Research

7 pages, 218 KiB

Open AccessCommunication

Nourishing Conversations: Using Motivational Interviewing in a Community Teaching Kitchen to Promote Healthy Eating via a Food as Medicine Intervention

by Sara Temelkova, Saria Lofton, Elaine Lo, Jeannine Wise and Edwin K. McDonald IV

Nutrients 2024, 16(7), 960; https://doi.org/10.3390/nu16070960 - 27 Mar 2024

Viewed by 716

Abstract

It is well known that dietary choices impact both individual and global health. However, there are numerous challenges at the personal and systemic level to fostering sustainable healthy eating patterns. There is a need for innovative ways to navigate these barriers. Food as [...] Read more.

It is well known that dietary choices impact both individual and global health. However, there are numerous challenges at the personal and systemic level to fostering sustainable healthy eating patterns. There is a need for innovative ways to navigate these barriers. Food as Medicine (FM) and Culinary Medicine (CM) are approaches to helping individuals achieve healthier diets that also recognize the potential to alleviate the burden of chronic diseases through healthy eating. Teaching kitchens, which offer an interactive environment for learning nutrition and cooking skills, are valuable educational tools for FM and CM interventions. Motivational interviewing (MI), a type of person-centered counseling, facilitates behavior change and may enhance FM and CM programs involving teaching kitchens. In this commentary, we share our experience with using MI in a community-based CM program at a teaching kitchen. In demonstrating our application of MI principles, we hope to offer an additional strategy for improving dietary quality and delivering nutrition education. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

20 pages, 1142 KiB

Open AccessArticle

Cultivating Healthier Habits: The Impact of Workplace Teaching Kitchens on Employee Food Literacy

by Richard Daker, Ghislaine Challamel, Chavanne Hanson and Jane Upritchard

Nutrients 2024, 16(6), 865; https://doi.org/10.3390/nu16060865 - 16 Mar 2024

Viewed by 817

Abstract

This research explores the impact of workplace teaching kitchen cooking classes on participants’ food literacy and identifies key predictors of employee engagement. Aligning with the existing literature, we demonstrate that a workplace teaching kitchen program, with hands-on cooking classes, effectively enhances food skills [...] Read more.

This research explores the impact of workplace teaching kitchen cooking classes on participants’ food literacy and identifies key predictors of employee engagement. Aligning with the existing literature, we demonstrate that a workplace teaching kitchen program, with hands-on cooking classes, effectively enhances food skills and intrinsic motivation—core aspects of food literacy. Importantly, our results reveal that even a single class can have a measurable impact. Teaching kitchens can successfully engage employees, particularly those with low food skills, showcasing their broad appeal beyond individuals already engaged in wellness or seeking social connection. Awareness emerges as the most influential predictor of participation, emphasizing the crucial role of marketing. Virtual classes prove as effective as onsite ones, offering the potential to increase access for employees. Recognizing employee wellness as a strategic opportunity for employers and a sought-after benefit for top talent, we underscore the importance of practical nutrition education to support individuals in shifting food choices within lifestyle constraints. Workplace teaching kitchens emerge as an effective and scalable solution to address this need. Future research should prioritize exploring the lasting impacts of teaching kitchen education on employee eating habits and health, contributing to ongoing strategy refinement. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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16 pages, 289 KiB

Open AccessArticle

Evaluation of the Effectiveness of a Bilingual Nutrition Education Program in Partnership with a Mobile Health Unit

by Madeleine L. French, Joshua T. Christensen, Paul A. Estabrooks, Alexandra M. Hernandez, Julie M. Metos, Robin L. Marcus, Alistair Thorpe, Theresa E. Dvorak and Kristine C. Jordan

Nutrients 2024, 16(5), 618; https://doi.org/10.3390/nu16050618 - 23 Feb 2024

Viewed by 1317

Abstract

There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. [...] Read more.

There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. The purpose of this paper is to report on the development, implementation, and evaluation of Journey to Health, a program designed for community implementation using the RE-AIM planning and evaluation framework. Reach and effectiveness were the primary outcomes. Regarding reach, 507 individuals registered for the program, 310 participants attended at least one nutrition class, 110 participants completed at least two biometric screens, and 96 participants attended at least two health coaching appointments. Participants who engaged in Journey to Health realized significant improvements in body mass index, blood pressure, and triglycerides. For higher risk participants, we additionally saw significant improvements in total and LDL cholesterol. Regarding dietary intake, we observed a significant increase in cups of fruit and a decrease in sugar sweetened beverages consumed per day. Our findings suggest that Journey to Health may improve selected biometrics and health behaviors in low-income and underrepresented minority participants. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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12 pages, 1457 KiB

Open AccessArticle

Culinary Medicine or Culinary Nutrition? Defining Terms for Use in Education and Practice

by Sharon Croxford, Emma Stirling, Julia MacLaren, John Wesley McWhorter, Lynn Frederick and Olivia W. Thomas

Nutrients 2024, 16(5), 603; https://doi.org/10.3390/nu16050603 - 22 Feb 2024

Viewed by 1564

Abstract

Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these [...] Read more.

Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these terms across work areas and disciplines. Thirty leading practitioners, academics, and researchers in the fields of food and nutrition across Australia, the United States, Canada, United Kingdom, Europe, and Asia were approached by investigators via email to submit definitions of key terms using a Qualtrics survey link. Further participants were reached through snowball recruitment. Initial emails were sent in October and November 2021 with subsequent reminders between November 2021 and March 2022. Two researchers undertook content analysis of the text answers for each of the terms and generated definitions for discussion and consensus. Thirty-seven participants commenced the survey and twenty-three submitted one or more definitions. Agreed definitions fell into two categories: practice concepts and practitioners. Further discussion amongst investigators led to the creation of a visual map to demonstrate the interrelationship of terms. Culinary nutrition science underpins, and interprofessional collaboration characterizes practice in this area, however, further work is needed to define competencies and model best practice. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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12 pages, 252 KiB

Open AccessArticle

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

by Caitlin D. French, Alexander Gomez-Lara, Arianna Hee, Akshara Shankar, Nayoung Song, Monserrath Campos, Mikelle McCoin and Susana L. Matias

Nutrients 2024, 16(5), 585; https://doi.org/10.3390/nu16050585 - 21 Feb 2024

Viewed by 1259

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

11 pages, 490 KiB

Open AccessArticle

Promoting Nutrition and Food Sustainability Knowledge in Apprentice Chefs: An Intervention Study at The School of Italian Culinary Arts—ALMA

by Cinzia Franchini, Beatrice Biasini, Francesca Giopp, Alice Rosi and Francesca Scazzina

Nutrients 2024, 16(4), 537; https://doi.org/10.3390/nu16040537 - 15 Feb 2024

Viewed by 852

Abstract

Chefs’ decisions can greatly improve the quality of food provided and positively guide diners’ choices. Culinary students’ knowledge of healthy and sustainable nutrition is still scarcely investigated and is limited to the nutritional aspect of the diet, without considering food sustainability or the [...] Read more.

Chefs’ decisions can greatly improve the quality of food provided and positively guide diners’ choices. Culinary students’ knowledge of healthy and sustainable nutrition is still scarcely investigated and is limited to the nutritional aspect of the diet, without considering food sustainability or the environmental impact of foods. This study aims to determine the effectiveness of an educational program designed for apprentice chefs. Two questionnaires were administered twice to each student who followed dedicated lectures about nutrition and food sustainability and to other students enrolled as the control group. A total of 264 and 252 apprentice chefs of The School of Italian Culinary Arts—ALMA were enrolled in the control and intervention groups, respectively. At baseline, both groups showed a good level of nutrition knowledge, whereas food sustainability knowledge was lower in all students, regardless of the group. This educational intervention proved to be effective in improving knowledge about nutrition and the environmental impact of food production and consumption. However, a small but significant improvement in nutritional knowledge was also found over time in the control group. Finally, a food sustainability knowledge questionnaire was developed and validated for this study, providing interesting results to be treated as a guide for future developments. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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16 pages, 1148 KiB

Open AccessArticle

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

by Nicola Rosenau, Uwe Neumann, Stacey Hamblett and Thomas Ellrott

Nutrients 2024, 16(4), 521; https://doi.org/10.3390/nu16040521 - 13 Feb 2024

Viewed by 1546

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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13 pages, 773 KiB

Open AccessArticle

Effect of the Emory Healthy Kitchen Collaborative on Employee Health Habits and Body Weight: A 12-Month Workplace Wellness Trial

by Sharon H. Bergquist, Danyang Wang, Rokhaya Fall, Jonathan P. Bonnet, Krystyna R. Morgan, Dominique Munroe and Miranda A. Moore

Nutrients 2024, 16(4), 517; https://doi.org/10.3390/nu16040517 - 13 Feb 2024

Viewed by 1203

Abstract

Introduction: Teaching kitchens are being used to facilitate lifestyle changes with a focus on culinary and nutrition programs to improve health behaviors. Less is known regarding their use as a worksite wellness program and their influence on employees’ quality of life, body weight, [...] Read more.

Introduction: Teaching kitchens are being used to facilitate lifestyle changes with a focus on culinary and nutrition programs to improve health behaviors. Less is known regarding their use as a worksite wellness program and their influence on employees’ quality of life, body weight, and adoption of healthy behaviors. We evaluated changes in self-reported healthy behaviors, overall health, and weight during a one-year multidisciplinary teaching kitchen program. Methods: Thirty-eight benefits-eligible employees were recruited, screened based on a priori eligibility criteria that prioritized elevated body mass index (BMI), co-morbid conditions, and high levels of motivation to make lifestyle changes, and consented to participate in The Emory Healthy Kitchen Collaborative. This 12-month program included a 10-week didactic and experiential curriculum followed by continued support and access to health coaching implemented in an academic health system university hospital workplace between 2019 and 2020. Comparative statistics, paired t-test, Mcnemar’s tests, and Wilcoxon signed-rank tests were used to assess changes at four time points. Results: Participants improved diet quality (p ≤ 0.0001), increased confidence in tasting new foods (p = 0.03), and increased mindful eating habits (p = 0.00002). Significant changes were seen in physical activity levels; aerobic activities (p = 0.007), strength resistance activities (p = 0.02), and participation in yoga (p = 0.002). Most participants weighed within 5 lbs. of their starting weight at 3 months (p = 0.57). Conclusions: A teaching kitchen intervention is an innovative model for improving employee health behaviors and general health self-perception. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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18 pages, 2252 KiB

Open AccessArticle

Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention

by Nicole Farmer, Ralph Tuason, Kimberly R. Middleton, Assumpta Ude, Gladys Tataw-Ayuketah, Sharon Flynn, Narjis Kazmi, Alyssa Baginski, Valerie Mitchell, Tiffany M. Powell-Wiley and Gwenyth R. Wallen

Nutrients 2024, 16(3), 463; https://doi.org/10.3390/nu16030463 - 05 Feb 2024

Viewed by 1156

Abstract

Background: Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may [...] Read more.

Background: Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may aid in designing community-tailored interventions. Methods: A sequential mixed methods study was conducted to determine the prospective acceptability of a planned community-located cooking intervention among African American adults living in a low food access area and with at least one cardiovascular disease risk factor. A semi-structured guide was used to conduct five virtual focus groups. Qualitative data were analyzed using thematic analysis and validated through participant check-in interviews. Survey responses were analyzed based on descriptive data. Geospatial analysis of participant locations that were reported for food shopping was conducted to show food environment utilization. Results: Focus groups with study participants (n = 20, all female, mean age 60.3, SD 9.3, mean cooking frequency per week 4.0, food insecure n = 7) were conducted between March and April, 2021. Thematic analysis of the focus group transcripts identified five main themes as follows: (A) Barriers to Cooking (family and caregiving, transportation, COVID-19 pandemic, time availability, household composition); (B) Motivators for Cooking (family, caregiving, health, enjoyment, COVID-19 pandemic); (C) Strategies (food shopping, social support, social media, meal planning); (D) Neighborhood (gentrification, perceived safety, stigmatization, disparities in grocery stores); (E) and Acceptability of the Intervention (reasons to participate, barriers, recruitment, intervention delivery). Participant validation interviews confirmed the themes and subthemes as well as the illustrative quotes. Geospatial analysis showed a majority of locations were outside of the participants’ residential areas. Conclusions: Prospective acceptability of a community-tailored cooking intervention found that the planned intervention could be modified to address individual level factors, such as caregiving and health, community contextual factors, such as perceived safety, and the general health needs of the community. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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7 pages, 1964 KiB

Open AccessCommunication

Development of a Culinary Medicine Curriculum to Support Nutrition Knowledge for Gastroenterology Fellows and Faculty

by Karen L. Lindsay, Jennifer Kennedy, Daniel Kim, Ankush Kalra and Nimisha K. Parekh

Nutrients 2024, 16(3), 404; https://doi.org/10.3390/nu16030404 - 30 Jan 2024

Viewed by 836

Abstract

Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine [...] Read more.

Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1–4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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11 pages, 260 KiB

Open AccessArticle

Addressing the Gap of Nutrition in Medical Education: Experiences and Expectations of Medical Students and Residents in France and the United States

by Solenn Thircuir, Nancy N. Chen and Kristine A. Madsen

Nutrients 2023, 15(24), 5054; https://doi.org/10.3390/nu15245054 - 09 Dec 2023

Viewed by 1776

Abstract

Distinct pedagogical approaches within medical curricula in France and in the U.S. reflect a growing recognition of the importance of nutrition to address major public health challenges. However, recent generations of medical students have expressed mixed opinions regarding nutrition education. What pedagogical approach [...] Read more.

Distinct pedagogical approaches within medical curricula in France and in the U.S. reflect a growing recognition of the importance of nutrition to address major public health challenges. However, recent generations of medical students have expressed mixed opinions regarding nutrition education. What pedagogical approach may improve nutrition education? Despite different medical systems, students from both France and the U.S. share similar concerns and expectations, that nutrition knowledge must be embedded in the curriculum and must be engaging. Hands-on, system-based, epistemological, and multidisciplinary approaches need better articulation to forge a robust medical curriculum. In the rapidly changing contexts of medicine and public awareness, social science research may facilitate recommendations for improved nutrition education. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

10 pages, 241 KiB

Open AccessArticle

Eat to Treat: The Methods and Assessments of a Culinary Medicine Seminar for Future Physicians and Practicing Clinicians

by Kate Donovan, Olivia W. Thomas, Ty Sweeney, Tyler J. Ryan, Sonja Kytomaa, Molly Zhao, Wayne Zhong, Michelle Long, Iniya Rajendran, Suzanne Sarfaty and Carine Lenders

Nutrients 2023, 15(22), 4819; https://doi.org/10.3390/nu15224819 - 17 Nov 2023

Viewed by 1242

Abstract

Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled “Eat to Treat: A Nutrition Course for Future Clinicians” that teaches culinary skills, nutrition science, [...] Read more.

Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled “Eat to Treat: A Nutrition Course for Future Clinicians” that teaches culinary skills, nutrition science, and counseling techniques to improve clinical nutrition management. The seminar was offered in-person to first-year medical students in a medical school-based teaching kitchen from 2017 to 2019. A virtual three-session course was also offered to practicing clinicians in 2020. Voluntary self-efficacy questionnaires were collected at the beginning of the first and last sessions of the student seminar, and paired t-tests determined the course’s effect on survey items. A total of 53 first-year medical students attended the program over five semesters, and 39 students (73.6%) completed both surveys. All except one measure of self-efficacy were significantly higher at session 6 than session 1 (p < 0.05). A post-course survey was utilized for the clinician seminar and of the 31 participants, 14 completed the surveys; 93% and 86% of respondents agreed the course was clinically relevant and improved their confidence, respectively. We developed a CM curriculum that improved nutrition knowledge and confidence among a professionally diverse cohort and may represent a scalable education model to improve nutrition education in US medical schools. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

14 pages, 1230 KiB

Open AccessArticle

Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign

by Marianna S. Wetherill, Lacey T. Caywood, Nicholas Hollman, Valarie P. Carter, Joshua Gentges, Ashli Sims and Carrie Vesely Henderson

Nutrients 2023, 15(20), 4417; https://doi.org/10.3390/nu15204417 - 18 Oct 2023

Viewed by 2103

Abstract

Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential [...] Read more.

Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of “food is medicine” interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed “food is medicine” guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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13 pages, 534 KiB

Open AccessArticle

Enhancing Chronic-Disease Education through Integrated Medical and Social Care: Exploring the Beneficial Role of a Community Teaching Kitchen in Oregon

by Jacob P. Tanumihardjo, Heidi Davis, Mengqi Zhu, Helen On, Kayla K. Guillory and Jill Christensen

Nutrients 2023, 15(20), 4368; https://doi.org/10.3390/nu15204368 - 14 Oct 2023

Cited by 2 | Viewed by 1820

Abstract

Teaching kitchens (TKs) are rapidly being utilized as models to integrate culinary education and chronic-disease education into healthcare settings. Our observational study details the structure and organizational processes (e.g., referral, services, medical and social care integration) of the Community TK at Providence Milwaukie [...] Read more.

Teaching kitchens (TKs) are rapidly being utilized as models to integrate culinary education and chronic-disease education into healthcare settings. Our observational study details the structure and organizational processes (e.g., referral, services, medical and social care integration) of the Community TK at Providence Milwaukie Hospital in Portland, OR. We utilize electronic medical-record data from engaged TK participants (n = 3077) to evaluate between the association of engagement and clinical outcomes (e.g., HbA1c, blood pressure, weight and cholesterol). Mean baseline HbA1c of Highly Engaged TK patients with diabetes (n = 88) reduced from 9.8% to 8.6% at 6 months (p < 0.0001) and sustained significant reductions at 12, 18, 24, 30, and 36 months (p < 0.05). Highly Engaged patients with hypertension (n = 152) had significant, sustained reductions in blood pressure (p < 0.0001). Engaged patients in the same high-risk groups also had significant improvements in HbA1c and blood pressure. Both engagement subgroups had moderate improvements in weight change and cholesterol. This study shows promising associations of TK services that promote chronic-disease self-management with improved clinical outcomes among higher risk patients (e.g., high blood pressure, high HbA1c, high low-density lipoprotein) with different medical issues (e.g., diabetes, obesity) and social barriers (e.g., food insecurity). Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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23 pages, 3306 KiB

Open AccessArticle

Characteristics of Current Teaching Kitchens: Findings from Recent Surveys of the Teaching Kitchen Collaborative

by Christina Badaracco, Olivia W. Thomas, Jennifer Massa, Rachel Bartlett and David M. Eisenberg

Nutrients 2023, 15(20), 4326; https://doi.org/10.3390/nu15204326 - 10 Oct 2023

Viewed by 1494

Abstract

Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) [...] Read more.

Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) to enhance the health and wellness of patients, staff, youth, and the general community. Although implementation of TKs is becoming more common, best practices for starting and operating programs are limited. The present study aims to describe key components and professionals required for TK operations. Surveys were administered to Teaching Kitchen Collaborative (TKC) members and questions reflected seven primary areas of inquiry: (1) TK setting(s), (2) audiences served, (3) TK model(s), (4) key lines of operations, (5) team member who manages or directs the TK, (6) team member(s) who performs key operations and other professionals or partnerships that may be needed, and (7) the primary funding source(s) to build and operate the TK (among various other topics). Findings were used to articulate recommendations for organizations seeking to establish a successful TK as well as for TKs to expand their collective reach, research capacity, and impact. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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14 pages, 801 KiB

Open AccessArticle

Comparison of Effectiveness regarding a Culinary Medicine Elective for Medical Students in Germany Delivered Virtually versus In-Person

by Selina Böttcher, Louisa Josefa Schonebeck, Laura Drösch, Anna Manuela Plogmann, Can Gero Leineweber, Seraphina Puderbach, Charlotte Buhre, Christoph Schmöcker, Uwe Neumann and Thomas Ellrott

Nutrients 2023, 15(19), 4281; https://doi.org/10.3390/nu15194281 - 08 Oct 2023

Cited by 1 | Viewed by 1614

Abstract

(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum [...] Read more.

(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum was either delivered virtually (2021) or in-person (2022/2023). Changes in teaching effectiveness were evaluated. (2) Methods: The elective included seven modules in the teaching kitchen for 3 h each. It consisted of a short introduction and a hands-on interactive cooking part illustrating important dietary principles in different disease groups. The elective was conducted virtually in 2021 in a fully interactive setup using videoconference tools. Students in this cohort attended from their private kitchens whereas students in the in-person cohort (2022/2023) attended the same classes in the teaching kitchen. Standardized comparative self-assessment questionnaires on counselling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5) before and after the elective were used to determine teaching effectiveness. Paired and unpaired t-tests were performed to evaluate results. (3) Results: A total of 70 students (mean semester 6.3) were included in the virtual cohort, and 80 students (mean semester 6.3) were in the in-person cohort. In both, counselling competencies on 25 nutrition and lifestyle medicine topics increased significantly. Significant changes also occurred in most nutrition knowledge categories. Subjective well-being as well as personal attitudes towards nutrition counselling in medical practice improved significantly during the elective. Healthy eating habits improved in both groups as students ate significantly less unfavourable foods. There were no significant differences between the two groups apart from minor differences in nutrition knowledge. (4) Conclusions: The elective in Culinary Medicine improved students counselling competencies, nutrition knowledge, attitudes, well-being, and eating habits with no relevant difference between virtual and in-person teaching. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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13 pages, 1033 KiB

Open AccessArticle

Standard Patient History Can Be Augmented Using Ethnographic Foodlife Questions

by June Jo Lee, John Wesley McWhorter, Gabrielle Bryant, Howard Zisser and David Miles Eisenberg

Nutrients 2023, 15(19), 4272; https://doi.org/10.3390/nu15194272 - 06 Oct 2023

Viewed by 1415

Abstract

The relationship between what and how individuals eat and their overall and long-term health is non-controversial. However, for decades, food and nutrition discussions have often been highly medicalized. Given the significant impact of poor nutrition on health, broader discussions about food should be [...] Read more.

The relationship between what and how individuals eat and their overall and long-term health is non-controversial. However, for decades, food and nutrition discussions have often been highly medicalized. Given the significant impact of poor nutrition on health, broader discussions about food should be integrated into routine patient history taking. We advocate for an expansion of the current, standard approach to patient history taking in order to include questions regarding patients’ ‘foodlife’ (total relationship to food) as a screening and baseline assessment tool for referrals. We propose that healthcare providers: (1) routinely engage with patients about their relationship to food, and (2) recognize that such dialogues extend beyond nutrition and lifestyle questions. Mirroring other recent revisions to medical history taking—such as exploring biopsychosocial risks—questions about food relationships and motivators of eating may be essential for optimal patient assessment and referrals. We draw on the novel tools of ‘foodlife’ ethnography (developed by co-author ethnographer J.J.L., and further refined in collaboration with the co-authors who contributed their clinical experiences as a former primary care physician (D.M.E.), registered dietitian (J.W.M.), and diabetologist (H.Z.)) to model a set of baseline questions for inclusion in routine clinical settings. Importantly, this broader cultural approach seeks to augment and enhance current food intake discussions used by registered dietitian nutritionists, endocrinologists, internists, and medical primary care providers for better baseline assessments and referrals. By bringing the significance of food into the domain of routine medical interviewing practices by a range of health professionals, we theorize that this approach can set a strong foundation of trust between patients and healthcare professionals, underscoring food’s vital role in patient-centered care. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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10 pages, 226 KiB

Open AccessArticle

Cooking up Change: DEIB Principles as Key Ingredients in Nutrition and Culinary Medicine Education

by Melinda Ring, David Ai, Geeta Maker-Clark and Raeanne Sarazen

Nutrients 2023, 15(19), 4257; https://doi.org/10.3390/nu15194257 - 05 Oct 2023

Cited by 2 | Viewed by 1532

Abstract

The integration of diversity, equity, inclusion, and belonging (DEIB) principles into healthcare education is essential to ensure culturally sensitive and equitable healthcare delivery. In the domain of nutrition, food, and health, these principles are particularly vital, as diet and food choices are strongly [...] Read more.

The integration of diversity, equity, inclusion, and belonging (DEIB) principles into healthcare education is essential to ensure culturally sensitive and equitable healthcare delivery. In the domain of nutrition, food, and health, these principles are particularly vital, as diet and food choices are strongly linked to cultural identities and socioeconomic conditions. Despite a growth of DEIB initiatives in undergraduate and graduate medical education, there is a significant gap regarding guidelines for implementing DEIB principles in education around nutrition and food, including that for dietitians, allied health and medical professionals. A literature review was conducted, analyzing peer-reviewed articles and current practices in academic medical education to understand DEIB in nutrition, food, and health. The outcome was the creation of a three-tiered checklist titled “Checklist for Culturally Competent Education in Nutrition”. It serves as a roadmap to cultivate culturally competent, equitable, and inclusive healthcare professionals that emphasizes avoiding bias, enhancing awareness, and building practical skills for DEIB implementation around nutrition. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

11 pages, 256 KiB

Open AccessArticle

Impact of a Teaching Kitchen Curriculum for Health Professional Trainees in Nutrition Knowledge, Confidence, and Skills to Advance Obesity Prevention and Management in Clinical Practice

by Christine K. Thang, Alma D. Guerrero, Cambria L. Garell, Janet K. Leader, Erica Lee, Kevin Ziehl, Catherine L. Carpenter, Shanika Boyce and Wendelin Slusser

Nutrients 2023, 15(19), 4240; https://doi.org/10.3390/nu15194240 - 30 Sep 2023

Cited by 1 | Viewed by 1038

Abstract

Nutrition knowledge, confidence, and skills are thought to be important elements in the role of healthcare professionals in obesity prevention and management. The Upstream Obesity Solutions curriculum goes upstream with a multidisciplinary approach to supplement nutrition education among health professional trainees. Educational strategies [...] Read more.

Nutrition knowledge, confidence, and skills are thought to be important elements in the role of healthcare professionals in obesity prevention and management. The Upstream Obesity Solutions curriculum goes upstream with a multidisciplinary approach to supplement nutrition education among health professional trainees. Educational strategies of didactics, teaching kitchens, and service-based learning were employed for medical, dental, and nursing students and resident physicians. Pre/post participation surveys assessed knowledge, attitude, and practices; lifestyle habits; and culinary skills among 75 trainees in this cross-sectional descriptive study. There was variability in statistically significant improvement in knowledge, attitudes, and practices about obesity management and nutrition education, lifestyle habits, and culinary skills among learner groups. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

14 pages, 1517 KiB

Open AccessArticle

Empowering Future Physicians and Communities on Chicago’s South Side through a 3-Arm Culinary Medicine Program

by Geeta Maker-Clark, Ashley McHugh, Hannah Shireman, Valeria Hernandez, Megha Prasad, Tiffany Xie, Arianna Parkhideh, Carlin Lockwood and Sonia Oyola

Nutrients 2023, 15(19), 4212; https://doi.org/10.3390/nu15194212 - 29 Sep 2023

Cited by 2 | Viewed by 1072

Abstract

The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in [...] Read more.

The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in the study. Data were obtained using pre- and post-course surveys and qualitative interviews from September 2021–July 2023. Results show increased confidence in medical students’ ability to provide nutrition counseling, with a high significance in their ability to provide counseling regarding chronic conditions. Participants managing chronic conditions demonstrated significant increases in self-reported confidence in their understanding of overall chronic disease management and care and in their kitchen skills, with participants who attended five or more classes having significantly higher means. Qualitative feedback from middle school students highlights their knowledge and willingness to try new foods after engaging with the curriculum. Findings add to the growing literature on culinary medicine and provide insight into the effectiveness of culinary medicine programming to increase knowledge and promote positive changes among future healthcare professionals and community members. However, more extensive research across a longer time span is needed to confirm the potential for sustained change. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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12 pages, 547 KiB

Open AccessArticle

Survivors Overcoming and Achieving Resiliency (SOAR): Mindful Eating Practice for Breast Cancer Survivors in a Virtual Teaching Kitchen

by Sherri Huang, Diane Riccardi, Sonya Pflanzer, Laura S. Redwine, Heewon L. Gray, Tiffany L. Carson, Marc McDowell, Zachary Thompson, Jesse J. Hubbard and Smitha Pabbathi

Nutrients 2023, 15(19), 4205; https://doi.org/10.3390/nu15194205 - 29 Sep 2023

Cited by 1 | Viewed by 1467

Abstract

The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen [...] Read more.

The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen intervention called Survivors Overcoming and Achieving Resiliency (SOAR). SOAR engaged participants through weekly cooking classes that also taught multiple domains of mindfulness. Participants (n = 102) were breast cancer survivors and completed the Mindful Eating Questionnaire (MEQ) prior to and after completion of the intervention. Linear regression analyses examined relationships between the aspects of mindful eating and body mass index (BMI). Wilcoxon (paired) rank sum tests evaluated the significance of the change in the MEQ total sum and subscales scores. A total of 102 participants completed both the pre- and post-intervention surveys. The mean change between the pre- and post-SOAR MEQ summary scores was 0.12 (sd = 0.30; Wilcoxon p-value = 0.0003). All MEQ subscale scores significantly increased with the exception of the distraction subscale. The MEQ summary scores increased for participants across both BMI stratifications. The SOAR teaching kitchen represents one of the first interventions that is tailored for breast cancer survivors and combines behavioral strategies from mindful eating training to nutritional knowledge and culinary medicine pedagogy in a virtual teaching kitchen. Further research is needed to examine whether mindful eating practices among cancer survivors result in sustainable healthy eating behaviors and food choices consistent with the cancer risk reduction guidelines. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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14 pages, 295 KiB

Open AccessArticle

Examination of an Online Cooking Education Program to Improve Shopping Skills, Attitudes toward Cooking, and Cooking Confidence among WIC Participants

by Dena R. Herman, Rachel Kimmel, Skye Shodahl and Jose H. Vargas

Nutrients 2023, 15(19), 4177; https://doi.org/10.3390/nu15194177 - 27 Sep 2023

Cited by 2 | Viewed by 1300

Abstract

The present study examined if adapting the Cooking Matters (CM) curriculum to be used in an online format would improve participants’ shopping skills, attitudes toward cooking, and feelings of cooking confidence, similar to the traditionally offered method, which is conducted in person. Results [...] Read more.

The present study examined if adapting the Cooking Matters (CM) curriculum to be used in an online format would improve participants’ shopping skills, attitudes toward cooking, and feelings of cooking confidence, similar to the traditionally offered method, which is conducted in person. Results from factor analyses indicated that the online CM program demonstrated construct and content reliability compared to in-person (Cronbach’s α ≥ 0.70). Repeated-measures ANOVA revealed a decrease in shopping skills overall (F = 5.91; p ≤ 0.05), consistent across age groups (F = 3.2; p ≤ 0.05) and food security status (F = 7.48; p < 0.01), with larger impacts on the food insecure (FI). Positive cooking attitudes increased with income (F = 2.86; p ≤ 0.05), especially among the <$20,000 and $30–39,000 income brackets. Cooking confidence increased post-intervention (F = 27.2, p < 0.001), with an interaction effect for food security status (F = 7.45; p ≤ 0.01), with greater improvement for households with food insecurity. These findings provide evidence to program and policymakers that virtual nutrition and cooking education services for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) should continue to be supported beyond the pandemic as they reduce barriers to receiving program benefits, nutrition education, and may lead to reductions in household food insecurity. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

18 pages, 2612 KiB

Open AccessArticle

“Zoom”ing to the Kitchen: A Novel Approach to Virtual Nutrition Education for Medical Trainees

by Justin A. Charles, Nathan I. Wood, Stephanie Neary, Jorge O. Moreno, Lindsey Scierka, Benjamin Brink, Xiwen Zhao and Katherine A. Gielissen

Nutrients 2023, 15(19), 4166; https://doi.org/10.3390/nu15194166 - 27 Sep 2023

Cited by 2 | Viewed by 2051

Abstract

While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included [...] Read more.

While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included plant-based nutrition, dietary history-taking and counseling, and culinary medicine. Students were surveyed before, immediately after, and four weeks after the curriculum to assess changes to nutrition-related knowledge, attitudes, confidence, and personal dietary behaviors. Seventy-three PA students (91%) completed the pre-survey, 76 (95%) completed the post-survey, and 42 (52.5%) completed the delayed post-survey. Knowledge scores increased immediately post-intervention (48.9% to 78.9%; p < 0.001) and persisted four weeks later (78.9% to 75.8%; p = 0.54). Post-intervention, students felt more confident in dietary history-taking (55% vs. 95%; p = 0.001) and nutrition counseling (53% vs. 84%; p = 0.003) and agreed that dietary changes alone could reverse type 2 diabetes (74% vs. 97%; p = 0.027) and coronary artery disease (66% vs. 92%; p = 0.039). Curricula using virtual teaching kitchens may be a scalable approach to nutrition education for medical trainees. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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17 pages, 1301 KiB

Open AccessArticle

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy

by Britta Retzlaff Brennan, Katherine A. Beals, Ryan D. Burns, Candace J. Chow, Amy B. Locke, Margaret P. Petzold and Theresa E. Dvorak

Nutrients 2023, 15(19), 4157; https://doi.org/10.3390/nu15194157 - 26 Sep 2023

Cited by 1 | Viewed by 1304

Abstract

Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated [...] Read more.

Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated the impact of an interprofessional CM course for medical and health professional students who experienced the hands-on cooking component in person or a in mixed-mode format (in-person and via Zoom) at the University of Utah from 2019–2023 (n = 84). A factorial ANOVA assessed differences between educational environment and changes between pre- and post-course survey responses related to diet and lifestyle counseling, interprofessional communication, and health behaviors and advocacy. Qualitative comments from post-course surveys were analyzed on a thematic level. Students rated themselves as having greater confidence and competence in diet and lifestyle counseling (p < 0.05) and increased ability to prepare eight healthy meals (p < 0.05). Additionally, a Mann–Whitney two-sample rank-sum test was used to compare data from exit survey responses from medical students who took the CM course (n = 48) and did not take the CM course (n = 297). Medical students who took CM were significantly more likely to agree that they could counsel patients about nutrition (p < 0.05) and physical activity (p < 0.05). CM courses may improve students’ confidence to provide diet and lifestyle counseling. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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12 pages, 1053 KiB

Open AccessArticle

Cooking Skills, Eating Habits and Nutrition Knowledge among Italian Adolescents during COVID-19 Pandemic: Sub-Analysis from the Online Survey COALESCENT (Change amOng ItAlian adoLESCENTs)

by Silvia Marconi, Loredana Covolo, Monica Marullo, Barbara Zanini, Gaia Claudia Viviana Viola, Umberto Gelatti, Roberto Maroldi, Nicola Latronico and Maurizio Castellano

Nutrients 2023, 15(19), 4143; https://doi.org/10.3390/nu15194143 - 25 Sep 2023

Cited by 1 | Viewed by 1637

Abstract

Background: Cooking skills (CS) have the potential to improve self-care behaviours and healthy development among adolescents. The COVID-19 pandemic has affected lifestyles worldwide, and the present study aims to investigate the level of CS after the pandemic, as well as its associations with [...] Read more.

Background: Cooking skills (CS) have the potential to improve self-care behaviours and healthy development among adolescents. The COVID-19 pandemic has affected lifestyles worldwide, and the present study aims to investigate the level of CS after the pandemic, as well as its associations with nutrition knowledge and eating behaviours among a cohort of Italian adolescents. Methods: We submitted an online survey about lifestyle changes to students aged 13–21 years during the pandemic. Based on overall culinary abilities, we divided respondents into high, medium and low CS. Worsening or improvement in diet quality was detected by assigning an eating habit index (EHI; 0–54). Results: Out of the 1686 questionnaires collected, 21.5%, 63.6% and 14.9% reported high, medium and low CS, respectively. The EHI scores were statistically higher among students who were able to cook more than 20 recipes compared to those reporting no cooking abilities (30.2 ± 5.9 vs. 26.6 ± 5.7; p = 0.0001). High CS significantly correlated with better EHI (OR 1.44; p = 0.009), lower consumption of ultra-processed food (OR 1.80; p < 0.0001) and better nutrition knowledge (OR 1.42; p = 0.007). Conclusions: Adolescents with good CS showed better nutrition knowledge and healthier eating habits, including lower consumption of ultra-processed foods. Projects aimed to improve CS in adolescents can therefore promote healthier development. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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16 pages, 421 KiB

Open AccessArticle

Redesigning Recruitment and Engagement Strategies for Virtual Culinary Medicine and Medical Nutrition Interventions in a Randomized Trial of Patients with Uncontrolled Type 2 Diabetes

by Molly F. McGuire, Patricia M. Chen, Carolyn Smith-Morris, Jaclyn Albin, Milette D. Siler, Miguel Angel Lopez, Sandi L. Pruitt, Vincent C. Merrill and Michael E. Bowen

Nutrients 2023, 15(19), 4124; https://doi.org/10.3390/nu15194124 - 25 Sep 2023

Viewed by 1481

Abstract

In-person culinary medicine (CM) can improve health behaviors, but its translation to virtual platforms and impact on diabetes outcomes are not well described. We designed a pragmatic trial comparing the effectiveness of virtual CM (eCM) to Medical Nutrition Therapy on diabetes outcomes among [...] Read more.

In-person culinary medicine (CM) can improve health behaviors, but its translation to virtual platforms and impact on diabetes outcomes are not well described. We designed a pragmatic trial comparing the effectiveness of virtual CM (eCM) to Medical Nutrition Therapy on diabetes outcomes among patients with uncontrolled diabetes within a safety-net healthcare system. All participants were provided cooking equipment and food from a food pantry. Due to low initial eCM participation, recruitment was paused, and eight semi-structured interviews were conducted to solicit feedback on study appeal, operations, and barriers to participation. Rapid thematic analysis was used to modify study operations. We found that participants were interested in the study and motivated by health concerns. While they valued food distribution and cooking equipment, they highlighted transportation barriers and conflicts with the pick-up time/location. Some eCM participants expressed discomfort with the virtual platform or preferred to observe rather than cook along. Study operations were modified by (1) moving supply pick-up to a familiar community clinic and diversifying food pick-up locations; (2) offering an in-person orientation to the program to increase comfort with the virtual platform; (3) emphasizing the credibility and relatability of the eCM instructor and encouraging participation of family members. This redesign led to the recruitment of 79 participants, of whom 75% attended at least one class. In conclusion, participant feedback informed pragmatic changes in study operations that increased engagement in this ongoing trial and may inform future eCM program design. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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13 pages, 290 KiB

Open AccessArticle

Cross-Sector Partnerships for Improved Cooking Skills, Dietary Behaviors, and Belonging: Findings from a Produce Prescription and Cooking Education Pilot Program at a Federally Qualified Health Center

by Kelly R. Ylitalo, Kathryn M. Janda, Reanna Clavon, Sheri Raleigh-Yearby, Catherine Kaliszewski, Jade Rumminger, Burritt Hess, Katie Walter and Wendy Cox

Nutrients 2023, 15(19), 4098; https://doi.org/10.3390/nu15194098 - 22 Sep 2023

Cited by 2 | Viewed by 1286

Abstract

Participant engagement, psychosocial factors, and dietary behaviors are important components of “Food as Medicine” and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons [...] Read more.

Participant engagement, psychosocial factors, and dietary behaviors are important components of “Food as Medicine” and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons (2022–2023), patients participated in four or six weekly 1.5 h hands-on cooking classes with shared meals, education, and produce delivery. Pretest–posttest surveys assessed sociodemographic information, health, psychosocial factors, and dietary behaviors; follow-up assessed group cohesion/sense of community in classes. Survey data were described using means and proportions. Across four cohorts, participants (n = 33; mean age: 45 ± 16 years) were 30% Hispanic/Latino, 18% non-Hispanic Black, and 52% non-Hispanic White; on average, participants attended 66% of sessions. Increases in cooking self-efficacy (p < 0.001) and diet-related self-management strategies (p < 0.001) were observed for those with follow-up data (n = 16); further, 44% reported increased vegetable consumption. All participants (100%) reported feeling like a valued member of their cooking group and 94% reported high levels of belonging. In a diverse community health center serving low-income patients, provision of produce and cooking education classes supported strategies to improve diet-related confidence, skills, and behavior. Cross-sector partnership within a health care setting may help patients and physicians prioritize nutrition and food access. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

13 pages, 580 KiB

Open AccessArticle

A Specific Carbohydrate Diet Virtual Teaching Kitchen Curriculum Promotes Knowledge and Confidence in Caregivers of Pediatric Patients with Inflammatory Bowel Disease

by Nancy Rivera, Kaylie Nguyen, Venus Kalami, Feifei Qin, Maya B. Mathur, Rebecca Blankenburg and Ann Ming Yeh

Nutrients 2023, 15(18), 3999; https://doi.org/10.3390/nu15183999 - 15 Sep 2023

Cited by 1 | Viewed by 1552

Abstract

Diet-based approaches such as the Specific Carbohydrate Diet (SCD) have proposed health benefits for patients with Inflammatory Bowel Disease (IBD). Despite its potential effectiveness, patients and caregivers identified barriers towards implementing the SCD, and a majority expressed interest in formal education surrounding the [...] Read more.

Diet-based approaches such as the Specific Carbohydrate Diet (SCD) have proposed health benefits for patients with Inflammatory Bowel Disease (IBD). Despite its potential effectiveness, patients and caregivers identified barriers towards implementing the SCD, and a majority expressed interest in formal education surrounding the SCD. This study aimed to determine the impact of a virtual teaching kitchen curriculum on caregivers’ knowledge and perspectives on implementing the SCD. Inclusion criteria included pediatric patients with IBD aged 3–21 years and their caregivers. Participants should have fewer than 12 months of experience with the SCD or have no experience with the SCD but with an interest in learning it. Twenty-three caregivers took part in a 90-min virtual teaching kitchen curriculum and completed pre- and post-session surveys. Caregivers had statistically significant increases in total curriculum scores (p < 0.0001) as well as increases in all curricular elements post-curriculum teaching. Caregivers indicated that they plan to apply the newly acquired recipes and cooking concepts and appreciated the encouragement and support they received during the course. Curricular strengths identified included the innovative multimodal curriculum structure and professional and community support. IBD centers can use this pilot study to create or expand SCD and other nutritional curricula for the IBD community. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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13 pages, 2622 KiB

Open AccessArticle

Experiential Culinary, Nutrition and Food Systems Education Improves Knowledge and Confidence in Future Health Professionals

by Katherine Shafto, Natalie Vandenburgh, Qi Wang and Jenny Breen

Nutrients 2023, 15(18), 3994; https://doi.org/10.3390/nu15183994 - 15 Sep 2023

Viewed by 1474

Abstract

The food system plays a crucial role in the relationship between environmental, population and individual health. While leading healthcare and environmental organizations call for urgent action to address climate–planetary–human health crises, it is often challenging for healthcare organizations to respond at a systems [...] Read more.

The food system plays a crucial role in the relationship between environmental, population and individual health. While leading healthcare and environmental organizations call for urgent action to address climate–planetary–human health crises, it is often challenging for healthcare organizations to respond at a systems level to these concerns. Additionally, there is little consensus and limited research exploring how future health professionals should be trained in order to work at both the individual and systems level to address or prevent the negative health impacts related to the current food system. The intervention of a 6-week, hands-on cooking and nutrition course for graduate health professional students which examines these intersections and equips students with clinically applicable skills was examined using matched pre- and post-course surveys and thematic analysis of reflective assignments. Results indicate improved knowledge and confidence in areas including understanding the food system, guiding patients through dietary change, working interprofessionally, and applying basic nutrition concepts to clinical practice. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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17 pages, 1871 KiB

Open AccessArticle

Feasibility of a Community Healthy Eating and Cooking Intervention Featuring Traditional African Caribbean Foods from Participant and Staff Perspectives

by Sally G. Moore, Aashna Kundra, Peter Ho, Esther Bissell and Tanefa Apekey

Nutrients 2023, 15(17), 3758; https://doi.org/10.3390/nu15173758 - 28 Aug 2023

Viewed by 1501

Abstract

Culturally appropriate healthy eating resources are intended to help people from different ethnic backgrounds consume diets reflecting government dietary recommendations, yet evidence on use in the target groups is lacking. This study evaluated the feasibility of a new brief culturally appropriate community intervention [...] Read more.

Culturally appropriate healthy eating resources are intended to help people from different ethnic backgrounds consume diets reflecting government dietary recommendations, yet evidence on use in the target groups is lacking. This study evaluated the feasibility of a new brief culturally appropriate community intervention that aimed to introduce food-based healthy eating and recipe resources featuring African Caribbean foods, which were recently co-developed with people from these ethnic backgrounds. Working with a community organization in the UK, a single-arm study was used to collect verbal data from participants and staff on the acceptability of intervention whilst knowledge, skills and behaviours related to healthy eating were evaluated using pre-, post- and follow-up questionnaires. A total of 30 participants were recruited, and 22 completed all three questionnaires; who were mostly female aged 55 years+ (n = 17) and of African Caribbean ethnicity (45%, n = 10), with 32% (n = 7) reporting no educational attainment. At post-intervention and follow-up, most participants reported high satisfaction (n = 21, 95%) with the intervention sessions and high levels of confidence in using the resources at home within budget. The number of participants who were familiar with the healthy eating guidance featuring Caribbean foods increased from pre- (36%, n = 8) to post-intervention/follow-up (n = 22, 100%) (p < 0.05). Findings suggest the intervention is feasible in a community setting and could help increase awareness and use of culturally appropriate healthy eating guidance amongst a diverse group. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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11 pages, 264 KiB

Open AccessArticle

Expectations from a Home Cooking Program: Qualitative Analyses of Perceptions from Participants in “Action” and “Contemplation” Stages of Change, before Entering a Bi-Center Randomized Controlled Trial

by Rani Polak, Adi Finkelstein, Maggi A. Budd, Brianna E. Gray, Hanni Robinson, Julie K. Silver, Mark D. Faries and Amir Tirosh

Nutrients 2023, 15(9), 2082; https://doi.org/10.3390/nu15092082 - 26 Apr 2023

Viewed by 2318

Abstract

Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person’s genes; yet, behavioral factors, such as participant “readiness” to make a change, may also impact treatment [...] Read more.

Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person’s genes; yet, behavioral factors, such as participant “readiness” to make a change, may also impact treatment preferences and outcomes. The purpose is to explore the expectations of participants in different stages of change from a home cooking intervention. Participants were recruited to a randomized controlled trial evaluating the impact of a home cooking intervention on weight. Stage of change assessed by a validated University of Rhode Island Change Assessment scale and expectations through an open-ended questionnaire. Sixteen (21%) participants were in the action stage of change, and 59 (79%) were in the contemplation stage. Participants from both groups shared similar expectations to achieve healthy eating and lifestyle goals and to adopt sustainable change. However, action group expectations also included expanding existing culinary knowledge and change of habits; the contemplation group expectations also included acquiring culinary knowledge, improving self-regulatory skills, and obtaining guidance and support. While action group participants were looking to expand existing knowledge and techniques, contemplation group participants were focusing on acquiring culinary knowledge and skills. This can potentially contribute to developing effective, personalized nutrition interventions. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

Review

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19 pages, 324 KiB

Open AccessReview

The Role of Agricultural Systems in Teaching Kitchens: An Integrative Review and Thoughts for the Future

by Alexis Cole, Jennifer Pethan and Jason Evans

Nutrients 2023, 15(18), 4045; https://doi.org/10.3390/nu15184045 - 18 Sep 2023

Cited by 1 | Viewed by 1746

Abstract

Diet-related chronic disease is a public health epidemic in the United States. Concurrently, conventional agricultural and food production methods deplete the nutritional content of many foods, sever connections between people and the origin of their food, and play a significant role in climate [...] Read more.

Diet-related chronic disease is a public health epidemic in the United States. Concurrently, conventional agricultural and food production methods deplete the nutritional content of many foods, sever connections between people and the origin of their food, and play a significant role in climate change. Paradoxically, despite an abundance of available food in the US, many households are unable to afford or attain a healthful diet. The linkages between agriculture, health, and nutrition are undeniable, yet conventional agriculture and healthcare systems tend to operate in silos, compounding these pressing challenges. Operating teaching kitchens in collaboration with local agriculture, including farms, community gardens, vertical farms, and urban agriculture, has the potential to catalyze a movement that emphasizes the role of the food system in promoting human and planetary health, building resilient communities, and encouraging cross-disciplinary collaboration. This paper reviews the current state of agricultural systems, food is medicine, consumer behavior, and the roles within these sectors. This is followed by a series of case studies that fill the gaps between TKs and agriculture. The authors summarize opportunities to combine the knowledge and resources of teaching kitchens and agriculture programs, as well as challenges that may arise along the way. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

12 pages, 1826 KiB

Open AccessReview

Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research

by David M. Eisenberg, Lorena S. Pacheco, Auden C. McClure, John W. McWhorter, Kate Janisch and Jennifer Massa

Nutrients 2023, 15(13), 2859; https://doi.org/10.3390/nu15132859 - 24 Jun 2023

Cited by 15 | Viewed by 3783

Abstract

There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. [...] Read more.

There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies. Moreover, TKs can be used as revenue-generating research sites in universities and hospitals performing sponsored research, and, potentially, as instruments of cost containment when placed in accountable care settings and self-insured companies. Thus, TKs can be considered for inclusion in future health professional training programs, and the recently published Biden–Harris Administration Strategy on Hunger, Nutrition and Health echoes this directive. Recent innovations in the ability to provide TK classes virtually suggest that their impact may be greater than originally envisioned. Although the impact of TK curricula on behaviors, outcomes and costs of health care is preliminary, it warrants the continued attention of medical and public health thought leaders involved with Food Is Medicine initiatives. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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Other

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14 pages, 2168 KiB

Open AccessCommentary

Teaching Kitchens and Culinary Gardens as Integral Components of Healthcare Facilities Providing Whole Person Care: A Commentary

by Angela M. Fals and Andrea M. Brennan

Nutrients 2023, 15(19), 4162; https://doi.org/10.3390/nu15194162 - 27 Sep 2023

Cited by 1 | Viewed by 1078

Abstract

Child and adult obesity continue to be major health concerns in the United States and can contribute to the development of chronic diseases. Culinary medicine, which incorporates teaching kitchens and gardens, may be a useful strategy for preventing and/or treating obesity-related disease by [...] Read more.

Child and adult obesity continue to be major health concerns in the United States and can contribute to the development of chronic diseases. Culinary medicine, which incorporates teaching kitchens and gardens, may be a useful strategy for preventing and/or treating obesity-related disease by providing the knowledge and skills that encourage consumption of whole plant-based foods prepared at home. Though emerging research describes the benefits of culinary medicine-based programming, examples of teaching kitchens and culinary gardens being integrated into current clinical practice is minimal. Here, we describe the development of innovative, community-centered culinary medicine programming borne from interdisciplinary collaboration at a leading healthcare system. Preliminary outcomes suggest improvements in anthropometrics, cardiometabolic risk factors, and participation in healthy lifestyle behaviors in pediatric weight management patients, as well as improved confidence, knowledge, and likelihood to prepare whole food, plant-based meals in healthcare employees following participation in culinary medicine workshops. Hospitals and culinary medicine partners can support each other through shared knowledge, vision, and resources to provide value-based care to patients in the community. Collaboration among gardeners, chefs, architects, educators, and healthcare professionals can transfer traditional physician-driven care to patients, empowering them with the tools, resources, and confidence to improve health and wellbeing. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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8 pages, 617 KiB

Open AccessBrief Report

Culinary Medicine eConsults Pair Nutrition and Medicine: A Feasibility Pilot

by Jaclyn L. Albin, Milette Siler and Heather Kitzman

Nutrients 2023, 15(12), 2816; https://doi.org/10.3390/nu15122816 - 20 Jun 2023

Cited by 3 | Viewed by 2284

Abstract

The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital [...] Read more.

The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital innovation in the delivery of nutrition-based clinical care. Aligning with an existing eConsult infrastructure in the institutional electronic health record (EHR), a physician–dietitian team developed a novel Culinary Medicine eConsult. During a pilot phase, the service was introduced to primary care clinicians, and a response algorithm for eConsults was created. During the 12-month pilot phase, the Culinary Medicine team completed 25 eConsults from 11 unique primary care clinicians with a 76% (19/25) insurance reimbursement rate. Topics varied from dietary strategies for preventing and managing common metabolic diseases to specific dietary influences on microbiome health and disease flares. Requesting clinicians reported time saved in their clinic encounters and high patient satisfaction with expert nutrition guidance. EConsults in Culinary Medicine promote the integration of interprofessional nutrition care into existing clinical structures and empower enhanced access to the vital domain of dietary health. EConsults deliver timely answers to clinical questions and create opportunities for further innovation in care delivery as communities, health systems, and payors seek solutions to the growing burden of diet-sensitive diseases. Full article

(This article belongs to the Special Issue How Can Health and Wellness Promotion Strategies Which Include Nutrition Education alongside Hands-On Cooking Be Organized, Evaluated, and Optimized for Maximal Impact)

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