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Krenek AM, Mobley AR, Andrade J, Dahl W, Mathews AE. Behavioral Frameworks and Translational Applications of Culinary Medicine and Culinary Nutrition. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00390-7. [PMID: 39152977 DOI: 10.1016/j.jneb.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/30/2024] [Accepted: 07/03/2024] [Indexed: 08/19/2024]
Abstract
Culinary medicine and culinary nutrition programs have emerged as innovative approaches to influencing dietary and lifestyle behavior change. These models vary in reported use of behavioral frameworks for planning purposes and attributing efficacy to current inconsistencies in format and delivery. This report aims to review current practice of behavior change theories in culinary medicine/culinary nutrition, delineate constructs that support positive outcomes, and describe future directions for translational applications in integrating the skills of chefs, nutrition educators, and medical professionals.
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Affiliation(s)
- Andrea M Krenek
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL
| | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, FL
| | - Jeanette Andrade
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL
| | - Wendy Dahl
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL
| | - Anne E Mathews
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL.
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Watanabe JA, Nieto JA, Suarez-Diéguez T, Silva M. Influence of culinary skills on ultraprocessed food consumption and Mediterranean diet adherence: An integrative review. Nutrition 2024; 121:112354. [PMID: 38458144 DOI: 10.1016/j.nut.2024.112354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/04/2024] [Indexed: 03/10/2024]
Abstract
The Mediterranean diet is a diet pattern with several healthy characteristics, including a high consumption of fresh fruits, vegetables, whole-grain products, and extra virgin olive oil as the main fat source. It is also characterized by a low consumption of processed foods and high-fat meats. However, there has been a nutritional transition such that, because of globalization and economic growth, the consumption of ultraprocessed foods is increasing, comprising 14% to 57% of total energy intake. North America and Australia have the worst prognosis. Further, the younger population consumes greater amounts of ultraprocessed foods compared with adults, whereas the older population has the lowest rates. Among the various factors responsible for the nutritional transition, culinary skills seem an important function of diet quality, but, unfortunately, culinary skills have been little investigated by the scientific community. Higher culinary skills may be related to increased consumption of homemade meals, higher diet quality, and greater consumption of vegetables and fruits and may be associated with higher Mediterranean diet adherence. Consequently, ultraprocessed foods, ready-to-eat food, and delivered meals, as well as meals outside the home, are reduced. Unfortunately, the process of generational transmission of cooking skills is progressively weakening, aggravated by the reduction of free time for home cooking. Still, even though there are few interventions conducted to improve culinary skills, especially those focused on children, the available results suggest that there have been positive changes in the direction of a healthier dietary pattern. This integrative review analyzes consumption levels of ultraprocessed foods. We then consider the extent to which culinary skills affect ultraprocessed food consumption levels and the relative impact on obesity.
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Affiliation(s)
- Juliana Aiko Watanabe
- Bioactivity and Nutritional Immunology Group (BIOINUT), Faculty of Health Science, Universidad Internacional de Valencia, Spain.
| | - Juan Antonio Nieto
- Bioactivity and Nutritional Immunology Group (BIOINUT), Faculty of Health Science, Universidad Internacional de Valencia, Spain.
| | - Teodoro Suarez-Diéguez
- Academic Area of Nutrition, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca de Soto, Mexico.
| | - Mariana Silva
- Bioactivity and Nutritional Immunology Group (BIOINUT), Faculty of Health Science, Universidad Internacional de Valencia, Spain.
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Hildebrand CA, Patel MB, Tenney AB, Logan JA, Luong KH, Crouch MJ, Osta AE, DeRoo C, Gilliland KO, Harlan TS, Ammerman AS. Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review. TEACHING AND LEARNING IN MEDICINE 2024:1-27. [PMID: 38686837 DOI: 10.1080/10401334.2024.2340977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
PHENOMENON Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging field of culinary medicine offers an experiential nutrition learning approach with the potential to address the need for improved nutrition training of physicians. Exploring this innovative nutrition training strategy, this scoping review describes the nature of culinary medicine experiences for medical students and resident physicians, their impact on the medical trainees, and barriers and facilitators to their implementation. APPROACH This scoping review used the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist as guides. Eligible publications described the nature, impact, facilitators, and/or barriers of nutrition and food preparation learning experiences for medical students and/or residents. Additional inclusion criteria were location (U.S. or Canada), allopathic or osteopathic, English, human subjects, and publication year (2002 or later). The search strategy included 4 electronic databases. Two reviewers independently screened titles/abstracts and a third reviewer resolved discrepancies. The full-text review consisted of 2 independent reviews with discrepancies resolved by a third reviewer or by consensus if needed, and the research team extracted data from the included articles based on the nature, impact, barriers, and facilitators of culinary medicine experiences for medical trainees. FINDINGS The publication search resulted in 100 publications describing 116 experiences from 70 institutions. Thirty-seven publications described pilot experiences. Elective/extracurricular and medical student experiences were more common than required and resident experiences, respectively. Experiences varied in logistics, instruction, and curricula. Common themes of tailored culinary medicine experiences included community engagement/service-based learning, interprofessional education, attention to social determinants of health, trainee well-being, and cultural considerations. Program evaluations commonly reported the outcome of experiences on participant attitudes, knowledge, skills, confidence, and behaviors. Frequent barriers to implementation included time, faculty, cost/funding, kitchen space, and institutional support while common facilitators of experiences included funding/donations, collaboratives and partnerships, teaching kitchen access, faculty and institutional support, and trainee advocacy. INSIGHTS Culinary medicine is an innovative approach to address the need and increased demand for improved nutrition training in medicine. The findings from this review can guide medical education stakeholders interested in developing or modifying culinary medicine experiences. Despite barriers to implementation, culinary medicine experiences can be offered in a variety of ways during undergraduate and graduate medical education and can be creatively designed to fulfill some accreditation standards.
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Affiliation(s)
- Caitlin A Hildebrand
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition at Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- University of North Carolina Center for Health Promotion and Disease Prevention, Chapel Hill, North Carolina, USA
| | - Meghana B Patel
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alyssa B Tenney
- Larner College of Medicine at The University of Vermont, Burlington, Vermont, USA
| | - Julia A Logan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Khanh H Luong
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Miranda J Crouch
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Amanda E Osta
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Courtney DeRoo
- Department of Health Policy and Management at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kurt O Gilliland
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Timothy S Harlan
- George Washington University School of Medicine, Washington, D.C., USA
| | - Alice S Ammerman
- Department of Nutrition at Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- University of North Carolina Center for Health Promotion and Disease Prevention, Chapel Hill, North Carolina, USA
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French ML, Christensen JT, Estabrooks PA, Hernandez AM, Metos JM, Marcus RL, Thorpe A, Dvorak TE, Jordan KC. Evaluation of the Effectiveness of a Bilingual Nutrition Education Program in Partnership with a Mobile Health Unit. Nutrients 2024; 16:618. [PMID: 38474746 DOI: 10.3390/nu16050618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. The purpose of this paper is to report on the development, implementation, and evaluation of Journey to Health, a program designed for community implementation using the RE-AIM planning and evaluation framework. Reach and effectiveness were the primary outcomes. Regarding reach, 507 individuals registered for the program, 310 participants attended at least one nutrition class, 110 participants completed at least two biometric screens, and 96 participants attended at least two health coaching appointments. Participants who engaged in Journey to Health realized significant improvements in body mass index, blood pressure, and triglycerides. For higher risk participants, we additionally saw significant improvements in total and LDL cholesterol. Regarding dietary intake, we observed a significant increase in cups of fruit and a decrease in sugar sweetened beverages consumed per day. Our findings suggest that Journey to Health may improve selected biometrics and health behaviors in low-income and underrepresented minority participants.
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Affiliation(s)
- Madeleine L French
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Joshua T Christensen
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Paul A Estabrooks
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Alexandra M Hernandez
- Osher Center for Integrative Health, University of Utah Health, Salt Lake City, UT 84112, USA
| | - Julie M Metos
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Robin L Marcus
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT 84108, USA
| | - Alistair Thorpe
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA
| | - Theresa E Dvorak
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Kristine C Jordan
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
- Osher Center for Integrative Health, University of Utah Health, Salt Lake City, UT 84112, USA
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Lindsay KL, Kennedy J, Kim D, Kalra A, Parekh NK. Development of a Culinary Medicine Curriculum to Support Nutrition Knowledge for Gastroenterology Fellows and Faculty. Nutrients 2024; 16:404. [PMID: 38337688 PMCID: PMC10857341 DOI: 10.3390/nu16030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1-4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice.
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Affiliation(s)
- Karen L. Lindsay
- Department of Pediatrics, School of Medicine, University of California Irvine, Orange, CA 92686, USA
- Susan Samueli Integrative Health Institute, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA 92617, USA
| | - Jennifer Kennedy
- Division of Gastroenterology, Department of Medicine, School of Medicine, University of California Irvine, Orange, CA 92686, USA
| | - Daniel Kim
- Division of Gastroenterology, Department of Medicine, School of Medicine, University of California Irvine, Orange, CA 92686, USA
| | - Ankush Kalra
- Division of Gastroenterology, Department of Medicine, School of Medicine, University of California Irvine, Orange, CA 92686, USA
| | - Nimisha K. Parekh
- Division of Gastroenterology, Department of Medicine, School of Medicine, University of California Irvine, Orange, CA 92686, USA
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Maker-Clark G, McHugh A, Shireman H, Hernandez V, Prasad M, Xie T, Parkhideh A, Lockwood C, Oyola S. Empowering Future Physicians and Communities on Chicago's South Side through a 3-Arm Culinary Medicine Program. Nutrients 2023; 15:4212. [PMID: 37836495 PMCID: PMC10574476 DOI: 10.3390/nu15194212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in the study. Data were obtained using pre- and post-course surveys and qualitative interviews from September 2021-July 2023. Results show increased confidence in medical students' ability to provide nutrition counseling, with a high significance in their ability to provide counseling regarding chronic conditions. Participants managing chronic conditions demonstrated significant increases in self-reported confidence in their understanding of overall chronic disease management and care and in their kitchen skills, with participants who attended five or more classes having significantly higher means. Qualitative feedback from middle school students highlights their knowledge and willingness to try new foods after engaging with the curriculum. Findings add to the growing literature on culinary medicine and provide insight into the effectiveness of culinary medicine programming to increase knowledge and promote positive changes among future healthcare professionals and community members. However, more extensive research across a longer time span is needed to confirm the potential for sustained change.
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Affiliation(s)
- Geeta Maker-Clark
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Ashley McHugh
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Hannah Shireman
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Valeria Hernandez
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Megha Prasad
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Tiffany Xie
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Arianna Parkhideh
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Carlin Lockwood
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Sonia Oyola
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
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Fals AM, Brennan AM. Teaching Kitchens and Culinary Gardens as Integral Components of Healthcare Facilities Providing Whole Person Care: A Commentary. Nutrients 2023; 15:4162. [PMID: 37836446 PMCID: PMC10574558 DOI: 10.3390/nu15194162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Child and adult obesity continue to be major health concerns in the United States and can contribute to the development of chronic diseases. Culinary medicine, which incorporates teaching kitchens and gardens, may be a useful strategy for preventing and/or treating obesity-related disease by providing the knowledge and skills that encourage consumption of whole plant-based foods prepared at home. Though emerging research describes the benefits of culinary medicine-based programming, examples of teaching kitchens and culinary gardens being integrated into current clinical practice is minimal. Here, we describe the development of innovative, community-centered culinary medicine programming borne from interdisciplinary collaboration at a leading healthcare system. Preliminary outcomes suggest improvements in anthropometrics, cardiometabolic risk factors, and participation in healthy lifestyle behaviors in pediatric weight management patients, as well as improved confidence, knowledge, and likelihood to prepare whole food, plant-based meals in healthcare employees following participation in culinary medicine workshops. Hospitals and culinary medicine partners can support each other through shared knowledge, vision, and resources to provide value-based care to patients in the community. Collaboration among gardeners, chefs, architects, educators, and healthcare professionals can transfer traditional physician-driven care to patients, empowering them with the tools, resources, and confidence to improve health and wellbeing.
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Affiliation(s)
- Angela M Fals
- AdventHealth for Children, 601 E. Rollins St., Orlando, FL 32803, USA
| | - Andrea M Brennan
- AdventHealth Research Institute, 800 N. Magnolia Ave., Orlando, FL 32803, USA
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Wood NI, Stone TA, Siler M, Goldstein M, Albin JL. Physician-Chef-Dietitian Partnerships for Evidence-Based Dietary Approaches to Tackling Chronic Disease: The Case for Culinary Medicine in Teaching Kitchens. J Healthc Leadersh 2023; 15:129-137. [PMID: 37520178 PMCID: PMC10378677 DOI: 10.2147/jhl.s389429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Since the middle of the 20th century, the American food environment has become increasingly ultra-processed. As a result, the prevalence of chronic, diet-related disease in the United States has skyrocketed. Meanwhile, physicians are still poorly trained in nutrition. A recent innovation that aims to address this is "culinary medicine" programming taught by teams of physicians, chefs, and registered dietitian nutritionists. Culinary medicine is an evidence-based, interprofessional field of medicine that combines culinary arts, nutrition science, and medical education to prevent and treat diet-related disease. It employs hands-on learning through healthy cooking and is typically taught in a teaching kitchen, either in-person or virtually. It can be dosed either as a patient care intervention or as experiential nutrition education for students, medical trainees, and healthcare professionals. Culinary medicine programs are effective, financially feasible, and well-received. As a result, healthcare systems and medical education programs are increasingly incorporating culinary medicine, teaching kitchens, and interprofessional nutrition education into their patient care and training models.
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Affiliation(s)
- Nathan I Wood
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Theresa A Stone
- Department of Internal Medicine, MedStar Health, Washington, DC, USA
| | - Milette Siler
- Moncrief Cancer Institute, University of Texas Southwestern Medical Center, Fort Worth, TX, USA
| | - Max Goldstein
- Digestive Health Center, Yale New Haven Health, New Haven, CT, USA
| | - Jaclyn Lewis Albin
- Departments of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Eisenberg DM, Pacheco LS, McClure AC, McWhorter JW, Janisch K, Massa J. Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research. Nutrients 2023; 15:2859. [PMID: 37447185 PMCID: PMC10343805 DOI: 10.3390/nu15132859] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies. Moreover, TKs can be used as revenue-generating research sites in universities and hospitals performing sponsored research, and, potentially, as instruments of cost containment when placed in accountable care settings and self-insured companies. Thus, TKs can be considered for inclusion in future health professional training programs, and the recently published Biden-Harris Administration Strategy on Hunger, Nutrition and Health echoes this directive. Recent innovations in the ability to provide TK classes virtually suggest that their impact may be greater than originally envisioned. Although the impact of TK curricula on behaviors, outcomes and costs of health care is preliminary, it warrants the continued attention of medical and public health thought leaders involved with Food Is Medicine initiatives.
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Affiliation(s)
- David M. Eisenberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | - Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | | | | | - Kate Janisch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | - Jennifer Massa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
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Mallya J, K T, Shettigar P. Uncovering culinary medicine research themes: Current status and future direction. F1000Res 2023; 12:173. [PMID: 38059134 PMCID: PMC10696491 DOI: 10.12688/f1000research.130947.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 12/08/2023] Open
Abstract
Background: Culinary medicine (CM), an emerging discipline, is a novel approach that focuses on the art of food and cooking to prevent or improve health outcomes among chronic patients suffering from lifestyle diseases. The concept originated in the USA, gaining interest from scholars in medicine, nutrition, nursing, and the gastronomic discipline. Notably, in the last five years, there has been exponential growth in CM literature. In this regard, this study sought to examine the growth, performance and distinct research themes of CM literature over time. Methods: To achieve the study's objectives, this study employs descriptive, performance and bibliometric analysis. The descriptive analysis was applied to examine the growth of the CM literature since its emergence. The performance analysis was used to identify the most influential journals, articles, and authors in the CM domain. The bibliographic coupling analysis was adopted to discover the various research themes of the CM knowledge base. Results: This study identifies three stages of literature development: Early stage, modest growth stage, and emerging stage. Further, the results indicate that most of the studies on CM had been conducted in developed countries. Our findings reveal a clear interest in integrating the CM curriculum into medical/nutrition education programs in recent years. Additionally, the study discovers four distinct main research themes: knowledge assessment, impact measurement, acceptance and efficacy, and implementation of CM. Conclusions: These findings are helpful for scholars in medicine, nutrition, nursing, and gastronomy as they provide an overview of CM's development and research focus. Future studies could focus on expanding the geographical distribution of research on CM and further exploring the identified research themes to gain a deeper understanding of the potential of this approach for improving health outcomes among chronic disease patients.
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Affiliation(s)
- Jyothi Mallya
- Library, Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Thirugnanasambantham K
- Food and Beverage Production, Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Pallavi Shettigar
- Dietetics and Applied Nutrition, Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Preparing Registered Dietitian Nutritionists for Leadership in Culinary Medicine: Opportunities, Barriers, and Alternatives in Registered Dietitian Nutritionist Education and Training. J Acad Nutr Diet 2023; 123:865-870. [PMID: 36740186 DOI: 10.1016/j.jand.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
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12
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Razavi AC, Latoff A, Dyer A, Albin JL, Artz K, Babcock A, Cimino F, Daghigh F, Dollinger B, Fiellin M, Johnston EA, Jones GM, Karch RD, Keller ET, Nace H, Parekh NK, Petrosky SN, Robinson A, Rosen J, Sheridan EM, Warner SW, Willis JL, Harlan TS. Virtual teaching kitchen classes and cardiovascular disease prevention counselling among medical trainees. BMJ Nutr Prev Health 2023; 6:6-13. [PMID: 37559965 PMCID: PMC10407392 DOI: 10.1136/bmjnph-2022-000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 12/15/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hands-on culinary medicine education for medical trainees has emerged as a promising tool for cardiovascular health promotion. PURPOSE To determine whether virtual culinary medicine programming associates with Mediterranean diet (MedDiet) adherence and lifestyle medicine competencies among medical trainees across the USA. METHOD A total of 1433 medical trainees across 19 sites over a 12-month period were included. The Cooking for Health Optimisation with Patients-Medical Trainees survey composed of 61 questions regarding demographics, nutritional attitudes, dietary habits including MedDiet score and lifestyle medicine counselling competencies. Multivariable logistic regression assessed the association of virtual culinary medicine education with MedDiet intake and nutritional attitudes. RESULTS There were 519 medical trainees who participated in virtual culinary medicine education and 914 medical trainees who participated in their standard nutrition curricula. More than one-half of participants were women (n=759) and the mean age was 27 years old. Compared with students enrolled in traditional nutrition curricula, participants in virtual culinary medicine education were 37% more likely to adhere to MedDiet guidelines for fruit intake (OR 1.37, 95% CI 1.03 to 1.83, p=0.03). Virtual culinary medicine education was associated with higher proficiency in lifestyle medicine counselling categories, notably recommendations involving fibre (OR 4.03; 95% CI 3.05 to 5.34), type 2 diabetes prevention (OR 4.69; 95% CI 3.51 to 6.27) and omega fatty acids (OR 5.21; 95% CI 3.87 to 7.02). Virtual culinary medicine education had a similar, although higher magnitude association with MedDiet counselling competency (OR 5.73, 95% CI 4.26 to 7.70) when compared with historical data previously reported using hands-on, in-person culinary medicine courseware (OR 4.97, 95% CI 3.89 to 6.36). CONCLUSIONS Compared with traditional nutritional educational curricula, virtual culinary medicine education is associated with higher MedDiet adherence and lifestyle medicine counselling competencies among medical trainees. Both virtual and hands-on culinary medicine education may be useful for cardiovascular health promotion.
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Affiliation(s)
- Alexander C Razavi
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Anna Latoff
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Amber Dyer
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | - Kristi Artz
- Spectrum Health, Grand Rapids, Michigan, USA
| | | | | | - Farzaneh Daghigh
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Beth Dollinger
- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, USA
| | - Maya Fiellin
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Emily A Johnston
- Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Grace Marie Jones
- Touro University California College of Osteopathic Medicine, Vallejo, California, USA
| | - Robert D Karch
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | | | - Heather Nace
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | | | - Amy Robinson
- University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Jessica Rosen
- New York Medical College School of Medicine, Valhalla, New York, USA
| | - Eva M Sheridan
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Susan W Warner
- The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Timothy S Harlan
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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13
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McWhorter JW, LaRue DM, Almohamad M, Danho MP, Misra S, Tseng KC, Weston SR, Moore LS, Durand C, Hoelscher DM, Sharma SV. Training of Registered Dietitian Nutritionists to Improve Culinary Skills and Food Literacy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:784-793. [PMID: 35644786 DOI: 10.1016/j.jneb.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN). METHODS Prepost study design evaluating pilot test of RDN train-the-trainer curriculum from September, 2019 to January, 2020. RESULTS On average, results indicate an increase in culinary nutrition skills (mean difference, 6.7 ± 4.4; P < 0.001; range, 10-30) and a significant increase in 5 of the 8 food literacy factors. Through process evaluation, RDNs rated the training as extremely useful to their practice (mean, 4.4 ± 0.3). CONCLUSIONS AND IMPLICATIONS Registered dietitian nutritionist participants increased culinary nutrition skills with statistically significant scores across all individual measures. This study describes an RDN training curriculum in culinary medicine across a diverse group of practicing RDNs from a large county health care system. Culinary medicine shows a promising impact on promoting nutrition skills and confidence; however, it warrants further assessment.
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Affiliation(s)
- John Wesley McWhorter
- Department of Health Promotion and Behavioral Sciences, and Nourish Program, UTHealth School of Public Health, Houston, TX.
| | - Denise M LaRue
- Population Health Transformation, Harris Health System, Houston, TX
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Melisa P Danho
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Shweta Misra
- Population Health Transformation, Harris Health System, Houston, TX
| | - Karen C Tseng
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | | | - Laura S Moore
- Department of Health Promotion and Behavioral Sciences, and Nourish Program, UTHealth School of Public Health, Houston, TX
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
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14
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Tan J, Atamanchuk L, Rao T, Sato K, Crowley J, Ball L. Exploring culinary medicine as a promising method of nutritional education in medical school: a scoping review. BMC MEDICAL EDUCATION 2022; 22:441. [PMID: 35672843 PMCID: PMC9175378 DOI: 10.1186/s12909-022-03449-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/10/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Dietary modifications are considered a first-line intervention for chronic disease management, yet graduating doctors still report not feeling competent to counsel patients on their diet. Research has focused on methods to address this shortfall in physician competency, including culinary medicine. Culinary medicine is an approach to education that involves hands-on food and cooking learning experiences to equip participants with tools for improving the nutrition behaviour and health of their future patients. Despite positive findings in the efficacy of these interventions, they differ markedly in approach and target, which therefore fails to provide adequate evidence that could serve to guide future culinary medicine interventions. OBJECTIVE A scoping review to synthesize the existing literature on culinary medicine interventions that are offered during medical training. METHODS Online databases were used to identify literature published prior to April 2022 that involve a hands-on culinary medicine component to nutrition and examine academic impact, feasibility and acceptability. RESULTS Twenty-four studies met the eligibility criteria. Despite promising gains in nutrition knowledge, confidence and high acceptability of the programs, large variations exist in delivery method, setting, and course content between programs. There is a lack of program cost reporting and long-term follow up of participants, inconsistent evidence for improved nutrition attitudes amongst participants, as well as geographically limited adoption of such programs. CONCLUSIONS The findings of this research demonstrate a clear increase in interest in the use of hands-on culinary medicine programs as educational tools, evidence of feasibility in implementation, and improved student nutritional knowledge, skill and counseling compared to a traditional didactic curriculum. The quality of culinary medicine research studies is increasing and the aims of research are narrowing to focus on how culinary medicine can positively impact medical education. The findings from this review will aid in legitimising culinary medicine as an effective delivery method of nutritional education in medical programs.
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Affiliation(s)
| | | | - Tanish Rao
- Griffith University, Gold Coast, Australia
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16
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Razavi AC, Dyer A, Jones M, Sapin A, Caraballo G, Nace H, Dotson K, Razavi MA, Harlan TS. Achieving Dietary Sodium Recommendations and Atherosclerotic Cardiovascular Disease Prevention through Culinary Medicine Education. Nutrients 2020; 12:E3632. [PMID: 33255901 PMCID: PMC7761274 DOI: 10.3390/nu12123632] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
Sodium-reduction initiatives have been a cornerstone of preventing hypertension and broader atherosclerotic cardiovascular disease (ASCVD) since the early 1970s. For nearly 50 years, public health and clinical guidelines have concentrated on consumer education, behavioral change, and, to a lesser extent, food policy to help reduce sodium intake among Americans. While these efforts undoubtedly helped improve awareness, average sodium consumption remains at approximately 4200 mg/day in men and 3000 mg/day in women, well above the United States Dietary Guidelines of 2300 mg/day. Culinary medicine is an emerging discipline in clinical and public-health education that provides healthcare professionals and community members with food-based knowledge and skills. With the hands-on teaching of kitchen education to individuals, culinary medicine provides eaters with tangible strategies for reducing sodium through home cooking. Here, we review opportunities for culinary medicine to help improve both individual- and population-level sodium-reduction outcomes through five main areas: increasing adherence to a plant-forward dietary pattern, food literacy, the enhancement of complementary flavors, disease-specific teaching-kitchen modules, and the delivery of culturally specific nutrition education. Through this process, we hope to further underline the value of formal, hands-on teaching-kitchen education among healthcare professionals and community members for ASCVD prevention.
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Affiliation(s)
- Alexander C. Razavi
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Amber Dyer
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Matthew Jones
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
| | - Alexander Sapin
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Graciela Caraballo
- George Washington University Culinary Medicine Program, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA; (G.C.); (K.D.); (T.S.H.)
| | - Heather Nace
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Kerri Dotson
- George Washington University Culinary Medicine Program, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA; (G.C.); (K.D.); (T.S.H.)
| | - Michael A. Razavi
- Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA 70119, USA; (A.D.); (M.J.); (A.S.); (H.N.); (M.A.R.)
| | - Timothy S. Harlan
- George Washington University Culinary Medicine Program, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA; (G.C.); (K.D.); (T.S.H.)
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Downer S, Berkowitz SA, Harlan TS, Olstad DL, Mozaffarian D. Food is medicine: actions to integrate food and nutrition into healthcare. BMJ 2020; 369:m2482. [PMID: 32601089 PMCID: PMC7322667 DOI: 10.1136/bmj.m2482] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Sarah Downer
- Center for Health Law and Policy Innovation, Harvard Law School, Harvard University, Cambridge, MA, USA
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Timothy S Harlan
- Section of General Internal Medicine George Washington University School of Medicine and Health Sciences, George Washington University Culinary Medicine Program, George Washington University, Washington, DC, USA
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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