from HPF, 95% CI 1.1-1.3). Ethnicity was the only significant moderator of the association between HPF consumption and DASH accordance, but this should be interpreted with caution due to high proportion of white participants.

CONCLUSIONS

While an association exists between HPF consumption and higher dietary quality, consumption of HPF or HPF's association with dietary quality does not vary substantially between socio-demographic groups. While HPF may be a part of the puzzle, it appears other factors drive socio-demographic variation in dietary quality.

Parent and School-Age Children's Food Preparation Cognitions and Behaviors Guide Recommendations for Future Interventions

OBJECTIVE

To investigate parent and child food preparation cognitions and behaviors qualitatively to create recommendations for nutrition programs targeting these audiences.

DESIGN

Focus groups were conducted in community settings with school-age children (n = 37) and parents (n = 38) in Florida, West Virginia, and New Jersey.

SETTING

Community settings in Florida, West Virginia, and New Jersey.

PARTICIPANTS

School-age children (n = 37) and parents (n = 38).

PHENOMENON OF INTEREST

Factors influencing food preparation of school-aged children and their parents to inform Social Cognitive Theory-based recommendations.

ANALYSIS

Content analysis.

RESULTS

Parents believed that child involvement in meal preparation was important for developing cooking skills, responsibility, and self-esteem, but noted that involvement was limited by time scarcity and concern regarding child safety in the kitchen. Parents recommended having children engage in age-appropriate food preparation activities, such as packing their own snacks. Children echoed parents' beliefs, stating they would need to know how to cook later in life. Many children acknowledged being a part of meal preparation by setting the table and helping grocery shop. Food preparation's link to improving diet quality was not mentioned by parents or children. To increase involvement, children suggested that parents demonstrate skills, select age-appropriate tasks for them, and reward them for helping.

CONCLUSIONS AND IMPLICATIONS

This research provides insight into parents' and children's food preparation cognitions (eg, beliefs, attitudes) and behaviors and assembles results into recommendations that may guide decisions during nutrition intervention development and potentially improve nutrition intervention.

Cooking Matters Mobile Application: a meal planning and preparation tool for low-income parents

OBJECTIVE

To describe low-income parents' and caregivers' perceptions of the Cooking Matters Mobile Application (CM App) meal planning and preparation features.

DESIGN

Explanatory mixed-methods design where data were gathered via online surveys based on the Theory of Planned Behaviour and the Theory of Reasoned Action, followed by telephone interviews.

SETTING

CM App, a mobile phone-based resource geared towards low-income parents and caregivers of young children (pregnancy/infant to age 5 years) for meal planning and preparation, with features based on skills taught in the Cooking Matters course: recipes, shopping list and meal planning.

PARTICIPANTS

Low-income parents and caregivers (survey participants, n 461; interview participants, n 20) who had downloaded the CM App to their smartphone and agreed to participate in the current evaluation.

RESULTS

Attitudes and self-efficacy related to CM App's subject matter and functions (meal planning; recipe use; creating and using a shopping list) were measured via surveys and interviews. Mean (sd) responses were positive towards 'meal planning' and 'shopping and cooking' (4·17 (0·63) and 3·49 (0·86) on a 5-point Likert scale, respectively). Interviewees described meal planning and preparation behaviours as intrinsic, based on habit, and influenced by family preference and food costs. Early adopters of the CM App may already be engaged in and/or are motivated to engage in the targeted health behaviours.

CONCLUSIONS

Users may benefit most from incorporating into their routines new ways to prepare easy, cost-efficient, healthy meals at home that their families will enjoy.

Beyond Nutrient Intake: Use of Digital Food Photography Methodology to Examine Family Dinnertime

OBJECTIVE

To explore the feasibility of using an image-based food photography methodology (Remote Food Photography Method) in a rural, low-resource audience and use the photos to examine the context of family dinner.

DESIGN

Parents used the SmartIntake app on study-issued tablets to take before and after photos of their and their child's dinner for about 7 nights and participated in a mini-focus group to discuss their experience with the Remote Food Photography Method.

SETTING

Six Head Start/preschool centers in rural Colorado.

PARTICIPANTS

Mother-child dyads (n = 31).

VARIABLES MEASURED

Number and quality of photos received, participant feedback, meal timing, concordance, location, preparation, and quality.

ANALYSIS

The researchers assessed feasibility via practicality (percent photos received) and acceptability (general inductive approach used to analyze mini-focus group transcripts for participant feedback); time stamps, meal quality, and food preparation scales were used to analyze dinner photos.

RESULTS

The majority of photographs (738 of 864) were received. Participants reacted favorably to the methodology; for some, it led to greater self-reflection about mealtime. Mother-child dyads usually ate dinner at the same time and often ate the same food. Children were frequently served protein and refined grains and were rarely served whole grains or fruit. Many families relied on convenience foods.

CONCLUSIONS AND IMPLICATIONS

Digital food photography was feasible in this audience. Photos yielded a holistic picture of family dinnertime: meal timing, location, concordance in parent-child meals, level of preparation, and meal quality.

Examining the Association between Food Literacy and Food Insecurity

Poor food literacy behaviours may contribute to food insecurity in developed countries. The aim of this research was to describe the apparent prevalence of food insecurity in adults at enrolment in a food literacy program and to examine the relationship between food insecurity and a range of independent variables. Individuals attending the Food Sensations^® for Adults program in Western Australia from May 2016 to April 2018 completed a pre-program questionnaire (n = 1433) indicating if they had run out of money for food in the past month (food insecurity indicator), frequency of food literacy behaviours, selected dietary behaviours, and demographic characteristics. The level of food insecurity reported by participants (n = 1379) was 40.5%. Results from multiple logistic regression demonstrated that behaviours related to planning and management, shopping, preparation, and cooking were all statistically independently associated with food insecurity, in addition to soft/soda drink consumption, education, employment status, and being born in Australia. The results are salient as they indicate an association between food literacy and food insecurity. The implications are that food insecure participants may respond differently to food literacy programs. It may be necessary to screen people enrolling in programs, tailor program content, and include comprehensive measures in evaluation to determine effect on the impact of food literacy programs on different subgroups.

Effectiveness of the Nutritional App "MyNutriCart" on Food Choices Related to Purchase and Dietary Behavior: A Pilot Randomized Controlled Trial

Objective: To pilot test the effectiveness of “MyNutriCart”, a smartphone application (app) that generates healthy grocery lists, on diet and weight. Methods: A pilot randomized trial was conducted to test the efficacy of using the “MyNutriCart” app compared to one face-to-face counseling session (Traditional group) in Hispanic overweight and obese adults. Household food purchasing behavior, three 24-h food recalls, Tucker’s semi-quantitative food frequency questionnaire (FFQ), and weight were assessed at baseline and after 8 weeks. Statistical analyses included t tests, a Poisson regression model, and analysis of covariance (ANCOVA) using STATA. Results: 24 participants in the Traditional group and 27 in the App group completed the study. Most participants were women (>88%), with a mean age of 35.3 years, more than a high school education (>80%), a family composition of at least three members, and a mean baseline body mass index (BMI) of 34.5 kg/m². There were significant improvements in household purchasing of vegetables and whole grains, in individual intakes of refined grains, healthy proteins, whole-fat dairies, legumes, 100% fruit juices, and sweets and snacks; and in the individual frequency of intake of fruits and cold cuts/cured meats within the intervention group (p < 0.05). However, no significant differences were found between groups. No changes were detected in weight. Conclusions: “MyNutriCart” app use led to significant improvements in food-related behaviors compared to baseline, with no significant differences when compared to the Traditional group. Cost and resource savings of using the app compared to face-to-face counseling may make it a good option for interventionists.

Influence of food preparation behaviors on 5-year weight change and obesity risk in a French prospective cohort

BACKGROUND

Food preparation behaviors may markedly determine dietary intake and consequently influence weight status. However, the few available studies have found equivocal results. No study has prospectively investigated the association between food preparation behaviors and weight change over time. We estimated the associations of food preparation behaviors with the 5-year relative weight change and the risk of developing obesity in 12,851 French adults participating in the NutriNet-Santé cohort study. The mediating effect of dietary intake was also addressed.

METHODS

Frequency and time for meal preparation, cooking skills, preparation from scratch, kitchen equipment, cooking enjoyment, willingness to cook better/more frequently and dietary intake were assessed at baseline using web-based questionnaire and 24 h records, respectively. Self-reported anthropometric data were collected using questionnaire, at baseline and after 5 years of follow-up. Associations of such behaviors with 5-year relative weight change and the mediation analyses were assessed through multivariate linear regression models, and obesity risk was analyzed with logistic regression, stratified by sex and adjusted for age, household composition, education, occupation, income, physical activity, smoking and history of dieting.

RESULTS

In women, preparation from scratch was prospectively associated with a decreased risk of obesity over the 5-year follow-up (OR = 1.32 (1.08; 2.32)) after adjustment. After including dietary mediating factors, the association between preparation from scratch and obesity risk in women did not remain significant (P = 0.08). This association appeared to be partly mediated by dietary factors with a difference of 59% of the estimate, in the group with the low score, between the adjusted model and those with mediators (OR = 1.13 (0.71; 1.77)). Regarding 5-year relative weight change, after adjustment for confounding factors, all associations between indicators of food preparation behaviors and weight change became non significant.

CONCLUSIONS

In the context from reduced time spent preparing meals that could have an impact on dietary quality and health in industrialized countries, our prospective study does not show effect of food preparation behaviors on 5-year relative weight change and obesity risk, except for preparation from scratch on obesity risk in women. Our study provides useful information about the long term implications of food preparation behaviors on health and should be corroborated by future studies, particularly on the effect of food preparation behaviors on chronic diseases such as incident diabetes, hypertension or cardiovascular diseases, compared with other determinants.

TRIAL REGISTRATION

NCT03335644 on ClinicalTrials.gov.

Impacts of a Vegetable Cooking Skills Program Among Low-Income Parents and Children

OBJECTIVE

To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability.

DESIGN

Baseline and postcourse surveys collected 1-week after the course.

SETTING

Low-income communities in Minneapolis-St Paul.

PARTICIPANTS

Parent-child dyads (n = 89; one third each Hispanic, African American, and white) with complete pre-post course data; flyer and e-mail recruitment.

INTERVENTION(S)

Six 2-hour-weekly sessions including demonstration, food preparation, nutrition education lessons, and a meal.

MAIN OUTCOME MEASURES

Parental cooking confidence and barriers, food preparation/resource management, child self-efficacy and cooking attitudes, vegetable liking, vegetable variety, and vegetable home availability.

ANALYSIS

Pre-post changes analyzed with paired t test or Wilcoxon signed-rank tests. Results were significant at P < .05.

RESULTS

Increased parental cooking confidence (4.0 to 4.4/5.0), healthy food preparation (3.6 to 3.9/5.0), child self-efficacy (14.8 to 12.4; lower score = greater self-efficacy), vegetable variety (30 to 32/37 for parent, 22 to 24/37 for child), and home vegetable availability (16 to 18/35) (all P < .05).

CONCLUSIONS AND IMPLICATIONS

A short-term evaluation of a vegetable-focused cooking and nutrition program for parents and children showed improvements in psychosocial factors, variety, and home availability.

Reprint of "The relationship between culinary skills and eating behaviors: Challenges and opportunities for parents and families"

Unhealthy dietary intake among American children and adults is of great concern to public health practitioners, nutritional scientists, and child development experts. Cooking skills are related to healthier dietary intake among Americans of all ages, but remain a substantial barrier for many parents who want to serve healthy meals for their families at home. Culinary education interventions are effective solutions for many parents who do not know how to cook, but issues with participation bias mean that these programs are not effective solutions for all individuals. The food industry should develop solutions to help those parents for whom learning cooking skills is not an option - specifically through the development of healthier pre-assembled or prepared foods that do not require cooking skills to make. In the future, the research community should also strive to collect comprehensive population-based data on the state of cooking skills in the United States.

What Drives Food Insecurity in Western Australia? How the Perceptions of People at Risk Differ to Those of Stakeholders

Food insecurity is considered a “wicked” problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who are actually experiencing the problem. The purpose of this study was to investigate whether there was a difference between the opinions of those “at risk” and stakeholders. A total of seven focus groups (two stakeholder groups n = 10, five “at-risk” groups n = 34) and three interviews (stakeholders n = 3) were conducted to ascertain perceptions. Thematic analysis generated 329 (209 “at-risk” and 120 stakeholder) coded statements related to food insecurity drivers. Respondents were in agreement for the majority of factors, and limited income was considered the primary driver of food insecurity. However, there were notable deviations in the perceived importance of certain drivers, particularly around the price of food and the lack of food literacy. Differences in the perception of causes of food insecurity may in part be attributed to the varied role each group plays in working towards the resolution of the problem, either at the household or system level.

The relationship between culinary skills and eating behaviors: Challenges and opportunities for parents and families

Unhealthy dietary intake among American children and adults is of great concern to public health practitioners, nutritional scientists, and child development experts. Cooking skills are related to healthier dietary intake among Americans of all ages, but remain a substantial barrier for many parents who want to serve healthy meals for their families at home. Culinary education interventions are effective solutions for many parents who do not know how to cook, but issues with participation bias mean that these programs are not effective solutions for all individuals. The food industry should develop solutions to help those parents for whom learning cooking skills is not an option - specifically through the development of healthier pre-assembled or prepared foods that do not require cooking skills to make. In the future, the research community should also strive to collect comprehensive population-based data on the state of cooking skills in the United States.

Association of parental investment of time and cost in food provisioning with adherence to dietary guidelines for the consumption of fruits, vegetables and non-core foods in pre-schoolers

OBJECTIVE

To assess whether parent-reported time and cost for provision of food is associated with consumption of fruits, vegetables and non-core foods in pre-schoolers.

DESIGN

Cross-sectional analysis of baseline data from the Healthy Habits randomised controlled trial. Two subscales of the Children's Dietary Questionnaire (CDQ) were used to assess fruit and vegetable, and non-core food consumption.

SETTING

Thirty pre-schools in the Hunter Region of New South Wales, Australia.

SUBJECTS

Parents (n 396) with a child aged 3-5 years attending a participating pre-school were recruited. Parents needed to reside with that child for at least four days per week and have primary responsibility for providing meals and snacks to their child.

RESULTS

Sixty-three per cent of children had a parent-reported subscale score indicating adherence to dietary guidelines for fruit and vegetable intake, while 64% of children had a subscale score indicating they were exceeding dietary guidelines for non-core foods. Regression models revealed significant positive associations between higher CDQ scores for non-core foods (indicating higher consumption levels) and minutes that parents spent preparing food (P=0·032 and 0·025) and amount spent on purchasing food (P=0·043 and 0·020). The magnitude of the effects was small (estimate=0·003 and 0·001).

CONCLUSIONS

Time and cost spent by parents on provision of food was not significantly associated with child fruit and vegetable consumption. Further explorations into time spent on food preparation and cost of food procurement are warranted to help address the increased consumption of non-core foods by pre-school children.

A Default Option to Enhance Nutrition Within Financial Constraints: A Randomized, Controlled Proof-of-Principle Trial

OBJECTIVE

This study aimed to examine the feasibility and initial efficacy of a novel default option intervention targeting nutritional quality of online grocery purchases within the financial constraints of food insecurity.

METHODS

Female undergraduates (n = 59) without eating disorder symptoms or dietary restrictions selected foods online with a budget corresponding to maximum Supplemental Nutrition Assistance Program benefits. Before completing the task again, participants were randomly assigned to receive a $10 incentive for selecting nutritious groceries (n = 17), education about nutrition (n = 24), or a default online shopping cart containing a nutritionally balanced selection of groceries (n = 18) to which they could make changes. Nutritional quality was quantified by using the Thrifty Food Plan Calculator.

RESULTS

Compared with the education condition, participants in the default condition selected significantly more whole grains and fruits and foods lower in cholesterol, saturated fats, sodium, and overall calories. There were no statistically significant differences in nutritional outcomes between the incentive condition and the other two groups.

CONCLUSIONS

Findings provide initial support for the efficacy of a default option in facilitating healthier food choice behaviors within financial constraints.

Mediation of psychosocial determinants in the relation between socio-economic status and adolescents' diet quality

PURPOSE

To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents.

METHODS

In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country.

RESULTS

The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect).

CONCLUSION

Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.

Interventions to address household food insecurity in high-income countries

Household food insecurity is a serious public health concern in high-income countries. Canada and the USA regularly monitor household food insecurity, while in other countries, such as the UK, it has been the rapid rise of food bank usage that has drawn increased attention to this longstanding, but largely overlooked, problem. This review evaluates evidence on interventions intended to reduce household food insecurity in high-income countries. Research on social protection interventions suggests both cash transfers and food subsidies (e.g. the US Supplement Nutrition and Assistance Programme) reduce household food insecurity. In contrast, research on community-level interventions, such as food banks and other food programmes, suggests limited impacts. Although food banks have become a common intervention for food insecurity in high-income countries, evidence suggests their reliance on donations of volunteer time and food make them inevitably limited in the assistance they are able to provide. The stigma people feel using food banks may also make them untenable. Alternatives to, or enhanced, food banks such as community shops or community kitchens, have become common, but evidence also suggests they may be limited in effectiveness if they do not reach people experiencing food insecurity. This review highlights the difficulty of trying to address household food insecurity with community-based food interventions when solutions likely lie upstream in social protection policies.

Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents

BACKGROUND

Food preparation skills may encourage healthy eating. Traditional assessment of child food preparation employs self- or parent proxy-reporting methods, which are prone to error. The eButton is a wearable all-day camera that has promise as an objective, passive method for measuring child food preparation practices.

PURPOSE

This paper explores the feasibility of the eButton to reliably capture home food preparation behaviors and practices in a sample of pre- and early adolescents (ages 9 to 13).

METHODS

This is a secondary analysis of two eButton pilot projects evaluating the dietary intake of pre- and early adolescents in or around Houston, Texas. Food preparation behaviors were coded into seven major categories including: browsing, altering food/adding seasoning, food media, meal related tasks, prep work, cooking and observing. Inter-coder reliability was measured using Cohen's kappa and percent agreement.

RESULTS

Analysis was completed on data for 31 participants. The most common activity was browsing in the pantry or fridge. Few participants demonstrated any food preparation work beyond unwrapping of food packages and combining two or more ingredients; actual cutting or measuring of foods were rare.

CONCLUSIONS

Although previous research suggests children who "help" prepare meals may obtain some dietary benefit, accurate assessment tools of food preparation behavior are lacking. The eButton offers a feasible approach to food preparation behavior measurement among pre- and early adolescents. Follow up research exploring the validity of this method in a larger sample, and comparisons between cooking behavior and dietary intake are needed.

Women's Perceptions of Usefulness and Ease of Use of Four Healthy Eating Blog Characteristics: A Qualitative Study of 33 French-Canadian Women

BACKGROUND

Healthy eating blogs are knowledge translation tools used by nutrition and dietetics practitioners for helping people improve their health behaviors and food choices.

OBJECTIVE

Our aim was to explore women's perceptions of the usefulness and ease of use of healthy eating blog (HEB) characteristics that might increase potential users' intention to use them as tools to improve their dietary habits.

DESIGN

We conducted qualitative research using semi-structured individual interviews.

PARTICIPANTS

Thirty-three women (mean age of 44 years; range=27 to 61 years) living in the Quebec City, Canada, metropolitan area were studied.

INTERVENTION

Four existing HEBs, written by French-Canadian registered dietitians (RDs) whose main objective was the promotion of a healthy diet, were explored by women during individual interviews. A standardized open-ended interview questionnaire based on the Technology Acceptance Model was used to identify women's perceptions about characteristics of type of blog content delivery, RD blogger's delivery of information, blog layout, and blog design.

MAIN OUTCOME MEASURES

Women's perceptions toward the contribution of HEB characteristics to the usefulness and ease of use of those tools to improve their dietary habits were measured.

ANALYSES PERFORMED

Interviews were audiorecorded, transcribed verbatim, coded, and analyzed through an inductive content analysis using NVivo software.

RESULTS

The most useful characteristics of type of blog content delivery identified by women were recipes, hyperlinks, and references. Among characteristics of RD blogger's delivery of information, most women reported that interaction between blog readers and the RD blogger created a sense of proximity and of connection that was helpful for improving their dietary behaviors. Women's perceptions toward various characteristics of blog layout and design were also discussed.

CONCLUSIONS

Incorporating specific characteristics when designing HEBs should be considered by RDs and future research to promote the use of those tools to support dietary behavior change efforts of internet users.

Social disparities in food preparation behaviours: a DEDIPAC study

Background

The specific role of major socio-economic indicators in influencing food preparation behaviours could reveal distinct socio-economic patterns, thus enabling mechanisms to be understood that contribute to social inequalities in health. This study investigated whether there was an independent association of each socio-economic indicator (education, occupation, income) with food preparation behaviours.

Methods

A total of 62,373 adults participating in the web-based NutriNet-Santé cohort study were included in our cross-sectional analyses. Cooking skills, preparation from scratch and kitchen equipment were assessed using a 0–10-point score; frequency of meal preparation, enjoyment of cooking and willingness to cook better/more frequently were categorical variables. Independent associations between socio-economic factors (education, income and occupation) and food preparation behaviours were assessed using analysis of covariance and logistic regression models stratified by sex. The models simultaneously included the three socio-economic indicators, adjusting for age, household composition and whether or not they were the main cook in the household.

Results

Participants with the lowest education, the lowest income group and female manual and office workers spent more time preparing food daily than participants with the highest education, those with the highest income and managerial staff (P < 0.0001). The lowest educated individuals were more likely to be non-cooks than those with the highest education level (Women: OR = 3.36 (1.69;6.69); Men: OR = 1.83 (1.07;3.16)) while female manual and office workers and the never-employed were less likely to be non-cooks (OR = 0.52 (0.28;0.97); OR = 0.30 (0.11;0.77)). Female manual and office workers had lower scores of preparation from scratch and were less likely to want to cook more frequently than managerial staff (P < 0.001 and P < 0.001). Women belonging to the lowest income group had a lower score of kitchen equipment (P < 0.0001) and were less likely to enjoy cooking meal daily (OR = 0.68 (0.45;0.86)) than those with the highest income.

Conclusion

Lowest socio-economic groups, particularly women, spend more time preparing food than high socioeconomic groups. However, female manual and office workers used less raw or fresh ingredients to prepare meals than managerial staff. In the unfavourable context in France with reduced time spent preparing meals over last decades, our findings showed socioeconomic disparities in food preparation behaviours in women, whereas few differences were observed in men.

Electronic supplementary material

The online version of this article (10.1186/s12937-017-0281-2) contains supplementary material, which is available to authorized users.

Food insecurity and food consumption by season in households with children in an Arctic city: a cross-sectional study

BACKGROUND

High rates of food insecurity are documented among Inuit households in Canada; however, data on food insecurity prevalence and seasonality for Inuit households with children are lacking, especially in city centres. This project: (1) compared food consumption patterns for households with and without children, (2) compared the prevalence of food insecurity for households with and without children, (3) compared food consumption patterns and food insecurity prevalence between seasons, and (4) identified factors associated with food insecurity in households with children in Iqaluit, Nunavut, Canada.

METHODS

Randomly selected households were surveyed in Iqaluit in September 2012 and May 2013. Household food security status was determined using an adapted United States Department of Agriculture Household Food Security Survey Module. Univariable logistic regressions were used to examine unconditional associations between food security status and demographics, socioeconomics, frequency of food consumption, and method of food preparation in households with children by season.

RESULTS

Households with children (n = 431) and without children (n = 468) participated in the survey. Food insecurity was identified in 32.9% (95% CI: 28.5-37.4%) of households with children; this was significantly higher than in households without children (23.2%, 95% CI: 19.4-27.1%). The prevalence of household food insecurity did not significantly differ by season. Demographic and socioeconomic characteristics of the person responsible for food preparation, including low formal education attainment (ORSept = 4.3, 95% CI: 2.3-8.0; ORMay = 3.2, 95% CI: 1.8-5.8), unemployment (ORSept = 1.1, 95% CI: 1.1-1.3; ORMay = 1.3, 95% CI: 1.1-1.5), and Inuit identity (ORSept = 8.9, 95% CI: 3.4-23.5; ORMay = 21.8, 95% CI: 6.6-72.4), were associated with increased odds of food insecurity in households with children. Fruit and vegetable consumption (ORSept = 0.4, 95% CI: 0.2-0.8; ORMay = 0.5, 95% CI: 0.2-0.9), as well as eating cooked (ORSept = 0.5, 95% CI: 0.3-1.0; ORMay = 0.5, 95% CI: 0.3-0.9) and raw (ORSept = 1.7, 95% CI: 0.9-3.0; ORMay = 1.8, 95% CI: 1.0-3.1) fish were associated with decreased odds of food insecurity among households with children, while eating frozen meat and/or fish (ORSept = 2.6, 95% CI: 1.4-5.0; ORMay = 2.0, 95% CI: 1.1-3.7) was associated with increased odds of food insecurity.

CONCLUSIONS

Food insecurity is high among households with children in Iqaluit. Despite the partial subsistence livelihoods of many Inuit in the city, we found no seasonal differences in food security and food consumption for households with children. Interventions aiming to decrease food insecurity in these households should consider food consumption habits, and the reported demographic and socioeconomic determinants of food insecurity.

An evidence-based conceptual framework of healthy cooking

Eating out of the home has been positively associated with body weight, obesity, and poor diet quality. While cooking at home has declined steadily over the last several decades, the benefits of home cooking have gained attention in recent years and many healthy cooking projects have emerged around the United States. The purpose of this study was to develop an evidence-based conceptual framework of healthy cooking behavior in relation to chronic disease prevention. A systematic review of the literature was undertaken using broad search terms. Studies analyzing the impact of cooking behaviors across a range of disciplines were included. Experts in the field reviewed the resulting constructs in a small focus group. The model was developed from the extant literature on the subject with 59 studies informing 5 individual constructs (frequency, techniques and methods, minimal usage, flavoring, and ingredient additions/replacements), further defined by a series of individual behaviors. Face validity of these constructs was supported by the focus group. A validated conceptual model is a significant step toward better understanding the relationship between cooking, disease and disease prevention and may serve as a base for future assessment tools and curricula.

Community Interventions to Improve Cooking Skills and Their Effects on Confidence and Eating Behaviour

Purpose of Review

Community-based interventions aiming to improve cooking skills are a popular strategy to promote healthy eating. We reviewed current evidence on the effectiveness of these interventions on different confidence aspects and fruit and vegetable intake.

Recent Findings

Evaluation of cooking programmes consistently report increased confidence in cooking skills in adults across different age groups and settings. The effectiveness of these programmes on modifying eating behaviour is less consistent, but small increases in self-reported consumption of fruit and vegetables are also described. Lack of large samples, randomization and control groups and long-term evaluation are methodological limitations of the evidence reviewed.

Summary

Cooking skill interventions can have a positive effect on food literacy, particularly in improving confidence on cooking and fruit and vegetable consumption, with vulnerable, low-socieconomic groups gaining more benefits. Consistency across study designs, delivery and evaluation of outcomes both at short and long terms are warranted to draw clearer conclusions on how cooking programmes are contributing to improve diet and health.

The Eating and Cooking Healthy (TEACH) Kitchen: A Research Protocol

Background

Diet-related chronic diseases, such as diabetes mellitus, hypertension, and hyperlipidemia have affected millions of individuals, resulting in disease-related complications and mortality. Strategies that may improve the outcome of chronic disease management include modification of lifestyle risk factors such as unhealthy diets. TEACH Kitchen is an experiential education program related to community nutrition, the goal of which is to teach patients management of chronic disease through dietary change.

Methods

Adults (n=144) ≥18 years old and their children (n=144) 7–17 years old will complete four 2-hour sessions. Components of each session will include brief nutrition education (20 min), an interactive cooking session (1 hr), and after-dinner discussion (40 min). Pre- and post-session questionnaires will be administered to all participants for self-reported demographics, knowledge, attitude, and beliefs about healthy nutrition. Medical records will be used to collect information about adult participants’ demographics and clinical indicators (hemoglobin A1c, lipid profile, blood pressure, weight, height, and body mass index [BMI]). Descriptive analyses will be performed to determine socio-demographic characteristics using frequencies and proportions for all categorical data, and means for continuous variables. T-tests and multiple logistic regression analysis will be accomplished to compare the differences in means.

Results

Differences in the pre- and post-session knowledge, attitude, and beliefs related to healthy eating will be evaluated for adults and children. The anticipated outcomes include enhanced education promoting healthy eating in the community, prevention of chronic disease complications related to poor diet, and prevention of obesity-related chronic diseases in children.

Conclusions

Enhancement of chronic disease management among patients, and the prevention of obesity among children, can be accomplished through healthy cooking and diet.

Reaching Low-Income Mothers to Improve Family Fruit and Vegetable Intake: Food Hero Social Marketing Campaign-Research Steps, Development and Testing

The objective of this study was to create/test a social marketing campaign to increase fruit/vegetable (FV) intake within Oregon Supplemental Nutrition Assistance Program (SNAP) eligible families. Focus groups (n = 2) and pre/post campaign phone surveys (n = 2082) were conducted in intervention counties (IC) and one control county. Participants were female (86%-100%) with 1-2 children at home. Mean FV intake/without juice was 3.1 servings/day; >50% preferred the Internet for delivery of healthy eating information. Participants reported time/financial burdens, low household FV variety and desirability of frozen/canned FV, and acceptance of positive messages. A Food Hero (FH) campaign was created/delivered daily August-October 2009 to mothers through multiple channels (e.g., grocery stores, online, educators). Results showed that the IC had better FH name recall (12%) and interpretation of intended messages (60%) vs. control (3%, 23%, respectively). Compared to controls, the IC were less likely to report healthy food preparation as time consuming or a FV rich diet expensive, and it was easier to get their family to eat fruit. Results did not vary based on county/household characteristics. The FH campaign increased FH awareness and positive FV beliefs. A longer campaign with FV assessments will increase understanding of the target audience, and allow for campaign refinement.

Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study

Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., "nutritional balance of the dish"), constraints (e.g., "my cooking skills"), pleasure (e.g., "originality of the dish"), specific diets (e.g., "my health status"), and organization (e.g., "what I planned to eat"). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62-0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10-1.19)) and specific diets (OR = 1.19 (95% CI: 1.17-1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking.

Self-Perceived Eating Habits and Food Skills of Canadians

OBJECTIVE

This study identified and described Canadians' self-perceived eating habits and food skills through the use of population-based data.

DESIGN

Data from the Canadian Community Health Survey 2013 Rapid Response on Food Skills was used to examine the eating quality and patterns of Canadians. Data were collected from all provinces in January and February 2013.

MAIN OUTCOME MEASURES

Respondent variables (sex, age, Aboriginal/immigrant status) were examined to assess differentiations between socio-demographic groupings (family structure, marital status, education, and income).

ANALYSIS

Logistic regression was used to determine whether demographic variables increased the likelihood of certain responses.

RESULTS

Forty-six percent of Canadians believe they have excellent/very good eating habits, with 51% categorizing their habits as good or fair. Similarly, the majority report having good food skills. Sex and age were significantly associated with food skills, with women rating their cooking skill proficiency higher than men (72% vs 55%), and older Canadians reporting higher food skill knowledge than their younger counterparts.

CONCLUSIONS AND IMPLICATIONS

Results indicate that while portions of the Canadian population have adequate food skills, others are lacking, which may negatively impact their diet. Findings from this study have implications for education and health promotion programs focusing on foods skills, particularly among vulnerable target groups.

Results of a Pilot Intervention in Food Shelves to Improve Healthy Eating and Cooking Skills Among Adults Experiencing Food Insecurity

Since the start of the 2007 economic downturn, reliance on emergency food assistance suppliers (e.g., food pantries, also known as food shelves) has increased. Many food shelves strive to provide effective nutrition programs to serve their clients, even while they are faced with a scarcity of resources. Rigorous evaluation of the impact of such programming on dietary outcomes is, therefore, warranted. The aim of this study was to evaluate the effectiveness of a pilot cooking and nutrition education intervention among food shelf clients. A six-session class was conducted with 63 participants in four food shelves in Minneapolis and St. Paul, MN. Diet was assessed through a 24-hour recall from which a Healthy Eating Index (HEI) score was created. Cooking skills were assessed by survey. Average HEI scores increased from 50.9 at baseline to 58.5 post-intervention (p = 0.01, n = 43). Participants demonstrated improved cooking skills scores post-intervention (35.9 vs. 33.1 at baseline, p = 0.002, n = 45). Future research is needed to advance our understanding of how best to improve client nutrition knowledge and cooking skills. This study provides some evidence that improvements in diet and skills can be demonstrated with minimal intervention.

Food Security Status and Barriers to Fruit and Vegetable Consumption in Two Economically Deprived Communities of Oakland, California, 2013-2014

Introduction

Food security status may moderate how people perceive barriers to fruit and vegetable consumption. This study aimed to 1) describe the association between fruit and vegetable consumption and microbarriers and mezzobarriers to consumption, and 2) test whether these associations differ by food security status.

Methods

We surveyed adults (n = 531) living in 2 economically deprived communities in Oakland, California, in 2013 and 2014. Multivariate linear regression assessed associations between microbarriers (taste, cost, busyness) and mezzobarriers (produce selection, quality, and purchase ease) and fruit and vegetable consumption, derived from a 26-item dietary screener. Interactions were tested by food security status.

Results

Respondents consumed a mean 2.4 (standard deviation, 1.5) servings of fruits and vegetables daily; 39% of the sample was food insecure. Being too busy to prepare healthy foods was associated with reduced fruit and vegetable consumption (β_busyness = −0.40; 95% confidence interval [CI], −0.52 to −0.28) among all respondents. Food security moderated the relationship between fruit and vegetable consumption and taste, cost, and perceived ease of purchase of healthy foods. Among the food secure, disliking healthy food taste (β_taste = −0.38; 95% CI, −0.60 to −0.15) and cost (β_cost = −0.29; 95% CI, −0.44 to −0.15) concerns were associated with lower consumptions of fruits and vegetables. Mezzobarriers were not significantly associated with consumption in either group.

Conclusion

Perceived time constraints influenced fruit and vegetable consumption. Taste and cost influenced fruit and vegetable consumption among the food secure and may need to be considered when interpreting analyses that describe dietary intake and designing diet-related interventions.

Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12)

Background

Food processing alters food from its natural state for safety, convenience, taste or palatability. Previous research suggests that industrially processed foods, and diets high in these products, tend to be less healthful. However, most previous work is based on household, rather than individual-level, data. Little has been reported on the relationship between processed food consumption and markers of health; or on socio-demographic correlates of processed food consumption.

Our objective was to describe: the nutritional content of foods classified according to degree of processing; the nutritional content of diets with different relative intakes of processed foods; the socio-demographic characteristics of individuals with different relative intakes of processed foods; and the association between intake of processed foods and body weight.

Methods

Secondary analysis of data from the UK National Diet and Nutrition Survey (2008–12), a large national cross-sectional study of diet. Dietary information was collected using four-day, unweighed, food-diaries. Foods were classified as: unprocessed or minimally processed (MPF; foods with no processing or mostly physical processes applied to single whole foods), processed ingredients (PI; extracted and purified components of single whole foods), or ultra-processed food products (UPF; products produced from industrial combining of MPF and PI).

Results

Two thousand one hundred seventy four adults were included. MPF and diets high in these foods, had the most healthful nutritional profile. UPF did not necessarily have the least healthful nutritional profile, but diets high in these foods did. Women, and older adults consumed more energy from MPF, and less from UPF. Those living in lower occupation social class households consumed less energy from MPF, but no more from UPF. Only higher intake of PI was consistently, inversely, associated with body weight.

Conclusions

This is the first study to explore correlates of processed food consumption, using individual-level data from a large, national sample. Although higher intakes of MPF and lower intakes of UPF were associated with the most healthful dietary profiles, only intake of PI was consistently associated with body weight. Consumption of UPF varied by age and gender, but, unexpectedly, not by occupational social class. Longitudinal work is required to confirm relationships with health markers.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0317-y) contains supplementary material, which is available to authorized users.

Prevalence and socio-demographic correlates of time spent cooking by adults in the 2005 UK Time Use Survey. Cross-sectional analysis

This study aimed to document the prevalence and socio-demographic correlates of time spent cooking by adults in the 2005 UK Time-Use Survey. Respondents reported their main activities, in 10 minute slots, throughout one 24 hour period. Activities were coded into 30 pre-defined codes, including 'cooking, washing up'. Four measures of time spent cooking were calculated: any time spent cooking, 30 continuous minutes spent cooking, total time spent cooking, and longest continuous time spent cooking. Socio-demographic correlates were: age, employment, social class, education, and number of adults and children in the household. Analyses were stratified by gender. Data from 4214 participants were included. 85% of women and 60% of men spent any time cooking; 60% of women and 33% of men spent 30 continuous minutes cooking. Amongst women, older age, not being in employment, lower social class, greater education, and living with other adults or children were positively associated with time cooking. Few differences in time spent cooking were seen in men. Socio-economic differences in time spent cooking may have been overstated as a determinant of socio-economic differences in diet, overweight and obesity. Gender was a stronger determinant of time spent cooking than other socio-demographic variables.

Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis

CONTEXT

It is well established in the literature that healthier diets cost more than unhealthy diets.

OBJECTIVE

The aim of this review was to examine the contribution of food prices and diet cost to socioeconomic inequalities in diet quality.

DATA SOURCES

A systematic literature search of the PubMed, Google Scholar, and Web of Science databases was performed.

STUDY SELECTION

Publications linking food prices, dietary quality, and socioeconomic status were selected.

DATA EXTRACTION

Where possible, review conclusions were illustrated using a French national database of commonly consumed foods and their mean retail prices.

DATA SYNTHESIS

Foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. Food budgets in poverty were insufficient to ensure optimum diets.

CONCLUSIONS

Socioeconomic disparities in diet quality may be explained by the higher cost of healthy diets. Identifying food patterns that are nutrient rich, affordable, and appealing should be a priority to fight social inequalities in nutrition and health.