“What’s Cooking?” Culinary nutrition education at the supermarket

“What’s Cooking?” Culinary nutrition education at the supermarket

Jennifer J. Kamps
Graduate Student
Clemson Universtiy

Margaret D. Condrasky
Department of Food Science and Human Nutrition
Clemson University

Katherine L. Cason
Department of Food Science and Human Nutrition
Clemson University

Abstract

The “What’s Cooking” supermarket culinary nutrition program complements the skills of Cooperative Extension and health promotion professionals by partnering with a chef to deliver a new hands-on meal preparation series. This study evaluated the effects of this approach with parents for increasing nutrition awareness, consumption of fruits and vegetables, and cooking frequency at home. Intervention participants received print materials, interacted with the program delivery team, and sampled recipes during a supermarket seven-week program. The control group received materials only. Baseline and follow-up on-line surveys and focus groups were conducted and analyzed for both groups. The intervention group demonstrated significant increases in five awareness-, two consumption-, and two cooking-related items. “What’s Cooking” demonstrated positive results and further supermarket implementation and testing of materials can yield valuable insight toward long-term program effectiveness. The program can further target adolescent, busy moms, and other traditionally difficult-to-reach audiences.

Keywords: culinary nutrition education, supermarket, home food preparation, fruit and vegetable consumption, chef

Introduction

The media has bombarded our nation with many misleading health messages indicating that Americans are eating too much. In reality, the message should be to eat more – specifically, more fruits and vegetables. Fewer than 60 percent of American adults eat the recommended servings of fruits and vegetables per day (The Dietary Guidelines for Americans 2005). Parents play an important role in the health status of their children, and studies have shown that parents can moderately influence their children’s intake of fruits and vegetables (Hopper 1996). Since eating habits are formed in childhood and persist into adulthood (Cooke 2004), it is critical to place children and their eating habits as a chief priority for future nutrition programs.

Fruits and vegetables

Several programs advise the addition of fruits and vegetables for improving overall health and quality of life. Healthy People 2010 advises anyone over two years of age to consume a minimum of five servings of fruits and vegetables per day (U.S. Department of HHS 2000), and the 2005 Dietary Guidelines for Americans recommends consuming between nine and eleven servings of fruits and vegetables daily (The Dietary Guidelines for Americans 2005). According to the “Fruits and Veggies More Matters” health initiative, the addition of more fruits and vegetables into one’s daily diet can drastically decrease the risk of certain chronic diseases (Produce for Better Health Foundation 2007).

However, in South Carolina, where the “What’s Cooking” program described in this paper has been pilot tested, only 16 percent of children consume five or more servings per day (Rafioura et al. 2002), and these results parallel national studies where a majority of America’s youth fail to eat the recommended amount of produce (Lino et al. 2007). Overall fruit and vegetable consumption is low in the U.S., but it is reported that the benefits are high. Therefore, it is important for nutrition educators to emphasize the need for families to adequately plan and prepare menus, to cook more often at home, and to increase consumption of fruits and vegetables.

Cooking habits at home

A change in family food choices and eating behavior has occurred over the past 30 years where traditional family meals consumed at home are becoming less common (Lin, Guthrie, and Frazao 1999). Fast food meals are oftentimes energy-dense and are proposed as a contributing factor of the obesity epidemic (MacInnis and Rausser 2005; McCaffrey et al. 2007). There has also been a trend toward the preparation of meals with fewer ingredients, which take less time and effort to prepare (Condrasky 2006), although there is a rapidly growing interest in television food programming that teaches cooking skills and habits (de Solier 2005). Additionally, research has shown that when parents eat dinner with their children, they can model healthy eating patterns and children tend to have a higher intake of fruits and vegetables (Gillman et al. 2000; Videon 2003; Condrasky 2006). Also, cooking at home can be an enjoyable experience and a bonding time for parents and children alike. Parents can foster cooking skills and sensible eating habits to their children through this time together (Birch et al. 1982; Skinner et al. 2002).

Supermarkets

Supermarkets are model settings for using social marketing principles (product, place, price, and promotion) for effective nutrition interventions. Because 80 percent of food is purchased in supermarkets, these settings are uniquely positioned to provide an environment easily accessible for nutrition interventions (Cobb 2003). Interior supermarket layouts, however, are commonly designed to have consumers pay more attention to profitable, energy dense, processed foods before reaching healthier options such as fruits and vegetables (Nestle 2006). Consumers have, however, reportedly become more concerned with their well-being, and the “The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity” report noted that 75 percent of adults used nutrition labeling when food shopping. Of those participants, 50 percent said they have put items back based on their nutritional content (The Keystone Center 2006). Promotion techniques such as food demonstrations and sampling are used widely in supermarkets to increase interest in product, measured by increased sales (Fitzgerald 1996; Lindstedt 1999; Moses 2005). In fact, 95 percent of supermarkets use food sampling and demonstrations with effective delivery (Park and German 2000). This study emphasizes the potential benefit of using these marketing strategies for nutrition information at supermarkets, highlighting and promoting healthier choices and the ease of their use.

“What’s Cooking” sessions

“What’s Cooking” is a seven-session supermarket program partnered with BI-LO, LLC, that delivers a one-week menu planning period for the consumer (family). It enables parents and caregivers to build their knowledge, skills, and behavior in the following areas

• cooking techniques
• increasing availability and accessibility of fruits and vegetables
• increasing fruit and vegetable consumption for the family
• planning healthy menus and
• experimenting with new fruit and vegetable recipes.

The program delivery team included a program leader, a dietetic student, a chef, and supermarket store staff. The program leader and dietetic student were the first line of contact with the customer as they enrolled participants and then engaged the participants with nutrition information and literature. The chef was stationed in the produce department of the supermarket during the intervention to assist in answering questions such as how to choose high quality produce, how to prepare fruits and vegetables before cooking, and what cooking method was appropriate for selected items. The supermarket produce staff was trained, knowledgeable, and able to provide guidance to participants during and between the seven weekly intervention sessions.

The study used both an intervention store, in which the full nutrition education program was implemented, and a control store, in which participants received only printed materials and no interaction with the program delivery team. The set-up at the intervention store included a display table located close to the entrance where all customers could view visual aids and interact with the program delivery team. Samples of the recipe of the day and other program materials were available on the display table. Topics for the seven sessions were (1) snacks, (2) fiber, (3) time-saving tips, (4) cost-effectiveness of produce, (5) portion sizes, (6) vegetable categories and health benefits, and (7) sneaking fruits and vegetables into recipes.

After enrollment, the program leader led a one-on-one discussion with the participant about the nutrition topic of the day and explained how the recipe of the day could be incorporated with the nutrition topic and the weekly meal plan. Participants were encouraged to ask questions about the topic of the day and to apply this knowledge to meal planning and cooking. The discussion lasted five to ten minutes, depending on the participant’s time availability and questions. The interaction stressed the simplicity and convenience of the recipe along with its role in the one-week meal plan. The program took place Saturdays between 11 a.m. and 2 p.m. because customer traffic was heavier during these times compared to other days of the week.

Description of program materials and procedures

Participants and recruitment
Because this was a pilot study, it was determined in collaboration with statistician support that this study sample size (n= 35 intervention group and n=17 control group) was small, but meaningful. Participants were recruited through the weekly newspaper circular, poster displays, and fliers placed in shopping bags at the two store locations two weeks before the study began. The recruitment materials included session dates, topics, and a listing of incentive materials for participants (food samples, meal plans, tip cards, recipe cards, healthy recipe collection, coupons).

Meal plan
The one-week meal plan, designed for a family of four, included 49 cups of fruit and 56 cups of vegetables (United States Department of Agriculture 2006). The specific foods on this sample menu for a week were determined through previous lab experience, interviews with taste panelists, review of popular women’s magazine recipes, menu guides, and data from the Meal Ideas survey (Condrasky 2006). The recipes for the meal plan originated from the Healthy Recipe Collection developed for this project.

Nutrition tip cards
The nutrition tip cards covered seven nutrition topics that were determined to be of parental concern and interest from previous studies (Condrasky 2006; Steenhuis, Van Assema, and Glanz 2001; Condrasky, Graham, and Kamp 2006). One topic was assigned as the focus for each week.

Recipe cards
Seven recipe cards were also developed and included as part of the incentive literature. The recipe cards included one recipe from each of the seven days of the one-week meal plan. Both the recipe and nutrition tip cards were printed by the industry supermarket partner on colorful index cards.

Healthy recipe collection
The healthy recipe collection was distributed in a three-ring binder to each family of participants at the focus group session scheduled one week after the conclusion of the final intervention session. The healthy recipe collection was provided to encourage continued consumption of fruits and vegetables and cooking at home. It emphasized the simplicity of incorporating fruits and vegetables into each meal component such as breads, soups, meatless entrees, main dishes, sides, and desserts.

Produce coupon booklet
Participants received a seven-page produce coupon booklet. Each page of the booklet was a coupon redeemable at the cashier for $1 off a fresh produce item purchase from the industry supermarket partner.

Survey tool

The on-line survey questionnaire was modeled from guidelines of The Tailored DesignMethod (Dillman 2000) and designed in a sociology graduate level course at Clemson University. The survey was pilot tested to assess validity and data collection techniques. A group of 50 adults was randomly recruited by graduate students to take the survey on laptops supported by program delivery team. Consent forms were signed by all participants, and confidentiality was maintained. The Office of Human Subjects Compliance approved all procedures and materials for this project. Validity was tested by comparing the responses of the pilot test to available national/state data. A group of three experts, selected based upon their knowledge in the areas of nutrition, fruit and vegetable consumption, and survey design, reviewed the survey instrument for content, comprehensiveness, and overall format.

Surveys were administered at baseline and at follow-up focus group discussions, and included 32 items. Items were constructed in a variety of formats including Likert-type measures and frequency items on parent, as well as child, indicators. The questions featured in the survey were classified into three basic categories: nutritional awareness, consumption of fruits and vegetables, and cooking patterns. Some items listed fruits separately from vegetables and other items combined the two. In the combined items, the study looked at produce consumption patterns in general, and it purposely did not differentiate between fruits or vegetables consumed. Participants were also asked to provide demographic information as part of the survey (frequency of grocery shopping within a week, participant age, gender, and income level, highest level of education, ethnicity, number of adults, and number as well as ages of children living in household). Examples of survey questions are listed below:

Awareness questions

• On average, how many servings of fruits should a child/adult eat per day?
• On average, how many servings of vegetables should a child/adult eat per day?
• Based on the New Food Guide Pyramid, are you aware that there are five vegetable categories?

Consumption questions

• Not counting juice, does your eldest/second eldest eat fruits/vegetables every day?
• Do you eat fruits/vegetables every day?
• On average, how often do you eat orange vegetables every week?

Cooking trends

• When meals or snacks are cooked at home, how often are the following considered?
  1. limiting salt
  2. limiting fat
  3. including vegetables
  4. including fruits
• On average, how often are the following meals prepared at home each week?
  1. breakfast
  2. lunch
  3. dinner

Focus group sessions

A focus group was held one week after the conclusion of the program for both groups. All participants from both stores were invited to attend focus group sessions by signage on display tables and reminder e-mails. Participants who attended completed follow-up surveys, program evaluations, and took part in a group discussion about the program. Facilitated discussion questions included feedback on program material, program display area (for intervention group only), influence on home menus and cooking, location and program delivery team interaction, and suggestions for future program enhancement. Facilitated discussion questions were developed by the program leader with input from nutrition educators and health promotion professionals. The proceedings were audio taped and transcribed in order to identify themes within the sessions.

Impacts

Since its development in 2005, the “What’s Cooking” program has been tested in five supermarkets with more than 800 participants. In this particular instance, a statistically significant increase (p<0.1) occurred between baseline and follow-up within the intervention group compared to the control group in a number of content areas.

Highlights of results from survey data

A significant increase between baseline and follow-up in the intervention group was noted in the following constructs:

• knowledge of the number of servings of fruit and vegetables an adult needs daily (p=0.02)
• awareness of an appropriate serving size of fruit and the appropriate serving size of vegetables (p=<0.01)
• agreement with the statement “fruits and vegetables are not too expensive to purchase” (p=<0.01)
• knowledge of the five vegetable categories (p=<0.01)
• consumption of daily average number of servings of fruits and vegetables (p=0.02)
• consumption of weekly average number of servings of dark green vegetables and orange vegetables (p=0.07) and
• preparation of weekly average number of meals were cooked at home (p=0.01).

Highlights of results from focus group sessions that were reviewed within a qualitative analysis were

• participants indicated that the program was a quick, effective, and informative experience
• participants felt that the survey was more effective by being available on-line
• participants expressed appreciation for one-to-one interaction and
• participants were grateful the program was “quick, interesting, and educational, all at the same time,” given the busy schedules they kept.

Implications for Extension

Supermarkets are prime arenas to build industry partnerships to deliver culinary nutrition education interventions. Participants can readily practice what they have learned as they shop for their families. Nutrition information and education is desired and appreciated in a supermarket setting with its wide-reaching consumer base. Since many customers are concerned about the financial resources they can use towards food purchases, future work should guide consumers towards economical and healthy food choices.

Opportunities for future work include creating and testing a program training manual for facilitators and testing materials at multiple sites with larger pools of participants. “What’s Cooking” is a new culinary nutrition education approach that engages a traditionally difficult-to-reach audience in a practical setting. By expanding the program in multiple locations, a greater clientele base could be reached. Additionally, there is wider potential to reach more diverse socioeconomic, racial, and marital demographic groups compared to the general Extension target of women, low- to mid-income, rural populations. The program complements the skills of the Cooperative Extension food and nutrition professional and provides an avenue for program enhancement. Extension personnel could use this data to incorporate knowledge of successful eating habits, cooking skills, and meal planning into their own nutrition education programs, and could also use the knowledge of partnerships of supermarkets in their own service areas. This “team” approach emphasizes Extension’s missions of community outreach, collaborative efforts, and practical application.

Conclusion

The program met its objectives to encourage fruit and vegetable consumption and to increase both nutritional awareness and cooking frequency at home. Many factors may have contributed to the program’s perceived effectiveness: the one-on-one, in-person interaction; topics of interest to parents; quick and easy recipes; ease of program administration for participants; and the provision of recipe samples.

The use of receipts or coupon redemption (as provided in the program) as a consumption tracking mechanism has not been thoroughly tested and could perhaps be an accurate and effective way to measure impact of a nutritional intervention. Cost analysis and industry partner contributions are being calculated.

The “What’s Cooking” program paves the way for others of its kind, with the goal of improving our nation’s health one fruit and one vegetable serving at a time. Culinary nutrition education programs should not emphasize the need to eat less unhealthy foods but rather highlight consumption of healthy food choices.

Acknowledgements

We wish to recognize Dr. Beth Wall-Bassett, R.D., as a collaborator in the manuscript development and review. She supports future design and planning of the “What’s Cooking” program in South Carolina.

 

 

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Cite this article

Kamps, Jennifer J., Condrasky, Margaret D., and Katherine L. Cason. 2008. “What’s Cooking?” Culinary nutrition education at the supermarket The Forum for Family and Consumer Issues, 13 (1).

On-line: http://ncsu.edu/ffci/publications/2008/v13n1-2008-spring/index-v13n1-apr-2008.php

 

 

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