Chefs have the potential to influence diet quality and food systems sustainability through their work. We aimed to assess the attitudes and perceptions of culinary students about nutrition and sustainability as part of their roles, responsibilities and future work as chefs.

We surveyed students attending the Culinary Institute of America (CIA) in the fall of 2019 (n 546). Descriptive statistics compared food priority rankings and Likert-scale distributions of nutrition and sustainability attitudes and beliefs. Adjusted generalised linear models were used to evaluate whether there were differences in attitudes and beliefs across demographic groups.

The CIA, a private, not-for-profit college and culinary school with US campuses in New York, California and Texas.

Students >18 years old currently enrolled in any of the school’s associate’s or bachelor’s degree programs.

Students agreed that chefs should be knowledgeable about nutrition (96·0 %) and the environmental impact of their ingredients (90·8 %) but fewer considered healthfulness (57·8 %) and environmental impact (60·2 %) of their food to be primary considerations in their career as a chef. Taste was the primary factor influencing culinary students’ food choices but food priorities differed by race/ethnicity.

Culinary students believe nutrition and sustainability are important. Opportunities exist to empower them with knowledge and skills for promoting public health and sustainable food systems in their future work as chefs.

To examine the effect of food insecurity during college on graduation and degree attainment.

Secondary analysis of longitudinal panel data. We measured food insecurity concurrent with college enrolment using the 18-question United States Department of Agriculture Household Food Security Survey Module. Educational attainment was measured in 2015–2017 via two questions about college completion and highest degree attained. Logistic and multinomial logit models adjusted for socio-demographic characteristics were estimated.

USA

A nationally representative, balanced panel of 1574 college students in the USA in 1999–2003 with follow-up through 2015–2017 from the Panel Study of Income Dynamics.

In 1999–2003, 14·5 % of college students were food-insecure and were more likely to be older, non-White and first-generation students. In adjusted models, food insecurity was associated with lower odds of college graduation (OR 0·57, 95 % CI: 0·37, 0·88, P = 0·01) and lower likelihood of obtaining a bachelor’s degree (relative risk ratio (RRR) 0·57 95 % CI: 0·35, 0·92, P = 0·02) or graduate/professional degree (RRR 0·39, 95 % CI: 0·17, 0·86, P = 0·022). These associations were more pronounced among first-generation students. And 47·2 % of first-generation students who experienced food insecurity graduated from college; food-insecure first-generation students were less likely to graduate compared to first-generation students who were food-secure (47·2 % v. 59·3 %, P = 0·020) and non-first-generation students who were food-insecure (47·2 % v. 65·2 %, P = 0·037).

Food insecurity during college is a barrier to graduation and higher-degree attainment, particularly for first-generation students. Existing policies and programmes that help mitigate food insecurity should be expanded and more accessible to the college student population.

To develop and implement a community-tailored, food agency-based cooking programme at a community health centre (CHC) and evaluate the effect of the intervention on cooking confidence and food waste.

This study used an exploratory, sequential mixed methods design. Focus groups (n 38) were conducted to inform the development of a cooking intervention, then six cooking classes (n 45) were planned and piloted in the health centre’s teaching kitchen. Changes in cooking confidence and related outcomes were assessed using pre- and post-class surveys. Follow-up interviews (n 12) were conducted 2–4 months post-intervention to assess satisfaction and short-term outcomes.

A CHC in Detroit, MI.

Spanish- and English-speaking adults aged ≥18 years recruited at the CHC.

In the formative focus groups, patients identified multiple barriers to cooking healthy meals, including trade-offs between quality, cost and convenience of food, chronic disease management and lack of time and interest. Each cooking class introduced a variety of cooking techniques and food preservation strategies. Participants demonstrated increased confidence in cooking (P 0·004), experimenting with new ingredients (P 0·006) and knowing how to make use of food before it goes bad (P 0·017). In post-class interviews, participants reported that they valued the social interaction and participatory format and that they had used the recipes and cooking techniques at home.

A community-tailored, hands-on cooking class was an effective way to engage patients at a CHC and resulted in increased cooking confidence.

To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults.

Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and stratified by income.

Nationally representative survey data from the USA.

Adults aged ≥20 years (with 2 d of 24 h dietary recall data) obtained from the 2007 to 2010 National Health and Nutrition Examination Survey (n 8668).

Compared with cooking dinner 0–2 times/week, greater cooking frequency was associated with higher HEI-2015 score overall (≥7 times/week: +3·57 points, P < 0·001), among lower-income adults (≥7 times/week: +2·55 points, P = 0·001) and among higher-income adults (≥7 times/week: +5·07 points, P < 0·001). Overall, total HEI-2015 score was higher among adults living in households where dinner was cooked ≥7 times/week (54·54 points) compared with adults living in households where dinner was cooked 0–2 times/week (50·57 points). In households in which dinner was cooked ≥7 times/week, total HEI-2015 score differed significantly based on income status (lower-income: 52·51 points; higher-income: 57·35 points; P = 0·003). Cooking frequency was associated with significant differences in HEI-2015 component scores, but associations varied by income.

More frequent cooking at home is associated with better diet quality overall and among lower- and higher-income adults, although the association between cooking and better diet quality is stronger among high-income adults. Strategies are needed to help lower-income Americans consume a healthy diet regardless of how frequently they cook at home.

To understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes).

Combination meals (lunch/dinner: n 258, breakfast: n 68, children’s: n 34) and their prices were identified from online menus; corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Linear models were used to examine the difference in total calories per dollar between default and higher-calorie combination meals, overall and by restaurant.

Ten large fast-food chain restaurants located in the fifteen most populous US cities in 2017–2018.

None.

There were significantly more calories per dollar in higher-calorie v. default combination meals for lunch/dinner (default: 577 kJ (138 kcal)/dollar, higher-calorie: 707 kJ (169 kcal)/dollar, difference: 130 kJ (31 kcal)/dollar, P < 0·001) and breakfast (default: 536 kJ (128 kcal)/dollar, higher-calorie: 607 kJ (145 kcal)/dollar, difference: 71 kJ (17 kcal)/dollar, P = 0·009). Results for children’s meals were in the same direction but were not statistically significant (default: 536 kJ (128 kcal)/dollar, higher-calorie: 741 kJ (177 kcal)/dollar, difference: 205 kJ (49 kcal)/dollar, P = 0·053). Across restaurants, the percentage change in calories per dollar for higher-calorie v. default combination meals ranged from 0·1 % (Dunkin’ Donuts) to 55·0 % (Subway).

Higher-calorie combination meals in fast-food restaurants offer significantly more calories per dollar compared with default combination meals, suggesting there is a strong financial incentive for consumers to ‘upsize’ their orders. Future research should test price incentives for lower-calorie options to promote healthier restaurant choices.

Excess meat consumption, particularly of red and processed meats, is associated with nutritional and environmental health harms. While only a small portion of the population is vegetarian, surveys suggest many Americans may be reducing their meat consumption. To inform education campaigns, more information is needed about attitudes, perceptions, behaviours and foods eaten in meatless meals.

A web-based survey administered in April 2015 assessed meat reduction behaviours, attitudes, what respondents ate in meatless meals and sociodemographic characteristics.

Nationally representative, web-based survey in the USA.

US adults (n 1112) selected from GfK Knowledgeworks’ 50 000-member online panel. Survey weights were used to assure representativeness.

Two-thirds reported reducing meat consumption in at least one category over three years, with reductions of red and processed meat most frequent. The most common reasons for reduction were cost and health; environment and animal welfare lagged. Non-meat reducers commonly agreed with statements suggesting that meat was healthy and ‘belonged’ in the diet. Vegetables were most often consumed ‘always’ in meatless meals, but cheese/dairy was also common. Reported meat reduction was most common among those aged 45–59 years and among those with lower incomes.

The public and environmental health benefits of reducing meat consumption create a need for campaigns to raise awareness and contribute to motivation for change. These findings provide rich information to guide intervention development, both for the USA and other high-income countries that consume meat in high quantities.

Despite the importance of cooking in modern life, public perceptions about what it means to cook are unknown. We aimed to examine perceptions of cooking and their association with cooking confidence, attitudes and behaviours in the USA.

We designed and fielded a nationally representative survey among US adults (n 1112) in April 2015. We used factor analysis to identify perceptions about cooking and multivariate ordered logit and Poisson models to explore associations between those perceptions and cooking confidence, attitudes and behaviours.

Nationally representative web-based survey of US adults.

US adults aged ≥18 years.

Americans conceptualized cooking in three ways: the use of scratch ingredients, convenience foods and not using heat. Respondents who perceived cooking as including convenience foods were less confident in their ability to cook from scratch (OR=0·52, P<0·001) and less likely to enjoy cooking (OR=0·68, P=0·01) than those who did not. Although individuals who perceived cooking as including only scratch ingredients reported cooking dinner (4·31 times/week) and using packaged/boxed products (0·95 times/week) the least frequently, few notable differences in the frequency of cooking meals were observed.

Cooking frequency is similar among US adults regardless of how they perceive cooking, but cooking confidence and enjoyment are lowest among Americans who perceive cooking as including the use of convenience foods. These insights should inform the development of more specific measures of cooking behaviour as well as meaningful and targeted public health messages to encourage healthier cooking.

To examine national patterns in cooking frequency and diet quality among adults in the USA, overall and by weight-loss intention.

Analysis of cross-sectional 24 h dietary recall and interview data. Diet quality measures included total kilojoules per day, grams of fat, sugar and carbohydrates per day, fast-food meals per week, and frozen/pizza and ready-to-eat meals consumed in the past 30 d. Multivariable regression analysis was used to test associations between frequency of cooking dinner per week (low (0–1), medium (2–5) and high (6–7)), dietary outcomes and weight-loss intention.

The 2007–2010 National Health and Nutrition Examination Survey.

Adults aged 20 years and over (n 9569).

In 2007–2010, 8 % of adults lived in households in which someone cooked dinner 0–1 times/week and consumed, on an average day, 9627 total kilojoules, 86 g fat and 135 g sugar. Overall, compared with low cookers (0–1 times/week), a high frequency of cooking dinner (6–7 times/week) was associated with lower consumption of daily kilojoules (9054 v. 9627 kJ, P=0·002), fat (81 v. 86 g, P=0·016) and sugar (119 v. 135 g, P<0·001). Individuals trying to lose weight consumed fewer kilojoules than those not trying to lose weight, regardless of household cooking frequency (2111 v. 2281 kJ/d, P<0·006).

Cooking dinner frequently at home is associated with consumption of a healthier diet whether or not one is trying to lose weight. Strategies are needed to encourage more cooking among the general population and help infrequent cookers better navigate the food environment outside the home.