The effect of culinary interventions (cooking classes) on dietary intake and behavioral change: a systematic review and evidence map

Bashar Hasan, Warren G Thompson, Jehad Almasri, Zhen Wang, Sumaya Lakis, Larry J Prokop, Donald D Hensrud, Kristen S Frie, Mary J Wirtz, Angela L Murad, Jason S Ewoldt, M Hassan Murad, Bashar Hasan, Warren G Thompson, Jehad Almasri, Zhen Wang, Sumaya Lakis, Larry J Prokop, Donald D Hensrud, Kristen S Frie, Mary J Wirtz, Angela L Murad, Jason S Ewoldt, M Hassan Murad

Abstract

Background: Culinary interventions (cooking classes) have been used to improve the quality of dietary intake and change behavior. The aim of this systematic review is to investigate the effects of culinary interventions on dietary intake and behavioral and cardiometabolic outcomes.

Methods: We conducted a systematic review of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus for comparative studies that evaluated culinary interventions to a control group or baseline values. The intervention was defined as a cooking class regardless of its length or delivery approach. Studies included populations of children, healthy adults or adults with morbidities. The risk of bias was assessed using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. Outcomes were pooled using the random-effects model and descriptive statistics and depicted in an evidence map. Simple logistic regression was used to evaluate factors associated with intervention success.

Results: We included 30 studies (6 were randomized, 7381 patients, average follow up 25 weeks). Culinary interventions were not associated with a significant change in body mass index (- 0.07 kg/m2, 95% CI: -1.53, 1.40), systolic (- 5.31 mmHg, 95% CI: -34.2, 23.58) or diastolic blood pressure (- 3.1 mmHg, 95% CI: -23.82, 17.62) or LDL cholesterol (- 8.09 mg/dL, 95% CI: -84.43, 68.25). Culinary interventions were associated with improved attitudes, self-efficacy and healthy dietary intake in adults and children. We were unable to demonstrate whether the effect of a culinary intervention was modified by various characteristics of the intervention such as its delivery or intensity. Interventions with additional components such as education on nutrition, physical activity or gardening were particularly effective.

Conclusions: Culinary interventions were not associated with a significant change in cardiometabolic risk factors, but were associated with improved attitudes, self-efficacy and a healthier dietary intake in adults and children.

Keywords: Chronic disease prevention; Cooking classes; Culinary intervention; Dietary intake; Evidence map; Nutrition; Systematic review.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

© The Author(s). 2019.

Figures

Fig. 1
Fig. 1
Analytic framework for the plausible effects of culinary interventions
Fig. 2
Fig. 2
Flow chart depicting the process of study selection
Fig. 3
Fig. 3
Forest Plots representing the overall mean difference and associated 95% confidence interval (CIs; horizontal lines) of (a). Body mass index (BMI), (b). Systolic blood pressure (SBP), (c). Diastolic blood pressure (DBP), (d). Low-density lipoprotein cholesterol (LDL-C). The gray squares the weights used in the meta-analysis. The asterisk (*) represents studies in children and the sign (δ) represents randomized clinical trials (RCTs)
Fig. 4
Fig. 4
Evidence map showing the effects of culinary interventions. ↑: significant improvement, ↔: No significant change, ↓: significant worsening. Colors reflect risk of bias (red is high and yellow is medium and green is low), BMI: Body mass index, DBP: Diastolic blood pressure, HbA1c: Hemoglobin A1c, HDL: High-density cholesterol, HOMA-IR: Homeostatic Model Assessment for Insulin Resistance, LDL: Low-density cholesterol, RCT: Randomized controlled trial, SBP: Systolic blood pressure, WC: Waist circumference

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