Perceptions of 'Home Cooking': A Qualitative Analysis from the United Kingdom and United States.

Cooking at home is likely to be associated with benefits to diet and health. However, the nuanced perceptions and practices linked to different types of cooking are not yet fully understood. This research aimed to explore the specific concept of 'home cooking', using qualitative research from the UK and US. Data from two previously completed studies exploring cooking at home were combined and a new secondary analysis was undertaken using the Framework Method. Data in the first study were drawn from participants in the North East of the UK who were interviewed. Data in the second study were drawn from participants in Baltimore, US, who took part in focus groups. Data from a total of 71 adults (18 UK and 53 US), with diverse sociodemographic characteristics and experiences of cooking, were analysed. In both countries, participants distinguished 'home cooking' as a distinct subtype of cooking at home. 'Home cooking' was defined in terms of preparing a meal from scratch, cooking with love and care, and nostalgia. Cooking at home had a range of dimensions, and perceptions of 'home cooking' tended to focus on social and emotional associations. In future, public health initiatives might, therefore, highlight the potential social and emotional benefits of 'home cooking', rather than emphasising implications for physical health.

Examining Associations between Body Mass Index in 18⁻25 Year-Olds and Energy Intake from Alcohol: Findings from the Health Survey for England and the Scottish Health Survey.

Evidence on the relationship between alcohol consumption and body mass index (BMI) is mixed, particularly for young adults. This study explored the relationship between energy obtained from alcoholic beverages and BMI using data for 18⁻25 year-olds (n = 7691) from pooled cross-sections of the 2008⁻2014 Health Survey for England and the Scottish Health Survey. Energy obtained from alcoholic beverages (excluding mixers) on the heaviest drinking day in the past week was expressed as percentage of total recommended dietary allowance (RDA) of energy (% RDA Energy). Linear regressions were estimated of BMI on alcohol intake categories controlling for intake frequency, physical activity, longstanding illness and other covariates, with separate analyses for men and women, and by beverage type. Significant associations with BMI were observed with the 'Very High' category of alcohol intake (>75% RDA Energy) for men (p < 0.001, 1.74, 95% confidence interval (CI) 0.98, 2.49) and with the "High" (>50% to 75% RDA Energy) (p < 0.001, 1.67, 95% CI 0.26, 2.58) and above category for women, when compared with the Low (>0⁻25% RDA Energy) category. Young adults drinking the highest levels of alcohol on a single occasion were more likely to be obese than those with the lowest intake. Interventions to address internationally rising youth obesity rates should also consider reducing alcohol consumption by increasing alcohol prices, and reducing availability and marketing exposure.

Time to address the double inequality of differences in dietary intake between Scotland and England.

Geographical disparities in health outcomes have been evident across the UK for decades. Recent analysis on the dietary differences between Scotland and England that might go some way to explain these health differences is limited. This study aimed to assess whether, and to what degree, aspects of diet and nutrition differ between Scottish and English populations, specifically between those with similar household incomes. A period of 12 years of UK food purchase data (2001-2012) were pooled and used to estimate household-level consumption data for Scotland and England. Population mean food consumption and nutrient intakes were estimated, adjusting for known confounders (year, age of household reference person, age they left full-time education and income). Comparison was also made within equivalised income quintiles. Analysis showed that the foods and nutrients that should be increased in the diet (highlighted in the Scottish Dietary Goals) were lower in Scotland than in England (e.g. fruit and vegetables 267 g/d; 99 % CI 259, 274 v. 298 g/d; 99 % CI 296, 301), P<0·001). Similarly, foods and drinks linked with poor health outcomes were higher in Scotland. These regional inequalities in diet were even more pronounced in the lower-income groups (e.g. red and processed meat consumption in the lowest-income quintile was 65 g/d; 99 % CI 61, 69 in Scotland v. 58 g/day; 99 % CI 57, 60 in England, P<0·001, but similar in the highest-income quintile (58 g/d; 99 % CI 54, 61 v. 59 g/d; 99 % CI 58, 60, respectively). A poorer diet in Scotland compared with England, particularly among disadvantaged groups, may contribute to differences in excess mortality between countries.

Identifying dietary differences between Scotland and England: a rapid review of the literature.

OBJECTIVE: Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. DESIGN: A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. A narrative synthesis of extracted information was conducted. RESULTS: Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding England-level data, lack of statistical testing and adjustment for key confounders. CONCLUSIONS: Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities.

A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis.

BACKGROUND: Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. METHODS: A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). RESULTS: A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. CONCLUSIONS: Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach.

Micronutrient intake and food sources in the very old: analysis of the Newcastle 85+ Study.

A number of socio-economic, biological and lifestyle characteristics change with advancing age and place very old adults at increased risk of micronutrient deficiencies. The aim of this study was to assess vitamin and mineral intakes and respective food sources in 793 75-year-olds (302 men and 491 women) in the North-East of England, participating in the Newcastle 85+ Study. Micronutrient intakes were estimated using a multiple-pass recall tool (2×24 h recalls). Determinants of micronutrient intake were assessed with multinomial logistic regression. Median vitamin D, Ca and Mg intakes were 2·0 (interquartile range (IQR) 1·2-6·5) µg/d, 731 (IQR 554-916) mg/d and 215 (IQR 166-266) mg/d, respectively. Fe intake was 8·7 (IQR 6·7-11·6) mg/d, and Se intake was 39·0 (IQR 27·3-55·5) µg/d. Cereals and cereal products were the top contributors to intakes of folate (31·5 %), Fe (49·2 %) and Se (46·7 %) and the second highest contributors to intakes of vitamin D (23·8 %), Ca (27·5 %) and K (15·8 %). More than 95 % (n 756) of the participants had vitamin D intakes below the UK's Reference Nutrient Intake (10 µg/d). In all, >20 % of the participants were below the Lower Reference Nutrient Intake for Mg (n 175), K (n 238) and Se (n 418) (comparisons with dietary reference values (DRV) do not include supplements). As most DRV are not age specific and have been extrapolated from younger populations, results should be interpreted with caution. Participants with higher education, from higher social class and who were more physically active had more nutrient-dense diets. More studies are needed to inform the development of age-specific DRV for micronutrients for the very old.

Macronutrient intake and food sources in the very old: analysis of the Newcastle 85+ Study.

Food and nutrient intake data are scarce in very old adults (85 years and older) - one of the fastest growing age segments of Western societies, including the UK. Our primary objective was to assess energy and macronutrient intakes and respective food sources in 793 85-year-olds (302 men and 491 women) living in North-East England and participating in the Newcastle 85+ cohort Study. Dietary information was collected using a repeated multiple-pass recall (2×24 h recalls). Energy, macronutrient and NSP intakes were estimated, and the contribution (%) of food groups to nutrient intake was calculated. The median energy intake was 6·65 (interquartile ranges (IQR) 5·49-8·16) MJ/d - 46·8 % was from carbohydrates, 36·8 % from fats and 15·7 % from proteins. NSP intake was 10·2 g/d (IQR 7·3-13·7). NSP intake was higher in non-institutionalised, more educated, from higher social class and more physically active 85-year-olds. Cereals and cereal products were the top contributors to intakes of energy and most macronutrients (carbohydrates, non-milk extrinsic sugars, NSP and fat), followed by meat and meat products. The median intakes of energy and NSP were much lower than the estimated average requirement for energy (9·6 MJ/d for men and 7·7 MJ/d for women) and the dietary reference value (DRV) for NSP (≥18 g/d). The median SFA intake was higher than the DRV (≤11 % of dietary energy). This study highlights the paucity of data on dietary intake and the uncertainties about DRV for this age group.

'Change4Life Smart Swaps': quasi-experimental evaluation of a natural experiment.

OBJECTIVE: To evaluate the impact on food purchasing behaviour of the 'Change4Life Smart Swaps' campaign to encourage families to make small changes to lower-fat or lower-sugar versions of commonly eaten foods and drinks. DESIGN: Quasi-experimental study comparing the proportion of swaps made by an intervention group (267 families who had signed up to the 'Smart Swaps' campaign promoted through various media, including television and radio advertising in early 2014) and a comparison group (135 families resident in Wales, signed up for 'Change4Life' materials, but not directly exposed to the 'Smart Swaps' campaign). During weeks 1, 2 and 3 of the campaign participants were asked to record their purchases of dairy products, carbonated drinks and breakfast cereals, using a mobile phone app questionnaire, when making a purchase within the category. SETTING: England and Wales. SUBJECTS: Families registered with 'Change4Life'. RESULTS: In weeks 2 and 3 a significantly higher percentage of the intervention group had made 'smart swaps' than the comparison group. After week 3, 58 % of participants had swapped to a lower-fat dairy product compared with 26 % of the comparison group (P<0·001), 32 % of the intervention group had purchased a lower-sugar drink compared with 19 % of the comparison group (P=0·01), and 24 % had made a change to a lower-sugar cereal compared with 12 % of the comparison group (P=0·009). CONCLUSIONS: In the short term a national campaign to change purchase habits towards healthier products may have some merit but the sustainability of change requires further investigation.

Weight loss for women with and without polycystic ovary syndrome following a very low-calorie diet in a community-based setting with trained facilitators for 12 weeks.

BACKGROUND: Polycystic ovary syndrome (PCOS) affects between 2% and 26% of reproductive-age women in the UK, and accounts for up to 75% of anovulatory infertility. The major symptoms include ovarian disruption, hyperandrogenism, insulin resistance, and polycystic ovaries. Interestingly, at least half of the women with PCOS are obese, with the excess weight playing a pathogenic role in the development and progress of the syndrome. The first-line treatment option for overweight/obese women with PCOS is diet and lifestyle interventions; however, optimal dietary guidelines are missing. Although many different dietary approaches have been investigated, data on the effectiveness of very low-calorie diets on PCOS are very limited. MATERIALS AND METHODS: The aim of this paper was to investigate how overweight/obese women with PCOS responded to LighterLife Total, a commercial very low-calorie diet, in conjunction with group behavioral change sessions when compared to women without PCOS (non-PCOS). RESULTS: PCOS (n=508) and non-PCOS (n=508) participants were matched for age (age ±1 unit) and body mass index (body mass index ±1 unit). A 12-week completers analysis showed that the total weight loss did not differ significantly between PCOS (n=137) and non-PCOS participants (n=137) (-18.5±6.6 kg vs -19.4±5.7 kg, P=0.190). Similarly, the percentage of weight loss achieved by both groups was not significantly different (PCOS 17.1%±5.6% vs non-PCOS 18.2%±4.4%, P=0.08). CONCLUSION: Overall, LighterLife Total could be an effective weight-loss strategy in overweight/obese women with PCOS. However, further investigations are needed to achieve a thorough way of understanding the physiology of weight loss in PCOS.

Trends in socio-economic inequalities in the Scottish diet: 2001-2009.

OBJECTIVE: To explore the association between diet and socio-economic position for 2007-2009 and investigate trends in socio-economic inequalities in the Scottish diet between 2001 and 2009. DESIGN: UK food purchase data (collected annually from 2001 to 2009) were used to estimate household-level consumption data. Population mean food consumption, nutrient intakes and energy density were estimated by quintiles of an area-based index of multiple deprivation. Food and nutrient intakes estimated were those targeted for change in Scotland and others indicative of diet quality. The slope and relative indices of inequality were used to assess trends in inequalities in consumption over time. SETTING: Scotland. SUBJECTS: Scottish households (n 5020). RESULTS: Daily consumption of fruit and vegetables (200 g, 348 g), brown/wholemeal bread (17 g, 26·5 g), breakfast cereals (16 g, 27 g) and oil-rich (21 g, 40 g) and white fish (77 g, 112 g) were lowest, and that of total bread highest (105 g, 91·5 g) in the most deprived compared with the least deprived households, respectively, for the period 2007-2009. With regard to nutrients, there was no association between deprivation and the percentage of food energy from total fat and saturated fat; however, non-milk extrinsic sugar intakes (15·5%, 14·3%) and energy density (741 kJ/100 g, 701 kJ/100 g) were significantly higher in the most deprived households. The slope and relative indices of inequality showed that inequalities in intakes between 2001 and 2009 have changed very little. CONCLUSIONS: There was no evidence to suggest that the difference in targeted food and nutrient intakes between the least and most deprived has decreased compared with previous years.

Energy density of the Scottish diet estimated from food purchase data: relationship with socio-economic position and dietary targets.

Frequent consumption of energy-dense foods has been strongly implicated in the global increase of obesity. The World Cancer Research Fund suggests a population-level energy density (ED) goal for diets of 523 kJ/100 g (125 kcal/100 g) as desirable for reducing weight gain and related co-morbidities. However, there is limited information about the ED of diets of contemporary populations. The aims of the present study were to (1) estimate the mean ED of the Scottish diet, (2) assess differences in ED over time by socio-economic position, by household (HH) composition and for HH meeting dietary targets for fat and fruit and vegetables, and (3) assess the relationship between ED and the consumption of foods and nutrients, which are indicative of diet quality. ED of the diet was estimated from food (including milk) from UK food purchase survey data. The average ED of the Scottish diet was estimated as 718 kJ/100 g with no change between the survey periods 2001 and 2009. Individuals living in the most deprived areas had a higher mean ED than those living in the least deprived areas (737 v. 696 kJ/100 g). Single-parent HH had the highest mean ED (765 kJ/100 g) of all the HH surveyed. The mean ED of HH achieving dietary targets for fat and fruit and vegetables was 576 kJ/100 g compared with 731 kJ/100 g for non-achievers. HH within the lowest quintile of ED were, on average, closest to meeting most dietary guidelines. Food purchase data can be used to monitor the quality of the diet in terms of dietary ED of the population and subgroups defined by an area-based measure of socio-economic status.

Slow pace of dietary change in Scotland: 2001-9.

Monitoring changes in the food and nutrient intake of a nation is important for informing the design and evaluation of policy. Surveys of household food consumption have been carried out annually in the UK since 1940 and, despite some changes over the years 1940-2000, the method used for the Expenditure and Food Survey (Living Costs and Food Survey from 2008) has been fundamentally the same since 2001. Using these surveys an analytical procedure was devised to compare food consumption and nutrient intake in Scotland with the Scottish dietary targets, and monitor change. This method takes into account contributions to composite foods and losses due to food preparation, as well as inedible and edible waste. There were few consistent improvements in consumption of foods or nutrients targeted for change over the period 2001-9. A significant but small increase was seen in mean fruit and vegetable consumption (259 g/d in 2001, 279 g/d in 2009, equating to an increase of less than 3 g/person per year). There was also a significant decrease in the percentage of food energy from SFA (15·5 % in 2001, 15·1 % in 2009) and from non-milk extrinsic sugars (15·5 % in 2001, 14·8 % in 2009), concurrent with a reduction in whole milk consumption and soft drink consumption, respectively. These small changes are encouraging, but highlight the time taken for even modest changes in diet to occur. To achieve a significant impact on the health of the present Scottish population, the improvements in diet will need to be greater and more rapid.

Strategies for achieving a high response rate in a home interview survey.

BACKGROUND: Response rates in surveys have been falling over the last 20 years, leading to the need for novel approaches to enhance recruitment. This study describes strategies used to maximise recruitment to a home interview survey of mothers with young children living in areas of high deprivation. METHODS: Mothers of two year old children received a letter from their GP inviting them to take part in a survey on diet. Participants were subsequently recruited by a researcher. The researcher first tried to contact potential participants by telephone, to discuss the study and make an appointment to conduct a home interview. Where telephone numbers for women could not be obtained from GP records, web searches of publicly available databases were conducted. After obtaining correct telephone numbers, up to six attempts were made to establish contact by telephone. If this was unsuccessful, a postal request for telephone contact was made. Where no telephone contact was achieved, the researcher sent up to two appointments by post to conduct a home interview. RESULTS: Participating GPs invited 372 women to take part in a home based interview study. GP practices provided telephone numbers for 162 women, of which 134 were valid numbers. The researcher identified a further 187 numbers from electronic directories. Further searches of GP records by practice staff yielded another 38 telephone numbers. Thus, telephone numbers were obtained for 99% of potential participants.The recruitment rate from telephone contacts was 77%. Most of the gain was achieved within four calls. For the remaining women, contact by post and home visits resulted in 18 further interviews, corresponding to 35% of the women not recruited by telephone. The final interview rate was 82%. This was possible because personal contact was established with 95% of potential participants. CONCLUSION: This study achieved a high response rate in a hard to reach group. This was mainly achieved by first establishing contact by telephone. The use of multiple sources identified the telephone numbers of almost all the sample. Multiple attempts at telephone contact followed by postal approaches led to a high home interview rate.

Measurement of food and alcohol intake in relation to chronic liver disease.

It is well established that the consumption of alcohol is implicated in both the cause and progression of chronic liver disease. The quantity of drink that is consumed, the pattern of drinking and type of alcoholic beverages consumed are all possible factors in disease aetiology. The impact of specific dietary components on the cause and progression of chronic liver disease is unclear although it is known that obesity, and hence the over-consumption of energy, is a predictor of fatty liver. Work to elucidate the role of both diet and alcohol in the aetiology of liver disease is hindered by the methods currently available to measure dietary (including alcohol) intake. The validity and reliability of retrospective methods of assessing diet are limited by their reliance on memory and, for the 24 h recall, the short-time period of intake assessed and its inability to assess variability across the week. Prospective methods which measure food and drink intake at the time of consumption, and include weighed or estimated food diaries, are useful for prospective cohort studies but are expensive and have a high respondent burden. For estimation of alcohol intake retrospectively, the Cognitive Lifetime Drinking questionnaire, which prompts responses using a lifetime calendar, is a useful tool but still depends on memory. More work is required to develop valid, reliable and easily administered tools for measurement of both diet and alcohol.

What maternal factors influence the diet of 2-year-old children living in deprived areas? A cross-sectional survey.

OBJECTIVE: To investigate the maternal factors associated with poor diet among disadvantaged children. DESIGN: Survey of 300 mothers of 2-year-old children from areas of high deprivation in Scotland (response rate 81 %). A diet quality score was derived from reported consumption of carbohydrates, protein, fruit and vegetables, dairy products and restriction of sugary fatty foods. RESULTS: Most children (85 %) were classified as having a poor quality diet (low diet quality score). Mothers' general knowledge about healthy eating was high, but did not predict the quality of the children's diet. Lower frequencies of food preparation and serving, such as cooking with raw ingredients, providing breakfast daily and the family eating together, were also associated with a poorer diet. Regression modelling identified five significant factors. An increased risk of a poor diet was associated with mothers being unlikely to restrict sweets (OR = 21.63, 95 % CI 2.70, 173.30) or finding it difficult to provide 2-3 portions of fruit daily (OR = 2.94, 95 % CI 1.09, 7.95). Concern that the child did not eat enough increased the risk of a poor diet (OR = 2.37, 95 % CI 1.09, 5.16). Believing a healthy diet would help the child eat more reduced the risk of having a poor diet (OR = 0.28, 95 % CI 0.11, 0.74), as did providing breakfast daily (OR = 0.22, 95 % CI 0.05, 0.99). CONCLUSIONS: Interventions to improve children's diet could promote more positive intentions about preparing and serving of foods, particularly of specific meals at which the family eats together. The benefits of these behaviours to the child (improved diet, weight control) should be emphasised.

Estimation of typical food portion sizes for children of different ages in Great Britain.

It is often the case in dietary assessment that it is not practicable to weigh individual intakes of foods eaten. The aim of the work described was to estimate typical food portion weights for children of different ages. Using the data available from the British National Diet and Nutrition Surveys of children aged 1 1/2-4 1/2 years (1992-1993) and young people aged 4-18 years (1997), descriptive statistics were obtained, and predicted weights were calculated by linear, quadratic and exponential regression for each age group. Following comparison of energy and nutrient intakes calculated from actual (from an earlier weighed intake study) and estimated portion weights, the final list of typical portion sizes was based on median portion weights for the 1-3- and 4-6-year age groups, and age-adjusted means using linear regression for the 7-10-, 11-14- and 15-18-year age groups. The number of foods recorded by fifty or more children was 133 for each of the younger age groups (1-3 and 4-6 years) and seventy-five for each of the older age groups. The food portion weights covered all food groups. All portion sizes increased with age with the exception of milk in tea or coffee. The present study draws on a unique source of weighed data on food portions of a large sample of children that is unlikely to be repeated and therefore provides the best possible estimates of children's food portion sizes in the UK.

The impact of a community-based food skills intervention on cooking confidence, food preparation methods and dietary choices - an exploratory trial.

OBJECTIVE: To evaluate the feasibility of undertaking a food skills intervention study in areas of social deprivation aimed at altering cooking confidence, food preparation methods and dietary choices. DESIGN: A standardised skills programme was implemented in community-based settings. Pre- (T1) and post-intervention (T2) and 6-month follow-up (T3) measures (7-day diaries and self-administered questionnaires) were undertaken in intervention and comparison groups. SETTING: Eight urban communities in Scotland. SUBJECTS: One hundred and thirteen adults living in areas of social deprivation. RESULTS: It was clear that many subjects led fragmented lives and found commitment to intervention classes problematic. Sixty-three subjects completed the final (T3) assessments. The response to each component varied due to inability to attend sessions, illness, study requirements, employment, moving out of the area, change in circumstances, loss of interest and loss of postal questionnaires. At baseline, reported consumption of fruit and vegetables was low (mean frequency 8.1 +/- 4.78 times per week). Fruit intake increased significantly (P < 0.05) between T1 and T2 in the intervention group (1.7 +/- 2.36 to 2.7 +/- 3.28 times per week) only. Between T1 and T3, there was a significant increase (P < 0.05) in intervention subjects who reported confidence in following a recipe (67-90%,). CONCLUSIONS: This exploratory trial shows that a food skills intervention is likely to have a small but positive effect on food choice and confidence in food preparation. A full-scale randomised controlled trial in this hard-to-reach group would require a range of flexible approaches rather than a fully defined intervention, and presents challenges for trial design.

A qualitative study of pregnant teenagers' perceptions of the acceptability of a nutritional education intervention.

OBJECTIVE: in order to assess the feasibility of nutritional education intervention sessions for pregnant teenagers, standard dietary assessment schedules were supplemented by a qualitative appraisal. Reported in this paper are the perceptions of pregnant teenagers who attended one or more of these sessions. DESIGN: qualitative study using a phenomenological approach. Data were collected using semi-structured tape-recorded group interviews. SETTING: two community centres and one maternity unit in Tayside, Scotland. PARTICIPANTS: ten pregnant teenagers aged 16-18 years. INTERVENTIONS: all had attended one or more of a series of food preparation sessions led by a midwife. Food to take away was provided, as were supermarket vouchers. FINDINGS: those who attended found the sessions to be social, educational, and practical. These young women appreciated being in a group which did not include 'older' pregnant women. To a limited extent they had changed their dietary habits at home. Food to take home was a significant attraction. Some of the teenagers sought maternity-related information from the midwife leading the session. KEY CONCLUSIONS: nutritional education remains an important public health issue. Despite offering a range of incentives, attracting teenagers to these sessions was difficult, making their economic feasibility questionable. IMPLICATIONS FOR PRACTICE: with better recruitment, such sessions could form an important part of improving nutrition and overall health for current and future generations.