Beyond Ramen: Investigating Methods to Improve Food Agency among College Students

Many college students struggle to cook frequently, which has implications for their diet quality and health. Students’ ability to plan, procure, and prepare food (food agency) may be an important target for shifting the college student diet away from instant and inexpensive staples like packaged ramen. The randomized intervention study included two sequential cooking interventions: (1) six weeks of cooking classes based in food agency pedagogy held once per week, and (2) six weekly home delivered meal kits (3 meals per kit) to improve food agency, diet quality, and at home cooking frequency of college students. Based on availability and subsequent randomization, participants were assigned to one of four conditions that included active cooking classes, meal kit provision, or no intervention. Participants who took part in the cooking intervention had significant improvement in food agency immediately following the intervention period. Participants who did not participate in cooking classes and only received meal kits experienced significant, though less pronounced, improvement in food agency scores following the meal kit provision. Neither intervention improved diet quality or routinely improved cooking frequency. Active cooking classes may improve food agency of college students, though further research is needed to determine how this may translate into improved diet quality and increased cooking frequency.     

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.     

Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic

BackgroundFood insecurity is a critical public health problem in the United States that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality.ObjectiveThis study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial months of the coronavirus disease 2019 pandemic.DesignThis cross-sectional study analyzed data from a national web-based survey (June 23 to July 1, 2020).Participants/settingParticipants were 1,739 low-income (<250% of the federal poverty level) adults in the United States.Main outcome measuresThe outcome was diet quality, measured by the Prime Diet Quality Score (PDQS-30D). The PDQS-30D is a food frequency questionnaire-based, 22-component diet quality index.Statistical analyses performedFood security status (high, marginal, low, or very low) and frequency of cooking dinner (7, 5 to 6, 3 to 4, or 0 to 2 times/week) were evaluated in relation to PDQS-30D scores (possible range = zero to 126) in age- and sex and gender-, and fully adjusted linear regression models. Postestimation margins were used to predict mean PDQS-30D score by food security status and dinner cooking frequency. The interaction between food security status and frequency of cooking dinner was also tested.ResultsOverall, the mean PDQS-30D score was 51.9 ± 11 points (possible range = zero to 126). The prevalence of food insecurity (low/very low) was 43%, 37% of the sample cooked 7 times/week and 15% cooked 0 to 2 times/week. Lower food security and less frequent cooking dinner were both associated with lower diet quality. Very low food security was associated with a 3.2-point lower PDQS-30D score (95% CI –4.6 to –1.8) compared with those with high food security. Cooking dinner 0 to 2 times/week was associated with a 4.4-point lower PDQS-30D score (95% CI –6.0 to –2.8) compared with cooking 7 times/week. The relationship between food insecurity and diet quality did not differ based on cooking dinner frequency.ConclusionsDuring the initial months of the coronavirus disease 2019 pandemic food insecurity and less frequently cooking dinner at home were both associated with lower diet quality among low-income Americans. More research is needed to identify and address barriers to low-income households’ ability to access, afford and prepare enough nutritious food for a healthy diet.     

Correlations between Self-Reported Cooking Confidence and Creativity and Use of Convenience Cooking Products in an Australian Cohort

Background: Most Australians do not meet vegetable intake recommendations. Vegetables are most often consumed in evening meals. However, they often require preparation and therefore cooking skills. Convenience cooking products such as meal bases/concentrates and ready-made sauces are increasingly common and popular and may help address the barriers to vegetable consumption in terms of cost and time. These products also typically provide recipes, which include vegetables, and as such, may help address the barriers of cooking skills, confidence, and creativity. However, the relationships between the use of these products, cooking confidence, and cooking creativity remain unknown. Methods: Australian adults were surveyed (snowball recruitment, n = 842) on their use of convenience cooking products (meal bases/recipe concentrates, simmer sauces, marinades, and other cooking sauces), cooking confidence (7 item scale) and creativity (6 item scale), and demographic information. Results: Overall, 63.2% of participants reported using convenience cooking products. Those using these products had lower mean cooking skills confidence and creativity scores than those who did not, in all product categories assessed. Among users, those who reported "always" following the recipes provided had lower mean cooking confidence and creativity scores than those who followed the recipes less regularly. Conclusions: Therefore, improving the vegetable content of recipes provided with these products may be a tool to increase vegetable intake by users with lower cooking skills (confidence and creativity). This may complement traditional approaches such as education in improving vegetable intake.     

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

BackgroundFood 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.ObjectiveThe 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.DesignParent–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/settingParents 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 measuresFood 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 performedAll 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.ResultsTwo 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).ConclusionsThis 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.     

Heterogeneities in Consumer Diet Quality and Health Outcomes of Consumers by Store Choice and Income

Obesity and other diet-related health conditions have received much attention in the public health literature over the past two decades. This study investigates the relationship between household food budget shares at different food outlets with diet quality and weight-related health outcomes in the United States. Our analysis used event-level food purchase data from the national household food acquisition and purchases survey (FoodAPS). We find that, after controlling for observables, food purchase location is significantly associated with diet quality and body mass index (BMI). Our findings indicate that larger food budget shares at convenience stores and restaurants are linked with poor diet quality based on the healthy eating index-2015 (HEI-2015) scores and higher BMI. We further explored potential heterogeneity on outcomes of interest across income groups. Results suggest heterogeneous effects may exist across income groups: low-income households, who spent a larger share of their food budget at convenience stores and fast-food restaurants are related to poor diet quality and more likely to be obese. Our findings will help improve understanding of the causes of diet-related health problems and may illuminate potential avenues of intervention to address obesity.     

Child Involvement in Choosing a Recipe,Purchasing Ingredients,and Cooking at School Increases Willingness to Try New Foods and Reduces Food Neophobia

ObjectiveTo investigate the effect of involving children in their feeding process (choosing a recipe, purchasing the ingredients, and cooking) on their lunch food choice in a school environment.DesignQuasi-experimental.SettingTwo schools in Bilbao, Spain.ParticipantsA total of 202 children (aged 8–9 years) participated in the study (43% girls), with 99 in the nutrition education (NE) group and 103 in the hands-on (HO) group.InterventionThree 1-hour workshops (1 workshop/wk), different for each group: HO, cooking-related activities, and NE, healthy habits promotion through nutrition education activities.Main Outcome MeasuresFood neophobia, diet quality, cooking self-efficacy and attitudes toward cooking, and food intake and selection of the experimental lunches.AnalysisChi-square test of independence, ANCOVA, and t tests were performed.ResultsStudents from the HO group selected and ate more spinach/broccoli (P < 0.001 and P = 0.02, respectively) for the first lunch; and selected more spinach/broccoli (P = 0.04) for the second lunch. After the intervention, improvements were observed for spinach liking and neophobia for the HO group and cooking self-efficacy and KidMed score for both groups.Conclusions and ImplicationsBoth interventions succeeded in improving children's diet quality, but only the HO group reduced food neophobia levels. Therefore, involving children in choosing a recipe, purchasing ingredients, and cooking may promote changing eating behaviors toward healthy habits such as increasing vegetable consumption.     

Diet Quality of Breast Cancer Survivors after a Six-Month Weight Management Intervention: Improvements and Association with Weight Loss

Purpose: Obesity and diet quality are two distinct lifestyle factors associated with morbidity and mortality among breast cancer survivors. The purposes of this study were to examine diet quality changes during a weight loss intervention among breast cancer survivors and to examine whether diet quality change was an important factor related to weight loss. Methods: Participants were overweight/obese breast cancer survivors (n = 180) participating in a weight loss intervention. Diet quality scores were calculated using the Healthy Eating Index (HEI)-2010. Paired sample t-tests were run to examine change in diet quality, and a latent difference model was constructed to examine whether change in diet quality was associated with weight change. Results: Participants significantly improved diet quality (P = 0.001) and lost 13.2 ± 5.8% (mean ± SD) of their weight (P = 0.001). Six-month HEI score was significantly associated with weight loss, controlling for baseline BMI (P = 0.003). Improvement in diet quality was also significantly associated with weight loss (P = 0.01). Conclusion: Our findings indicate that a weight loss intervention can result in both clinically significant weight loss and improvement in diet quality, and that improved diet quality is predictive of weight loss. Both weight loss and diet quality are implicated in longevity and quality of life for breast cancer survivors.     

Short-term effects of whole-grain wheat on appetite and food intake in healthy adults: a pilot study

While it has been proposed, based on epidemiological studies, that whole grains may be beneficial in weight regulation, possibly due to effects on satiety, there is limited direct interventional evidence confirming this. The present cross-over study aimed to investigate the short-term effects on appetite and food intake of 48 g of whole-grain wheat (daily for 3 weeks) compared with refined grain (control). A total of fourteen healthy normal-weight adults consumed, within their habitual diets, either two whole-grain bread rolls (providing 48 g of whole grains over two rolls) or two control rolls daily for 3 weeks. Changes in food intake were assessed using 7 d diet diaries. Changes in subjective appetite ratings and food intake were also assessed at postprandial study visits. There were no significant differences between interventions in energy intake (assessed by the 7 d diet diaries and at the ad libitum test meal), subjective appetite ratings or anthropometric measurements. However, there was a significant difference between interventions for systolic blood pressure, which decreased during the whole-grain intervention and increased during the control intervention (-2 v. 4 mmHg; P = 0·015). The present study found no effect of whole grains on appetite or food intake in healthy individuals; however, 48 g of whole grain consumed daily for 3 weeks did have a beneficial effect on systolic blood pressure. The findings from the present study therefore do not support epidemiological evidence that whole grains are beneficial in weight regulation, although further investigation in other population groups (such as overweight and obese) would be required.     

The Impact of a Culinary Coaching Telemedicine Program on Home Cooking and Emotional Well-Being during the COVID-19 Pandemic

The coronavirus pandemic enforced social restrictions with abrupt impacts on mental health and changes to health behaviors. From a randomized clinical trial, we assessed the impact of culinary education on home cooking practices, coping strategies and resiliency during the first wave of the COVID-19 pandemic (March/April 2020). Participants (n = 28) were aged 25–70 years with a BMI of 27.5–35 kg/m². The intervention consisted of 12 weekly 30-min one-on-one telemedicine culinary coaching sessions. Coping strategies were assessed through the Brief Coping with Problems Experienced Inventory, and resiliency using the Brief Resilient Coping Scale. Home cooking practices were assessed through qualitative analysis. The average use of self-care as a coping strategy by the intervention group was 6.14 (1.66), compared to the control with 4.64 (1.69); p = 0.03. While more intervention participants had high (n = 5) and medium (n = 8) resiliency compared to controls (n = 4, n = 6, respectively), this difference was not significant (p = 0.33). Intervention participants reported using home cooking skills such as meal planning and time saving techniques during the pandemic. The key findings were that culinary coaching via telemedicine may be an effective intervention for teaching home cooking skills and promoting the use of self-care as a coping strategy during times of stress, including the COVID-19 pandemic.     

Cooking Frequency and Perception of Diet among US Adults Are Associated with US Healthy and Healthy Mediterranean-Style Dietary Related Classes: A Latent Class Profile Analysis

Background: Meal habits are associated with overall dietary quality and favorable dietary patterns determined by the Healthy Eating Index (HEI). However, within dietary patterns, complexities of food combinations that are not apparent through composite score determination may occur. Also, explorations of these food combinations with cooking and perceived diet quality (PDQ) remain unknown. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 were utilized to determine the frequency of cooking at home and PDQ, along with sociodemographic variables. Latent class profile analysis was performed to determine person-centered data-driven analysis using the dietary index, HEI-2010, at both the daily and dinner meal-time levels. Multinomial logistic regression analysis was utilized to evaluate the association of dietary patterns with all covariates. Results: For daily HEI, five distinct dietary classes were identified. For dinner HEI, six classes were identified. In comparison to the standard American diet classes, home cooking was positively associated with daily (p < 0.05) and dinner (p < 0.001) dietary classes that had the highest amounts of total vegetable and greens/beans intake. PDQ was positively associated with these classes at the daily level (p < 0.001), but negatively associated with healthier classes at the dinner level (p < 0.001). Conclusion: The use of latent class profile analysis at the daily and dinner meal-time levels identified that food choices coalesce into diverse intakes, as shown by identified dietary classes. Home cooking frequency could be considered a positive factor associated with higher vegetable intake, particularly greens/beans, at the daily and dinner levels. At the same time, the perception of diet quality has a positive association only with daily choices.     

Advance Quantity Meal Preparation Pilot Program Improves Home-Cooked Meal Consumption,Cooking Attitudes,and Self-Efficacy

ObjectiveTo evaluate the effects of a group-based Advance Quantity Meal Preparation (AQMP) program on the consumption of home-cooked meals, cooking attitudes, and self-efficacy in healthy adults.MethodsParticipants (n = 10) in a group setting prepared healthy meals weekly consisting of 10 entrees and 5 snacks for 6 weeks. A survey assessing cooking attitudes, cooking self-efficacy, and cooking behavior and consumption at 3 time points: preprogram, postprogram (T2), and 3 months postprogram (T3).ResultsThe AQMP program increased the proportion of overall home-cooked meal consumption (T2, P = 0.03), home-cooked dinner consumption (T2, P = 0.04), cooking attitudes (T3, P = 0.01), and cooking self-efficacy (T2, P = 0.002).Conclusions and ImplicationsThis pilot study indicates that AQMP may increase home-cooked meal consumption, cooking attitudes, and cooking self-efficacy.     

Impacts of a Vegetable Cooking Skills Program Among Low-Income Parents and Children

Objective

To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability.

Position of the American Dietetic Association: liberalized diets for older adults in long-term care

It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by a liberalized diet. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person's individual medical condition, needs, desires, and rights. One of the major determinants among the predictive factors of successful aging is nutrition. Long-term care includes a continuum of health services ranging from rehabilitation to supportive care. Nutrition care for older adults in long-term settings must meet two goals: maintenance of health through medical care and maintenance of quality of life. However, these goals often seem to compete, resulting in the need for a unique approach to medical nutrition therapy (MNT). Typically, MNT includes assessment of nutritional status and development of an individualized nutrition intervention plan that frequently features a theraperutic diet appropriate for managing a disease or condition. MNT must always address medical needs and individual desires, yet for older adults in long-term care this balance is especially critical because of the focus on maintaining quality of life. Dietetics professionals must help residents and health care team members assess the risks versus the benefits of therapeutic diets. For frail older adults, overall health goals may not warrant the use of a therapeutic diet because of its possible negative effect on quality of life. A diet that is not palatable or acceptable to the individual can lead to poor food and fluid intake, which results in weight loss and undernutrition, followed by a spiral of negative health effects. Often, a more liberalized nutrition intervention that allows an older adult to participate in his or her diet-related decisions can provide for the person's nutrient needs and allow alterations contingent on medical conditions while simultaneously increasing the desire to eat and enjoyment of food. This ultimately decreases the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.     

Comparative strategies for using cluster analysis to assess dietary patterns

OBJECTIVES: To characterize dietary patterns using two different cluster analysis strategies. DESIGN: In this cross-sectional study, diet information was assessed by five 24-hour recalls collected over 10 months. All foods were classified into 24 food subgroups. Demographic, health, and anthropometric data were collected via home visit. SUBJECTS: One hundred seventy-nine community-dwelling adults, aged 66 to 87 years, in rural Pennsylvania. STATISTICAL ANALYSIS: Cluster analysis was performed. RESULTS: The methods differed in the food subgroups that clustered together. Both methods produced clusters that had significant differences in overall diet quality as assessed by Healthy Eating Index (HEI) scores. The clusters with higher HEI scores contained significantly higher amounts of most micronutrients. Both methods consistently clustered subgroups with high energy contribution (eg, fats and oils and dairy desserts) with a lower HEI score. Clusters resulting from the percent energy method were less likely to differentiate fruit and vegetable subgroups. The higher diet quality dietary pattern derived from the number of servings method resulted in more favorable weight status. CONCLUSIONS: Cluster analysis of food subgroups using two different methods on the same data yielded similarities and dissimilarities in dietary patterns. Dietary patterns characterized by the number of servings method of analysis provided stronger association with weight status and was more sensitive to fruit and vegetable intake with regard to a more healthful dietary pattern within this sample. Public health recommendations should evaluate the methodology used to derive dietary patterns.     

基于手机应用程序的膳食干预对超重或肥胖人群减重及食物成瘾的影响

目的探讨基于手机应用程序(application,APP)的膳食干预对成年超重或肥胖人群减重及食物成瘾的影响。方法收集2015年8月至2018年1月宁波市第一医院肥胖多学科联合门诊的18岁以上超重或肥胖者101例作为研究对象。受试者接受健康宣教和个体化饮食指导,并通过智能手机体重管理APP上交饮食日志,营养师对饮食不达标的受试者进行指导和纠正12周。在干预前和干预后(12周)分别进行询问调查、体格检查、实验室检查及耶鲁食物成瘾量表问卷调查,比较干预前后受试者的体重、食物成瘾症状计数得分及食物成瘾者比例的变化情况。分别采用配对资料的t检验、卡方检验或Fisher精确检验对体成分测量值、血生化指标以及症状计数得分进行统计学检验。结果共纳入101例超重或肥胖受试者,男性31例,女性70例,年龄为(30.4±7.3)岁,体质指数(BMI)为(32.76±4.46)kg/m2,体重为(89.95±17.12)kg,食物成瘾者占比为26.73%。通过手机APP膳食干预12周后,患有食物成瘾的人数从27例减至14例,比例下降了12.9%,症状计数≥3的比例从41.6%下降到19.8%(χ2=5.17、11.26,均P<0.01),症状计数由2.25±1.61下降到1.50±1.31(t=3.64,P<0.001);同时,体重、BMI和腰围较干预前分别下降了(6.54±1.03)kg、(2.35±0.36)kg/m2、(6.50±0.86)cm(t=6.36、5.62、3.78,均P<0.001);代谢指标如空腹血糖、胰岛素抵抗指数和低密度脂蛋白胆固醇显著改善,分别下降了(0.38±0.10)mmol/L、1.83±0.46、(0.22±0.75)mmol/L(t=3.67、3.59、2.97,均P<0.01)。结论基于智能手机APP的膳食干预能有效改善超重和肥胖人群的血糖、血脂水平,减少内脏脂肪堆积,减轻胰岛素抵抗程度,改善食物成瘾状态。     

Taking control of your personal eating and exercise environment: a weight maintenance program

The current investigation examined the impact of a weight maintenance intervention (MI) designed to empower people to create a personal healthy food and physical activity environment on weight loss treatment outcomes. It was hypothesized that behavioral weight loss program (BWLP) participants who received an additional MI would evidence superior weight loss maintenance compared to participants who received a BWLP alone (no contact [NC]). Fifty-one obese adults were randomly assigned to participate in a 16-week weight loss intervention followed by NC or a 6-week MI. Thirty-eight participants completed the six-month follow-up. Body weight, percent body fat, cardiorespiratory fitness, self-reported physical activity, and self-reported diet (i.e., calories, percent daily intake of fat, protein, and carbohydrates) were assessed. Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). MI participants had significantly greater weight loss maintenance than NC participants (ps<.05). Helping obese individuals to modify their personal eating and physical activity environment in order to reduce exposure to "obesogenic" cues may contribute to long-term weight loss maintenance.