Cooking Education Improves Cooking Confidence and Dietary Habits in Veterans

Purpose

The purpose of the study was to evaluate a 12-week cooking education class on cooking confidence, dietary habits, weight status, and laboratory data among veterans with prediabetes and diabetes.

Methods

The sample for this study included 75 veterans within the Overton Brooks Veteran Affairs Medical Center who completed the 12-week class in an in-person group setting in Shreveport, Louisiana, or via Clinical Video Telehealth (CVT) in Longview, Texas. Veterans were referred to the Healthy Teaching Kitchen by their primary care provider or primary care dietitian. Enrollment in the class was on a volunteer basis. The cooking and nutrition education classes included topics such as carbohydrate counting, safety and sanitation, meal planning, and creating budget-friendly recipes. Participants completed 2 questionnaires for assessment of healthy dietary habits and confidence related to cooking. Changes in body weight, lipid panel, and hemoglobin A1C were assessed. Differences in class settings were tested via independent samples t tests. Paired samples t tests were completed to compare changes in mean laboratory results, weight, and questionnaire responses.

Results

Subjects lost a mean 2.91 ± 5.8 lbs ( P < .001). There was no significant difference in percent change in laboratory data and weight between subjects participating via CVT and subjects in the live class. Overall, there was significant improvement in the confidence questionnaire ratings and Healthy Habits Questionnaire responses.

Conclusions

Cooking and nutrition education can increase cooking confidence and dietary quality. These results provide support for the need for further research on the long-term effects of nutrition cooking education and for the benefits of using CVT software to provide education to remote facilities.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION

NCT03335644 on ClinicalTrials.gov.

Critical review of behaviour change techniques applied in intervention studies to improve cooking skills and food skills among adults

BACKGROUND

Cooking and food skills interventions have grown in popularity; however, there is a lack of transparency as to how these interventions were designed, highlighting a need to identify and understand the mechanisms of behavior change so that effective components may be introduced in future work. This study critiques cooking and food skills interventions in relation to their design, behavior change techniques (BCTs), theoretical underpinnings, and outcomes.

METHODS

A 40-item CALO-RE taxonomy was used to examine the components of 59 cooking and food skills interventions identified by two systematic reviews. Studies were coded by three independent coders.

RESULTS

The three most frequently occurring BCTs identified were #1 Provide information on consequences of behavior in general; #21 Provide instruction on how to perform the behavior; and #26 Prompt Practice. Fifty-six interventions reported positive short-term outcomes. Only 14 interventions reported long-term outcomes containing BCTs relating to information provision.

CONCLUSION

This study reviewed cooking and food skills interventions highlighting the most commonly used BCTs, and those associated with long-term positive outcomes for cooking skills and diet. This study indicates the potential for using the BCT CALO-RE taxonomy to inform the design, planning, delivery and evaluation of future interventions.

Healthy Eating Exploratory Program for the Elderly: Low Salt Intake in Congregate Meal Service

OBJECTIVES

This study reported on an exploratory program to help the low income elderly improve healthy eating behavior, specifically by reducing salt intake.

DESIGN

We conducted an exploratory program for 4 weeks for this study. The exploratory program involved offering menus with reduced salt and providing education on healthy eating. After the exploratory program, a survey of the elderly and in-depth interviews allowed us to evaluate the program for foodservice providers (dietitian, social workers, and volunteer workers). This study included both foodservice workers and elderly who actually used the foodservice in a congregate meal service system. This is a unique approach.

SETTING

A congregate meal service center in Seoul, Korea.

PARTICIPANTS

Seventy four elderly in a congregate meal service center.

MEASUREMENTS

Demographics were collected, and the healthy eating program and healthy eating education for elderly respondents were evaluated.

RESULTS

The elderly showed high satisfaction with the exploratory program for healthy eating. We found no significant differences in satisfaction with the program between the elderly who attended education sessions and those who did not, but more of the elderly from the education sessions showed positive behavioral change intentions.

CONCLUSION

The exploratory program influenced to reduce the salt intake of the elderly in congregate meal service. This study suggests cooperation of foodservice providers and the support of administrators is critical to the success of such programs.

Eat Smart, Live Strong intervention increases fruit and vegetable consumption among low-income older adults

This study evaluated the impact of a four-session interactive nutrition education program-Eat Smart, Live Strong (ESLS)-on the consumption of fruit and vegetables by low-income older adults. A pre-post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants' self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants' average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs

OBJECTIVE

Cooking programs are growing in popularity; however, an extensive review has not examined their overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research.

DESIGN

Literature review and descriptive summative method.

MAIN OUTCOME MEASURES

Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes.

ANALYSIS

Articles evaluating the effectiveness of interventions that included cooking/home food preparation as the primary aim (January, 1980 through December, 2011) were identified via Ovid MEDLINE, Agricola, and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories.

RESULTS

Of 28 studies identified, 12 included a control group with 6 as nonrandomized and 6 as randomized controlled trials. Evaluation was done postintervention for 5 studies, pre- and postintervention for 23, and beyond postintervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, nonrigorous study designs, varying study populations, and the use of nonvalidated assessment tools limited stronger conclusions.

CONCLUSIONS AND IMPLICATIONS

Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes.

Food Tasting as Nutrition Education For Older Adults

Purpose: The likelihood of experiencing poor nutrition status increases as people age. Sampling new foods may promote a continued interest in food and enjoyment of eating. This pilot study was designed to describe and provide a preliminary evaluation of food-tasting activities integrated into nutrition displays directed at community-living older adults.

Methods: Three consecutivemonthly nutrition displays incorporating a food-tasting activity were presented at a Guelph, Ontario, recreation centre for seniors. Seniors had an opportunity to taste two recipes at each of three displays; 226 food samples and 155 copies of recipes were taken. Feedback forms were used to determine participants’ interest inmaking the recipes, and whether tasting influenced their interest in preparing the food.

Results: Among 54 participants who completed feedback forms about the program, 75.9%indicated that they intended to prepare one or both of the recipes tasted at the display; 70.4%indicated that they would not ormay not havemade the recipe without tasting it beforehand.

Conclusions:Dietitians working with community-living older adults could use food tastings to help translate key educational messages into practice, and to encourage eating enjoyment as people age.

Food workshops, nutrition education, and older adults: a process evaluation

Three years of process evaluation data are presented for Evergreen ActionNutrition food workshops conducted at an older adults' recreation center. Over a three-year period, 475 written evaluations of single and three-session series workshops were completed. Additionally, data were collected from four focus groups of older adult participants (n = 19). Older persons report intention to change behavior based on attendance at a single workshop. Series workshop participants report increased knowledge, confidence in cooking, and motivation to make changes. Focus group participants identified the following as key aspects to success and empowerment of behavior change: relevant information, specifically in the form of recipes; interactive format, including taste-testing; social experience; consistent, high-quality education; and small size of the group. Food workshops or demonstrations can be meaningful nutrition education activities for older adults.

Evaluation of nutrition education interventions for older adults: a proposed framework

This study was undertaken to identify nutrition interventions that could provide a basis for designing effective and measurable nutrition education programs for older adults. The authors conducted a literature search of articles published from 1990-2003 using Medline and Agricola. Key words were "elderly," "older adults," "nutrition intervention," and "nutrition education." Of 128 references identified, 25 studies included intervention and/or evaluation components and targeted adults over age 55 years. Although interventions tended to report limited success in behavior change, certain features had positive outcomes. These included limiting educational messages to one or two; reinforcing and personalizing messages; providing hands-on activities, incentives, cues, and access to health professionals; and using appropriate theories of behavior change. Based on these findings, a theoretical framework that includes these features but is set within a social and environmental context is proposed as a guideline for designing nutrition interventions for older adults.

Interactive Learning for Congregate Nutrition Site Nutrition Education

Older adults who participate in the Older Americans Act Title III-C Elderly Nutrition Program often are at moderate to high nutritional risk. Although nutrition education is a component of the Elderly Nutrition Program, there are numerous barriers to promoting behavior change in older adults. Nutrition education programs targeted to congregate nutrition site participants must address their unique nutritional needs, while engaging them in activities that promote learning and motivate them to make positive behavior changes. This paper describes a pilot study of a theory-driven, five-lesson educational module designed to promote healthful eating behaviors among congregate nutrition site participants through interactive learning.