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This report was prepared by Cathy Chenhall, M.H.Sc., P.Dt for the Healthy Living Issue Group (HLIG) of the Pan-Canadian Public Health Network. The HLIG's Strategic Collaboration Working Group facilitates multi-sectoral, multi-lateral collaborations annually to advance the goals of the Integrated Pan-Canadian Healthy Living Strategy. In their 2009/10 workplan, the HLIG agreed to support a collaborative project on healthy eating, specifically examining cooking and food preparation skills among children and families. This project was the result of a collaboration between the Public Health Agency of Canada, Health Canada, the Federal/Provincial/Territorial Group on Nutrition and the HLIG.
Food choices, eating behaviours and resulting nutritional health are influenced by a number of complex and inter-related individual, collective and policy-related determinants. A growing body of research is supporting the relationship between food preparation and cooking skills and food choices of children and adolescents within the family context.
Over the past several decades, a transition or change in cooking and food preparation skills has been hypothesized and observed, which could have an important impact on healthy eating and the health of Canadians, presently and in the future. This transition in cooking and food preparation skills involves the increased use of pre-prepared, packaged and convenience foods, which require fewer and/or different skills than what is often referred to as traditional or 'from scratch' cooking. Several technological, food system-related and broader shifts within the social, economic, physical and cultural environments have been identified as factors influencing the culture of cooking and food preparation within the home or domestic environment, including the following:
The purpose of this paper is to synthesize the state of knowledge and research gaps related to cooking and food preparation skills among children and families. The paper describes the state of cooking and food preparation skills, nationally and internationally; implications of a transition in cooking and food preparation skills and challenges and opportunities related to the improvement of cooking and food preparation skills within the context of the family environment.
The literature search strategy resulted in the identification of approximately 40 publications having direct relevance to the paper. Of the over 40 publications, approximately two-thirds could be described as being descriptive or contextual and one-third described the results of cooking and food preparation skill interventions across population subgroups.
In terms of the suggested 'transition', limited national and international quantifiable and generalizable data exists to confirm the state of, and changes to, cooking and food preparation skills within populations, children and families. Despite the inherent limitations associated with comparing data collected from different populations using different methodologies at different times, the following common themes emerged from the review and synthesis of available and relevant research:
In terms of the implications of a change or transition, information is limited to substantiate a direct relationship between cooking and food preparation skills and health.
Research and food purchasing and consumption data, nationally and internationally, do confirm that food choice and consumption patterns have transitioned with increased processed, pre-prepared and convenience foods being purchased, 'assembled' and consumed across population subgroups on a daily basis. The results of several research studies support the normalization of processed, pre-prepared and convenience foods within the eating patterns of individuals and families, again across population subgroups. Related to this normalization is the potential lack of transference of basic, traditional or 'from scratch' cooking and food preparation skills from parents (primarily mothers) to children and adolescents, which has traditionally been the primary mode of learning. Without the opportunity to observe and practice basic or 'from scratch' cooking and food preparation skills within the home environment, many argue that children and adolescents will not be equipped with the necessary skills to make informed choices within an increasingly complex food environment. In support of this argument, low self-efficacy and self-perceived inadequate cooking and food preparation skills have been identified as barriers to food choice within several recent research initiatives, potentially resulting in a greater reliance on pre-prepared or convenience foods, reduced variety in food choice and consumption and the atrophy of cooking and food preparation skills.
The most common potential challenges identified related to the development of successful strategies or interventions to enhance cooking and food preparation skills among children within the context of families include time, individual/familial food choice and the diminished value placed on 'cooking from scratch' or traditional cooking skills. An even greater challenge is associated with the lack of clear evidence describing the characteristics of successful intervention strategies for specific age and population subgroups. While the results of published interventions are generally quite moderate, several researchers believe that some studies do indicate that food skills interventions may be a useful starting point for initiating dietary change, while acknowledging that addressing any one barrier to change is unlikely to radically alter established eating behaviours among adults, in particular. In the absence of definitive direction, available evidence and experience indicates that programs/interventions specifically designed for children, and having some involvement of adults/parents have the following characteristics:
The information presented within the synthesis indicates that despite noted limitations in surveillance and intervention-related data, concerns related to a transition in cooking and food preparation skills and the potential impact on food choice, health and health inequalities are not unfounded. Furthermore, the information synthesized supports the need for further research and surveillance to strengthen understanding and potential to influence the determinants, prevalence and characteristics of cooking and food preparation skills among children and families in Canada. In addition, the influence of cooking and food preparation skills on food choice, dietary quality and nutritional health across and within population subgroups of interest requires further exploration.
Food choices, eating behaviours and resulting nutritional health are influenced by a number of complex and inter-related individual, collective and policy-related determinantsFootnote 1. There is a growing body of research supporting the relationship between food preparation and cooking skills and food choices of children and adolescents within the family context.
Paralleling the nutrition transition which has been occurring over the past several decades in the developed world, and more recently in the developing world, a transition or change in cooking and food preparation skills has been hypothesized and observed, which could have an important impact on healthy eating and the health of Canadians, presently and in the future. This "nutrition transition" is characterized by consumption patterns that have higher energy (versus nutrient) density, total fat, saturated fat, added sodium and sugar, and simple carbohydrates and a decreased or changing proportion of fruit and vegetables, whole grains, and pulsesFootnote 2-Footnote 5. The corresponding transition in cooking and food preparation skills involves the increased use of pre-prepared, packaged and convenience foods, which require fewer and/or different skills than what is often referred to as traditional or 'from scratch' cookingFootnote 6.
Not unlike the worldwide nutrition transition, changes in cooking and food preparation skills have been influenced by factors within complex, shifting social, economic and physical environments nationally and globally, notably changes within global food systems, labour market participation of women and decreased opportunities for cooking and food preparation skill development within the home and school environmentsFootnote 6. These trends and issues have resulted in a growing interest in the state of cooking and food preparation skills across the population and within specific subgroups and the implications of, in most cases, presumed changes on food choice and potentially nutritional and overall health.
The purpose of this paper is to synthesize the state of knowledge and research gaps related to cooking and food preparation skills among children and families. This paper describes the state of cooking and food preparation skills, nationally and internationally, based on largely contextual and limited quantifiable data; implications of a transition in cooking and food preparation skills; and challenges and opportunities related to the improvement of cooking and food preparation skills within the context of the family environment.
This literature review is one component of the project titled, "Improving Cooking and Food Preparation Skills: A Synthesis of the evidence and lessons learned to inform program and policy development." The second component of the project profiles selected national and international programs and activities aimed at improving cooking and food preparation skills to gather lessons learned.
The literature search focused on identifying publications that describe the state of knowledge and research gaps as they relate to cooking and food preparation skills, particularly among children and families.
Searches were conducted on the electronic computer indexed databases MEDLINE/Pubmed/NLM Gateway, EMBASE, CINAHL, Cochrane Library, and ERIC. The following key words and phrases were used: determinants of cooking skills, determinants of food preparation skills, cooking skills and transition, food preparation skills and transition, cooking skills and children, food preparation skills and children, cooking skills and families, food preparation skills and families, food deskilling and children, food deskilling and families, cooking skills and food security, food preparation skills and food security, cooking skills and health, food preparation skills and health. A generalized internet search using Google, Google-Scholar and Bing was also conducted using a subset of the search terms.
Grey literature was accessed through a variety of mechanisms including project authority staff, members of the Strategic Collaboration Working Group (SCWG) of the Healthy Living Issue Group, and via the generalized internet search. Reference lists and "related article" links within electronic indexed databases were used to identify additional sources of literature.
The search was limited to English language literature and included articles published from 2002 to the present, with exceptions made for seemingly sentinel articles. In addition, to focus the search and synthesis, the following criteria were determined and applied, in consultation with the SCWG:
The search of the indexed databases using all search terms and the inclusion criteria identified many citations. Titles and abstracts were reviewed for relevance and over 55 publications were retrieved. Of these publications, approximately 40 were of direct relevance to the paper. Of the over 40 publications, approximately two-thirds could be described as being descriptive or contextual and one-third described the results of cooking and food preparation skill interventions across population subgroups.
As described within the search strategy, identifying literature related to cooking and food preparation skills and childhood overweight and obesity while not a focus, was of interest in light of the significance of this public health issue and linkages with the Integrated Pan-Canadian Healthy Living Strategy. Several publications were identified, however, upon review it was determined that they were not of direct relevance to the stated purpose of the synthesis. That being said, all publications reviewed related to the prevention of childhood overweight and obesity reinforced the importance and significance of parental influence in the development and maintenance of healthy eating (and physical activity) behaviours of children from birth to young adulthood, which will be addressed in section 4.1.3, Highlights of Existing Research Describing Food Preparation and Cooking Skills, specifically under the adult heading.
Efforts to identify research related to food security status and food preparation and cooking skills were included within the search strategy as a result of growing interest in the potential inter-relationship between cooking skills and health disparities. While often viewed as matters of individual behaviour, as will be discussed further within the synthesis, the acquisition of cooking skills relies on structural factors, for example, cultural norms and education policyFootnote 7. Several relevant publications were identified, the highlights of which are included within the subsection of section 4.1.3, Highlights of Existing Research Describing Food Preparation and Cooking Skills,specifically under the preschool/young children and adults headings. Generally speaking, the majority of articles identified via inclusion of food security as a search term reported the results of research initiatives involving individuals and families from low socioeconomic groups, without always specifically quantifying their food security status.
Overall, there is limited national and international quantifiable and generalizable data to describe the state of, and changes to, cooking and food preparation skills within populations, children and families. This information gap, however, has not limited the growing discourse and concern within public/popular and academic sectors over the past decade and has, in fact, stimulated research in a number of jurisdictions. Of note is the United Kingdom, where food skill-related changes to the National Curriculum for public schools in the late 1990s stimulated considerable research and dialogueFootnote 6-Footnote 8, relevant components of which are included within this synthesis.
As noted earlier, several technological, food system-related and broader shifts within the social, economic, physical and cultural environments have been identified as factors influencing the culture of cooking and food preparation within the home or domestic environment. These include:
In addition to the factors noted above, the "nutrition transition" that has been taking place globally over the past several decades has had a notable influence on cooking and food preparation skills, primarily as a result of the increased availability of processed, pre-prepared and convenience foods within the retail and foodservice environments. Consequently, this transition has involved fundamental dietary shifts within entire cultures (developing and developed countries), resulting in negative implications for nutritional and overall health, specifically, significant increases in diet-related chronic diseases and conditions, including overweight and obesityFootnote 2-Footnote 5. Further to the influences on cooking and food preparation skills noted above, Lang and CaraherFootnote 6 propose that a 'culinary' transition, ".... the process in which whole cultures experience fundamental shifts in the pattern and kind of skills required to ..." choose, prepare and consume food, has occurred. Concerns related to this culinary transition and its presumed impact on consumer control of food choice, healthy eating behaviours and resulting nutritional health and food sovereignty led to recommendations for enhanced professional and state support to ensure widespread basic cooking proficiency within at least one jurisdictionFootnote 6. ShortFootnote 12-Footnote 14 and LyonFootnote 9, from somewhat differing perspectives, acknowledge a continual shift and change in the culture of cooking and food preparation skills which they argue is inevitable with ongoing social, environmental and technological changes and should not necessarily be a barrier to efforts to empower healthy food choices, dietary habits and enjoyment in food preparation.
In contrast, several other researchersFootnote 10, Footnote 11 view changes in cooking and food preparation skills as a largely negative process of deskilling. They argue that significant and planned restructuring within the agri-food industry and food systems has resulted in both worker deskilling in food manufacturing and food-related consumer deskilling which, they contend, has and will have significant consequences on consumer choice, diet and health. Further to this point, Jaffe and GertlerFootnote 10 and KornelsonFootnote 11 argue this trend will continue resulting in increased distance between consumers and the sites and processes of food production, including basic commodities, which they believe is profitable for industry. As a result of this food deskilling and the parallel availability of increasingly complex packaged, processed and "industrially transformed" foodstuffs, many consumers have lost the knowledge necessary to make informed food decisions from the perspectives of quality, health, environmental sustainability and local economic developmentFootnote 10, Footnote 11.
Having some similarity with aspects of both perspectives described above, the 2005 report prepared for Agriculture and Agri-Food Canada, Consumer Food Trends to 2020: A Long Range Consumer Outlook, identifies the following as being among the top trends to 2020:
In addition to food system related trends and influences on cooking and food preparation skills, the social change resulting from the rise in the number of women in the waged labour force over the past several decades has been linked to changes in food choice, eating habits and food preparation activities. While women are still primarily responsible for food and meal planning, selection and preparation with the home and family environment, across socioeconomic groupsFootnote 6, Footnote 7, Footnote 9, Footnote 10, Footnote 16, Footnote 17, the time constraint introduced through workforce participation facilitated the development of a market for pre-prepared and convenience foodsFootnote 6 which food manufacturers and retailers have been quick to respond to, and some argue, exploitFootnote 6. As a result, social and food system trends suggest a move from cooking in the home with basic ingredients and commodities to a society that relies on the labour of others with ready-prepared foodsFootnote 10, Footnote 11. Some have further argued that the ready availability of prepared food has made traditional cooking skills (i.e. transforming raw ingredients into complete, culturally appropriate dishes and meals) unnecessary and redundantFootnote 6, Footnote 9. While typically presented as food system innovations unfairly imposed on those primarily responsible for food preparation, several researchers note that use of increasingly prepared foods has provided comparative or competitive choices for consumers/families who did not enjoy, feel confident or skilled or place value/priority on traditional food and meal preparationFootnote 6, Footnote 9, Footnote 12, Footnote 14. Related to time constraints, which are often reported as barriers to cooking and healthy eating, several sources have reported that time 'saved' through the use of pre-prepared and convenience foods has been essentially replaced by time spent making food-related decisions and purchases from largely suburban supermarkets and grocery stores and re-heating and assembling foodFootnote 6, Footnote 18.
The role of players within the food system, notably processors, retailers and restaurants, on food choice and food consumption patterns is undeniable. According to Cash, Goddard and LerohlFootnote 19 the food industry is essentially the gatekeeper of food choice, determining the products consumers can choose and modifying behaviours through available offerings and marketing practices. Innovation based on market research and science is integral to the food industry. In recent years, industry has worked with and responded to recommendations and policy directives from non-government organizations, national and international governments and associated research institutes to develop healthier alternatives for consumers, aiming for consistency with national and international dietary guidelines, standards and policy. To be successful, however, new, healthier products must continue to be reasonably priced, tasty and convenient; traditional factors that remain important to consumersFootnote 19. In addition, and as noted above, the food industry has actively responded through product development, innovation and industry-led information and education to societal trends which have impacted how children and families learn about and choose foodFootnote 20. In recognition of the importance of public policies that enable positive outcomes for both industry (i.e. profit) and public health (i.e. improved health outcomes), over the past decade in many jurisdictions, national and international food industry trade associations have been invited to, and have actively participated in, food and nutrition-related health policy initiativesFootnote 19.
Related to, but somewhat in contrast with, the gendered and time constrained context within which daily or regular food and meal preparation occurs, a growing interest in creative/recreational/leisure cooking is emerging, with some bias among men and young adultsFootnote 9. As noted earlier, Lyon et alFootnote 9 argue that emphasizing the creative aspects of domestic food preparation skills may be essential within the current context where "... we do not have to acquire cooking skills in order to survive, and where we can easily convince ourselves that our health will not be affected by the menu we have in front of us ....".
Opportunities for children and youth to acquire 'traditional', basic or 'from scratch' food preparation and cooking skills from parents (primarily mothers) and extended family members, the primary route of transmission from a historical perspective, has been cited as a casualty of changes within the home food environmentFootnote 6, Footnote 9. Research does support that populations, with some subgroups being more effected than others, are unsure of specific cooking techniques and lack the confidence to apply techniques and cook certain foods. This is a result of limited time, opportunity and exposure within the family environment, thereby limiting food choiceFootnote 6, Footnote 7, Footnote 16, Footnote 17. Building on these culinary transitions versus deskilling perspectives, one perspective within the literature argues that processes need to be developed to ensure that current and future generations learn and pass down "traditional" food preparation and cooking skills to protect consumer choice and nutritional healthFootnote 6, while the other argues that convenience foods can play a role in the intergenerational transference of skillsFootnote 12-Footnote 14.
Changes within public school curricula in several national jurisdictions, including Canada, has stimulated further concern related to the development of cooking and food preparation skills among children and youth, as learning within the education system has traditionally been identified as the second most common route for the acquisition of skills and knowledgeFootnote 6, Footnote 7. StittFootnote 8 details that when nutrition and food-related course content have been maintained within curricula, they are 'options' (versus requirements) for students, and have been adapted to place greater emphasis on technology, food production and marketing from an industry or commercial perspective as opposed to the development of an essential, domestic life-skill. Consistent with concerns noted above, the anticipated consequence of these changes is even greater reliance on generally pre-prepared and convenience foods which are nutritionally inferior and more expensive than food traditionally prepared within the home environment, a concern which has potentially greater implications for low income familiesFootnote 8. StittFootnote 8 concludes that deskilling within the education curriculum will have widespread implications for the entire food and eating culture as a missed opportunity to maintain one of the most effective health promotion strategies which protects the ability of individuals and families to make informed food choices.
Regardless of the perspective from which the issue is viewed, a decline in cooking and food preparation skills has been noted within the popular and published literature for some time, with only limited quantifiable data to support this trend. Several initiatives report cross-sectional data, however, longitudinal or surveillance data is lacking which would enable trends in cooking and food preparation skills within and across population subgroups to be monitored and reported.
In cases where data does exist, the lack of use of a definition of cooking skills and the use of inconsistent definitions across research initiatives, differing methodologies and differing indicators limits comparisonsFootnote 6, Footnote 7, Footnote 9, Footnote 12, Footnote 13. Several authorsFootnote 9, Footnote 12, Footnote 13 argue that the often assumed definitions need to evolve from a perceived "Golden Age" of cooking (specifically post World War II when basic commodities and technology were limited thus requiring enhanced knowledge and skill) to reflect the current food and social/societal contexts. ShortFootnote 12, Footnote 13 contends that modern cooking incorporates greater skills in timing, planning, judgement and organization in addition to traditional cooking abilities and use of techniques, often described as being largely mechanical and practical.
The Region of Waterloo Public Health (Ontario) recently articulated the following working definition for food skills, as part of their evidence and practice-informed planning, in response to the 2008 Ontario Public Health Standards, which require the provision of "opportunities for skill development in the areas of food skills and healthy eating practices for priority populations"Footnote 21. Their definition, which follows, largely inspired by Short'sFootnote 12 research and perspective, addresses the full scope of how they interpret "food skills" for planning programs and services, noting that the food skills are described in a household context and that these skills are necessary to accomplish the goal - food for the household. Foods skills are defined as follows:
"At an individual and household level, food skills are a complex, inter-related, person-centred, set of skills that are necessary to provide and prepare safe, nutritious, and culturally acceptable meals for all members of one's household."Footnote 21.
Food skills include:
To achieve the stated purpose of the literature synthesis, the search strategy identified several relevant references, many of which report research data specific to age subgroups within a broader definition of children. In addition, as a result of potential research and intervention implications for children and families, broadly defined, the findings of research initiatives involving young adults as well as parents of children experiencing food insecurity were included within the synthesis. As well, a recent, unpublished source of survey data describing self-perceived cooking and food preparation skills within the Canadian context was included.
Further to the description above, the following research highlights are organized by age group (preschool, school-aged, adolescent, young adult and adult) for the ease of the reader. The highlights are presented for the most part as annotations in light of previously described variations in methodology and indicators and the resulting comparison challenges.
For perhaps obvious reasons, publications which specifically reported research findings documenting food preparation and cooking skills among very young children were not identified. This section therefore highlights the findings of several references reporting relevant food choice-related research of mothers (as primary influencers and gatekeepers) of very young children.
Byrd-Bredbenner and AbbotFootnote 17 recruited a sample of mothers of children aged one to twelve years (n=201) from around the state of New Jersey to complete an on-line survey assessing demographic characteristics, food decision influencer constructs and dietary intake. Respondents had a moderate income, were food secure, in stable domestic relationships and lived in a single geographic region. Additional relevant demographic characteristics assessed included time spent weekly on food shopping and meal preparation activities, self-reported knowledge of nutrition and food preparation, food preparation and skill and the health and nutrition status of herself and each family member. Food decision influencer constructs assessed included the following: outlook on life (i.e. goal orientation, stress management, life satisfaction), health characteristics (i.e. health-related values, locus of control, healthy eating self-efficacy, health protective behaviours), food-related activities (i.e. meal planning and associated enjoyment, use of food product information, food price consciousness, health-related food preparation values and beliefs, family involvement), interest in learning about meals, food characteristics (i.e. food quality and purity-related values, beliefs about healthy and convenience foods, and use of convenience foods), eating/food relationships and family meals (i.e. participant's responsibility for healthy family meals, value placed on family meals, importance of positive feedback, managing food preferences, and beliefs about the healthfulness of one's family diet)Footnote 17.
Findings specifically relevant to cooking and food preparation skills included the following:
To increase the application of these findings, Byrd-Bredbenner and AbbotFootnote 17 translated them into goals for nutrition education interventions for mothers of young children. Highlights of these interventions have been incorporated into section 4.3 Improving Cooking and Food Preparation Skills within the Context of the Family Environment: Challenges and Opportunities.
Broughton, Janssen, Hertzman, Innis and FrankishFootnote 22 assessed the association between various environmental predictors and household food security among a convenience sample of families (n=142) with children two-five years of age in Vancouver. Contextual factors of relevance to the relationship between food preparation and cooking skills and food security assessed included number of cooking appliances, self-rated cooking skill and access to quality food. Related to food, one of the most common concerns among food insecure parents was reliance on a few kinds of low cost foods for their children. As well, households with less-equipped kitchen facilities had three times the odds of reporting food insecurity compared to households with the greatest resources after adjusting for household income. Parents with less personal capacity in terms of self-rated cooking skill had eight times the odds of reporting food insecurity, also as compared to households with the greatest resources after adjusting for household income. Furthermore, households with the least access to food of reasonable quality had ten times the odds of reporting food insecurity relative to those reporting greatest access to quality food. These researchers conclude that the results suggest that cooking skills and appliances play a role in providing choice and control over food, as food insecure parents manage the conflicting priorities of taste, nutritional value, cost and convenience in food selections. Government produced publications that promote consumption of unprocessed foods were criticised as lacking necessary programs and supports to increase parents' food-related skills and capacities. Concerns related to the marketing of cost-effective, palatable, but unhealthy food choices to children, and lack of access to full-service grocery stores in low-income neighbourhoods were also cited as issues, particularly for food insecure familiesFootnote 22.
The international Institute for Grocery Distribution (IGD) conducted small discussion groups with convenience groups of seven to nine year old children (n= 400 children) in the UK to "uncover what children think about food, cooking and meal times"Footnote 20. The discussion groups were followed by a web-based quantitative survey, also completed by 400 children aged seven to nine years old in the UK to test themes which emerged from the discussion groups. Highlights of the research included the following:
Related to the last finding above, the author concludes that stimulating curiosity about food is essential in securing the interest of children in cooking and healthy eating. Furthermore, children's views seem to be consistent with a recent trend noted among adults where cooking as an everyday task or chore is distinguished from cooking for entertainmentFootnote 20.
Caraher, Baker and BurnsFootnote 18 conducted a series of consultations with eight and nine year old children in three schools in England and Wales to determine how children "view the world of cooking and food". The draw and write technique was used to identify children's experience and perceptions of cooking and food preparation, allowing them to express themselves in either words or pictures. To achieve this research aim, participating children were first asked to draw a picture of or write about a food/meal that they wanted to share with a friend/creature from outer space who was visiting Earth to learn how to cook. Secondly, the children were instructed to draw a picture of someone cooking at home and then tell the story of what was happening in their picture. A purposive sampling technique was employed to represent a range of urban and rural communities and those coming from families with varying levels of affluence. Qualitative analysis of the children's creations based on a description of the content of the drawings and all words included in the drawings resulted in the identification of the following themes or categories: ethnicity; traditional foods and the proper meal; fried foods; pizzas, burgers and "McFoods"; tea and coffee; mums and dads in the kitchen; and celebrity chefsFootnote 18.
Specifically, the children:
These researchers conclude that the children who participated in their research are exposed to, engaged with and interested in, cooking within the home environmentFootnote 18. The findings support that food preparation and food choice are influenced by social, regional, cultural and family circumstances. Concern is expressed about the influence and normalization of fried, fast and prepared foods on eating within and outside of the home environment, while acknowledging children's attempts to create or complete a traditional or "proper meal" with the addition of vegetables and other healthier food choices. As well, the results raise concern about the early development of taste preferences for processed foods and foods high in fat as well as the influence of media and branding on the same. Mothers and older sisters were identified as the primary persons responsible for the transmission of cooking skills. However, stories provided evidence that men/fathers are becoming more involved in the kitchen, as is the role of celebrity chefs in perceptions of food preparation. These findings highlight the role of food as a means of expressing love and caring within families and the related importance of children exploring and learning cooking food preparation skillsFootnote 18.
Findings from a 1993 poll of seven-sixteen year olds for the UK Department of Health Get Cooking! project suggests that young peoples' food skills rise with greater technological inputs in the preparation of food (i.e. using a microwave versus preparing a food from basic or raw ingredients)Footnote 6. Findings from a subsequent survey in 1998 for the UK-based Good Food Foundation found that young people identified the following as cookery skills in order of popularity: making a sandwich, making toast, opening cereal boxes, cooking chips, preparing cake mixes from a packet, cooking eggs and cooking a pizzaFootnote 6. The authors of this study point out that what they term 'hands-on' cooking or cooking from scratch are only minimally included within the findings and that the most frequently reported skills require assembly of ingredients and/or the opening of packagesFootnote 6.
An analysis of adolescent involvement (middle and high school students in one US city) in food shopping and preparation was conducted to determine if a relationship exists between involvement and dietary qualityFootnote 23. The frequency of involvement in food shopping and preparation over the past week was self-reported using the Project EAT (Eating Among Teens) survey and dietary intake was assessed using the Youth/Adolescent Food Frequency Questionnaire, both of which demonstrated validity and reliability. Frequency of family meals was also assessed. The findings were based on Project EAT surveys completed by 4,746 adolescents (81.5% of eligible students) and Youth/Adolescent Food Frequency Questionnaires completed by 4,206 adolescents (89% of the sample). Participants were equally divided by sex and the mean age of respondents was 14.9 years. Relevant results included the following:
The authors conclude that the results of this research parallel other research findings relating household responsibilities and positive psychosocial outcomes, notably self-efficacy, among adolescents. Self-efficacy is enhanced when opportunities to practice behaviours exist and furthermore, greater self-efficacy in food preparation skills can enhance dietary quality. Support for community and school-based programs to enhance practical and health-oriented food preparation and purchasing skills among children and youth is stated as is promoting the involvement of adolescents in food-related tasks within the home/family environmentFootnote 23.
Building on research reported in the previous section, Larson, Perry, Story, and Neumark-SztainerFootnote 24 conducted an analysis of food-preparation behaviours, cooking skills, resources for preparing food and associations with diet quality among a sample of males (n=764) and females (n=946) aged 18-23 years (mean=20.4 years) in one US city. Participants were mailed the Project EAT (Eating Among Teens) survey, which includes self-assessment of frequency of involvement in food shopping and preparation over the past week, and the Youth/Adolescent Food Frequency Questionnaire to assess dietary intake. Via the two survey tools, young adults were specifically asked to report how often they performed five food preparation and purchasing behaviours over the past 12 months, their perceived skill and resources to perform household food tasks, and dietary intake and fast food consumption. Demographic information and weight status were also self-reportedFootnote 24.
Relevant findings included:
The authors conclude that while young adult males and females may have basic skills in food purchasing and preparation (as indicated by perceived self-adequacy), they were not using them on a regular basisFootnote 24. As a result of the demonstrated link between food preparation skills and dietary quality, the authors recommend that young adults be encouraged to improve and practice their food preparation skills at home. Further to the finding that time constraints and cost were identified as barriers to preparation, the authors suggest that programs focusing on developing skills for preparing quick and economical meals may be warranted, however further intervention research is required to confirm program specificsFootnote 24.
While their status as parents of children was not necessarily declared within the findings of all of the following research annotations, a decision was made to include this information given its relevance to the general population in Canada and also vulnerable population subgroups. As well, several annotations or summaries do not detail the extent of cooking and food preparation skills among adults/parents. However, the findings do illuminate the influence of parents' food and nutrition related knowledge, perspectives and resulting behaviours on those of their children.
Using data from the 1993 Health and Lifestyles Survey of England, Caraher, Dixon, Lang and Carr-HillFootnote 7 report findings on "how, why and when people using cooking skills; (and) where and from whom people learn these skills". The survey sample consisted of 5,553 interviews with randomly selected (by address) 16-74 year olds in England, stratified by National Health Service Region. Data was weighted to make the results more representative, as a result of several noted biases. The authors note that the survey was conducted before cooking was excluded from the new English National Curriculum for public schoolsFootnote 7.
Relevant findings included:
The authors conclude that the data suggest that there are considerable variations in knowledge about cooking, its application, role and relevance to health, with specific aspects of cooking being related to gender, income and social class. While not supporting a direct relationship between cooking skills and health status from an inequities perspective, the data demonstrate class-related differences between cooking, skills and confidenceFootnote 7.
Four focus groups were conducted with Plains Indians in four reservations to explore access and barriers to food items and food preparation, one component of a larger culturally appropriate research initiative to address diabetes and nutrition among the populationFootnote 25. Relevant findings included:
The researchers concluded that providing practical education in a culturally appropriate fashion is essential to increase access and reduce barriers to healthy eating, thereby impacting the epidemic of diabetes among Plains IndiansFootnote 25.
Using a participatory, community-based, qualitative research design, Engler-StringerFootnote 16 explored the cooking practices of a group of young (18-33 years), urban, french-speaking, low-income women with the purpose of contributing to the current understanding of how social and physical food environments shape daily food and cooking practices. Maximum variation sampling was used to seek out participants who could share a variety of perceptions of the experiences related to food preparation on a low-income. Focus group questions were based on the following five broad themes: food and cooking preferences; food skills learning during the formative years; current cooking and grocery shopping practices; participants' understanding of what are pre-prepared foods and basic ingredients; and the effects of low-income on cooking practices. Focus groups were conducted until no new major themes emerged, resulting in a final sample of five groups. Most of the sample women in the focus group were in their twenties and more than half had children. Three-quarters were single and more than one-third of participants were students with just under one-third being employed. The majority of participants had annual household incomes of less than $20,000 CanadianFootnote 16.
Focus group data analysis led to the identification of six data categories and themes. Relevant findings included:
The author concludes that the findings support the observed culinary transition, described by Lang and CaraherFootnote 6, and that the young women in the study have adapted the tasks involved in food acquisition and preparation to their life circumstances, an observation also supported by other researchFootnote 12-Footnote 14, Footnote 16. The challenges associated with making decisions between highly available, inexpensive and flavourful, prepared foods and often comparably priced, basic foods requiring food preparation skills were discussed. Engler-StringerFootnote 16 emphasizes the importance of understanding the context (i.e. food culture) of food choice and cooking practices when designing interventions and strategies to improve the nutritional health of specific population subgroups.
The Region of Waterloo Public Health assessed self-reported cooking and food preparation skills of 703 adult residents (60% response rate) of the Waterloo Regional Area, conducted by the University of Waterloo Survey Research CentreFootnote 26. While the sample was a random cross-section of Waterloo Region's adult population (Census, 2006) proportionally representative by gender, younger adults and adults living in rental housing (lower income) were under-represented among the survey respondents. The food skills component of the survey was intended to provide baseline surveillance of prevalence of food skills in the community to provide information having potential implications for policies, programs and services. Respondents were asked to rate their skill in 13 food skills/activities using a four point Likert scale. Respondents were also asked to report the time required to prepare the main meal eaten in their home, to identify if they were the main person responsible for meal preparation, how often meals were prepared from 'scratch' using basic ingredients in the previous week and whether any home- or community garden- grown food was consumed by anyone in their household over the past 12 monthsFootnote 26.
Highlights of the survey included:
The authors of this report proposed that continued surveillance of food-related skills will facilitate monitoring changes in food skills and behaviours, providing relevant information for the planning of community-based learning opportunities for food skill developmentFootnote 26.
While not reporting specific quantifiable data to illustrate the state of, or trends in cooking and food preparation skills, several publications emphasized the role and influence of parents in developing and maintaining healthy eating behaviours of preschoolers, school-aged children and adolescentsFootnote 23, Footnote 27-Footnote 35. With specific role-related behaviours somewhat differing across socioeconomic groups and with a child's development stage, Hart et alFootnote 27, Hildebrand et alFootnote 28, Lindsay et alFootnote 33 and RheeFootnote 34 identify parents as powerful nutrition and food skills educators and educational intermediaries as a result of their impact on children's developing food behaviours. Specifically, research supports parents discrete and interacting roles in ensuring availability and accessibility of healthy food choices, in demonstrating, modelling and reinforcing positive attitudes and beliefs toward nutritious foods and cooking and food preparation, and in ensuring health promoting meal structures and home eating patterns (i.e. home eating environment), on healthy eating patterns and behavioursFootnote 27, Footnote 28, Footnote 33, Footnote 34. Further to the identification of parental roles, research supports the involvement of parents in comprehensive nutrition and cooking skills education initiatives for children. As well, parent-focused interventions need to recognize and act on existing levels of influence, motivation, knowledge/ understanding, skill and perceived self-efficacy, when behaviour change is the primary goalFootnote 27, Footnote 28, Footnote 33, Footnote 34.
Despite the inherent limitations associated with comparing data collected from different populations using different methodologies at different times, the following common themes, similar to those described in A Culinary Transition or Consumer Deskilling?, emerged from the research findings presented in this section:
The specific implications of a transition in cooking and food preparation skills are difficult to assess given the lack of concrete data detailing that a transition, specifically deskilling, has taken place. However, the research presented generally reports respondents' self-perceived general satisfaction with their cooking and food preparation skills. This finding is presented alongside evidence demonstrating that decisions are being made not to use these skills, presuming a definition of basic, traditional or 'from scratch' cooking, for a variety of reasons.
What is clear and supported by both research and food purchasing and consumption data, nationally and internationally, is that food choice and consumption patterns have transitioned with increased processed, pre-prepared and convenience foods being purchased, 'assembled' and consumed across population subgroups on a daily basis. The results of several research initiatives reported in the previous section support the normalization of processed, pre-prepared and convenience foods within the eating patterns of individuals and families, again across population subgroupsFootnote 7, Footnote 16, Footnote 18, Footnote 23-Footnote 25. Related to this normalization is the potential lack of transference of basic, traditional or 'from scratch' cooking and food preparation skills from parents (primarily mothers) to children and adolescents, which has traditionally been the primary mode of learning. Without the opportunity to observe and practice basic or 'from scratch' cooking and food preparation skills within the home environment, many argue that children and adolescents will not be equipped with the necessary skills to make informed choices within an increasingly complex food environmentFootnote 6, Footnote 7. In support of this argument, low self-efficacy and self-perceived inadequate cooking and food preparation skills have been identified as barriers to food choice within several recent research initiativesFootnote 16, Footnote 22, potentially resulting in a greater reliance on pre-prepared or convenience foods, reduced variety in food choice and consumption and the atrophy of cooking and food preparation skillsFootnote 9-Footnote 11. Several authors suggest that this will have greater dietary and overall health implications for those living on a lower income. While the gap is narrowing between the price of pre-prepared foods and whole/raw foods, healthier pre-prepared or convenience foods tend to cost more. Although not completely substantiated by research, several authors suggest that the implications of the culinary transition on food choice and potentially, dietary quality, are not likely consistent across socio-economic groups or gradients. Those from more affluent groups can afford to essentially 'buy their way out of' the health and social implications through the purchase of healthier pre-prepared foods and mealsFootnote 6, Footnote 7.
Some evidence does exist demonstrating a relationship between decreased use of traditional or basic food preparation skills, increased consumption of pre-prepared, packaged and convenience foods and dietary quality. That being said, several authors point out that the information is limited to substantiate a direct relationship between cooking and food preparation skills and healthFootnote 6, Footnote 7, Footnote 23, Footnote 24, Footnote 35. While the results of interventions may be quite moderate, WriedenFootnote 39 and othersFootnote 7, Footnote 23, Footnote 24 believe that some studies do indicate that food skills interventions may be a useful starting point for initiating dietary change, while recognizing that addressing any one barrier to change (i.e. in isolation of others or a broader context) is unlikely to radically alter established eating behaviours, particularly among adults.
The most common potential challenges identified related to the development of successful strategies or interventions to enhance cooking and food preparation skills among children within the context of families include time, individual/familial food choice (and challenges associated with managing and planning for different food preferences among family members). As well, there is diminished value (real or perceived) placed on 'cooking from scratch' or traditional cooking skills. An even greater challenge is associated with the lack of clear evidence describing the characteristics of successful intervention strategies for specific age and population subgroups.
Several authors report that programs are generally received favourably by both children and parents. However, there are limited changes in knowledge and/or behaviour maintained over short periods of time (e.g. willingness to try new foods, increase in one serving of fruit and vegetables, greater knowledge of food safety behaviours, improved self-efficacy). There is a need to better understand how children understand messages communicated, the role of practical skills and parental influence over the same in healthy eating, and the relationship between 'dosage' of nutrition education interventions related to cooking and food preparation skills and movement to higher stages of sustained behaviour changeFootnote 23, Footnote 24, Footnote 27-Footnote 30. The most efficient and effective strategy for achieving the desired/necessary long-term and whole diet behaviour modification among the school-aged population, specifically, has yet to be established. However, the articles reviewed, which reported the limited or moderate results of cooking and food skills interventions, provided recommendations for future research. In addition, adult participants in numerous descriptive research studies indicated an interest in learning new, and/or further developing existing cooking and food preparation skills. As well, within our current society, where we do not have to acquire or use cooking skills 'to survive', some researchers suggest capitalizing on people's interest in the creative (versus 'mundane') aspect of cooking and food preparation when developing and promoting interventionsFootnote 9.
The literature reviewed to inform this section of the synthesis focused on interventions designed to improve cooking and food preparation skills among childrenFootnote 17, Footnote 29-Footnote 31, improve consumption of specific foods and food groups among childrenFootnote 28 and explore parental perceptions and perspectives related to both food-related skills development and food consumptionFootnote 27-Footnote 29, Footnote 32. With the exception of one intervention program reviewed which used a computer-based multi-media approachFootnote 31, the remainder were 'traditional' multi-week nutrition education and skills development programs having hands-on food preparation opportunities for children and a parental communication/education involvement or evaluation component. Several programs incorporated activities to increase nutrition-related knowledge, decision-making and problem solving. An almost equal number of programs were delivered within the school (largely extra-curricular) and community environments. All programs were provided free of charge to participants with some providing basic kitchen utensils to participants, most providing recipes of foods prepared during the program and some allowing for food to be brought home for other family members to try. Only one program included within the review was intended for 'full family participation'.
While clear evidence detailing successful intervention strategies for specific age and population subgroups does not currently exist, available evidence and experience indicates that programs/interventions specifically designed for children, and having some involvement of adults/parents, often have common characteristics. These include:
The literature specifically supports the importance of setting goals by participants, which address the following: barriers/negative aspects of performing a desired/favourable behaviour change, increasing availability and accessibility of specific healthy foods, and increasing preferences for specific healthy foods and increasing skillsFootnote 27, Footnote 28. Related to the last characteristic above, ParrisFootnote 30 cites research conducted by Contento et alFootnote 36 , which indicates that nutrition education programs with ample time and intensity of teaching are more effective than shorter programsFootnote 36. Based on a review of nutrition education programs, Contento et alFootnote 36 discovered that 15 contact hours could be expected to bring about changes in knowledge and 50 hours were required for changes in attitudes and behaviours. The work of Contento et alFootnote 36 and Lytle and AchterbergFootnote 37, were cited in several of the specific intervention references reviewed.
As noted earlier within the synthesis, nutrition and food-related changes within the UK's National Curriculum for public schools in the late 1990s stimulated great dialogue, research and action involving government, academics and non-government organizations. One result of this dialogue, research and action having relevance for the development of programs and initiatives that aim to develop and/or strengthen cooking and food preparation skills among children and youth are the "food competencies for young children"Footnote 38. According to the website, the food competencies for children aged five-sixteen years are organized as a framework of core skills and knowledge for young people to assist young people in choosing, cooking and eating safe and healthy food. While primarily intended for use by schools and community-based organizations in supporting young people in developing a consistent set of food skills and knowledge, supporting wider government health-related initiatives, the competencies can be met at home or through other activities. The theme areas of the detailed competencies are: diet and health, consumer awareness, cooking (food preparation and handling) and food safety. Current users of the competencies are detailed within the information available on the webFootnote 38.
The information presented within this synthesis indicates that despite noted limitations in surveillance and intervention-related data, concerns related to a transition in cooking and food preparation skills and the potential impact on food choice, health and health inequalities are not unfounded.
Furthermore, the information synthesized supports the need for further research and surveillance to strengthen understanding and potential to influence the determinants, prevalence and characteristics of cooking and food preparation skills among children and families in Canada. In addition, the influence of cooking and food preparation skills on food choice, dietary quality and nutritional health, across and within population subgroups of interest, requires further exploration. The report outlines suggested characteristics of successful knowledge and skills-based food and nutrition education, success being defined as sustained and notable dietary behaviour change among children and families.
To address identified knowledge gaps, the following research questions are suggested for further exploration:
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