Narrative Review of Culinary Interventions with Children in Schools to Promote Healthy Eating: Directions for Future Research and Practice

Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets

Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.

Antioxidant Activity and Seasonal Variations in the Composition of Insoluble Fiber from the Cladodes of Opuntia ficus-indica (L.) Miller: Development of New Extraction Procedures to Improve Fiber Yield

Opuntia ficus-indica (L.) Miller is a plant belonging to the Cactaceae family adapted to live in environments characterized by long periods of drought and arid or desert climates. This plant is characterized by an aerial part composed of structures transformed by branches, called "cladodes", which are essential to reduce excessive perspiration of water and appear covered with thorns. The composition of the cladodes includes water, polysaccharides, fiber, proteins, vitamins, fatty acids, sterols, polyphenols, and minerals. The main purposes of this scientific work are (a) to compare the insoluble fiber (IF) extracted from the cladodes of O. ficus-indica belonging to the same plant but collected in different seasonal periods (winter and summer) and develop new extraction protocols that are able to improve the yield obtained and (b) evaluate the antioxidant potential of the fiber and study possible variations as a result of the extraction protocol chosen. The first objective was achieved (1) by measuring the amount of IF extracted from cladodes harvested in winter and summer (CW and CS, respectively) and (2) by modifying three variables involved in the fiber extraction protocol. To achieve the second objective, the following experiments were carried out: (1) measurement of the antioxidant potential of IF in CW and CS; (2) measurement of cellular reactive oxygen species; (3) measurement of the activity of some antioxidant enzymes; and (4) comparison of the polyphenol content in CW and CS. In conclusion, the results obtained showed that the IF extraction process can be improved, achieving a uniform yield regardless of seasonality; the antioxidant effect may vary depending on the extraction protocol.

Testing the Effects of Two Field-to-Fork Programs on the Nutritional Outcomes of Elementary School Students From Diverse and Lower-Income Communities

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar's and Wilcoxon signed rank tests. The proportion of students knowing how to cook a vegetable rich recipe increased with both programs (Multi-visit Program p < .001; After-school Club p  =  .002). Vegetable consumption increased with the After-school Club (p  =  .002). Farm-to-school programming can increase knowledge of cooking vegetable rich recipes and vegetable intake among elementary school students from diverse, urban, and lower-income communities.

Relative impacts of a virtual cooking and nutrition program for children and families

Among the many factors contributing to increased consumption of ultraprocessed foods, a societal decline in cooking skills is a barrier to achieving healthy dietary patterns among children and adolescents. The current study assessed the effectiveness of a healthy cooking program, its geographic reach, and whether program format (child only, in-person format vs. family-based, virtual format) influenced outcomes. This was a quasi-experimental comparison study using youths' (8-18 years old) pre-post surveys, paired t-tests, propensity score matching, and hot spot analysis. Children participated in one of two healthy cooking programs: Flint Kids Cook (FKC)] in-person or [Flint Families Cook (FFC) virtual. FKC was facilitated inside a farmers' market commercial kitchen, whereas FFC took place virtually, in families' homes. Youth were eligible to participate in FKC if they were age 8-18 years, spoke English, and had not participated in a prior session. Families were eligible to participate in FFC if they had a child(ren) age 8-18 years, spoke English, and had not participated in a prior session of FKC or FFC. A total of 246 children (152 FKC; 94 FFC) completed assessments. FFC participants reported improved cooking self-efficacy (p < 0.001), intake of vegetables (p = 0.04), health-related quality of life (HRQoL; p = 0.01), and physical functioning (p < 0.001). Geographic reach, cooking self-efficacy, attitude towards cooking, and HRQoL exit scores did not differ between virtual or in-person programs. However, virtual program participants reported higher intake of whole grains (p = 0.02) and total fruits (p = 0.02) than in-person participants. Differences in outcomes based on program format included notable dietary improvements among youth who participated in the family-based virtual program.

Cooking and Its Impact on Childhood Obesity: A Systematic Review

INTRODUCTION

This systematic review aimed to study the effect of a cooking intervention on obesity among children and adolescents aged < 18 years.

METHODS

Articles that studied the effect of cooking intervention with at least 4 sessions among children and adolescents on obesity (from January, 2000 to December, 2021) were included for analysis. Of the 500 articles identified through PubMed and ScienceDirect database, 9 studies qualified to be included in this review.

RESULTS

One-third of the studies found a positive effect of a cooking intervention on obesity among children and adolescents. School-based studies conducted among elementary school students were promising. Centers for Disease Control and Prevention body mass index percentile was the most common tool used to identify children and adolescents with overweight and obesity. The majority of the studies had a strong methodology.

DISCUSSION

All studies showed improvement in diet-related factors. Active participation of parents is crucial in making childhood interventions successful. It is difficult to delineate the effect of cooking alone on obesity as almost all studies had multicomponent interventions.

IMPLICATIONS FOR RESEARCH AND PRACTICE

These diverse results highlight the need for longitudinal studies in natural settings to comprehend the effect of long-term cooking on obesity in children and adolescents.

Effects of a School-Based Gardening, Cooking, and Nutrition Cluster Randomized Controlled Trial on Unprocessed and Ultra-Processed Food Consumption

BACKGROUND

School-based gardening and nutrition education interventions report improvements in dietary intake, notably through fruit and vegetables. However, gardening, cooking, and nutrition randomized controlled trials are limited in evaluating dietary quality, and none have examined processed food consumption to date.

OBJECTIVES

The study examined the effects of Texas Sprouts (TX Sprouts), a gardening, cooking, and nutrition education intervention, compared with control on unprocessed and ultra-processed food (UPF) consumption in predominately low-income Hispanic children.

METHODS

TX Sprouts was a school-based cluster randomized controlled trial that consisted of 16 elementary schools randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools) over 3 y (2016-2019). TX Sprouts schools received an outdoor teaching garden and 18 1-h lessons taught by trained educators throughout the school year. Dietary intake data via 2 24-h dietary recalls were collected on a random subsample (n = 468) at baseline and postintervention. All foods and beverages were categorized using the NOVA food classification system (e.g., unprocessed, processed, ultra-processed). Generalized linear mixed effects modeling tested changes in percent calories and grams of NOVA groups between the intervention and control estimates with schools as random clusters.

RESULTS

Of the sample, 63% participated in the free and reduced-price lunch program, and 57% were Hispanic, followed by non-Hispanic White (21%) and non-Hispanic Black (12%). The intervention, compared to the control, resulted in an increase in consumption of unprocessed foods (2.3% compared with -1.8% g; P < 0.01) and a decrease in UPF (-2.4% compared with 1.4% g; P = 0.04). In addition, Hispanic children in the intervention group had an increase in unprocessed food consumption and a decrease in UPF consumption compared to non-Hispanic children (-3.4% compared with 1.5% g; P < 0.05).

CONCLUSIONS

Study results suggest that school-based gardening, cooking, and nutrition education interventions can improve dietary intake, specifically increasing unprocessed food consumption and decreasing UPF consumption. This trial was registered at clinicaltrials.gov as NCT02668744.

A systematic appraisal of the information, engagement, aesthetic and functional quality of nutrition-related smartphone apps for children and adolescents

OBJECTIVE

Nutrition-related smartphone applications (apps) could improve children's nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4-17.

DESIGN

This systematic appraisal is guided by the Protocol for App Store Systematic Reviews.

SETTING

Using Google's Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps' objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information.

RESULTS

Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4-8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90.

CONCLUSIONS

More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.

A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: A Pilot Study Protocol

Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's "halo" effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.

Fruit and Vegetable Intake and Home Nutrition Environment among Low-Income Minority Households with Elementary-Aged Children

Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (n = 6074) were obtained from adult-child dyad participants enrolled in Brighter Bites, an evidence-based health promotion program, in the fall of 2018. For every once/day increase in frequency of parent FV intake, there was an increase in child FV intake by 0.701 times/day (CI: 0.650, 0.751, p < 0.001) and 0.916 times/day (CI: 0.762, 1.07; p < 0.001) among Hispanic/Latinos and African Americans, respectively. In Hispanic/Latino participants, significant positive associations were found between fruits as well as vegetables served at mealtimes ≥3 times/week (p < 0.001), family mealtimes 7 times/week (p = 0.018), parent-child communication about healthy eating and nutrition at least sometimes during the past 6 months (p < 0.05), and frequency of child FV intake, after adjusting for covariates. In African American participants, a significant positive association was found in fruits served at mealtimes ≥1 times/week (p < 0.05), and vegetables served at mealtimes ≥5 times/week (p < 0.05). Meals cooked from scratch a few times a day/all the time were significantly positively associated with frequency of child FV intake for both Hispanic/Latino (p = 0.017) and African American (p = 0.007) groups. The relationship between home nutrition environment and child FV intake varied by race and ethnicity. Future programs should consider designing culturally tailored interventions to address racial/ethnic-specific influences that match the child's race, culture, and ethnicity.

11- to 13-Year-Old Children's Rejection and Acceptance of Unfamiliar Food: The Role of Food Play and Animalness

Promoting children's healthy food behavior is important in reducing the risk of developing obesity; it is therefore relevant to investigate methods to promote healthy food choices. This study's aim was to investigate differences in rejection-acceptance mechanisms related to unfamiliar foods depending on the inclusion of tactile exercises prior to cooking and food origin. Participant observation was applied in a school setting. Eight fifth and sixth grade classes were recruited from four Danish schools (n = 129). The classes were divided into two groups: animal (AG; quail) and nonanimal (NAG; bladderwrack). AG and NAG were subdivided into two groups: food print (FP) and no food print (NFP). Applied thematic analysis was applied. During preparation/cooking, NFP displayed disgust-related rejection, whereas FP displayed inappropriateness-related rejection. FP exhibited more playful behavior. Inappropriateness and animalness drove AG rejection. NAG rejection was driven by the slimy texture of the food and the perception of it 'not being food'. Acceptance was driven by taste and familiarity. In conclusion, the inclusion of tactile exercises could increase children's exploratory food behavior, and the promotion of children's healthy food behavior should not solely focus on choosing foods deemed safe and familiar, since, despite rejection during cooking, acceptance is ultimately possible.

Fourth-Grade Cooking and Physical Activity Intervention Reveals Associations With Cooking Experience and Sex

OBJECTIVE

Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index.

DESIGN

Randomized controlled trial.

SETTING

Eight elementary schools in 2 Northern Colorado districts.

PARTICIPANTS

Fourth-grade students; 7-month interventions: school (S.FFF)-theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities.

MAIN OUTCOME MEASURE(S)

Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight.

ANALYSIS

Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05.

RESULTS

The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable.

CONCLUSIONS AND IMPLICATIONS

Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions.

Perceived challenges and strategies to achieve Canada's Food Guide recommendation to "Cook more often": Findings from parents of young children

Unhealthy diets are detrimental to health, but home meal preparation is associated with better diet quality. Among a sample of parents of children aged 2-12, this study aimed to 1) explore perceived challenges and strategies to meeting the 2019 Canada's Food Guide recommendation of "Cook more often". From October 2019 to January 2020, 8 focus groups were conducted with 40 parents (73% mothers; 78% white) from Southwestern Ontario, Canada. Sessions were audio-recorded and transcribed verbatim. A hybrid thematic approach with inductive and deductive data analysis was used. Reported challenges included time constraints, picky eating, lacking cooking skills, high price of some fresh ingredients, school restrictions on meals at school, and the influence of children's peers on food choices, mainly unhealthy snacks. Reported strategies to mitigate some challenges included planning and preparing meals ahead of time, using technology or services to make meal planning and grocery shopping more convenient, using devices and kitchen instruments, such as Crockpot®, to make cooking faster, receiving help from spouse or child(ren), and acknowledging that foods perceived as less healthful in moderation can be included in meal preparation. These findings can help inform interventions and educational campaigns to support cooking among families with young children.

Perceptions of adequacy of fruit and vegetable intake as a barrier to increasing consumption

AIM

To investigate New South Wales adults' perceived adequacy of their fruit and vegetable consumption and to identify the barriers to consumption.

METHOD

An online cross-sectional survey of a sample of adults in New South Wales (n = 1603) in February 2019 measured self-reported fruit and vegetable intakes, perception of consumption adequacy and barriers to consumption. Proportions of participants whose reported consumption met the daily recommended serves of fruit and vegetables per day were calculated. Chi-square and Fisher's exact tests were used to explore differences between demographic characteristics and meeting fruit and vegetable recommendations. For those not meeting recommendations, Chi-square and Fisher's exact tests were used to explore perceived adequacy of intake as a potential barrier to consumption.

RESULTS

The sample included 52.7% women, 40.0% aged under 40 years and 28.6% over 59 years, 68.2% lived in a major city, and 32.6% were university educated. Overall, 64.8% of participants reported consuming adequate fruit and 12.4% reported consuming adequate vegetables. Of those consuming less than the guidelines, 21.3% perceived that they were eating enough fruit and 53.7% perceived they were eating enough vegetables. The most common barriers to eating more fruit were preference for other foods (29.6%), fruit spoiling too quickly (28.3%), and habit (27.0%). The most common barriers to eating more vegetables were the perception that they eat enough (26.8%), preference for other foods (21.9%), and habit (19.7%).

CONCLUSIONS

Greater efforts are needed to support the public to eat adequate fruit and vegetables, consistent with dietary guidelines. Public education campaigns specifically targeting increasing vegetable consumption are required to address knowledge gaps, given a large proportion of our study population consumed inadequate levels of vegetables yet perceived their intake to be adequate.

Culinary Nutrition Education Programs in Community-Dwelling Older Adults: A Scoping Review

BACKGROUND

Culinary nutrition education programs are increasingly used as a public health intervention for older adults. These programs often integrate nutrition education in addition to interactive cooking workshops or displays to create programs suitable for older adults' needs, ability and behaviour change. Synthesising the existing literature on nutrition education and interactive cooking programs for older adults is important to guide future program development to support healthy ageing.

OBJECTIVES

To determine the extent of published literature and report the characteristics and outcomes of interactive culinary nutrition education programs for older adults (> 51 years).

DESIGN

This scoping review followed the PRISMA-ScR guidelines recommended for reporting and conducting a scoping review.

METHODS

Five databases were searched of relevant papers published to May 2022 using a structured search strategy. Inclusion criteria included: older adults (≥ 51 years), intervention had both an interactive culinary element and nutrition education and reported dietary outcome. Titles and abstracts were screened by two reviewers, followed by full-text retrieval. Data were charted regarding the characteristics of the program and outcomes assessed.

RESULTS

A total of 39 articles met the full inclusion criteria. The majority of these studies (n= 23) were inclusive of a range of age groups where older adults were the majority but did not target older adults exclusively. There were large variations in the design of the programs such as the number of classes (1 to 20), duration of programs (2 weeks to 2 years), session topics, and whether a theoretical model was used or not and which model. All programs were face-to-face (n= 39) with only two programs including alternatives or additional delivery approaches beside face-to-face settings. The most common outcomes assessed were dietary behaviour, dietary intake and anthropometrics.

CONCLUSION

Culinary nutrition education programs provide an environment to improve dietary habits and health literacy of older adults. However, our review found that only a small number of programs were intentionally designed for older adults. This review provides a summary to inform researchers and policy makers on current culinary nutrition education programs for older adults. It also recommends providing face-to-face alternatives that will be accessible to a wider group of older adults with fewer restrictions.

Fuel for Fun Process Evaluation Reveals Strong Implementation and Approval with Varied Parent Engagement

OBJECTIVE

To describe the implementation and process characteristics of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF).

DESIGN

Mixed methods.

SETTING

Elementary schools in 2 Northern Colorado school districts.

PARTICIPANTS

Fourth graders (aged 9-11 years), parents, school staff, and implementation researchers; measured over 2 consecutive years in 8 schools (851 students, 45 classrooms).

INTERVENTION(S)

Social Cognitive and active learning theory-based classroom cooking with tasting lessons, active recess games, cooking with tasting food promotion during school lunch, family nights, and take-home intervention reinforcements. A 7-month program delivered by a trained intervention team.

MAIN OUTCOME MEASURE(S)

Implementation measures (observations and debriefings) assessed context, reach, dose delivered, fidelity, and dose received; process measures (surveys) assessed student and parent perceptions and intervention participation.

ANALYSIS

Descriptive statistics for quantitative and themes for qualitative data.

RESULTS

Minor adjustments in program delivery plans were required to accommodate changes in school schedules and policies. Process measures demonstrated > 90% achievement of goals for nearly all child-centered activities. One-quarter of eligible families participated in evening events, with strong parent and student approval. Fifty out of 116 parents (43%) completing an online survey reported preparing ≥ 1 of 5 recipes with their child. Fifty-nine percent of eligible students completed >1 of 10 take-home activity sheets with their parents.

CONCLUSIONS AND IMPLICATIONS

Engagement and commitment of the intervention team and school staff supported strong implementation. Participant responses were positive, but improvement in parent engagement requires investigation.

School-based obesity prevention programs in rural communities: a scoping review

OBJECTIVE

The objective of this review was to examine existing literature and conceptually map the evidence for school-based obesity prevention programs implemented in rural communities, as well as identify current gaps in the literature.

INTRODUCTION

Pediatric obesity is a significant public health condition worldwide. Rural residency places children at increased risk of obesity. Schools have been identified as an avenue for obesity prevention in rural communities.

INCLUSION CRITERIA

We considered citations focused on children (5 to 18 years of age) enrolled in a rural educational setting. We included obesity prevention programs delivered in rural schools that focused on nutrition or dietary changes, physical activity or exercise, decreasing screen time, or combined nutrition and physical activity that aimed to prevent childhood obesity. We included all quantitative, qualitative, and mixed methods research designs, as well as text and opinion data.

METHODS

A search was conducted of published and unpublished studies in English from 1990 through April 2020 using PubMed, CINAHL Complete, ERIC, Embase, Scopus, Academic Search Premier, Cochrane Register of Controlled Trials, and ClinicalTrials.gov. Gray literature was also searched. After title and abstract review, potentially relevant citations were retrieved in full text. The full texts were assessed in detail against the inclusion criteria by 2 independent reviewers. Included citations were reviewed and data extracted by 2 independent reviewers and captured on a spreadsheet targeting the review objectives.

RESULTS

Of the 105 studies selected for full-text review, 72 (68.6%) were included in the final study. Most of the studies (n = 50) were published between 2010 and 2019 and were conducted in the United States (n = 57). Most studies included children in rural elementary or middle schools (n = 57) and targeted obesity prevention (n = 67). Teachers implemented the programs in half of the studies (n = 36). Most studies included a combination of physical activity and nutrition components (n = 43). Other studies focused solely on nutrition (n = 9) or physical activity (n = 9), targeted obesity prevention policies (n = 9), or other components (n = 8). Programs ranged in length from weeks to years. Overall, weight-related, physical activity-specific, and nutrition-specific outcomes were most commonly examined in the included citations.

CONCLUSIONS

Obesity prevention programs that focused on a combination of physical activity and nutrition were the most common. Multiple outcomes were examined, but most programs included weight-specific and health behavior-specific outcomes. The length and intensity of rural school-based obesity prevention programs varied. More research examining scientific rigor and specific outcomes of rural school-based obesity prevention programs is needed.

College student motivations for and perceived impacts of volunteering with a nutrition and cooking education program for children

To assess among college students their motivations for and perceived impacts of volunteering with Cooking Matters for Kids as part of No Kid Hungry NC. Seventeen college student volunteers responded to an online survey questionnaire assessing their motivations for volunteering and how they were impacted by their experiences. Motivational functions for volunteering (values, understanding, social, career, protective, enhancement) were assessed using the Volunteer Functions Inventory. The strongest motivational functions for volunteering were values and understanding. Students were also strongly motivated to volunteer related to the areas specifically addressed by the program (i.e., nutrition, public health, working with children). Perceived impacts of volunteering included being more comfortable working with children, improving knowledge/skills, gaining experience related to their future career, and having fun. Volunteering with Cooking Matters for Kids benefited college students. Issues addressed by the program and the desire to gain experience motivated students to volunteer.

Cooking Matters for Kids Improves Attitudes and Self-Efficacy Related to Healthy Eating and Cooking

OBJECTIVE

To assess changes in self-efficacy and attitudes related to healthy eating and cooking in Cooking Matters for Kids participants.

DESIGN

Prepost study design.

SETTING

Cooking Matters for Kids programs offered by 35 organizations.

PARTICIPANTS

Predominantly third- to fifth-grade children participating in Cooking Matters for Kids lessons during fiscal years 2012-17 with matched presurvey and postsurveys (n = 18,113).

INTERVENTION(S)

Cooking Matters for Kids consists of six 2-hour experiential nutrition and cooking education lessons.

MAIN OUTCOME MEASURE(S)

Self-efficacy related to healthy eating and cooking and attitudes toward healthy foods assessed through the Cooking Matters for Kids Participant Survey.

ANALYSIS

Changes from the presurvey to postsurvey were assessed using mixed models and repeated measures ordered logistic regression accounting for clustering by course. Effect sizes were calculated using Cohen d for repeated measures. A Bonferroni adjustment was used to correct for multiple comparisons (α = 0.025).

RESULTS

Both overall and individual self-efficacy and attitude scores improved from presurvey to postsurvey (P < 0.0001). The effect sizes were 0.35 for overall self-efficacy score and 0.17 for overall attitude score.

CONCLUSIONS AND IMPLICATIONS

Participation in Cooking Matters for Kids was associated with improvements in self-efficacy and attitudes related to healthy eating and cooking.

Culinary Nutrition Education Improves Home Food Availability and Psychosocial Factors Related to Healthy Meal Preparation Among Children

OBJECTIVE

To evaluate the effectiveness of a culinary nutrition education intervention on children's home food availability and psychosocial factors related to healthy meal preparation.

DESIGN

Randomized-controlled trial.

SETTING

Schools in Kuala Lumpur, Malaysia.

PARTICIPANTS

Eighty-three school children aged 10-11 years and their parents.

INTERVENTION

Twelve weeks of culinary nutrition education with 5 hands-on healthy meal preparation modules and a module with parents on home food availability (conducted every 2 weeks).

MAIN OUTCOME MEASURES

Psychosocial factors (knowledge, attitude, practice, and self-efficacy) related to healthy meal preparation and home food availability (fruits, vegetables, healthful foods, and less healthful foods) assessed via children and parents, respectively, using validated questionnaires at baseline, postintervention, and 3-month follow-up.

ANALYSIS

Repeated measures ANOVA.

RESULTS

Intervention group had a higher (P < 0.001) mean knowledge score (mean difference, 1.2), attitude (mean difference, 2.6), practice (mean difference, 4.4) and self-efficacy (mean difference, 3.9) of healthy meal preparation as compared with control group across 3-time points. Improvements were seen in the availability of fruits (mean difference, 3.0; P < 0.001), vegetables (mean difference, 2.4; P < 0.001), healthful foods (mean difference, 1.5; P < 0.001) and less healthful foods (mean difference, -0.9; P = 0.001), favoring the intervention group.

CONCLUSION AND IMPLICATIONS

Culinary nutrition education had positive impact on children's psychosocial factors and home food availability, demonstrating the potential to improve children's nutrition.

A Review of Experiential School-Based Culinary Interventions for 5–12-Year-Old Children

Cooking is an essential skill and the acquisition of cooking skills at an early age is associated with higher diet quality. This review aimed to describe the characteristics of school-based experiential culinary interventions and to determine the value of these to child (5–12 years) health outcomes. Interventions were eligible for inclusion if they took place in school during school hours, included ≥3 classes, and had a control group. Interventions published up to May 2021 were included. The databases searched were PubMed, CINAHL, and EMBASE, and the grey literature was searched for published reports. The search strategy yielded 7222 articles. After screening, five published studies remained for analysis. Four studies targeted children aged 7–11 years, and one targeted children aged 5–12 years. The interventions included food tasting, food gardening, and/or nutrition education alongside experiential cooking opportunities. Improvements were evident in self-reported attitudes toward vegetables, fruits, and cooking, and two studies reported small objective increases in vegetable intake. School-based experiential cookery interventions have the potential to positively impact health-related aspects of the relationship children develop with food. However, a greater number of long-term methodologically rigorous interventions are needed to definitively quantify the benefits of such interventions.

How Does the Family Influence Adolescent Eating Habits in Terms of Knowledge, Attitudes and Practices? A Global Systematic Review of Qualitative Studies

Promoting healthy eating habits can prevent adolescent obesity in which family may play a significant role. This review synthesized findings from qualitative studies to identify family barriers and facilitators of adolescent healthy eating in terms of knowledge, attitudes, and practices (KAP). A literature search of four databases was completed on 31 July 2020; qualitative studies that explored family factors of adolescent (aged 10 to 19 years) eating habits were included. A total of 48 studies were identified, with the majority being from North America and sampled from a single source. Ten themes on how family influences adolescent dietary KAP were found: Knowledge—(1) parental education, (2) parenting style, and (3) family illness experience; Attitudes—(4) family health, (5) cultivation of preference, and (6) family motivation; Practices—(7) home meals and food availability, (8) time and cost, (9) parenting style, and (10) parental practical knowledge and attitudes. This review highlights five parental characteristics underlying food parenting practices which affect adolescents’ KAP on healthy eating. Adolescents with working parents and who are living in low-income families are more vulnerable to unhealthy eating. There is a need to explore cultural-specific family influences on adolescents’ KAP, especially regarding attitudes and food choices in Asian families.

In Their Own Words: Parents and Key Informants' Views on Nutrition Education and Family Health Behaviors

Parents, health professionals, and communities are integral in the development of nutrition behaviors that reduce children's risk for high body mass index (BMI) and chronic disease. The aim of this study was to conduct formative evaluations with key health informants and parents to understand the specific strategies that families use at mealtimes to promote their family's health, along with the barriers they face in attending current nutrition education programming. Focus groups (in English and Spanish) were conducted with parents (n = 22; 63.64% Black/African American, 13.64% Black but not African American, 18.18% Hispanic/Latinx) whose household was located in a community where 50% of residents' gross income was ≤185% of the federal poverty level. Semi-structured interviews were conducted with six key informants with expertise in family health and nutrition. Inductive thematic analysis was used to identify themes across interviews. Six general themes emerged from the interviews including perceptions of health, relationships, health behaviors, facilitators, barriers, and desired changes. Across the six themes, participants responded with suggestions for community-based health promotion programs such as incorporating a broader definition of health to better address the individual and systemic barriers that perpetuate health inequities and make healthy eating difficult. Participants identified stress reduction, health literacy, and cooking knowledge as areas of interest for future programming.

The Effects of Horticultural Activity Program on Vegetable Preference of Elementary School Students

This study was conducted to investigate effects of a horticultural activity program based on a mediating variable model for improving vegetable preference among elementary students. A quasi-experimental design was employed with 136 students and 136 primary carers in Seoul, South Korea. Based on the mediation model for improving children’s vegetable preference, 12 sessions were conducted, including gardening, nutrition education, and cooking activities using harvests. The program was conducted weekly for 12 weeks from March to July 2019. To investigate the effect of this program, mediating factors of the children were evaluated before and after the program. Pearson correlation analysis was used to identify the mediating factors. The nutrition index, attitude, knowledge, and eating habits of the primary carers were evaluated. Results showed children’s nutrition and gardening knowledge, dietary self-efficacy, outcome expectancies, and vegetable preference were significantly improved (p < 0.001). Primary carers showed significant improvement in the nutrition index, knowledge, and attitude (p < 0.05). The correlation analysis confirmed that most of the mediating factors had significant correlations (p < 0.05). Therefore, administering a structured program involving horticultural activities and nutrition education as mediating factors for 12 sessions was effective in improving eating behavior for vegetables elementary school students and primary carers.

Family Perceptions of a Cooking and Nutrition Program for Low-Income Children and Adolescents

Background. Flint Kids Cook, a nutrition and culinary program for children and adolescents, was created in October 2017 to address health concerns among youth and families in a low-income, urban community. In this study, researchers examined family experiences with the 6-week, chef-led program, which was taught in a farmers' market kitchen. Methods. At the conclusion of each session, researchers used an open-ended focus group format to assess program experiences, perceived impact on youth self-efficacy for cooking and healthy eating, and caregiver support. This qualitative study was guided by thematic analysis. Results. Between November 2017 and December 2018, 72 caregivers (n = 38) and students (n = 34) participated in separate focus groups. Caregivers were primarily female (74%) and African American (71%). Most students were African American (76%) and half were female. Recurrent themes included food acceptance, dietary modifications, confidence in the kitchen, and program design. Caregivers and students agreed that location and design of the program alongside facilitation by an experienced chef were important factors for program success. Conclusions. This study demonstrated that a chef-led healthy cooking program for youth was effective in improving perceived food acceptance, dietary habits, and confidence in the kitchen. The program could be modeled in similar communities to address diet and health of children and adolescents.

Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review

Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.

Can eating pleasure be a lever for healthy eating? A systematic scoping review of eating pleasure and its links with dietary behaviors and health

The aims of this review were to map and summarize data currently available about 1) key dimensions of eating pleasure; 2) associations of eating pleasure, and its key dimensions, with dietary and health outcomes and 3) the most promising intervention strategies using eating pleasure to promote healthy eating. Using the scoping review methodology, a comprehensive search of the peer-reviewed literature (Medline, PsycInfo, Embase, ERIC, Web of Science, CINAHL, ABI/Inform global and Sociology Abstract) and of the grey literature (ProQuest Dissertations & Theses and Google) was carried out by two independent reviewers. We included 119 of the 28,908 studies found. In total, 89 sub-dimensions of eating pleasure were grouped into 22 key dimensions. The most frequently found related to sensory experiences (in 50.9% of the documents), social experiences (42.7%), food characteristics besides sensory attributes (27.3%), food preparation process (19.1%), novelty (16.4%), variety (14.5%), mindful eating (13.6%), visceral eating (12.7%), place where food is consumed (11.8%) and memories associated with eating (10.9%). Forty-five studies, mostly cross-sectional (62.2%), have documented links between eating pleasure and dietary and/or health outcomes. Most studies (57.1%) reported favorable associations between eating pleasure and dietary outcomes. For health outcomes, results were less consistent. The links between eating pleasure and both dietary and health outcomes varied according to the dimensions of eating pleasure studied. Finally, results from 11 independent interventions suggested that strategies focusing on sensory experiences, cooking and/or sharing activities, mindful eating, and positive memories related to healthy food may be most promising. Thus, eating pleasure may be an ally in the promotion of healthy eating. However, systematically developed, evidence-based interventions are needed to better understand how eating pleasure may be a lever for healthy eating.

Influences of psychosocial factors and home food availability on healthy meal preparation

The involvement of children in healthy meal preparation activities has emerged as a potential strategy to promote healthy eating behaviour among children. However, there is a lack of understanding of children's internal (psychosocial factors) and external factors (home food availability) that may support the practice of preparing healthy meals. This study aimed to determine children's psychosocial factors of healthy meal preparation within themselves and their external environment of home food availability as predictors for the practice of healthy meal preparation. Public schools (n = 8) from all three zones (Bangsar-Pudu, Keramat and Sentul) in Kuala Lumpur, Malaysia, were selected through stratified random sampling. Two hundred children aged 9-11 and their parents participated. Children's psychosocial factors towards healthy meal preparation and their home food availability were assessed through children and parents, respectively, using validated questionnaires. Majority of the schoolchildren (86.5%) had poor practice of healthy meal preparation. Increased attitude (r = 0.344, P < 0.001) and self-efficacy (r = 0.501, P < 0.001) of healthy meal preparation and the availability of fruits (r = 0.304, P < 0.001), vegetables (r = 0.243, P < 0.001) and healthful ready-to-eat foods (r = 0.227, P = 0.001) at home were positively correlated with the practice of preparing healthy meals. After adjusting for age, sex and monthly household income, increased self-efficacy (P < 0.001), availability of fruits (P = 0.01) and lower availability of less healthful ready-to-eat food (P = 0.01) were associated with better healthy meal preparation practices. Outcomes revealed that positive self-efficacy of healthy meal preparation, home food availability of fruits and less healthful alternatives were associated with the practice of healthy meal preparation and thus should be targeted in future health-promotion strategy.

The taste of biodiversity: science and sensory education with different varieties of a vegetable to promote acceptance among primary school children

OBJECTIVE

To determine the impact of an educational programme for primary schools that explored the biodiversity of tomato, by promoting science and sensory education with three distinct varieties of it, in the acceptance of vegetables.

DESIGN

A randomised controlled study in which children were exposed to the educational programme (intervention group) or remained in the class, as usual (control group). The educational programme consisted of three sessions where children explained the observed differences between the three varieties of tomato and individual perceptions of their flavours based on sensory-based food education and by planning and implementing experiments to explain those differences. We tested the effects on both children's willingness to try and their liking for tomato, and for lettuce and cabbage to study the carry-over effect, compared with the control group (Mann-Whitney U test; P < 0·05).

SETTING

The study took place in public primary schools in Porto, Portugal.

PARTICIPANTS

Children in the third grade (8-13-year-old children) (n 136) were randomly assigned to intervention or control group.

RESULTS

Children in the intervention group reported significant increases in their willingness to try and liking for tomato compared to the control group (P < 0·05), but not for lettuce and cabbage (P > 0·05).

CONCLUSIONS

These results highlight the potential for fostering children's acceptance of a vegetable by exploring biodiversity through science education. Further work may clarify the effects of exploring biodiversity on the consumption of vegetables and establish whether the results are stable over time and replicable across contexts and populations.

Flint Kids Cook: positive influence of a farmers' market cooking and nutrition programme on health-related quality of life of US children in a low-income, urban community

OBJECTIVE

To examine changes in health-related quality of life (HRQoL) among youth who participated in Flint Kids Cook, a 6-week healthy cooking programme for children, and assess whether changes in HRQoL were associated with changes in cooking self-efficacy, attitude towards cooking (ATC) and diet.

DESIGN

Pre-post survey (Pediatric Quality of Life Inventory, Block Kids Food Screener, 8-item cooking self-efficacy, 6-item ATC) using child self-report at baseline and programme exit. Analysis involved paired sample t-tests and Pearson's correlations.

SETTING

Farmers' market in Flint, Michigan, USA.

PARTICIPANTS

Children (n 186; 55·9 % female, 72·6 % African American) participated in Flint Kids Cook from October 2017 to February 2020 (mean age 10·55 ± 1·83 years; range 8-15).

RESULTS

Mean HRQoL summary score improved (P < 0·001) from baseline (77·22 ± 14·27) to programme exit (81·62 ± 14·43), as did mean psychosocial health summary score (74·68 ± 15·68 v. 79·04 ± 16·46, P = 0·001). Similarly, physical (P = 0·016), emotional (P = 0·002), social (P = 0·037), and school functioning (P = 0·002) improved. There was a correlation between change in HRQoL summary score and change in ATC (r = -0·194, P = 0·025) as well as change in cooking self-efficacy (r = -0·234, P = 0·008). Changes in HRQoL and psychosocial health summary scores were not correlated with dietary changes, which included decreased added sugar (P = 0·019) and fruit juice (P = 0·004) intake.

CONCLUSIONS

This study is the first to report modest yet significant improvements in HRQoL among children and adolescents who participated in a healthy cooking programme. Results suggest that cooking programmes for youth may provide important psychosocial health benefits that are unrelated to dietary changes.

[Delphi method to reach consensus on education methods to promote healthy eating behaviors in adolescents]

Introduction

Background: adolescence is a relevant period to educate in healthy eating behaviors. For this purpose it is necessary to obtain expert opinions and reach consensus and prioritize the best methodologies available to educate adolescents on healthy eating. Methods: the Delphi method was chosen to get consensus through repeated iterations of anonymous opinions in two rounds. Participants were experts in nutrition (24), education (14), and cooking (2), selected with the following inclusion criteria: outstanding professional career; interest shown in their knowledge area, and expertise in healthy eating education. The 40 experts in the first round were reduced to 37 in the second round. The questionnaire was mailed in the first round and the results were sent to establish priorities in the second round. The analysis was done with descriptive statistics (%). Consensus was reached if ≥ 75th percentile. Cronbach's alpha coefficient was used to analyze internal consistency, which was considered good for an alpha value higher than 0.7, and moderate for values between 0.6 and 0.7. Results: there was 90% consensus for food habits, culinary skills, and methodologies. In food habits experts prioritized improving access to healthy food and curricular changes at school. In culinary skills they agreed on healthy breakfast and healthy snack preparations; in methodologies the consensus was to educate in healthy eating at breakfast and lunch at school, and on participative activities such as cooking workshops. Conclusions: the Delphi method was useful to obtain consensus and priorities on the methodologies to educate adolescents in healthy eating.

Forecasting Your Future: Nutrition Matters Curriculum with Teacher Training Promotes Students to Try New Fruits and Vegetables

BACKGROUND

Many high school students do not consume the recommended amounts of fruits and vegetables.

OBJECTIVE

This study evaluated student outcomes from a new nutrition curriculum that includes messages from the 2015-2020 Dietary Guidelines for Americans with a teacher training component for high school Family and Consumer Sciences (FACS) teachers.

METHODS

A cluster-randomized controlled study was conducted with 1104 students in FACS classes from 35 schools, taught by teachers trained in implementing a new curriculum (intervention) and teachers using their usual curricula (control). Students completed online surveys at the beginning and end of the semester, that is, pre- and postexposure to the nutrition curricula. Intention-to-treat analyses as hierarchical linear modeling were performed to determine if the intervention students had significant changes compared with the control students for knowledge of nutrition concepts, familiarity of, preferences for, affinity toward, number of times trying new, and daily times eating fruits and vegetables. Per-protocol analyses used the same hierarchical linear model but instead of control and intervention groups, students were split into 3 levels describing the amount of the new curriculum they received (0%, 1-50%, and 51-100%).

RESULTS

Students exposed to 51-100% of the new curriculum tried more fruits and vegetables than both the control students and the students that received 1-50% of the curriculum (P = 0.009 for fruits and P = 0.002 for vegetables). Additionally, there were higher increases in the number of times intervention students tried a new fruit (P = 0.027) and vegetable (P = 0.022) compared with the control students, regardless of the amount of curriculum received.

CONCLUSIONS

Our findings show that the curriculum, Forecasting Your Future: Nutrition Matters, has promise for increasing exposure to new fruits and vegetables for students. If teachers use most of the curriculum, students are likely to try more new fruit and vegetables, which could ultimately contribute to improved health.

Influence of Cooking Workshops on Cooking Skills and Knowledge among Children Attending Summer Day Camps

This study aimed to measure the influence of the Chefs in Action program (3 cooking workshops) on cooking skills, nutrition knowledge, and attitudes towards healthy eating in children attending summer day camps and compare it with a single cooking workshop. Groups of children (8–12 years) were randomly assigned to the intervention group (n = 25) or to 1 of 3 comparison groups performing a single workshop (group 1, n = 16; group 2, n = 36; group 3, n = 24). Two dietitians evaluated cooking skills during the workshops. Nutrition knowledge and attitudes towards healthy eating were assessed before and after the intervention. No improvement in cooking skills was observed in the intervention group (P = 0.25). The intervention group’s cooking skills score was significantly higher than comparison group 1 (P < 0.001). Nutrition knowledge was significantly improved in the intervention group and the comparison group 3 (P < 0.0001) but no effect on attitudes towards healthy eating was observed (Pgroup × time = 0.36). In conclusion, the Chefs in Action program positively impacted nutrition knowledge in children. The results also suggest that the type of recipe may influence nutrition knowledge and cooking skills. Further studies are needed to better assess the degree of difficulty required in cooking workshop recipes to improve cooking skills in children.

Are primary/elementary school-based interventions effective in preventing/ameliorating excess weight gain? A systematic review of systematic reviews

This systematic review of systematic reviews addresses a current gap in evidence by synthesizing findings relating to weight management interventions set entirely in primary/elementary schools targeting, diet, and/or physical activity as key strategies. Eight databases were searched for systematic reviews of trials of school-based interventions targeting children aged 4 to 12 years that looked at biometric and behavioral outcomes. From the 10 selected systematic reviews, we found that interventions designed to promote physical activity or reduce sedentary behavior were most effective for weight loss. Interventions designed to improve diet and nutrition had a small effect on behavioral and cognitive outcomes, and these outcomes could be enhanced through the use of experiential learning. The most effective interventions involved a range of stakeholders in the development process and included parents and families in implementation. This systematic review of systematic reviews offers evidence-based guidance for the development and implementation of multistrategy weight-management interventions in primary/elementary schools.

Culinary Education Programs for Children in Low-Income Households: A Scoping Review

Child obesity in the United States is at an all-time high, particularly among underserved populations. Home-cooked meals are associated with lower rates of obesity. Helping children develop culinary skills has been associated with improved nutrition. The purpose of this study is to report results from a scoping review of culinary education interventions with children from low-income families. Three databases and hand searches of relevant articles were examined. Retained articles met inclusionary criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, as appropriate. A data extraction template was developed. Data were independently extracted and verified. Only nine out of 370 articles met the inclusionary criteria and were included in the review. Most interventions were school-based, used a quasi-experimental design, and recruited minority children. Children-only was the primary intervention focus. Primary outcomes were mostly psychosocial from child self-report. Most interventions focused on children only and were guided by Social Cognitive Theory. Most reported stakeholder involvement; however, type and degree varied. All had an in-person component; only one used technology. Few reported training program leaders. Culinary education programs for children from low-income families could benefit from a broader theoretical grounding, program leader training, and greater parental involvement.

Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial

BACKGROUND

Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2).

METHODS

Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2).

RESULTS

One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills.

CONCLUSIONS

Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity.

TRIAL REGISTRATION

NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.

Cooking and Gardening Behaviors and Improvements in Dietary Intake in Hispanic/Latino Youth

Background: School gardening interventions typically include cooking and gardening (CG) components; however, few studies have examined associations between CG psychosocial behaviors (attitudes, self-efficacy, and motivation), dietary intake, and obesity parameters. This study assessed the association between changes in CG behaviors with changes in dietary intake and obesity in participants of the LA Sprouts study, an after-school, 12-week, randomized controlled CG intervention conducted in four inner-city elementary schools in Los Angeles. Methods: Process analysis using data from 290 low-income, primarily Hispanic/Latino third through fifth-grade students who were randomized to either the LA Sprouts intervention (n = 160) or control group (n = 130). Height, weight, waist circumference, dietary intake via questionnaire, and CG behaviors were collected at baseline and postintervention. Linear regressions determined whether changes in CG behaviors predicted changes in dietary intake and obesity outcomes. Results: There were no differences in changes in CG psychosocial behaviors between intervention and control groups, therefore groups were combined. Participants were 49% male, 87% Hispanic/Latino, and an average age of nine. Increases in cooking behaviors significantly predicted increases in dietary fiber intake (p = 0.004) and increases in vegetable intake (p = 0.03). Increases in gardening behaviors significantly predicted increased intake of dietary fiber (p = 0.02). Changes in CG behaviors were not associated with changes in BMI z-score or waist circumference. Conclusions: Results from this study suggest that school-based interventions should incorporate CG components, despite their potentially costly and time-intensive nature, as these behaviors may be responsible for improvements in dietary intake of high-risk minority youth.

A Community-Based Participatory Assessment of the Health Status and Obesity Risks in Children From Rural Farmworker Families in the Midwest

Obesity prevalence is higher among Hispanic children (22.4%) compared with general U.S. children (17%). Children of migrant and seasonal farmworking families are at heightened risk for obesity and related conditions. Limited research, including needs assessments and health promotion programs, has been conducted in Latino migrant farm working communities. Our objective was to identify needs, opportunities, and barriers for designing health promotion programs for children attending a community agency in a small Midwestern town. As part of a community-based participatory research project, a needs assessment was undertaken with 38 children aged 5 to 12 years (74% Latino). Measures included demographics, dietary patterns, physical activity (PA), and anthropometrics. The study was approved by the university's institutional review board and written parental consent, and child assent, was obtained. More than half of the sample had overweight (29%) or obesity (26%); 31% had elevated blood pressure levels. Participants did not meet the U.S. Department of Agriculture recommendations for most food groups and nutrients; 13% fell into the "poor" and 87% into the "needs improvement" category based on Healthy Eating Index scores. PA levels were low; only 34% of respondents engaged in sufficient exercise. Findings indicate the need for programs promoting improvements in dietary intake and increased PA.

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.

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.