Associations of Caregiver Cooking Skills with Child Dietary Behaviors and Weight Status: Results from the A-CHILD Study.

We examined whether caregiver cooking skills were associated with frequency of home cooking, child dietary behaviors, and child body weight status in Japan. We used cross-sectional data from the 2018 Adachi Child Health Impact of Living Difficulty study, targeting primary and junior high school students aged 9-14 years in Adachi City, Tokyo, Japan (n = 5257). Caregiver cooking skills were assessed using a scale with good validity and reliability modified for use in Japan. Child heights and weights derived from school heath checkup data were used to calculate WHO standard body mass index z-scores. After adjusting for potential confounders, caregivers with low-level cooking skills were 4.31 (95% confidence interval (CI): 2.68-6.94) times more likely to have lower frequency of home cooking than those with high level of cooking skills. Children with low-level caregiver cooking skills were 2.81 (95% CI: 2.06-3.84) times more likely to have lower frequency of vegetable intake and 1.74 (95% CI: 1.08-2.82) times more likely to be obese. A low level of caregiver cooking skills was associated with infrequent home cooking, unhealthy child dietary behaviors, and child obesity.

Association of Funding and Meal Preparation Time With Nutritional Quality of Meals of Supplemental Nutritional Assistance Program Recipients.

Importance: The Supplemental Nutrition Assistance Program (SNAP) is a federal program that provides food-purchasing assistance to low-income people; however, its current design does not account for the time availability of SNAP recipients to prepare meals. Objective: To evaluate the association of the availability of funding for food purchases and time for meal preparation with the nutritional quality of meals of SNAP recipients. Design, Setting, and Participants: This study used decision analytical modeling to evaluate the nutritional quality of meals of SNAP recipients. The model was developed from February 6, 2017, to December 12, 2020, using data from 2017 and is based on discrete optimization. The model describes food and grocery purchasing, in-home meal preparation, and meal plan choices of a family of SNAP participants (2 adults and 2 children) while considering food preferences, meal preparation time, and food costs. The model assumes food preferences match the foods typically purchased by SNAP households. Costs of food ingredients and prepared foods are taken from a single zip code. Exposures: Time availability and total amount and type of funding were varied. Allowing prepared delicatessen foods and disallowing frozen prepared foods for purchase using SNAP funds were considered. Main Outcomes and Measures: The primary outcome was the number of home-cooked meals and the amounts of fruits, vegetables, protein, sodium, sugar, and fiber consumed from generated meal plans. Amounts were evaluated as a percentage of the quantity recommended by established dietary guidelines. Results: Increased time availability was associated with increases in the percentage of home-cooked meals and servings of fruits/vegetables and decreased sodium consumption. Higher levels of funding were associated with increased consumption of fiber, fruits/vegetables, protein, sodium, and sugar. With 20 min/d of cooking time, $400/mo of SNAP benefits, and $100/mo of self-funding, the meal plan had a mean (SE) of 20.1% (0.3%) of meals home cooked, 0.5 (<0.1) servings/d per person of fruits/vegetables, 100.3% (0.6%) of daily recommended protein per person, 115.1% (0.8%) of daily recommended sodium per person, 241.8% (1.0%) of daily recommended sugar per person, and 31.2% (0.3%) of daily recommended fiber per person. With 20 min/d of cooking time, $400/mo of SNAP benefits, and $600/mo of self-funding, the meal plan had a mean (SE) of 23.9% (1.0%) of meals home cooked, 2.8 (0.1) servings/d per person of fruits/vegetables, 134.9% (1.6%) of daily recommended protein per person, 200.9% (3.1%) of daily recommended sodium per person, 295.1% (3.1%) of daily recommended sugar per person, and 90.1% (1.0%) of daily recommended fiber per person. With 60 min/d of cooking time, $400/mo of SNAP benefits, and $100/mo of self-funding, the meal plan had a mean (SE) of 52.7% (0.9%) of meals home cooked, 1.4 (<0.1) servings/d per person of fruits/vegetables, 109.0% (1.1%) of daily recommended protein per person, 108.7% (1.0%) of daily recommended sodium per person, 298.6% (2.0%) of daily recommended sugar per person, and 38.8% (0.4%) of daily recommended fiber per person. With 60 min/d of cooking time, $400/mo of SNAP benefits, and $600/mo of self-funding, the meal plan had a mean (SE) of 42.8% (1.2%) meals home cooked, 4.3 (0.1) servings/d per person of fruits/vegetables, 144.4% (1.8%) of daily recommended protein per person, 165.2% (2.8%) of daily recommended sodium per person, 322.4% (2.4%) of daily recommended sugar per person, and 91.0% (0.9%) of daily recommended fiber per person. Conclusions and Relevance: In this decision analytical model, meal preparation time was associated with the ability of SNAP recipient families to consume nutritious meals, suggesting that increased funding alone may be insufficient for improving the nutritional profiles of SNAP recipients. Given the current US food supply, governmental interventions that provide the equivalence in increased time availability to achieve nutritious meals may be needed.

The Joint Effect of Maternal Marital Status and Type of Household Cooking Fuel on Child Nutritional Status in Sub-Saharan Africa: Analysis of Cross-Sectional Surveys on Children from 31 Countries.

The current study sought to investigate the joint effect of maternal marital status and type of household cooking fuel on child nutritional status in sub-Saharan Africa. Data in the children's files of 31 sub-Saharan African countries were pooled from the Demographic and Health Surveys collected between 2010 and 2019. The outcome variables were three child anthropometrics: stunting (height-for-age z-scores); wasting (weight-for-height z-scores); and underweight (weight-for-age z-scores). The joint effect of maternal marital status and type of household cooking fuel on child nutritional status was examined using multilevel regression models. The results were presented as adjusted odds ratios (aORs) at p < 0.05. The percentages of children who were stunted, wasted and underweight in the 31 countries in sub-Saharan Africa were 31%, 8% and 17%, respectively. On the joint effect of maternal marital status and type of household cooking fuel on stunting, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who use unclean household cooking fuel, children born to single women who use clean household cooking fuel, and children born to married women who used unclean household cooking were more likely to be stunted. With wasting, children born to single mothers who used unclean household cooking fuel and children born to married women who used unclean household cooking fuel were more likely to be wasted compared to children born to married mothers who used clean household cooking fuel. With underweight, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who used unclean household cooking fuel, children born to single women who used clean household cooking fuel and children born to married women who used unclean household cooking were more likely to be underweight. It is imperative for the governments of the 31 sub-Saharan African countries to double their efforts to end the use of unclean household cooking fuel. This goal could be achieved by promoting clean household cooking fuel (e.g., electricity, gas, ethanol, solar, etc.) through effective health education, and promotion programmes. The attention of policymakers is drawn to the urgent need for children's nutritional status policies and programmes (e.g., dietary supplementation, increasing dietary diversity, improving agriculture and food security) to be targeted towards at-risk sub-populations (i.e., single mothered households).

Solid cooking fuel use and cognitive decline among older Mexican adults.

Studies of air pollution and cognition often rely on measures from outdoor environments. Many individuals in low- and middle-income countries are exposed to indoor air pollution from combustion of solid cooking fuels. Little is known about how solid cooking fuel use affects cognitive decline over time. This study uses data from the 2012, 2015, and 2018 Mexican Health and Aging Study (n = 14 245, age 50+) to assess how use of wood or coal for cooking fuel affects cognition of older adults relative to use of gas. It uses latent change score modeling to determine how using solid cooking fuel affected performance in Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency. Solid cooking fuel was used by 17% of the full sample but was more common in rural areas. Solid fuel users also had lower socioeconomic status. Compared to those using gas, solid fuel users had lower baseline scores and faster decline in Verbal Learning (ß = -0.18, p < 0.05), Visual Scanning (ß = -1.00, p < 0.001), and Verbal Fluency (ß = -0.33, p < 0.001). Indoor air pollution from solid cooking fuels may represent a modifiable risk factor for cognitive decline. Policy should focus on facilitating access to clean cooking fuels.

Association Between Frequency of Eating Away-From-Home Meals and Risk of All-Cause and Cause-Specific Mortality.

BACKGROUND: Dining out is a popular activity worldwide. Evidence on the association between eating meals away from home and long-term health outcomes is still limited. OBJECTIVE: The objective of this study was to examine the association of frequency of eating meals prepared away from home with all-cause and cause-specific mortality. PARTICIPANTS/SETTING: This study included 35,084 adults aged 20 years or older from the National Health and Nutritional Examination Survey 1999-2014, who reported their dietary habits including frequency of eating meals prepared away from home in a questionnaire during face-to-face household interviews. MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular mortality, and cancer mortality were ascertained by linkage to death records through December 31, 2015. STATISTICAL ANALYSES PERFORMED: Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all-cause, cardiovascular, and cancer mortality. RESULTS: During 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 death from cancer. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, and body mass index, the hazard ratio of mortality among participants who ate meals prepared away from home very frequently (2 meals or more per day) compared with those who seldom ate meals prepared away from home (fewer than 1 meal/wk) was 1.49 (95% CI 1.05 to 2.13) for all-cause mortality, 1.18 (95% CI 0.55 to 2.55) for cardiovascular mortality, and 1.67 (95% CI 0.87 to 3.21) for cancer mortality. CONCLUSIONS: Frequent consumption of meals prepared away from home is significantly associated with increased risk of all-cause mortality. The association of eating meals prepared away from home with cardiovascular mortality and cancer mortality warrants additional investigation.

CooC11 and CooC7: the development and validation of age appropriate children's perceived cooking competence measures.

BACKGROUND: Learning cooking skills during childhood and adolescence is associated with positive dietary outcomes in adulthood as well as being tracked from adolescence to adulthood. In addition studies have found that perceived competence to be a greater motivator to perform a behaviour than actual competence. However, a lack of validated tools that effectively measure behavioural and dietary changes including cooking confidence in children is a limitation. Therefore, this research aimed to develop and validate age-appropriate perceived cooking competence measures for younger and older primary school aged children. METHODS: Two measures of perceived Cooking Competence (CooC11 and CooC7) for older (8-12 years) and younger (6-7 years) children were developed from a critical evaluation of publically available recommendations and expert consultation. The cooking skills within the measures were illustrated by a graphic designer in consultation with a chef and reviewed in an iterative manner by the research team. The measures were piloted for clarity, ease of use and initial face validity. Multiple studies were used for both CooC11 and CooC7 to establish psychometric properties of the measures, temporal stability, internal consistency reliability, construct validity, as well as responsiveness to change for CooC11. Analysis included Exploratory Factor Analysis, Confirmatory Factor Analysis, Intraclass Correlation Coefficients, Pearson's Correlations, ANOVAs and Cronbach's Alphas. RESULTS: Both measures had high levels of face validity and received positive user feedback. Two factors were shown in both measures with the measures showing excellent temporal stability (ICC > 0.9) and good internal consistency (Cronbach's Alphas > 0.7). Both measures showed initial discriminant validity, with significant differences (P< 0.001) between those who reported assisting their parents with dinner preparation and those who did not. Additionally, CooC11 was significantly correlated with an adult cooking measure and had a significant responsiveness to change (P< 0.01). CONCLUSIONS: The CooC11 and CooC7 are the first validated age-appropriate measures for assessing children's perceived Cooking Competence for ages 8-12 and 6-7 years respectively. They can be used to evaluate the efficacy of children's cooking intervention studies or school nutrition education programmes.

Gender differences in global estimates of cooking frequency prior to COVID-19.

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N = 145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of 'scratch' cooking lunch and dinner across the globe by gender. Poisson regression was used to assess predictors of cooking frequency. Associations between disparities in cooking frequency (at the country level) between men and women with perceptions of subjective well-being were assessed using linear regression. Across the globe, cooking frequency varied considerably; dinner was cooked more frequently than lunch; and, women (median frequency 5 meals/week) cooked both meals more frequently than men (median frequency 0 meals/week). At the country level, greater gender disparities in cooking frequency are associated with lower Positive Experience Index scores (-0.021, p = 0.009). Prior to the COVID-19 pandemic, the frequency with which men and women cook meals varied considerably between nations; and, women cooked more frequently than men worldwide. The pandemic, and related 'stay at home' directives have dramatically reshaped the world, and it will be important to monitor changes in the ways and frequency with which people around the world cook and eat; and, how those changes relate to dietary patterns and health outcomes on a national, regional and global level.

Cooking, smoking, and stunting: Effects of household air pollution sources on childhood growth in India.

This paper investigates the effects of household air pollution (HAP) on child stunting in India using a sample of 206, 898 under-five children from the latest National Family Health Survey (2015-16). Descriptive statistics and multivariate analysis were used to understand the association of stunting by type of cooking fuel, separate kitchen, and indoor smoking in the household. Using clean cooking fuels (CCFs), having a separate kitchen, and being unexposed to smoking can reduce the prevalence of stunting by 4%, 1%, and 1%, respectively, from the current prevalence of stunting (38%). The probability of childhood stunting among children living in households using unclean cooking fuel (UCF) was significantly higher (OR-1.16; 95% CI: 1.13-1.19) than those living in households using CCF. Findings were similar results in the absence of separate kitchen (OR-1.08; 95% CI: 1.05-1.10) and exposure to environmental tobacco smoke (OR-1.06; 95% CI: 1.04-1.08). Households using UCF had a 16% higher likelihood of stunting, while there was a strong gradient of HAP with stunting after controlling socioeconomic and demographic factors. Therefore, the LPG programs, such as the Pradhan Mantri Ujjwala Yojana, may be crucial to reduce HAP and its adverse impact on stunting, and successively to achieve sustainable development goals.

Home Cooking Is Related to Potential Reduction in Cardiovascular Disease Risk among Adolescents: Results from the A-CHILD Study.

This study aimed to investigate the association between the frequency of home cooking and cardiovascular disease risk among Japanese adolescents. We used cross-sectional data on adolescents from the 2018 Adachi Child Health Impact of Living Difficulty study, which targeted junior high school students aged 13-14 years in Adachi, Tokyo, Japan. Frequency of home cooking by 553 caregivers was assessed via questionnaire and classified as high (almost daily), medium (4-5 days/week), or low (≤3 days/week). Cardiovascular disease risk factors included blood pressure, serum cholesterol (total, LDL, and HDL), hemoglobin A1c, and body mass index. Multiple linear regression analysis revealed that adolescents exposed to a low frequency of home cooking showed higher diastolic blood pressure (ß = 3.59, 95% confidence interval [CI]: 0.42 to 6.75) and lower HDL cholesterol (ß = -6.15, 95% CI: -11.2 to -1.07) than those exposed to a high frequency of home cooking, adjusting for adolescents' sex, household income, and parental comorbidity. Future studies are needed to clarify the causal relationship and mechanisms through which home cooking influences adolescents' cardiovascular health.

Cooking Frequency and Perception of Diet among US Adults Are Associated with US Healthy and Healthy Mediterranean-Style Dietary Related Classes: A Latent Class Profile Analysis.

: Background: Meal habits are associated with overall dietary quality and favorable dietary patterns determined by the Healthy Eating Index (HEI). However, within dietary patterns, complexities of food combinations that are not apparent through composite score determination may occur. Also, explorations of these food combinations with cooking and perceived diet quality (PDQ) remain unknown. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 were utilized to determine the frequency of cooking at home and PDQ, along with sociodemographic variables. Latent class profile analysis was performed to determine person-centered data-driven analysis using the dietary index, HEI-2010, at both the daily and dinner meal-time levels. Multinomial logistic regression analysis was utilized to evaluate the association of dietary patterns with all covariates. RESULTS: For daily HEI, five distinct dietary classes were identified. For dinner HEI, six classes were identified. In comparison to the standard American diet classes, home cooking was positively associated with daily (p < 0.05) and dinner (p < 0.001) dietary classes that had the highest amounts of total vegetable and greens/beans intake. PDQ was positively associated with these classes at the daily level (p < 0.001), but negatively associated with healthier classes at the dinner level (p < 0.001). CONCLUSION: The use of latent class profile analysis at the daily and dinner meal-time levels identified that food choices coalesce into diverse intakes, as shown by identified dietary classes. Home cooking frequency could be considered a positive factor associated with higher vegetable intake, particularly greens/beans, at the daily and dinner levels. At the same time, the perception of diet quality has a positive association only with daily choices.

Household and personal air pollution exposure measurements from 120 communities in eight countries: results from the PURE-AIR study.

BACKGROUND: Approximately 2·8 billion people are exposed to household air pollution from cooking with polluting fuels. Few monitoring studies have systematically measured health-damaging air pollutant (ie, fine particulate matter [PM2·5] and black carbon) concentrations from a wide range of cooking fuels across diverse populations. This multinational study aimed to assess the magnitude of kitchen concentrations and personal exposures to PM2·5 and black carbon in rural communities with a wide range of cooking environments. METHODS: As part of the Prospective Urban and Rural Epidemiological (PURE) cohort, the PURE-AIR study was done in 120 rural communities in eight countries (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Data were collected from 2541 households and from 998 individuals (442 men and 556 women). Gravimetric (or filter-based) 48 h kitchen and personal PM2·5 measurements were collected. Light absorbance (10-5m-1) of the PM2·5 filters, a proxy for black carbon concentrations, was calculated via an image-based reflectance method. Surveys of household characteristics and cooking patterns were collected before and after the 48 h monitoring period. FINDINGS: Monitoring of household air pollution for the PURE-AIR study was done from June, 2017, to September, 2019. A mean PM2·5 kitchen concentration gradient emerged across primary cooking fuels: gas (45 µg/m3 [95% CI 43-48]), electricity (53 µg/m3 [47-60]), coal (68 µg/m3 [61-77]), charcoal (92 µg/m3 [58-146]), agricultural or crop waste (106 µg/m3 [91-125]), wood (109 µg/m3 [102-118]), animal dung (224 µg/m3 [197-254]), and shrubs or grass (276 µg/m3 [223-342]). Among households cooking primarily with wood, average PM2·5 concentrations varied ten-fold (range: 40-380 µg/m3). Fuel stacking was prevalent (981 [39%] of 2541 households); using wood as a primary cooking fuel with clean secondary cooking fuels (eg, gas) was associated with 50% lower PM2·5 and black carbon concentrations than using only wood as a primary cooking fuel. Similar average PM2·5 personal exposures between women (67 µg/m3 [95% CI 62-72]) and men (62 [58-67]) were observed. Nearly equivalent average personal exposure to kitchen exposure ratios were observed for PM2·5 (0·79 [95% 0·71-0·88] for men and 0·82 [0·74-0·91] for women) and black carbon (0·64 [0·45-0·92] for men and 0·68 [0·46-1·02] for women). INTERPRETATION: Using clean primary fuels substantially lowers kitchen PM2·5 concentrations. Importantly, average kitchen and personal PM2·5 measurements for all primary fuel types exceeded WHO's Interim Target-1 (35 µg/m3 annual average), highlighting the need for comprehensive pollution mitigation strategies. FUNDING: Canadian Institutes for Health Research, National Institutes of Health.

Food Skills and Their Relationship with Food Security and Dietary Diversity Among Asylum Seekers Living in Norway.

OBJECTIVE: To investigate the impact of food skills on food security and dietary diversity among asylum seekers living in Norwegian reception centers. DESIGN: Cross-sectional study. SETTING: Eight asylum reception centers. PARTICIPANTS: A total of 205 asylum seekers (131 men and 74 women) recruited through convenience sampling. MAIN OUTCOME MEASURES: Food skills were measured using questions from the Canadian Rapid Response on Food Skills and divided into cooking skills and shopping skills. Food security was measured with the 10-item version of the Radimer/Cornell Scale. The dietary diversity score was based on a 24-h recall. ANALYSIS: Bivariate and multivariable logistic regression. RESULTS: Cooking skills were associated with adequate dietary diversity (adjusted odds ratio, 2.12; 95% confidence interval, 1.04-4.31), but not with adult food insecurity (adjusted odds ratio. 0.63; 95% confidence interval, 0.26-1.53). Shopping skills were not associated with either measure of dietary diversity or adult food insecurity. Women had higher cooking skills than men, but there were no gender differences in shopping skills. CONCLUSIONS AND IMPLICATIONS: Food skills had a limited association with food security and dietary diversity. Further research is needed to identify food skills beneficial for asylum seekers and to address the multiple causes of food insecurity.

Socio-economic Correlates and Spatial Heterogeneity in the Prevalence of Asthma among Young Women in India.

BACKGROUND: Asthma is one of the leading causes of disease burden when measured in terms of disability adjusted life years, despite low prevalence of self-reported cases among young women. This paper deals with the meso-scale correlates and spatial heterogeneity in the prevalence of self-reported Asthma across 640 districts in India, using a nationally representative sample of 699,686 women aged 15-49 years from all 36 States/UTs under NFHS-4 (2015-16). METHODS: Analytical methods used in this paper include multivariate logistic regression to examine the adjusted effects of various independent variables on self-reported Asthma and poor-rich ratios (PRR) and concentration index (CI) to understand the economic inequalities in the prevalence of Asthma. For the spatial analysis in the prevalence of Asthma, univariate and bivariate local Moran's I statistic have been computed in addition to measure of spatial autocorrelation and auto regression using spatial error and spatial lag models. RESULTS: Results highlight that women's education was an important marker to the prevalence of Asthma. Smoking tobacco in any form among women were significantly more likely to suffer from Asthma. The prevalence of Asthma was further aggravated among women from the households without a separate room for kitchen, as well as those using unclean fuel for cooking. The poor-rich ratio in the prevalence of Asthma across various States/UTs in India depict inherent inequality. An analysis of spatial clustering in the prevalence of Asthma based on spatial autocorrelation portrays that Moran's I values were significant for improved source of drinking water, clean fuel used for cooking, and household environment. When spatial weights are taken into consideration, the autoregression model noticeably becomes stronger in predicting the prevalence of Asthma. CONCLUSIONS: Any programmatic effort to curb the prevalence of Asthma through vertical interventions may hinge around the use of clean fuel, poverty, and lifestyle of subjects, irrespective of urban-rural place of their residence, environmental and ecological factors.

Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households.

Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (ß = -0.77; 95% CI: -0.88, -0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (ß = -1.18; 95% CI: -1.45, -0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.

Cooking skills related to potential benefits for dietary behaviors and weight status among older Japanese men and women: a cross-sectional study from the JAGES.

BACKGROUND: Poor cooking skills have been linked to unhealthy diets. However, limited research has examined associations of cooking skills with older adults' health outcomes. We examined whether cooking skills were associated with dietary behaviors and body weight among older people in Japan. METHODS: We used cross-sectional data from the 2016 Japan Gerontological Evaluation Study, a self-report, population-based questionnaire study of men (n = 9143) and women (n = 10,595) aged ≥65 years. The cooking skills scale, which comprises seven items with good reliability, was modified for use in Japan. We calculated adjusted relative risk ratios of unhealthy dietary behaviors (low frequency of home cooking, vegetable/fruit intake; high frequency of eating outside the home) using logistic or Poisson regression, and relative risk ratios of obesity and underweight using multinomial logistic regression. RESULTS: Women had higher levels of cooking skills, compared with men. Women with a moderate to low level of cooking skills were 3.35 (95% confidence interval [CI]: 2.87-3.92) times more likely to have a lower frequency of home cooking and 1.61 (95% CI: 1.36-1.91) times more likely to have a lower frequency of vegetable/fruit intake, compared with women with a high level of cooking skills. Men with a low level of cooking skills were 2.56 (95% CI: 2.36-2.77) times more likely to have a lower frequency of home cooking and 1.43 (95% CI: 1.06-1.92) times more likely to be underweight, compared with men with a high level of cooking skills. Among men in charge of meals, those with a low level of cooking skills were 7.85 (95% CI: 6.04-10.21) times more likely to have a lower frequency of home cooking, 2.28 (95% CI: 1.36-3.82) times more likely to have a higher frequency of eating outside the home, and 2.79 (95% CI: 1.45-5.36) times more likely to be underweight, compared with men with a high level of cooking skills. Cooking skills were unassociated with obesity. CONCLUSIONS: A low level of cooking skills was associated with unhealthy dietary behaviors and underweight, especially among men in charge of meals. Research on improving cooking skills among older adults is needed.

Willingness to pay for whole turkey attributes during Thanksgiving holiday shopping in the United States.

Although whole turkeys served at Thanksgiving are the ubiquitous kickoffs to the US winter holiday season, much remains unknown about shopping behaviors for holiday food items. Given the once-a-year purchase of the whole turkey for most households, collecting data about demand and preferences necessitated the collection of data during the week before Thanksgiving, while turkey shopping was at the forefront of consumers' minds. Despite a self-reported confidence in cooking turkeys, many respondents indicated they thawed frozen meat using improper methods. Ninety-five percent of respondents indicated that they consumed meat; 89% of respondents who consumed meat or had someone in the household who did, indicated they had purchased turkey products. Positive willingness to pay (WTP) was found for all attributes of whole turkeys studied: free range, fed a vegetarian diet, hormone use not permitted, and antibiotic use not permitted. Mean estimated WTP for free range ranged from $0.37/lb for industry verified free range to $0.74/lb for USDA verified free range; although those 2 estimates were not statistically different from each other, they were both statistically different from zero. The statistically significant estimated mean WTP for hormone use not permitted ranged from $0.85/lb for industry verification to $1.35 for USDA verification but were again not statistically different from each other. Mean WTP estimates, which were statistically significant but not different from one another for antibiotic use not permitted, ranged from $0.62/lb for industry certification to $0.72 for retailer certified. Turkeys certified to be fed a vegetarian diet had a mean WTP estimate of $0.39/lb for retailer verification to $0.60/lb for USDA verification; those mean WTP estimates were not statistically different from each other but were each statistically different from zero. Social desirability bias, which can be defined as the relative over-reporting of one's own goodness, was detected with respect to self-reported holiday eating and healthfulness statements. Relationships were found between social desirability bias, gender, and age for holiday eating statements using a seemingly unrelated regression.

Meat preparation techniques: results of the ISACamp population-based survey.

This article aims to identify meat preparation techniques according to sociodemographic variables and health-related behaviors. Cross-sectional population-based survey that used one 24-hour recall to identify the meat preparation techniques. We analyzed 3,376 24-hour recalls. The meat preparation techniques were classified as moist-heat (sauté, stew, boil; MH) or dry-heat (sauté, stew, boil; MH) and dry-heat (baking, grilling/barbecuing and frying; DH). The prevalence of use was 39.0% for moist cooking, 32.7% for frying and 28.3% for baking/grilling. Women, the elderly and those from other municipalities/states were more likely to use MH cooking. MH techniques were least prevalent among those of higher socioeconomic status. Among the techniques of DH cooking, women, the elderly and people with higher education and income were less likely to fry meats. Those born in Campinas and those with higher income, education, and those who ate fruits and vegetables on a higher weekly frequency were more likely to roast/grill meats. The results show the epidemiological profile associated with meat preparation techniques. Women, the elderly and those with lower education are more likely to use MH cooking techniques and less likely to fry meats. Those economically more favored are less likely to use MH techniques and frying, and more roasting/grilling.

Household cooking fuel use and its health effects among rural women in southern India-A cross-sectional study.

The use of biomass fuel is associated with the deterioration of human health and women are more likely to develop health conditions due to their exposure to indoor air pollution during cooking. This study was conducted to assess the pattern of fuel used for cooking in households as well as to determine the association between the types of fuel used with respect to socio-demographic characteristics and health status of women. A community based cross-sectional survey was conducted between August 2016 and September 2018 in four rural areas and one semi-urban area of Udupi district, Karnataka, India. The study comprised 587 families including 632 women. A pre-tested semi-structured questionnaire was used to collect data on the type of fuel as well as self-reported health conditions. Overall, 72.5% of the families used biomass, where 67.2% families were currently using both biomass and liquefied petroleum gas while only biomass was used in 5.3% of the families for cooking. Among women, being ever exposed to biomass fuel was significantly associated with their age, literacy level, occupation and socio-economic status (p < 0.001). Those who were exposed to biomass fuel showed a significant association with self-reported ophthalmic (AOR = 3.85; 95% CI: 1.79-8.29), respiratory (OR = 5.04; 95% CI: 2.52-10.07), cardiovascular (OR = 6.07; 95% CI: 1.88-19.67), dermatological symptoms /conditions (AOR = 3.67; 95% CI: 1.07-12.55) and history of adverse obstetric outcomes (AOR = 2.45; 95% CI: 1.08-5.57). A positive trend was observed between cumulative exposure to biomass in hour-years and various self-reported health symptoms/conditions (p < 0.001). It was observed that more than two-thirds of women using biomass fuel for cooking were positively associated with self-reported health symptoms. Further longitudinal studies are essential to determine the level of harmful air pollutants in household environment and its association with various health conditions among women in this region.

Exploring the association between food insecurity and food skills among school-aged children.

OBJECTIVE: To examine the relationship between household food insecurity (FI) and children's involvement in family meal choices and food preparation, used as proxies for children's food skills, and to explore gender differences within these associations. DESIGN: Households were classified as food-secure or food-insecure using the six-item, short-form Household Food Security Survey Module. Children's involvement in family meal choices and food preparation were treated as proxies for children's food skills. Mixed-effects multinomial logistic regression models were used. SETTING: Public schools in Nova Scotia, Canada. PARTICIPANTS: 5244 children in the fifth grade (10-11 years old) participating in the Children's Lifestyle and School Performance Study (CLASS). RESULTS: Most children reported being involved in family meal choices or food preparation at least weekly (74 and 68 %). The likelihood of helping choose family meals once a week was 33 % lower among girls from food-insecure households compared to girls from food-secure households. No differences in boys' involvement in family meal choices were observed according to household FI status. Boys from food-insecure households were 65 % more likely than boys from food-secure households to assist with food preparation/cooking four times per week. No differences in girls' involvement in food preparation were observed according to household FI status. CONCLUSIONS: Findings support that household FI is not due to a lack of food skills but most likely due to inadequate access to resources. This supports the call for upstream policies targeting the structural issues underpinning household FI such as low income.

Meat preparation techniques: results of the ISACamp population-based survey / Técnicas de preparo de carne: resultados da pesquisa de base populacional ISACamp

Abstract This article aims to identify meat preparation techniques according to sociodemographic variables and health-related behaviors. Cross-sectional population-based survey that used one 24-hour recall to identify the meat preparation techniques. We analyzed 3,376 24-hour recalls. The meat preparation techniques were classified as moist-heat (sauté, stew, boil; MH) or dry-heat (sauté, stew, boil; MH) and dry-heat (baking, grilling/barbecuing and frying; DH). The prevalence of use was 39.0% for moist cooking, 32.7% for frying and 28.3% for baking/grilling. Women, the elderly and those from other municipalities/states were more likely to use MH cooking. MH techniques were least prevalent among those of higher socioeconomic status. Among the techniques of DH cooking, women, the elderly and people with higher education and income were less likely to fry meats. Those born in Campinas and those with higher income, education, and those who ate fruits and vegetables on a higher weekly frequency were more likely to roast/grill meats. The results show the epidemiological profile associated with meat preparation techniques. Women, the elderly and those with lower education are more likely to use MH cooking techniques and less likely to fry meats. Those economically more favored are less likely to use MH techniques and frying, and more roasting/grilling.

Resumo O objetivo deste artigo é identificar as técnicas de preparo utilizadas em carnes, segundo variáveis sociodemográficas e de comportamentos relacionados à saúde. Trata-se de estudo transversal de base populacional que utilizou um Recordatório de 24 horas para identificar as técnicas de preparo de carnes. Foram analisados 3.376 recordatórios. As técnicas de preparo foram classificadas em cocção úmida (refogar, ensopar, fervura) e cocção seca (assar, grelhar, fritar). As prevalências de uso foram de 39,0% para cocção úmida, 32,7% para fritura e 28,3% para assar/grelhar. A cocção úmida foi mais prevalente nas mulheres, idosos e nos naturais de outros municípios/Estados, e menos prevalente nos segmentos de melhor nível socioeconômico. Das técnicas de cocção seca, a fritura foi menos utilizada por mulheres, idosos e por pessoas com maior nível de educação e renda. O assar/grelhar foram as técnicas mais aplicadas pelos nascidos em Campinas e pelos estratos mais altos de renda, escolaridade, e que ingeriam frutas e hortaliças ≥ 4 vezes/semana. Os resultados revelam o perfil epidemiológico associado às técnicas de preparo de carnes; mulheres e idosos empregam mais calor úmido e menos fritura, e os mais favorecidos economicamente usam menos cocção úmida e fritura, e mais o assar/grelhar.