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|All Health and Nutrition Bites|
Cooking in School has an Impact
Chefs Adopt a School is a program founded in 1990 by a UK culinary association, the Academy of Culinary Arts. In this program, professional chefs visit local primary schools to present a brief series of cooking-related classes. The idea behind the program is to improve future generations' health by teaching basic food preparation skills along with healthy eating and nutrition. The program reaches about 21,000 schoolchildren each year.
Change is here
I have been standing at the intersection of food and health for over 30 years. After closing my restaurant and finding my way toward medical school, the way that I cooked changed slowly but steadily. Those were the bad old days of nutrition when we thought that butter was bad and margarine was good. That and a lot of other very restrictive practices in the world of nutrition forced me to be very creative. I learned to cook differently – better, I think – and I have worked hard to keep up with the state of the art in evidence-based nutrition while balancing that with a food-first approach.
Take-out vs. made-from-scratch: weighing and pricing the options
I've been saying for years that cooking at home is cheaper and better for you than eating fast food, using products like Hamburger Helper®, or even getting take-out. That's one of the reasons the Goldring Center for Culinary Medicine exists: to get people back into the kitchen, cooking their own food and improving their diets, by offering free cooking classes that include how to plan your weekly meals - crucial to cost-effective cooking.
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If you're a longtime Dr. Gourmet reader, you've probably heard me talk about my work at the Goldring Center for Culinary Medicine. We are the first teaching kitchen to be implemented at a medical school, with the express purpose of teaching medical students and practicing physicians how to cook and eat healthy foods.
In turn, these physicians and future physicians can more effectively talk with their patients about how what they eat impacts their health - and make practical, efficient, and cost-conscious suggestions for improvement. Our curriculum, known as Health Meets Food, teaches attendees the practical aspects of healthy eating, including what to buy at the grocery store, choosing healthy recipes, cooking when you're short on time, and cooking on a budget.
It might seem like a great - almost obvious - idea: after all, when physicians started quitting smoking and told their patients to do the same, people did indeed start quitting. But as you also know, dear Longtime Reader, I'm an evidence-based physician: I report on (and utilize in my own practice as well as in the Health Meets Food curriculum) quality research, not anecdote. If we teach physicians how to cook, will that have a real impact on their patients? We think so, but it's critical to know.
A team of researchers in Brazil thought that teaching college students how to cook might improve their diets, so instead of saying, "Of course!" they created a randomized controlled trial to test their idea (Appetite 2018;130(1):247-255).
The authors recruited a total of 76 university students, all of whom were not living with their parents and had access to at least a minimally-equipped kitchen. Half of the students participated in a total of 6 cooking-related classes, held once per week: five hands-on classes and one field trip to a local grocery store to address topics like choosing produce. The other half of the students did not attend any cooking-related and acted as the control group (they attended the classes the following year).
The authors surveyed all of the participants, both those attending cooking classes and the control group, at the start of the study (before the cooking classes), at the end of the series of cooking classes, and then again six months later. The surveys asked the participants about the following topics:
Accessibility and Availability of Fruits and Vegetables Index: questions regarding the availability of fruits and vegetables in their home over the previous week
Cooking Attitude: whether the participants agreed or disagreed (on a 7-point scale from 'strongly disagree' to 'strongly agree') with statements about time spent cooking, whether it was affordable, and how engaged they were with cooking
Cooking Behavior at Home: how often the participants cooked at home, with a range of responses from 'not at all' to 'about every day'
Self-Efficacy for Basic Cooking Techniques: how confident were the students with their knowledge of basic cooking techniques?
Self-Efficacy for Using Fruits, Vegetables, and Seasonings (while cooking): how confident were the students in using fruits, vegetables, and spices?
Produce Consumption Self-Efficacy: how confident did the students feel that they met the (Brazilian) government's criteria for appropriate consumption of fruits and vegetables?
Knowledge of Cooking Terms and Techniques: tested the students' cooking knowledge in a multiple choice format
The authors compared the responses of the students who received the cooking classes with those who did not, and found that between the first survey (before classes) and the second survey (just after the end of the classes) those who had the classes:
1. Significantly improved the accessibility and availability of fruits and vegetables in their home;
2. Reported a statistically significant increase in their knowledge of cooking terms and techniques; and
3. Were less likely to eat their main meal at a fast food restaurant or at the snack bars available at the university.
On the other hand, the intervention group did not actually cook any more frequently than before, and there was no statistically significant change in their BMI. Further, while those taking the cooking classes were less likely to eat at a fast food restaurant or snack bar just after taking the cooking class, six months later their likelihood of eating at a fast food restaurant or snack bar had rebounded by about 30%.
This is certainly encouraging: cooking classes do appear to improve people's knowledge of cooking, and at least the amount of fruits and vegetables in the home and available for people to eat is increased. Similarly, even a small net decrease in eating at fast food joints is a good thing.
The drawback here is that the test groups were college students, with access to the university's food services, making them less likely to do their own cooking even though they had access to a kitchen. A similar study in "free living" (that is, those living on their own like most adults) persons would be even more interesting: we at the Goldring Center for Culinary Medicine have been surveying the medical students who take our classes and the results have been encouraging. I look forward to the days when we can investigate the impact of our curriculum on our attendees' patients.
Would you like to see a physician who has attended our classes and knows about food and health? We offer CME (continuing medical education) classes as well as a Certified Culinary Medicine Specialist certification. Tell your primary care physician to visit healthmeetsfood.com for more information on the CCMS certification, or share this article with them.
First posted: December 12, 2018