Influence of culinary skills on ultraprocessed food consumption and Mediterranean diet adherence: An integrative review

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.

Barriers to home food preparation and healthy eating among university students in Catalonia

Despite college being a critical life stage for developing enduring healthy dietary behaviours, Spanish university students show poor adherence to a healthy diet. Since research has shown an association between home cooking and healthy eating, the aim of this study was to analyse the main barriers that influence home food preparation and healthy eating among students at three Catalan universities. Focus groups, the photovoice technique and a validated questionnaire were used. Six focus groups (10 female; 14 male; aged 18-22) were conducted. NVivo9, was used to analyse the transcripts using an inductive thematic analysis. In two focus groups, the photovoice technique was used to further explore their perceptions about a healthy diet and their barriers for home cooking and healthy eating. The validated questionnaire was sent out to obtain data on students' diet quality, food environment and cooking self-efficacy for the focus group's design. We found that lack of motivation was the main barrier to healthy eating and home cooking, which was further influenced by the lack of cooking self-efficacy. Young adults lacked the knowledge and skills to prepare quick, affordable, and nutritious meals. Hence, even lack of time was cited as a primary barrier, time constraints seemed to be related to personal priorities. Students did not feel motivated to eat healthy and adopt time-deepening behaviours that influence food-choices. Thus, further research is required to develop context-specific culinary interventions that enhance students' cooking self-efficacy and identify strategies for encouraging students to adopt healthier eating habits.

Impact of a Food Skills Course with a Teaching Kitchen on Dietary and Cooking Self-Efficacy and Behaviors among College Students

College students may face barriers to eating healthy foods. Educational interventions providing practical knowledge and skills may help students to overcome financial barriers or other barriers to acquiring, preparing, and consuming healthy foods. We evaluated the association between participation in a semester-long food skills course with an interactive teaching kitchen and dietary and cooking self-efficacy and behaviors. Participants were recruited from course enrollees (intervention) and the general student population (comparison). We assessed differences in pre-post changes in the outcomes between groups using the propensity score weighting and mixed effects linear or Poisson regression. Course participation was associated with improved self-efficacy around cooking (group × time β-coefficient [SE]: 3.25 [0.57], p < 0.0001) and fruit (6.33 [1.19], p < 0.0001), vegetable (5.43 [1.42], p = 0.0002), and whole grain (5.83 [1.40], p < 0.0001) consumption. Course participants reported smaller pre-post decreases in vegetable consumption compared to non-participants (0.35 [0.16], p = 0.03), increased cooking frequency (0.22 [0.10], p = 0.03) and a decreased frequency of skipping meals (-0.47 [0.16], p = 0.003). There were no changes associated with the intervention in the consumption of fruit or whole grains, or in eating out frequency. Participation in a semester-long, personal food skills course with a teaching kitchen may improve self-efficacy, cooking, and vegetable consumption among college students.

University Students as Change Agents for Health and Sustainability: A Pilot Study on the Effects of a Teaching Kitchen-Based Planetary Health Diet Curriculum

Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of their degree paths, all university students, in their role as potential future experts and leaders in their fields, can serve as important change agents in society. In this paper, we (a) introduce a university curriculum in a teaching kitchen setting that is based on the planetary health diet (PHD) of the EAT-Lancet Commission, (b) investigate its feasibility, and (c) analyze its effects on the planetary health diet literacy of a pilot cohort of university students enrolled in various degree programs. We developed seven flipped classroom teaching kitchen sessions based on social cognitive theory (SCT), each consisting of a one-hour seminar with student presentations on various nutrition- and sustainability-related key topics, followed by corresponding two-hour hands-on cooking classes. To assess feasibility, specific questions from the official teaching evaluation of the University of Göttingen were analyzed. Changes in self-assessed planetary health diet literacy were measured using a pre- and post-survey. During the pilot phase, 26 students successfully completed the course. A total of 25 participants responded to the teaching evaluation and expressed high satisfaction with the course, the learning outcomes, and the level of demand. A total of 26 participants completed the pre- and post-survey. At the post-intervention, the students rated their planetary health diet literacy as 21 to 98% higher than before their course participation. The findings of this pilot study indicate that the curriculum was well-received and feasible with the target group, and they demonstrate that the course participation increased the university students' self-assessed ability to disseminate strategies for more sustainable and healthy diets. Through replication at other universities worldwide, the teaching kitchen-based planetary health diet curriculum might foster a social shift towards healthier and more climate-friendly food systems.

Assessing food availability and healthier options in an urban Chinese university: a case study using the Chinese Nutrition Environment Measurement Survey for Stores (C-NEMS-S)

Young adults (18-24 years) in universities are frequently exposed to an environment that promotes unhealthy eating behaviors. Using a validated tool, the Chinese Nutrition Environment Measurement Survey for Stores (C-NEMS-S), we assess the food availability and healthier options in a large, urban Chinese university. We employed C-NEMS-S for scoring criteria and weighting. A total of 52 on-campus canteen outlets were audited in an urban university located in Shijiazhuang City, China. General food outlets (n 43) and self-served food outlets (n 7) were further categorized into eight subtypes. Beverage outlets (n 2) were discussed separately from food outlets. C-NEMS-S scores were significantly different across food outlet types (P = 0.0024), especially between noodle and rice outlets (P = 0.0415). Food availability scores for starchy tubers (P < 0.001), dry beans (P < 0.001), vegetables (P = 0.0225), and fruits (P < 0.001) were significantly different across food outlet subtypes. Healthier options were scarce and only appeared in "grains" (n 2) and "meat and poultry" (n 2) categories. Further research on improving the accustomed audit tool and assessing university student diet quality is warranted.

A qualitative exploration of perceived barriers and facilitators to following an intuitive eating style

BACKGROUND

Intuitive eating involves following internal cues of hunger and satiety to guide eating choices as opposed to responding to external signals, strong emotions, or dietary rules. This style of eating has consistently been shown to be related to better physical and psychological health indicators, and more interventions are being designed and studied to promote this eating style. The current study aimed to identify anticipated facilitators and barriers to following this style of eating among a group of college students enrolled in a larger study of intuitive eating.

METHOD

Following a week of tracking their current eating as part of a larger study, college students read a description of intuitive eating. They then answered three open-ended questions about following intuitive eating including facilitators, barriers, and perceived ability to follow long term. Responses were coded using thematic analysis to identify themes across responses.

RESULTS

Among 100 participants, 86 % were female, 46 % were Hispanic (41 % non-Hispanic White, 13 % other race/ethnicity), mean age was 24.3 years, and mean body mass index was 26.2. The most commonly anticipated participant-reported facilitators of intuitive eating were being in touch with the body's needs and hunger cues, positive perceptions of intuitive eating, and health considerations. The most commonly anticipated barriers were logistical constraints (e.g., busyness and mealtimes), difficulty with hunger cues and reactions to food, and negative perceptions of intuitive eating. The majority of participants (64 %) would consider following this style of eating long term.

DISCUSSION

This study provides information that can be used to improve efforts aimed at promoting intuitive eating to college students, including marketing intuitive eating interventions, and clarifying misunderstandings of its key tenets that might serve as barriers.

A systematic review of the association of diet quality with the mental health of university students: implications in health education practice

University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small-moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications.

Obstacles to food security, food pantry use, and educational success among university students: a mixed methods approach

Purpose. This study contrasts views of university students with very low or high food security scores with respect to: obstacles to healthy eating, food pantry use, and managing dietary and educational needs. Method. Comments on open-ended survey questions (n = 1374) were counted, compared, and thematically analyzed to discern differences between the two student groups. Results. Cost concerns were paramount among students with very low food security scores. Students with very low food security experienced significant challenges in reconciling dietary needs and long-term educational goals; this was not problematic among students with high food security. Students from both very low and high food security groups mostly expressed an openness to the campus food pantry, though stigma associated with its use remained a deterrent. Conclusion. While all students face similar challenges to healthy eating, food security status substantially shapes dietary health and the management of dietary and educational needs.

The Relationships between Food Literacy, Health Promotion Literacy and Healthy Eating Habits among Young Adults in South Korea

The obesity problem has reached a critical level and is threatening not only personal health but also public health systems around the world. Obesity in young adults is especially rapidly growing and many studies have confirmed that the best prevention is developing healthy eating habits with the improvement of food and health promotion literacy competencies. In this context, this study diagnoses the present levels of food literacy and health promotion literacy among young adults and explores the relationships between both literacies and their healthy eating habits. A total of 325 young adults in South Korea participated in this research, and the results are as follows. First, all food literacy components, which are food and nutrition knowledge, food skills, and resilience, are positively associated with healthy eating habits. Second, health promotion literacy is also positively associated with young adults’ healthy eating habits. Lastly, unlike the primary information sources, gender has a moderating effect on the relationships between both literacies and healthy eating habits. This indicates that the government and educational sectors should propose more policy supports and solid education systems in order to help young adults develop their food and health promotion literacies for overall well-being in the future.

Pilot Intervention Using Food Challenges and Video Technology for Promoting Fruit and Vegetable Consumption

OBJECTIVE

To evaluate the feasibility of a Social Cognitive Theory-based intervention on cognitive, affective, and behavioral outcomes in a college nutrition course.

DESIGN

A pre-post quasi-experimental design.

SETTING

Large metropolitan university.

PARTICIPANTS

College students (n = 138) aged 18-40 years.

INTERVENTIONS

Students participated in weekly food challenges during a 15-week nutrition course to apply nutrition knowledge, develop self-efficacy and promote positive behavior change. Food challenges were implemented by a guided goal-setting strategy. Cooking videos, which modeled important nutrition-related skills, accompanied each challenge. Students independently selected 2-goal options to implement weekly and wrote a reflection about their experiences.

MAIN OUTCOME MEASURES

Cognitive outcomes (nutrition and cooking self-efficacy), affective outcome (cooking attitudes), and behavioral outcomes (fruit and vegetable consumption).

ANALYSIS

Descriptive statistics and paired sample t tests.

RESULTS

Analyses showed significant increases in cognitive outcomes (produce consumption self-efficacy [P = 0.004], cooking self-efficacy [P = 0.002], using fruit/vegetables and seasoning self-efficacy [P = 0.001]) and behavioral outcomes (fruit consumption [P < 0.001], and vegetable consumption [P < 0.001]).

CONCLUSION AND IMPLICATIONS

This pilot study suggested a framework for behavioral change, grounded in constructs central to Social Cognitive Theory, that simplified the goal-setting process (by using guided goal setting) and used video technology to decrease the cost of implementation.

Meal preparation and consumption before and during the COVID-19 pandemic: The relationship with cooking skills of Brazilian university students

OBJECTIVE

This study aimed to analyze meal preparation and the place of its consumption by university students before and during the COVID-19 pandemic, according to their individual characteristics and cooking skills.

METHODS

Data were collected with 1919 Brazilian university students using the Brazilian Cooking Skills Questionnaire (BCSQ) and questions about gender, living arrangement, knowing how to cook and location of meal consumption. Bayesian multilevel ordinal regression models were used to estimate the probabilities of meal preparation and local location of its consumption by Brazilian university students before and during the COVID-19 pandemic, according to their individual characteristics and cooking skills.

RESULTS

Most of participants showed reported a high level of cooking skills (70.7%). Also, they reported a decrease in ordering delivery of take-away food and eating fast-food, while increasing homemade meals with fresh ingredients, ultra-processed food or both during the pandemic compared to the period before the quarantine. Lastly, they increased their cooking frequency during the pandemic, regardless of their cooking skills level. However, the group with high cooking skills had a greater increase in the use of fresh ingredients.

CONCLUSIONS

The study showed that the pandemic was an opportunity for university students to increase their cooking skills and frequency of cooking at home with a variety of foods. Particular attention should be given to those with low cooking skills and that use ultra-processed foods, promoting interventions to disseminate information and with behavior change components to teach about healthy cooking to increase cooking knowledge and skills, focusing on preparation of fresh ingredients.

"We think about the quantity more": factors influencing emerging adults' food outlet choice in a university food environment, a qualitative enquiry

BACKGROUND

In recent decades, the food environment has seen rapid transformation globally, altering food availability and access along with how people interact with the food environment and make food-related choice.

OBJECTIVES & METHOD

This explorative study aimed to identify the factors that shape the decision-making process for food outlet choices among emerging adults in a Ghanaian University food environment. The study uses focus group discussions in combination with novel dyadic interviews with best friend pairs. Verbatim transcripts were analysed thematically using NVivo 12.

RESULTS

Drawing on socio-ecological model (SEM) of behaviour, the study used testimony from 46 participants aged 18-25, 47% female, including individuals from major ethnicities and religions in Ghana, and identified three interwoven levels of influence shaping emerging adults' choices of food outlet. The main factors influencing food outlet choice were identified as food prices, spatial accessibility, budget, and food quantity/satiety with additional factors including hygiene, variety of foods, food quality and taste preferences as well as societal factors such as ambience and peer influence.

CONCLUSION

Multi-component approaches that combine structural level interventions in food retailing along with individual level components may be effective at changing emerging adult consumption behaviour in SSA, although this needs to be studied.

Spanish Validation of the Self-Perceived Food Literacy Scale: A Five-Factor Model Proposition

Food literacy is a combination of functional, critical, and relational skills that pave the way for navigating the food system properly, taking personally and contextually available resources into account. The aim was to validate the Spanish version of the self-perceived food literacy scale in university students to explore the factorial structure of it and to correlate food literacy with other variables. The sample was composed of 362 Spanish university students (314 women). The full questionnaire was administered online and also assessed adherence to a Mediterranean diet, impulsivity, and health-related quality of life for convergent validity testing purposes. Confirmatory factor analysis was conducted to determine the factor structure of the food literacy scale. The Spanish version of the scale showed good indices of internal consistency (Cronbach's α = 0.894). Confirmatory factor analysis revealed a five-factor model that had a better fit index than the seven-factor model of the original scale. External validity was assessed by showing significant correlations with the rest of the variables. Therefore, the Spanish version of the scale is a reliable and valid measure of food literacy. It could be used to promote policies at Spanish universities to improve the food-related behaviors of students.

Tobacco and alcohol consumption and health behaviors among nursing students

Objetive: To evaluate the association between attitudes, health behaviors, and the use of tobacco and alcohol among nursing students. Materials and method: Exploratory, descriptive and cross-sectional study conducted with 182 undergraduate nursing students in the countryside of São Paulo, Brazil. Sociodemographic Information Form, Alcohol Use Disorders Identification Test – C(AUDIT-C), Fagerström Test for Nicotine Dependence (FTND), Attitudes and Health Behaviors Questionnaire (AHBQ), and Patient Health Questionnaire – 2 (PHQ-2) were applied. Results: More than half of the students showed appropriate health behaviors and positive attitudes. Approximately 50% of the participants had consumed alcoholic beverages in the last month. Experimental use of illicit drugs and smoking were also observed. In addition, students who reported excessive alcohol use presented a deficit in self-care. Conclusion: The precariousness in health attitudes and behaviors identified in this study was associated with various patterns of psychoactive substance use. Thus, the results indicate the need for interventions aimed at promoting well-being and a healthy lifestyle in the university environment.

Changes in Physical Activity Levels and Eating Behaviours during the COVID-19 Pandemic: Sociodemographic Analysis in University Students

The COVID-19 pandemic has forced schools and universities to shift their activities online, influencing the adoption of health-related behaviours such as physical activity and healthy dietary habits. The present study investigates the changes in adherence to a healthy diet and regular physical activity in university students in Italy before and during the COVID-19 pandemic and understands the role of sociodemographic variables in creating the changes above. We conducted a repeated cross-sectional survey performing the same sampling strategy at the first data collection (T0) and second data collection (T1) with a combination of convenience and snowball sampling approaches. The sample is composed of a total of 2001 students, 60.2% women and 39.8% men, with an average age of 22.7 (±5.5 SD). At T1, 39.9% of the students reported regular physical activity. During the pandemic, however, many, especially male students, abandoned or reduced physical activity practice (T1 40%), with an increase in social media use (T0 52.1%; T1 90%). A direct association between very low frequency of physical activity and increased sedentary time (r = 0.2, p = 0.001) and between change in dietary style and increased Body Mass Index (BMI) value (r = 0.3, p = 0.002) was found. The multivariate analysis for the total sample showed that some sociodemographic variables such as gender, age, parents’ level of education, area of study, household type, and perception of one’s body influence eating behaviours and physical activity. Our findings suggest that universities should invest in the protection and promotion of the health of their students with specific awareness programmes, and further research should repeat the survey in the post-lockdown period to investigate the long-term effects on health-related behaviours.

Effects of University Students’ Perceived Food Literacy on Ecological Eating Behavior towards Sustainability

Due to the COVID-19 pandemic and industrialized food systems, people’s eating behavior has become seriously restricted. Especially, university students have started to overly depend on processed foods and carnivorous diets, and it places a huge burden on society by inducing the deterioration of health and environmental sustainability. Therefore, this study was undertaken to examine the effects of university students’ perceived food literacy on ecological eating behavior towards sustainability. A total of 395 university students in South Korea participated in this research. First, students’ food literacy components, which are reading labels and budgeting, healthy snack styles, healthy food stockpiling and resilience and resistance, exert positive influences on ecological eating behavior; second, the other two components, which are food preparation skills and social and conscious eating, have no positive impact on ecological eating behavior. Finally, the influences of food literacy on ecological behavior are significantly moderated by gender differences. This suggests that strengthening university students’ food literacy through education is necessary to promote ecological eating behaviors and advance the development of sustainable society.

Using geographic information systems to characterize food environments around historically black colleges and universities: Implications for nutrition interventions

ObjectiveTo understand the distribution of healthy and unhealthy food stores near historically black colleges and universities (HBCUs). Participants and methods: Using ArcGIS Pro's network analysis tools and ReferenceUSA database, this study characterized the healthy (favorable) and unhealthy (unfavorable) retail food stores within a 5-mile radius, 15-min driving, and 15-min walking distance from each HBCU in North Carolina. Results: Most retail food stores within a 5-mile buffer radius of the 10 HBCUs in North Carolina were unfavorable. Within 15-min driving from each HBCU, 1082 stores (76.0%) were unfavorable food stores, while 332 (24.0%) were favorable. Additionally, there were four favorable and 35 unfavorable retail food stores within the 15-min walking distance of each HBCU. Conclusions: Favorable food retail stores around HBCUs in North Carolina are limited. Researchers, policy makers, and community stakeholders should work together to improve food environments surrounding HBCUs.

Life-course perspectives of milk consumption among young Norwegian women and their knowledge of milk as a source of iodine: a qualitative study

Mild to moderate iodine deficiency has been found among young Norwegian women of reproductive age. In Norway, cow’s milk is the main source of iodine; however, milk consumption is decreasing, particularly among young women. This study aimed to investigate milk consumption practices in young Norwegian women and their attitudes toward milk consumption from childhood to young adulthood in a life-course perspective and their knowledge of milk as a source of iodine. Convenience sampling was used to recruit 30 bachelor students (women, 18–25 years old) from five different study programs. Interpretative phenomenological analysis (IPA) was used to interpret milk consumption practices from a life-course perspective. Five focus group interviews were conducted using a semistructured interview guide. The transcribed interviews were coded according to emerging themes related to milk consumption practices and turning points. Milk consumption practices were dynamic and changed over time and were influenced by several factors: family traditions, school milk subscription, friends and social media, social acceptance, availability, price, and attitudes toward health and the environment. Young women tend to be in a phase of life in which milk is not part of their food practices. Most of the women were not aware of the consequences of omitting milk from their diet and had limited knowledge of iodine and how to secure adequate dietary iodine intake. Awareness of possible consequences of omitting milk from the diet should be promoted along with information on how to secure adequate iodine intake.

Brazilian Cooking Skills Questionnaire evaluation of using/cooking and consumption of fruits and vegetables

OBJECTIVE

Young adults are often faced with barriers to cooking their own food. These barriers are associated with poor diet. The aim of this study was to explore the factor structure of the Brazilian Cooking Skills and Healthy Eating Questionnaire (BCSQ) to identify the barriers to cooking, use, and consumption of fruits and vegetables by young adults.

METHODS

Data were collected from a baseline study with Brazilian university students (N = 767). Forty-eight items from the BCSQ (composed of the following scales: Cooking Attitude, Cooking Behavior, Produce Consumption Self-Efficacy, Cooking Self-Efficacy, Self-Efficacy in Using Cooking Techniques, and Self-Efficacy in Using Fruits, Vegetables, and Seasonings) were submitted to exploratory factor analysis, confirmatory factor analysis (ten fit indexes), and internal consistency reliability evaluation. Multilevel linear regression models were used to analyze variations on the BCSQ dimensions by sex, living arrangements, knowledge of how to cook, location of main meal, and time available for cooking.

RESULTS

The 20-item BCSQ showed good fit indexes. The items based on negative cooking attitudes, frequency of using leftovers, and self-efficacy related to cooking from scratch, using and eating fruits and vegetables were adequate for the evaluation of cooking skills. These items represent and reflect the health dimensions applied to this research. The self-efficacy in using cooking techniques, which was not validated in previous study scale, was excluded due to its dimension.

CONCLUSIONS

These results enabled us to shorten the BCSQ, which can be used to evaluate the barriers to cooking among young adults, as well as measuring their healthy eating practices, supporting future research and programs.

Evaluation of a College-Level Nutrition Course With a Teaching Kitchen Lab

OBJECTIVE

To evaluate the impact of a college nutrition course with a teaching kitchen lab on students' attitudes, self-efficacy, and behaviors about healthful eating and cooking.

METHODS

Preintervention and postintervention design, and anonymous online survey of sociodemographic information and students' attitudes and self-efficacy about consuming fruits, vegetables, and whole grains and about cooking, self-reported intake, and cooking behaviors.

RESULTS

Two-hundred and fourteen participants enrolled in the study during 5 semesters. Of these, 171 (80%) had complete pretest and posttest data. Attitudes and self-efficacy scores about consuming fruits, vegetables, whole grains, and cooking were significantly higher in the posttest (vs pretest; all P < 0.0001). Self-reported intake of fruits (P < 0.0001) and vegetables (P = 0.0006) also increased. Cooking frequency increased (P < 0.0001), skipping meals frequency decreased (P < 0.0001), whereas no significant changes were observed for eating out, take-out, or premade meals frequency.

CONCLUSIONS AND IMPLICATIONS

A college nutrition course with a teaching kitchen lab could improve healthful eating and promote cooking in young adults.

Food Experiences and Dietary Patterns of International Students at a Canadian University

Purpose: Postsecondary students who move to a new country to continue their education experience a drastic shift in food landscape, often resulting in unhealthy dietary adaptations.Methods: This mixed-method study explored the eating experiences and dietary patterns of 30 international students attending a Canadian university. Data were collected through focus groups that were analyzed thematically and dietary records analyzed for compliance with Canada's Food Guide for Healthy Living (2007).Results: Results showed that many participants want to maintain home country food traditions, yet their new independent living status and novel food environments led to changes in dietary habits. Limited food skills, busy schedules, reduced access to familiar foods, and fast-food environments contributed to unhealthy eating patterns. These perceptions were reflected in the high consumption of "other", less nutritious foods and low servings of fruits and vegetables, milk products and alternatives, and grain products.Conclusions: These findings show that international university students face dual challenges of transitioning into independent living without sufficient food skills and family supports, and exposure to unfamiliar and unhealthy food environments. Resources need to be developed for newly enrolled international students that emphasize food awareness, food skills, and healthy eating habits.

Association of personal characteristics and cooking skills with vegetable consumption frequency among university students

Most university students are transitioning to adulthood, and tend to adopt unhealthy eating habits characterised by a low intake of fruits and vegetables. Few studies have specifically addressed the consumption of vegetables, which have a high content of minerals, fibre, and active compounds. The aim of this investigation was to assess vegetable consumption frequency among university students in a Brazilian capital and examine associations with individual characteristics and cooking skills. This crosssectional study used a online questionnaire to collect data. Cooking skills were evaluated in eight dimensions. Vegetable consumption was recorded in five frequency groups and then categorised into daily and non-daily consumption. Data were subjected to Pearson's chi-squared or analysis of variance followed by Bonferroni post hoc test. Associations between cooking skill dimensions and daily vegetable consumption were identified by crude and adjusted logistic regression analyses.Adjustment was performed for sex, age, paternal education, and overweight/obesity.Results are expressed as odds ratios (p < 0.05). Less than half of the respondents (N = 237; 45%) reported consuming vegetables daily. Higher level of paternal education, not being overweight or obese, and higher scores on seven cooking skill dimensions were positively associated with daily vegetable consumption. Given the scarcity of research on the topic, the findings of this study make a significant contribution to knowledge and may support public health strategies for promoting vegetable consumption among university students.

Development and proposed evaluation of an eHealth learning tool for undergraduate university students in Ireland

Undergraduate university students are at a critical stage of development in terms of their academic, social, psychological and behavioural health. Patterns established during these formative years can last a lifetime. eHealth tools have the potential to be engaging, convenient and accessible to a wide range of students by providing health information and enhancing the uptake of positive health behaviours. The 'Healthy Trinity Online Tool' (H-TOT) was developed in collaboration with students and a transdisciplinary team with decades of experience between them in terms of research, clinical responsibility and service delivery. Developmental steps undertaken included: a literature review to formulate the topic content choices; a survey of students to check the relevance and suitability of topics identified; and, the tacit experience of the development team. This co-design model led to the development of content encompassing academic life, healthy eating, physical activity, mood, financial matters, alcohol, tobacco, drugs and relaxation. Qualitative focus groups were subsequently conducted for in-depth exploration of the usage and functionality of H-TOT. The theoretical underpinnings include the locus of control and social cognitive theory. Evidence-based behavioural change techniques are embedded throughout. During early pre-piloting of H-TOT, the team identified and solved content functionality problems. The tone of the content was also revised to ensure it was non-judgemental. To make the H-TOT as interactive as possible, video scenarios were included and all content was audio-recorded to allow playback for students with visual or learning difficulties. Evaluation plans for the pilot year of H-TOT are outlined.

Using the Food Skills Questionnaire (FSQ) to Evaluate a Cooking Intervention for University Students: A Pilot Study

Purpose: To pilot test the Food Skills Questionnaire (FSQ) to evaluate a cooking intervention.Methods: Students attending Western University were invited to participate in 3 cooking classes over a 3-month period. All participants were asked to complete the FSQ pre- and post-intervention. The FSQ evaluated food skills in 3 domains-Food Selection and Planning, Food Preparation, and Food Safety and Storage-with a maximum score of 100 per domain. Domain scores were then computed as a weighted average for the Total Food Skills Score out of 100. Open-ended questions assessed participants' perceptions of the classes.Results: Forty-four students participated. There was a significant increase in food planning (70.6 ± 13.5-77.6 ± 14.3, P < 0.01), food preparation (67.5 ± 14.0-74.9 ± 12.9, P < 0.01), food safety (78.0 ± 9.9-80.8 ± 13.0, P = 0.04), and total food skills (71.9 ± 8.9-77.8 ± 10.6, P < 0.01) post-intervention. Content analysis of open-ended questions indicated that participants enjoyed healthy recipes, supportive Peer Educators, discussions, the cooking experience, socializing, and the safe environment.Conclusions: The FSQ shows strong potential for evaluating basic (e.g., peeling, chopping, slicing) to intermediate (e.g., meal planning) food skills in an effective and feasible manner. It can also capture changes in specific domains, allowing the development of more focused nutrition education and skills-based interventions.

The “Comida de República” web-based course to promote healthy eating among college students

ABSTRACT Objective The work aimed to investigate dietary practices of university students after an action aiming to promote adequate and healthy food. Methods The article reports the experience of the distance education course Comida da República, promoted by the Universidade Federal de São Paulo as an educational space for sharing and exchanging knowledge, experiences, and thoughts on eating in the university context, especially in student homes or fraternities (repúblicas). Online questionnaires assessed the profile of participants and changes in their perception or relationship with food. The Students’ t-test was adopted to compare perceptions before and after the intervention, and content analysis for qualitative data. Results The course had 201 students enrolled and 82 who concluded it, with 35.4% living in repúblicas. Before the course, 89.6% of those who completed the course indicated the need to improve their diets, and 57.3% classified their diets as “regular”. There was a significant change in perception after the course: 58.5% of those who completed it rated their food as “good”. Dietary changes were categorized into two themes: “vision on food production and distribution” and “food and meal consumption”. The emerging codes show a greater awareness and criticism about food systems and a greater appreciation of cooking, commensality, and unprocessed and minimally processed foods. Participants identified environmental, personal, and interpersonal barriers (67.1%) to dietary changes. The course emerged as a facilitator of these changes. Conclusions This intervention proved to be an important educational tool to promote adequate and healthy eating, in addition to contributing to the planning and execution of student affairs and food security policies.

Supporting food literacy among children and adolescents: Undergraduate students apply public health nursing principles in clinical practice

Effective public health nurses excel in partnership building and program planning to address priority health concerns, such as childhood obesity and disordered eating. Worldwide, children are at risk for low food and nutrition literacy with associated patterns of low fruit and vegetable consumption. This report focuses on the application of public health nursing principles by undergraduate nursing student teams in the design and delivery of food literacy interventions among a population of children and adolescents. Over a four-year time period, the cumulative intervention reach was 640 children/adolescents. Over 75 nursing students implemented the public health nursing process in support of food literacy, gaining skills across multiple practice domains. Lessons learned from academic-community partnerships to promote food literacy among children and adolescents have direct implications for undergraduate nursing education. Chief among these implications include the growing significance of integrating nutrition in the nursing curriculum and the need for scaffolding to support clinical application of interventions beyond health teaching to address broad determinants of health.

Pulse Knowledge, Attitudes, Practices, and Cooking Experience of Midwestern US University Students

Many American college students fail to meet dietary guideline recommendations for fruits, vegetables, and fiber. Pulses are a subgroup of legumes, harvested solely for dry grain seeds within a pod. Commonly consumed pulses include dry beans, dry peas, lentils, and chickpeas. Pulses are high in shortfall nutrients and could fill some nutritional gaps of college students. However, little is known about pulse intakes among young adults. The study aims were: (1) to identify knowledge, attitudes, and practices regarding pulse consumption; and (2) to describe experiences of preparing dry pulses among college students. A convenience sample of 1433 students aged 18–30 enrolled at a Midwestern university in the United States completed an online survey in April 2020. Demographic and attitude variables were compared by the monthly count of pulse types eaten using chi-square, analysis of variance, and logistic regression modeling to predict pulse type intakes. Higher numbers of pulse types eaten was associated with being White, vegetarian/vegan, higher cooking self-efficacy, positive attitudes toward pulses, and greater daily intake of fruits, vegetables, and fiber. Knowledge and experience of cooking dry pulses was low, with canned pulses purchased more often. College students may not be consuming pulses due to unfamiliarity with them, low knowledge of nutrition benefits, and a general lack of cooking self-efficacy. Increased familiarization and promotion surrounding pulses may increase their consumption.

"It's Important but, on What Level?": Healthy Cooking Meanings and Barriers to Healthy Eating among University Students

The negative impact of a sedentary lifestyle and poor diet on health is evident across the lifespan, but particularly during the university period. Usually, the diet of university students is rich in sweetened drinks and processed foods and low in fruits, vegetables and legumes. Although there is an association between maintaining a healthy diet and the frequency of cooking at home, the time currently spent on cooking or learning how to cook is decreasing globally. The main aim of this study was to explore university students’ perceptions about healthy cooking and barriers to eating healthily. A group of 26 students participated in four focus groups. Content analysis was conducted using Atlas.ti v.8. Students perceived cooking healthily as a more complicated and time-consuming process than cooking in general. Individual and environmental factors were the most reported barriers. Costs and time, among others, were the main barriers pointed out by students with regard to healthy eating. This study highlights the need to develop interventions that modify these false perceptions about cooking healthily, and to train students so that they are able to cook healthy meals in a quick, easy, and cost-effective way. Further, specific actions are required in the university setting to minimize access to unhealthy options and to promote those linked to healthy eating.

Eating Habits Associated with Nutrition-Related Knowledge among University Students Enrolled in Academic Programs Related to Nutrition and Culinary Arts in Puerto Rico

University students frequently develop unhealthy eating habits. However, it is unknown if students enrolled in academic programs related to nutrition and culinary arts have healthier eating habits. We evaluated the relationship of eating habits and nutritional status of students in academic programs with knowledge on nutrition, as well as cooking methods and techniques. A descriptive cross-sectional study was conducted in spring of 2019, while we completed a survey measuring eating habits and knowledge on nutrition, as well as cooking methods and techniques. Anthropometric measurements were collected for nutritional status estimation. The non-probabilistic convenience sample comprised 93 students pursuing degrees at Universidad Ana G. Mendez, Puerto Rico. Inadequate body mass index (BMI) was observed in 59% of the students. Eating habits, knowledge on nutrition, and knowledge on cooking methods and techniques were inadequate in 86%, 68%, and 41% of the population, respectively. Eating habits were associated with knowledge on nutrition and academic program, but not with knowledge on cooking methods and techniques. Most students reported having inadequate eating habits and BMI. Nutrition and dietetics students had the best knowledge on nutrition compared to culinary management students, a majority of whom had inadequate knowledge. We can conclude that there are other factors inherent to students’ life that may have a stronger influence on eating habits.

The Healthy Cooking Index: Nutrition Optimizing Home Food Preparation Practices across Multiple Data Collection Methods

BACKGROUND

Food preparation interventions are an increasingly popular target for hands-on nutrition education for adults, children, and families, but assessment tools are lacking. Objective data on home cooking practices, and how they are interpreted through different data collection methods, are needed.

OBJECTIVE

The goal of this study was to explore the utility of the Healthy Cooking Index in coding multiple types of home food preparation data and elucidating healthy cooking behavior patterns.

DESIGN

Parent-child dyads were recruited between October 2017 and June 2018 in Houston and Austin, Texas for this observational study. Food preparation events were observed and video recorded. Participants also wore a body camera (eButton) and completed a questionnaire during the same event.

PARTICIPANTS/SETTING

Parents with a school-aged child were recruited as dyads (n=40). Data collection procedures took place in participant homes during evening meal preparation events.

MAIN OUTCOME MEASURES

Food preparation data were collected from parents through direct observation during preparation as well as eButton and paper questionnaires completed immediately after the event.

STATISTICAL ANALYSES PERFORMED

All data sets were analyzed using the Healthy Cooking Index coding system and compared for concordance. A paired sample t test was used to examine significant differences between the scores. Cronbach's α and principal components analysis were conducted on the observed Healthy Cooking Index items to examine patterns of cooking practices.

RESULTS

Two main components of cooking practices emerged from the principal components analysis: one focused on meat products and another on health and taste enhancing practices. The eButton was more accurate in collecting Healthy Cooking Index practices than the self-report questionnaire. Significant differences were found between participant reported and observed summative Healthy Cooking Index scores (P<0.001), with no significant differences between scores computed from eButton images and observations (P=0.187).

CONCLUSIONS

This is the first study to examine nutrition optimizing home cooking practices by observational, wearable camera and self-report data collection methods. By strengthening cooking behavior assessment tools, future research will be able to elucidate the transmission of cooking education through interventions and the relationships between cooking practices, disease prevention, and health.

Food Agency in the United States: Associations with Cooking Behavior and Dietary Intake

“Food agency” is one’s ability to procure and prepare food within the contexts of one’s social, physical, and economic environment. In 2018, we used Amazon TurkPrime to field two large national surveys in the United States (US) to examine food agency and several food- and cooking-related factors. The first survey (n = 1,457) was fielded in a national sample of US adults. The second survey (n = 1,399) comprised of parents of 2–9-year-old children. Analyses included hierarchical linear regression to examine factors that explained variation in food agency and used Poisson and generalized linear models to examine the association between food agency and between cooking behavior and dietary intake, respectively. Cooking skills; food skills; and cooking confidence, attitudes, and perceptions explained a high degree of food agency variance. Higher food agency was associated with more frequent cooking of all meals, more frequent scratch cooking, and less frequent cooking with packaged ingredients among both adults and parents. Higher food agency was also associated with higher consumption of vegetables among both adults and children. Food agency encompasses a number of the interrelated factors important for home cooking and is a useful construct for understanding and promoting home cooking behavior.

Validity and Reliability of a Food Skills Questionnaire

OBJECTIVE

Develop, validate, and assess reliability of a food skills questionnaire.

DESIGN

Phase 1: Questionnaire development categorized questions into domains (Food Selection and Planning, Food Preparation, and Food Safety and Storage). Phase 2: Content validity included expert panel quantitative and qualitative feedback. Phase 3: Face validity involved pilot testing. Phase 4: Reliability assessed test-retest and inter-item reliability.

SETTING

Phase 1: The authors developed a draft questionnaire in London, Ontario, Canada.

PARTICIPANTS

Phase 2: Dietitians, home economists, academics, and chefs completed content validity (n = 17; 57% response rate). Phase 3: A convenience sample of students completed face validity (n = 20; 17% response rate). Phase 4: Randomly selected students completed test-retest reliability (time 1: n = 189, time 2: n = 165; 9% response rate).

MAIN OUTCOME MEASURES

Lawshe content validity ratio, Lawshe content validity index, intraclass correlation coefficients (ICCs), and Cronbach α.

ANALYSIS

Test-retest reliability was evaluated using ICC, and inter-item reliability by Cronbach α coefficient.

RESULTS

In phase 2, Lawshe content validity index was 0.80 (90% expert panel consensus). In phase 3, 85% of respondents identified the main construct. In phase 4, Cronbach α coefficients were .67-.88 for domains and .90 for the questionnaire overall, and ICC scores ranged from 0.67-0.92 for questions, 0.86-0.93 for domains, and 0.92 for the questionnaire overall.

CONCLUSIONS AND IMPLICATIONS

This questionnaire demonstrated strong content validity, face validity, test-retest reliability, and good inter-item reliability. It is appropriate for evaluating food skills in a population with basic to intermediate skills (eg, young adults).

From Mediterranean diet to Mediterranean lifestyle: a narrative review

OBJECTIVE

To summarize the recent scientific evidence regarding the wellness-promoting capacity of the Mediterranean lifestyle (ML), with a special focus on physical, social and environmental wellness.

DESIGN

Narrative review of English-language publications in PubMed, Scopus and Embase, from 1 January 2010 to 31 October 2018.

SETTING

Prospective cohort studies, interventional studies, meta-analyses and reviews of those investigating the effect of at least one component of the ML on wellness parameters.

PARTICIPANTS

General population.

RESULTS

Although an explicit definition of ML is missing, compliance with various combinations of its components improves metabolic health and protects against or ameliorates disease state. However, there is heterogeneity in the healthy behaviours that the ML-focused studies include in their design and the way these are assessed. Also, despite that features of the ML could contribute to other wellness dimensions, there are no studies exploring the effect this healthy lifestyle could confer to them.

CONCLUSIONS

Chronic lifestyle diseases are of multifactorial aetiology and they warrant multifaceted approaches targeting the general way of living. ML, if thoroughly evaluated, can provide a valuable tool to holistically promote health and wellness.

Predictors of Food Skills in University Students

Purpose: To determine predictors of food skills in university students, specifically, the relative effects of a food and nutrition (FN) course; sex, age, and body mass index; food-related behaviours in the parental home; and food-related behaviours in university. Methods: Undergraduate students (n = 30 310) at Western University were invited to complete an online cross-sectional survey that assessed 7 components of food skills, from mechanical (e.g., peeling/chopping) to conceptual (e.g., weekly meal planning). The primary outcome measure was Total Food Skills Score (TFSS). All variables that were statistically associated with TFSS (P < 0.05) were analyzed hierarchically in 4 regression models. Results: The sample was comprised of 3354 students living independently for 2.6 ± 1.1 years. Students who had taken an FN course had higher food skills than those who had not (B = 30.72; P < 0.001), and this relationship remained significant through all subsequent models. The strongest predictor of food skills was meal preparation as a teen (B = 25.66; P < 0.001). Frequency of using a grocery list, packing a lunch, and time spent preparing meals on weekends were positively associated with food skills (P < 0.001), whereas frequency of buying pre-prepared meals was negatively associated with food skills (P < 0.001). Conclusions: Food skill development should occur well before young adults begin living independently.

Food Choices of Young Adults in the United States of America: A Scoping Review

Understanding food choice is critical to developing effective health promotion efforts to counter the leading causes of morbidity and mortality in the United States. Although physiologic, environmental, and social factors influence the development of health conditions, routine decisions, such as food choice, also contribute substantially over time. Behavioral scientists believe that these routine decisions represent a key opportunity to improve population health. We conducted a scoping review of both health and business literature to identify themes in the food choices of young adults aged 19-24 y in the United States. Informed by the Joanna Briggs Institute processes for scoping reviews, we conducted a structured search of 8 health and business databases on 18 April 2017. The databases were PubMed, Business Source Complete, PsycInfo, Cochrane Library, CINAHL, Web of Science, SCOPUS, and ABI/Inform Collection. Eligible literature captured real-world dietary choices of the general population of young adults between 1 January, 2007 and 31 December, 2017. Records were screened in Covidence. Data was extracted into Excel and key findings thematically analyzed. The search returned 9085 records. Ninety-nine records met the eligibility criteria. Themes identified in the foods chosen by young adults include inadequate fruit and vegetable consumption, choosing international flavors and food formats, convenience foods, frequent snacking, the selection of healthy foods based on perceptions of what is healthy rather than the nutrient or calorie content of foods, an interest in sustainable production methods, the desire to customize/tailor foods, foods young people find interesting, and regional foods. This research identified common food choices that can help inform the tailoring of health promotion efforts; however, more research is needed to understand the underlying mechanisms and principles shaping these choices.

Very Low Food Security Status is Related to Lower Cooking Self-Efficacy and Less Frequent Food Preparation Behaviors Among College Students

OBJECTIVE

Investigate the relationships between food security status and cooking self-efficacy and food preparation behaviors among college students.

METHODS

Students living off campus while attending the University of Alabama completed an online survey between February and April 2016. Food security status was assessed using the Adult Food Security Survey Module. Cooking self-efficacy and food preparation behaviors were assessed using validated questionnaires. Multiple regression analysis was used to test for significant differences in cooking self-efficacy and food preparation scores by food security status.

RESULTS

Among respondents (n = 368), 38.3% were food insecure. Very low food secure students had significantly lower cooking self-efficacy scores and food preparation scores than food secure students (P = .001).

CONCLUSIONS AND IMPLICATIONS

Preparing meals at home is less common for very low food secure students, and these students demonstrate less confidence in cooking ability. Further study of food-related decisions and trade-offs under resource constraints are needed.

A Canadian University "Understanding Foods" Course Improves Confidence in Food Skills and Food Safety Knowledge

The impact of a hands-on foods course on undergraduate students' food skills was examined at the University of Guelph. For a convenience sample, first- and second-year students (n = 47, 87% female) registered in the "Understanding Foods" course were recruited to participate in a survey administered on Qualtrics at the beginning of the semester and again at the end of the semester. Participants were asked questions related to demographics and food habits; additional questions on food skills, in Likert-scale format, included confidence in food preparation, food safety knowledge, and grocery shopping habits. Subscales were combined for an overall Food Skills Questions (FSQ) score and differences were determined by paired t tests. Overall, significant (P < 0.05) improvements were observed related to students' confidence and food safety knowledge scores as well as the overall FSQ score. Students, however, rated their personal eating habits more poorly (P < 0.05) at the end of the semester. As a lack of food skills is often considered a barrier for healthy eating among students, these results signify the importance of a hands-on introductory cooking course at the undergraduate level.

Food processing: criteria for dietary guidance and public health?

The NOVA food categorisation recommends ‘avoiding processed foods (PF), especially ultra-processed foods (UPF)’ and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers’ confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed.

Development of culinary recipes in an intervention program with Brazilian university students

ABSTRACT Objective Develop and test recipes for a cooking skills intervention program aimed at students of a Brazilian university. Methods Culinary recipes were selected for the Nutrition and Culinary in the Kitchen program, which offers cooking classes for participants to practice and develop their cooking skills. The Nutrition and Culinary in the Kitchen program is based on the Cooking with a Chef program of the United States of America. A literature search was conducted to establish criteria for the selection and development of recipes. A decision tree was constructed to determine if Cooking With a Chef recipes were appropriate for the Nutrition and Culinary in the Kitchen program. Recipes were evaluated in the laboratory by untrained university students using an acceptance test that comprised the analysis of sensorial attributes and healthiness criteria. Results Of the 32 developed recipes, nine were based on the Cooking With a Chef program. Recipes were adapted to increase the use of fresh fruits, whole grains, and vegetables; eliminate ultra-processed foods; and take into account local food habits and seasonality of ingredients. In the first test, 53.3% (n=16) of the dishes received an acceptance score of less than 70.0% mainly because of unsatisfactory taste. Culinary recipes considered inadequate were redesigned in terms of ingredients and/or cooking methods and were retested until achieving a score of 100.0%. Conclusion Culinary recipes adapted to the Brazilian food culture and the target audience with the use of healthy ingredients and cooking techniques were considered appropriate for the Nutrition and Culinary in the Kitchen cooking skills intervention program and might increase participants’ adherence to healthy eating habits.

The concept of cooking skills: A review with contributions to the scientific debate

ABSTRACT This paper aimed to conduct a literature review about the concept of cooking skills to contribute to the scientific debate about the subject. A systematic search was performed in the Scopus, PubMed/MedLine and Web of Science databases as well as the periodicals of the Federal Agency for Support and Evaluation of Graduate Education in Brazil Coordenação de Aperfeiçoamento de Pessoal de Nível Superior website, using the following Portuguese and English keywords: cooking skills, cooking and food/meal preparation. We also consulted references cited by these papers, electronic dictionaries (in Portuguese, English and French), technical documents found on public and private institutional websites, as well as books. Basic, etymological/vernacular and systematic definitions for cooking were identified, including historical global and national contexts. To conceptualize cooking skills, categories related to food and individuals were established, purposing a conceptual model. The category related to food referred to the use of unprocessed/minimal processed foods (which require procedures prior to their preparation), and/or processed/ultra-processed foods (which need a little or no preparation, such as re-heating). The category related to individuals involved dimensions such as confidence, attitudes, behavior, and individual knowledge used to prepare foods. The historical definitions of cooking allowed us to clarify the concept of cooking skills. Considering the global context of valuing and recovering cooking for the promotion of healthy eating, this review can contribute to the scientific discussion about the concept of cooking skills. The purposed conceptual model enables parameters to be established for further investigations, allowing cooking interventions to be directed toward promoting healthy eating.

Nutrition and Culinary in the Kitchen Program: a randomized controlled intervention to promote cooking skills and healthy eating in university students - study protocol

Background

Community-based intervention studies that aim at developing cooking skills have increased in the scientific literature and are related to healthier food practices. However, methodological limitations are observed and only a few studies have university students as the target. The university entrance period has been related to negative changes in eating habits among young people and it represents an important period for developing interventions for health promotion. This study describes the study protocol and the evaluation framework for the Nutrition and Culinary in the Kitchen program. This program aims to develop cooking skills in university students, and is based on the Cooking with a Chef program in the United States.

Methods

This ongoing, randomized controlled intervention was designed with a six month follow-up study. The intervention consisted of three-hour weekly classes during a six week period with printed materials provided. Five of the classes were hands-on cooking and one was a tour to a popular food market. There were eight primary outcome measures: changes in relation to i) accessibility and availability of fruits and vegetables; ii) cooking attitudes; iii) cooking behaviors at home; iv) cooking behaviors away from home; v) produce consumption self-efficacy; vi) self-efficacy for using basic cooking techniques; vii) self-efficacy for using fruits, vegetables, and seasonings (while cooking); and viii) knowledge of cooking terms and techniques. Secondary outcomes included changes in body mass index and in personal characteristics related to cooking. Repeated measures were collected through the application of an online self-completed survey, at baseline, after intervention and six months after intervention. A sample of 80 university students (40: intervention group; 40: control group) was estimated to detect a mean change of 1.5 points in cooking knowledge, with study power of 80%, and 95% level of confidence, plus 20% for random losses and 10% for confounding factors. The control group participants have continued with their usual activities. Data analyses will evaluate the intervention effect on changes in outcomes within and between groups, as well as explore relations with personal characteristics.

Discussion

This method provides new evidence about whether or not a culinary intervention targeting university students has an impact on the improvement of cooking skills and healthy eating practices.

Trial registration

Brazilian Clinical Trials Registry - RBR-8nwxh5 (http://www.ensaiosclinicos.gov.br/rg/RBR-8nwxh5/)

Social Determinants and Poor Diet Quality of Energy-Dense Diets of Australian Young Adults

This research aimed to determine the diet quality and socio-demographic determinants by level of energy-density of diets of Australian young adults. Secondary analysis of the Australian National Nutrition and Physical Activity Survey-2011/2012 for adults aged 18–34 years (n = 2397) was conducted. Diet was assessed by 24-h recalls. Dietary energy-density was calculated as dietary energy/grams of food (kJ/g) and the Healthy-Eating-Index-for-Australians (HEIFA-2013) was used to assess diet quality (highest score = 100). Dietary energy-density was examined with respect to diet quality and sociodemographic determinants including gender, highest tertiary-education attainment, country-of-birth, age, income, and socio-economic-index-for-area (SEIFA). Higher dietary energy-density was associated with lower diet quality scores (β = −3.71, t (2394) = −29.29, p < 0.0001) and included fewer fruits and vegetables, and more discretionary foods. The mean dietary energy-density was 7.7 kJ/g and 7.2 kJ/g for men and women, respectively. Subpopulations most at risk of consuming high energy-dense diets included those with lower education, Australian and English-speaking countries of birth, and men with low income and women from areas of lower socio-economic status. Young adults reporting low energy-dense diets had higher quality diets. Intensive efforts are needed to reduce the high energy-density of young adults’ diets, and should ensure they include populations of lower socio-economic status.

TEACH Kitchen: A Chronological Review of Accomplishments

BACKGROUND

The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap.

METHODS

TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl's.

RESULTS

Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of pre-and post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c.

CONCLUSIONS

TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases.

Developing a Questionnaire to Evaluate College Students' Knowledge, Attitude, Behavior, Self-efficacy, and Environmental Factors Related to Canned Foods

OBJECTIVE

Develop a questionnaire to measure students' knowledge, attitude, behavior, self-efficacy, and environmental factors related to the use of canned foods.

METHODS

The Knowledge-Attitude-Behavior Model, Social Cognitive Theory, and Canned Foods Alliance survey were used as frameworks for questionnaire development. Cognitive interviews were conducted with college students (n = 8). Nutrition and survey experts assessed content validity. Reliability was measured via Cronbach α and 2 rounds (1, n = 81; 2, n = 65) of test-retest statistics. Means and frequencies were used.

RESULTS

The 65-item questionnaire had a test-retest reliability of .69. Cronbach α scores were .87 for knowledge (9 items), .86 for attitude (30 items), .80 for self-efficacy (12 items), .68 for canned foods use (8 items), and .30 for environment (6 items).

CONCLUSIONS AND IMPLICATIONS

A reliable questionnaire was developed to measure perceptions and use of canned foods. Nutrition educators may find this questionnaire useful to evaluate pretest-posttest changes from canned foods-based interventions among college students.

Determinants of health-related lifestyles among university students

Aims:

The aim of this study was to investigate students’ health-related lifestyles and to identify barriers and social determinants of healthier lifestyles.

Methods:

An online survey, two focus groups and three in-depth interviews across 2014/2015. A stratified by school size and random sample ( n = 468) of university students answered a 67-item questionnaire comprising six scales: Rapid Assessment of Physical Activity, Rapid Eating and Activity Assessment for Patients–Short Version, CAGE, Fagerström Test for Nicotine Dependence, Warwick–Edinburgh Mental Wellbeing Scale short version, and ad hoc scale for drug use/misuse. Stratified by gender, χ2 tests were run to test associations/estimate risks and three multivariate Logistic Regression models were adjusted. A thematic approach guided the analysis of qualitative data.

Results:

A total of 60% of the respondents were insufficiently physically active, 47% had an unbalanced diet and 30% had low mental wellbeing. Alcohol drinkers versus abstinent were almost equally distributed. A total of 42% of alcohol drinkers reported getting drunk at least once a month. Smokers accounted for 16% of the respondents. Identified risk factors for suboptimal physical activity were as follows: being a woman, not using the university gym and smoking. Risk factors for unbalanced diet were low mental wellbeing and drug use. Poor mental wellbeing was predicted by unbalanced diet, not feeling like shopping and cooking frequently, and a lack of help-seeking behaviour in cases of distress. Qualitative analysis revealed seven thematic categories: transition to new life, university environment and systems, finances, academic pressure, health promotion on campus and recommendations.

Conclusion:

This study provides robust evidence that the health-related lifestyles of the student population are worrying and suggests that the trend in chronic diseases associated with unhealthy lifestyles sustained over years might be unlikely to change in future generations. University students’ health-related lifestyle is a concern. Nine out of the identified 10 predictors of problematic physical activity, nutrition and mental wellbeing, were environmental/societal or institutional barriers. Universities must expand corporate responsibilities to include the promotion of health as part of their core values.