Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation

Exploring the world of food with families: perspectives of low-income families on factors influencing their food choices

OBJECTIVE

The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland.

DESIGN

A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices.

SETTING

The participants were interviewed online via Microsoft Teams.

PARTICIPANTS

The participants were parents or guardians of children between the ages of 2 and 18 who self-defined as 'living on a tight budget'.

RESULTS

Twenty-eight participants were recruited and interviewed for this study, including twelve parents in Northern Ireland and sixteen in the Republic of Ireland. The findings were mapped on to Bronfenbrenner's Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour.

CONCLUSIONS

While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families.

Identifying High-Priority Populations for Dietary Salt Reduction Using the TARPARE Model: A Cross-Sectional Study

The application of social marketing to public health activities has recently garnered attention. This study aimed to identify high-priority segments for salt reduction interventions using the TARPARE model in a rural Japanese city. This cross-sectional study used convenient sampling. Scored indicators of the TARPARE model were used, and data was collected from 1874 adults to establish the priority order of target segments for promoting salt reduction. The model considers the total number of individuals (T), at-risk persons (AR), persuasibility (P), accessibility (A), resources required (R), and equity (E). For T, the salt content was evaluated using spot urine, and the salt check sheet was scored for each segment according to sex and age in the city's population. AR was the individuals who were overweight. P was determined by the behavior modification stage of salt reduction, unknown recommended salt reduction goals, and lack of knowledge in at least one aspect of salt reduction. A and R were characterized by communication with family or friends and family support, respectively. E was considered an education up to high school. The average aggregated score was 19.9 (standard deviation = 14.0), with higher scores in segments that consistently subjectively restrict salt intake but have a high objective salt intake. The highest priority was given to women in their 60s (49.3 points) and 70s (54.4 points). This study identified high-priority populations for salt reduction in a rural city in Japan. Our priority segments offer guidance for efficient and targeted interventions for salt reduction initiatives.

Using Mobile Ecological Momentary Assessment to Understand Consumption and Context Around Online Food Delivery Use: Pilot Feasibility and Acceptability Study

BACKGROUND

Mobile ecological momentary assessment (EMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, the way we access food is changing. Online food delivery (OFD) services may further encourage unhealthy food consumption habits, given the high availability of energy-dense, nutrient-poor foods. We used EMA to understand the real-time effects of OFD on individuals' food choices and consumption behaviors.

OBJECTIVE

The primary aims of this pilot study were to assess the feasibility and acceptability of using EMA in young users of OFD and compare 2 different EMA sampling methods. The secondary aims were to gather data on OFD events and their context and examine any correlations between demographics, lifestyle chronic disease risk factors, and OFD use.

METHODS

This study used EMA methods via a mobile app (mEMASense, ilumivu Inc). Existing users of OFD services aged 16 to 35 years in Australia who had access to a smartphone were recruited. Participants were randomly assigned to 1 of 2 groups: signal-contingent or event-contingent. The signal-contingent group was monitored over 3 days between 7 AM and 10 PM. They received 5 prompts each day to complete EMA surveys via the smartphone app. In contrast, the event-contingent group was monitored over 7 days and was asked to self-report any instance of OFD.

RESULTS

A total of 102 participants were analyzed, with 53 participants in the signal-contingent group and 49 participants in the event-contingent group. Compliance rates, indicating the feasibility of signal-contingent and event-contingent protocols, were similar at 72.5% (574/792) and 73.2% (251/343), respectively. Feedback from the participants suggested that the EMA app was not easy to use, which affected their acceptability of the study. Participants in the event-contingent group were 3.53 (95% CI 1.52-8.17) times more likely to have had an OFD event captured during the study. Pizza (23/124, 18.5%) and fried chicken (18/124, 14.5%) comprised a bulk of the 124 OFD orders captured. Most orders were placed at home (98/124, 79%) for 1 person (68/124, 54.8%). Age (incidence rate ratio 0.95, 95% CI 0.91-0.99; P=.03) and dependents (incidence rate ratio 2.01, 95% CI 1.16-3.49; P=.01) were significantly associated with the number of OFD events in a week after adjusting for gender, socioeconomic status, diet quality score, and perceived stress levels.

CONCLUSIONS

This pilot study showed that EMA using an event-contingent sampling approach may be a better method to capture OFD events and context than signal-contingent sampling. The compliance rates showed that both sampling methods were feasible and acceptable. Although the findings from this study have gathered some insight on the consumption and context of OFD in young people, further studies are required to develop targeted interventions.

Cooking behaviours after Diabetes Prevention Program (DPP) participation among DPP participants in Baltimore, MD

OBJECTIVE

The Diabetes Prevention Program (DPP) is a widely implemented 12-month behavioural weight loss programme for individuals with prediabetes. The DPP covers nutrition but does not explicitly incorporate cooking skills education. The objective of the current study is to describe food and cooking skills (FACS) and strategies of recent DPP participants.

DESIGN

Photo-elicitation in-depth interviews were conducted from June to August, 2021.

SETTING

Baltimore, MD, USA.

PARTICIPANTS

Thirteen Black women who participated in DPP.

RESULTS

The DPP curriculum influenced participants' healthy cooking practices. Many participants reported shifting from frying foods to air-frying and baking foods to promote healthier cooking and more efficient meal preparation. Participants also reported that their participation in DPP made them more mindful of consuming fruits and vegetables and avoiding foods high in carbohydrates, fats, sugars and Na. With respect to food skills, participants reported that they were more attentive to reading labels and packaging on foods and assessing the quality of ingredients when grocery shopping.

CONCLUSIONS

Overall, participants reported changing their food preferences, shopping practices and cooking strategies to promote healthier eating after completing the DPP. Incorporating hands-on cooking skills and practices into the DPP curriculum may support sustained behaviour change to manage prediabetes and prevent development of type 2 diabetes among participants.

Cooking and food skills confidence of team sport athletes in Ireland

Nutritional support often focuses on cooking and food skills such as food selection, recipe planning and meal preparation. Individuals with greater cooking and food skills confidence have previously displayed higher diet quality scores and lower intakes of overall calories, saturated fat and sugar. Despite this, the cooking and food skills of team sport athletes have yet to be investigated. This study aimed to evaluate the relationship between cooking and food skills confidence and athletes' demographic characteristics. A validated measure for the assessment of cooking and food skills confidence was distributed via an online survey. Participants were required to rate their confidence on a Likert scale (1 "very poor" - 7 "very good") for 14 items related to cooking skills and 19 items for food skills. Food engagement, general health interest and self-reported fruit and vegetable consumption as a measure of diet quality were also measured. The survey was completed by 266 team sport athletes (male: 150, female: 116, age: 24.8 ± 6.1 years). Group differences were explored using t-tests and ANOVA and associations were evaluated using Spearman's correlation and hierarchical multiple regressions. Athletes' total cooking and food skills confidence was 62.7 ± 17.4 (64.0 ± 17.8%) and 83.8 ± 20.1 (63.0 ± 15.1%), respectively. Females reported greater confidence in both cooking (+20.3%, p < 0.01) and food skills (+9.2%, p < 0.01). Hierarchical multiple regressions explained 48.8% of the variance in cooking skills confidence and 44% of the variance in food skills confidence with gender, previous culinary training, cooking learning stage, general health interest and food engagement all remaining significant in the cooking skills confidence model and cooking frequency, previous culinary training, general health interest and food engagement remaining significant in the food skills confidence model. Male team sport athletes may benefit the most from educational interventions designed to increase cooking and food skills confidence.

Complex, Varied and Evolving Manifestations of Food Agency in Daily Life Among Diabetes Prevention Program Participants in Baltimore, Maryland

OBJECTIVE

To characterize food agency (one's capacity to procure and prepare food in particular contexts) among Diabetes Prevention Program (DPP) participants and gather perspectives about experiences with DPP.

DESIGN

Photograph-elicitation in-depth interviews and survey measures.

SETTING

Baltimore, Maryland (June-August 2021).

PARTICIPANTS

Black women (n = 13) who participated in DPP.

PHENOMENON OF INTEREST

Food agency and strategies used to procure and prepare food and the influence of DPP on daily food behaviors. Surveys measured food agency using the Cooking and Food Provisioning Action Scale and cooking behaviors.

ANALYSIS

Thematic analysis of qualitative in-depth interviews and descriptive statistics for quantitative measures.

RESULTS

As quantitative and qualitative data revealed, participants were frequent and confident cooks with high food agency. Participants viewed cooking as a key strategy for healthy eating and desired more hands-on cooking instruction within DPP to develop new healthy cooking skills. The primary barriers identified were related to lack of time or energy. Food procurement and preparation practices shifted over time, and DPP was a key influence on current behaviors.

CONCLUSIONS AND IMPLICATIONS

Food agency is complex and manifests heterogeneously in daily life. A life course, contextual, and food agency-based approach could be considered for future diabetes prevention interventions.

Cook like a Boss Online: an adapted intervention during the COVID-19 pandemic that effectively improved children's perceived cooking competence, movement competence and wellbeing

BACKGROUND

The COVID-19 pandemic has further exacerbated physical inactivity, poor dietary intake and reduced mental wellbeing, contributing factors to non-communicable diseases in children. Cooking interventions are proposed as having a positive influence on children's diet quality. Motor skills have been highlighted as essential for performance of cooking skills, and this movement may contribute to wellbeing. Additionally, perceived competence is a motivator for behaviour performance and thus important for understanding intervention effectiveness. Therefore, this research aimed to assess the effectiveness of an adapted virtual theory-based cooking intervention on perceived cooking competence, perceived movement competence and wellbeing.

METHODS

The effective theory-driven and co-created 'Cook Like A Boss' was adapted to a virtual five day camp-styled intervention, with 248 children across the island of Ireland participating during the pandemic. Pre- and post-intervention assessments of perceived cooking competence, perceived movement competence and wellbeing using validated measurements were completed through online surveys. Bivariate Correlations, paired samples t-tests and Hierarchical multiple regression modelling was conducted using SPSS to understand the relationships between the variables and the effect of the intervention.

RESULTS

210 participants had matched survey data and were included in analysis. Significant positive correlations were shown between perceived cooking competence, perceived movement competence and wellbeing (P < 0.05). Children's perceived cooking competence (P < 0.001, medium to large effect size), perceived movement competence (P < 0.001, small to medium effect size) and wellbeing (P = 0.013, small effect size) all significantly increased from pre to post intervention. For the Hierarchical regression, the final model explained 57% of the total variance in participants' post-intervention perceived cooking competence. Each model explained a significant amount of variance (P < 0.05). Pre-intervention perceived cooking competence, wellbeing, age and perceived movement competence were significant predictors for post-intervention perceived cooking competence in the final model.

CONCLUSION

The 'Cook Like A Boss' Online intervention was an adapted virtual outreach intervention. It provides initial evidence for the associations between perceived cooking competence, perceived movement and wellbeing as well as being effective in their improvement. This research shows the potential for cooking to be used as a mechanism for targeting improvements in not only diet quality but also movement and wellbeing.

TRIAL REGISTRATION

NCT05395234. Retrospectively registered on 26th May 2022.

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

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

A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland

Background

The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland.

Methods

A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach.

Results

Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house.

Conclusions

The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12307-1.

Cook Like A Boss: An effective co-created multidisciplinary approach to improving children's cooking competence

Cooking interventions are emphasised as promising methods for changing children's food-related preferences, attitudes and behaviours. However, criticisms remain, including relatively weak intervention designs; lack of validated tools, and limited underpinning theory. Therefore, this research aimed to assess the effectiveness of a theory-driven co-created children's cooking intervention with underpinning rationale for the content, using a validated measure. 'Cook Like A Boss' was a one week, controlled cooking camp style intervention. Thirty two children aged 10-12 years participated. The intervention was developed using the Cook-Ed model for planning, implementing and evaluating cooking programs and was underpinned by Social Learning theory and Experiential Learning theory. The intervention content was developed in a co-creation process with the research team, a chef and the children. The underlying developmental skills required for the recipes were assessed to ensure they were age-appropriate. Children completed pre and post measurements including perceived cooking competence. Process evaluations were also gathered. There was a significant increase in perceived cooking competence after the intervention (P < 0.05) and a significant difference between the intervention and control group (P < 0.001). Additionally, process evaluations found the intervention to have high fidelity and dose received and that it was received extremely positively. The 'Cook Like A Boss' children's cooking camp was an effective multidisciplinary co-created intervention with a vulnerable group, e.g. children, guided by a model and underpinned by theory. The content was developed to ensure it was age-appropriate and achievable for the children. This approach could act as a template for future children's cooking interventions.

Sustainable Meat: Looking through the Eyes of Australian Consumers

Sustainability is a complex and multifaceted concept that comprises environmental, economic, social, and cultural dimensions. Growing consumer concerns over the impacts of global meat production and consumption have led to increasing interest in sustainability initiatives and the use of sustainability labels. Yet, an understanding of what sustainability means to consumers in the context of meat and how consumers relate production-related credence attributes of chicken meat to sustainability remains limited. Between September 2019 and January 2020, an exploratory research study was conducted using a multi-method approach. Participants completed an online survey before participating in a series of eye-tracking choice tasks followed by in-depth interviews. The study revealed that the environmental dimension of sustainability is most important to consumers’ definition of a “sustainable food system”. Likewise, the sustainability of chicken meat products was most commonly associated with the perceived environmental impact of chicken meat production, followed by animal welfare aspects. Consumers made incorrect inferences about some sustainability labels and these inferences sometimes contributed to positive associations with sustainability. Consumers frequently associated a higher price with higher sustainability, indicating a belief that “doing the right thing” might cost more. This study provides new insights regarding consumers’ perceptions of production-related credence attributes and sustainability labels.

Perspectives of Black/African American and Hispanic Parents and Children Living in Under-Resourced Communities Regarding Factors That Influence Food Choices and Decisions: A Qualitative Investigation

Families living in under-resourced communities are at risk of obesity and obesity-related chronic diseases. To develop effective interventions, it is important to identify parent and child perspectives of factors that influence food-related choices and decisions. This paper reports qualitative findings from a larger mixed method study investigating this topic. Hybrid thematic analysis was used to code and analyze the interviews. Family-generated photographs of factors influencing food choices were discussed during the interviews. Qualitative findings were organized by the socio-ecological model. Verbatim quotes and photographs were used to support themes. Thirty-six interviews were conducted (18 parents, 18 children). Findings from parents revealed personal (e.g., culture, beliefs, time), family (e.g., mother, child, father, health, finances, cohesiveness), environmental (e.g., availability, convenience, cost), and other (e.g., school food) factors influenced food choices. Similarly, child-reported influences were personal (e.g., preferences, beliefs, taste), family (e.g., mother, family encouragement, father, family time), social (e.g., school, friends), environmental (e.g., availability), and other (e.g., media, sports). The socio-ecological model provided a useful framework for identifying factors that influence food choices and decisions of families living in under-resourced communities. A deeper understanding of these factors could enhance both responsiveness and effectiveness of interventions to enhance diet and reduce obesity risk in families living in under-resourced communities.

Rethinking Sustainable Community-Based Tourism: A Villager’s Point of View and Case Study in Pampang Village, Indonesia

Community-based tourism (CBT) considers one sustainable form of tourism to enhance tourists’ and local communities’ relationships. By investigating and studying the previous scientific production of the CBT field in general and, in particular, rural CBT, the researchers found that the local communities’ roles in shaping this type of tourism have been given great importance. This literature mainly focuses on rural CBT from the academic researcher’s perspective. This study aimed to understand the villager’s view on rural sustainable CBT in Pampang Village, Indonesia. In our research, we used the triangulation method based on three kinds of data: in-depth structured interviews, non-participant field observations, and quantitative sustainability aspects of the local attractions. The research results helped us design a model for the formation of sustainable rural CBT activities in Indonesia, which depends on formal and informal leader figures in the community instead of only the community’s solidarity, as much previous research has indicated.

Gender differences in global estimates of cooking frequency prior to COVID-19

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N = 145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of 'scratch' cooking lunch and dinner across the globe by gender. Poisson regression was used to assess predictors of cooking frequency. Associations between disparities in cooking frequency (at the country level) between men and women with perceptions of subjective well-being were assessed using linear regression. Across the globe, cooking frequency varied considerably; dinner was cooked more frequently than lunch; and, women (median frequency 5 meals/week) cooked both meals more frequently than men (median frequency 0 meals/week). At the country level, greater gender disparities in cooking frequency are associated with lower Positive Experience Index scores (-0.021, p = 0.009). Prior to the COVID-19 pandemic, the frequency with which men and women cook meals varied considerably between nations; and, women cooked more frequently than men worldwide. The pandemic, and related 'stay at home' directives have dramatically reshaped the world, and it will be important to monitor changes in the ways and frequency with which people around the world cook and eat; and, how those changes relate to dietary patterns and health outcomes on a national, regional and global level.

Lebanese meal management practices and cultural constructions of food waste

Food waste is a global issue with major environmental and socio-economic implications. The problem is even worse in Arab countries where tremendous amounts of food are wasted everyday. In this study, we engaged in an ethnographic journey documenting meal management practices in rural Lebanese households as they relate to food waste. We interviewed 60 women from the Chahhar region (closest communities to the nation's largest landfill) who are in charge of their households' food management. We kept detailed reflexive notes of observations and photo-journaled the provision, preparation, preservation, consumption, and disposal of food. We found that despite the enormity of the food waste crisis in Lebanon, the environmental impact was strikingly absent from the participants' construction of food-related practices. Yet, the women exhibited a strong food waste averse behavior rooted in cultural norms and religious beliefs built on active avoidance of food waste. Our findings shed the light on the intricate connections of family and community routines anchored in frugality and hospitality practices.

Perceptions of 'Home Cooking': A Qualitative Analysis from the United Kingdom and United States

Cooking at home is likely to be associated with benefits to diet and health. However, the nuanced perceptions and practices linked to different types of cooking are not yet fully understood. This research aimed to explore the specific concept of 'home cooking', using qualitative research from the UK and US. Data from two previously completed studies exploring cooking at home were combined and a new secondary analysis was undertaken using the Framework Method. Data in the first study were drawn from participants in the North East of the UK who were interviewed. Data in the second study were drawn from participants in Baltimore, US, who took part in focus groups. Data from a total of 71 adults (18 UK and 53 US), with diverse sociodemographic characteristics and experiences of cooking, were analysed. In both countries, participants distinguished 'home cooking' as a distinct subtype of cooking at home. 'Home cooking' was defined in terms of preparing a meal from scratch, cooking with love and care, and nostalgia. Cooking at home had a range of dimensions, and perceptions of 'home cooking' tended to focus on social and emotional associations. In future, public health initiatives might, therefore, highlight the potential social and emotional benefits of 'home cooking', rather than emphasising implications for physical health.

Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy

Background: Salt intakes in Latin America currently double the World Health Organization’s recommendation of 5 g/day. Various strategies to reduce the population’s salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents’ perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru. Methods: Using a sequential exploratory methods design, parents of pre-school children, of high and low socioeconomic status, provided qualitative data in the form of interviews and focus groups. Following this, quantitative data was obtained via questionnaires, which were sent to all parents. The information was analyzed jointly. Results: 296 people (mean age 35.4, 82% women) participated, 64 in the qualitative and 232 in the quantitative phase of the study. Qualitative data from the first phase revealed that the majority of mothers were in charge of cooking, and female participants expressed that cooking was “their duty” as housewives. The qualitative phase also revealed that despite the majority of the participants considered their salt intake as adequate, half of them mentioned that they have tried to reduce salt consumption, and the change in the flavor of the food was stated as the most difficult challenge to continue with such practice. Quantitative data showed that 67% of participants would be willing to reduce their salt intake, and 79.7% recognized that high salt intake causes hypertension. In total, 84% of participants reaffirmed that mothers were in charge of cooking. There were no salient differences in terms of responses provided by participants from high versus low socioeconomic groups. Conclusions: The results point towards the identification of women as a potential target-audience of a social marketing strategy to promote reductions in salt intake in their families and, therefore, a gender-responsive social marketing intervention is recommended.

Cooking Online With a Chef: Health Professionals' Evaluation of a Live Culinary Coaching Module

Introduction:

Cooking Online With a Chef (COWC) is a live, telemedicine module delivered by a health coach chef to participants who log in from their home kitchen. Our purpose is to identify health professionals’ perceptions on its educational value and to determine feasibility for clinical practice.

Method:

Sixty-four health care professionals participated in a 75-minute COWC module as active participants during a live remote Continuing Medical Education (CME) program that includes five 75-minute telemedicine sessions. Post-program questionnaire elicited feedback on the module educational value and relevance to clinical practice through Likert-type scale and open-ended questions. This report presents descriptive analysis of the Likert-type scale questions and thematic qualitative analysis of the open-ended question.

Results:

Seventy percent of health care professional participants rated the quality of the COWC module as either very good or excellent, and 73% rated its relevance to clinical practice as very good or excellent. Open-ended question feedback showed appreciation of the learning experience with specific suggestions about how to improve participants’ preparation for the module.

Conclusions:

The COWC telemedicine module was well received by self-selected health care professionals. Future studies are being planned to determine the efficacy of the module on patients’ nutrition.

Impact of multiple food environments on body mass index

Background

Although the relationship between residential food environments and health outcomes have been extensively studied, the relationship between body mass index (BMI) and multiple food environments have not been fully explored. We examined the relationship between characteristics of three distinct food environments and BMI among elementary school employees in the metropolitan area of New Orleans, LA. We assessed the food environments around the residential and worksite neighborhoods and the commuting corridors.

Research methodology/principal findings

This study combined data from three different sources: individual and worksite data (ACTION), food retailer database (Dunn and Bradstreet), and the U.S. Census TIGER/Line Files. Spatial and hierarchical analyses were performed to explore the impact of predictors at the individual and environmental levels on BMI. When the three food environments were combined, the number of supermarkets and the number of grocery stores at residential food environment had a significant association with BMI (β = 0.56 and β = 0.24, p < 0.01), whereas the number of full-service restaurants showed an inverse relationship with BMI (β = -0.15, p < 0.001). For the commute corridor food environment, it was found that each additional fast-food restaurant in a vicinity of one kilometer traveled contributed to a higher BMI (β = 0.80, p <0.05), while adjusting for other factors. No statistical associations were found between BMI and worksite food environment.

Conclusions

The current study was the first to examine the relationship between BMI and food environments around residential neighborhoods, work neighborhoods, and the commuting corridor. Significant results were found between BMI and the availability of food stores around residential neighborhoods and the commuting corridor, adjusted for individual-level factors. This study expands the analysis beyond residential neighborhoods, illustrating the importance of multiple environmental factors in relation to BMI.

Perceptions about home cooking: an integrative review of qualitative studies

This study aimed to review qualitative studies on perceptions of home cooking. A systematic search was conducted in Scopus and SciELO databases using English and Portuguese terms related to home cooking, without date or language restrictions. Twenty-six articles, published between 2004 and 2017, investigated, whether as a primary objective or as a secondary finding, the perceptions of individuals on home cooking. More than half of the studies were conducted in English-speaking countries. Study participants included women and men, adults and seniors as well as residents of urban and rural areas, Eastern and Western countries, and developing and developed nations. Thematic analysis showed that home cooking has different interpretations and meanings in diverse contexts and revealed differences in how individuals plan and cook their meals at home. Cognitive, practical, affective, and emotional factors are the major motivators to home meal preparation. Having a cooking role model in the family, cooking confidence and skills, and living alone were reported as facilitators of home cooking. A better understanding of the heterogeneity of perceptions and meanings of home cooking can contribute to the development of effective and culturally appropriate interventions for stimulating healthy cooking habits.

Comparison of individuals with low versus high consumption of home-prepared food in a group with universally high dietary quality: a cross-sectional analysis of the UK National Diet & Nutrition Survey (2008-2016)

Background

Despite inconclusive evidence, the idea that a lack of home food preparation and skills is a limiting factor in achieving a healthy diet is widespread. Cooking skills interventions proliferate, and several countries now mention cooking in their dietary guidelines. The aim of this study was to determine whether substantial consumption of home-prepared food is necessary for high dietary quality by exploring whether individuals can eat healthily while eating little home-prepared food. The diets of these individuals were characterised, and socio-demographic characteristics and prevalence of obesity were also explored.

Methods

Cross-sectional analysis of UK dietary survey data with objectively measured height and weight and a 4-day food diary for each participant was conducted. A subsample (N = 1063, aged ≥19 years) with a high dietary quality (determined using a score derived from the Dietary Approaches to Stopping Hypertension (DASH) diet) was analysed. Within this, participants were grouped as either high or low home preparation based on the proportion of energy derived from home-prepared food. Regression models were used to determine whether and how those in the high and low home preparation groups differed in terms of socio-demographic characteristics, DASH score, energy intake, prevalence of obesity, and dietary composition.

Results

The low home preparation group included 442 participants, while 621 participants were in the high home preparation group. The low home preparation group were more likely to be older and white, and less likely to have a degree level education. After adjustment for socio-demographic characteristics, there were no differences in DASH score, energy intake or obesity prevalence between the groups. After adjustment, the low home preparation group consumed more fruit (30.8 additional g/day, 95% CI 5.5–56.1), more low-fat dairy foods (24.6 additional g/day, 95% CI 1.7–47.5) and less red meat (10.4 fewer g/day, 95% CI 4.3–16.6), but also more sugar (11.6 additional g/day, 95% CI 7.5–15.6) and sodium (107.8 additional mg/day, 95% CI 13.8–201.8).

Conclusion

Home food preparation should not be presented as a prerequisite to a high quality diet. The public health community should recognise the existence of a set of food practices which allows individuals to achieve a healthy diet with little contribution from home-prepared food, and make space for it in the design of their policies and interventions.

Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential

PURPOSE OF REVIEW

Various dietary regimes have proven effective in preventing diabetes, yet its prevalence is growing. This review's goals are to examine the relationship between home cooking and diabetes and to present the literature on home cooking education programs as a novel strategy to improve adherence to healthy nutrition, thus decreasing the risk of diabetes.

RECENT FINDINGS

Consumption of home-cooked food is linked to healthier nutrition and decreased risk of diabetes. Further, home cooking interventions have a short-term positive impact on nutritional intake of both children and adults, and on diabetes prevention. Well-designed randomized controlled studies are needed to rigorously evaluate the long-term impact of home cooking interventions on cooking behavior, dietary intake, diabetes, and healthcare costs. Culinary education is an emerging field that aims to change nutrition education paradigms. Clinicians can empower patients to adopt home cooking by role modeling home cooking themselves, including home cooking content in their medical encounters, and through comprehensive lifestyle medicine interventions.