Teaching Kitchen Collaborative Research Day AbstractsThe Estate Yountville, Napa Valley, CA, USA February 7, 2018 A day of original research and innovative strategies involving teaching kitchens and their potential to positively impact behaviors, improve health outcomes, and reduce costs.
2018; Mary Ann Liebert, Inc.; Volume: 24; Issue: 7 Linguagem: Inglês
10.1089/acm.2018.29049.abstracts
ISSN1557-7708
AutoresDavid M. Eisenberg, Naomi Laporte, Allison Righter, E. Jason Baron, Jennifer Massa, Marissa Black, Robin LaCroix, Sean Walsh, Dana Schneeberger, James Perko, Jane Pernotto Ehrman, Kristin Kirkpatrick, Judi Bar, Jonathan Doyle, Danielle Riedel, Michael F. Roizen, Mladen Golubić, Gang Liu, Geng Zong, Kana Wu, Yang Hu, Yanping Li, Walter C. Willett, Frank B. Hu, Qi Sun, Margaret Raber, Monika R. Patterson, Wenyan Jia, Mingui Sun, Tom Baranowski,
Tópico(s)Nutrition, Genetics, and Disease
ResumoThe Journal of Alternative and Complementary MedicineVol. 24, No. 7 AbstractsFree AccessTeaching Kitchen Collaborative Research Day AbstractsThe Estate Yountville, Napa Valley, CA, USAFebruary 7, 2018A day of original research and innovative strategies involving teaching kitchens and their potential to positively impact behaviors, improve health outcomes, and reduce costs.Published Online:1 Jul 2018https://doi.org/10.1089/acm.2018.29049.abstractsAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Oral AbstractsO1.01 CHARACTERISTICS OF TEACHING KITCHENS IN 2017-RESULTS OF A SURVEY OF 32 ORGANIZATIONS WITH TEACHING KITCHENSDavid Eisenberg, MD (1), Naomi Yoshinari Laporte (2), Allison Righter, MSPH, RDN (3), Emily Baron (1), Jennifer Massa, ScD (1)(1) Harvard T.H. Chan School of Public Health, Boston, MA, USA(2) Stanford Business School, Stanford, CA, USA(3) Culinary Institute of America, Hyde Park, NY, USAPurpose: Innovative strategies are needed to help individuals improve the way they eat, cook, move, and think. “Teaching kitchens” are an emerging model. These typically include: (1) nutrition education; (2) hands-on culinary instruction; (3) enhanced exercise; (4) optimal use of web-based technologies; (5) mindfulness training; and (6) personalized coaching. However, little is known about the specifics of emerging models.Methods: Survey of 32 organizations with teaching kitchens (members of Teaching Kitchen Collaborative [www.TKCollaborative.org]) using Qualtrics, July 2017.Results: Response rate 87% (n = 27). Teaching kitchens settings include: medical schools and hospitals (11), colleges/universities (8), corporate work sites (5), healthcare delivery systems (5), community venues (3) and others in the US, Italy and Japan. Since 2015 more than 50,000 individuals have participated in classes across 27 sites, with largest numbers at Google >25,000 (in US and globally), Barilla >14,000 (Italy) and Compass >3,000 (US). Most kitchens are built-in (37%); borrowed (27%), mobile or pop-up (18%). Most classes involve tastings (88%), demos (73%) and hands on cooking (65%). Most common credentials of staff are dietician/nutritionist (42%) and chefs (37%). Across TK's, 100% teach nutrition and cooking; 70% mindfulness; 20%); >10 class series (15%). Majority have developed own curricula; most focus on general health not disease. Up-front investments range from $10K to >$500K, mainly from philanthropy. Top priorities include: collaborative outcomes research; reproducible curricula; standard setting.Conclusion: In 2017 there is a range of teaching kitchen models. These share an aspiration to develop collaborative research, reproducible curricula and standards for future teaching kitchens.Contact: David Eisenberg, deisenbe@hsph.harvard.eduO1.02 THE REACH, ADOPTION, AND IMPLEMENTATION OF HEALTHY TEACHING KITCHENS ACROSS THE VETERANS HEALTH ADMINISTRATIONMarissa Black (1), Robin LaCroix (1), Sean Walsh (2)(1) Veteran Affairs, Seattle, WA, USA(2) VA Sierra Nevada Health Care System, Reno, NV, USAPurpose: To describe the adoption timeline, reach and variability of implementation of Healthy Teaching Kitchen (HTK) initiative across Veterans Affairs (VA) and whether those sites are collecting data for quality improvement.Methods: The HTK Tool Kit was prepared by the VA National Center for Health Promotion and Disease Prevention and describes the “VHA Healthy Teaching Kitchen Levels of Implementation.” The HTK toolkit and database were shared on a internal Sharepoint site enabling sites to assess their level of implementation, levels 1 through 5. Level 1 was defined as cooking demonstrations that include cold items, having a curriculum, receiving workload credit, and collecting outcomes data. Level 5, the most complex level of implementation, was defined as hands on nutrition education for Veterans and their significant other offered on nights and weekends with a set curriculum, cooking both hot and cold items in a fully equipment stocked, home-like kitchen facility, having available funding for food and a garden, and collecting outcomes.Results: The first site implemented the program in 2009, by 2014 there were 79 sites, and by September 2017 there were 116. Of the sites, 109 have entered level of implementation. Eight sites are level five, 24 are level four, 39 are level three, 24 are level two and 8 are level one. Frequency among these class offerings varies from weekly to quarterly. Some sites administer one time classes and others series of classes ranging from four to twelve weeks long. As of 2017, over 31 HTK sites are collecting qualitative data and over 20 HTK are collecting quantitative data. In fiscal year 2017, at least 2108 Veterans attended HTK classes nationally.Conclusion: The implementation of the HTK model is widespread across the Veterans Health Administration. To measure the impact of the HTK program an analysis of qualitative and quantitative data should be done.Contact: Marissa Black, marissa.black@va.govO1.03 CLEVELAND CLINIC LIFESTYLE ESSENTIALS: A SHARED MEDICAL APPOINTMENT MODELDana Schneeberger, James Perko, Jane Ehrman, Kristin Kirkpatrick, Judi Bar, Jonathan Doyle, Danielle Riedel, Michael Roizen, Mladen GolubicCleveland Clinic, Wellness Institute, Cleveland, OH, USAPurpose: Although well-established chronic disease management guidelines call for lifestyle changes as first-line therapy, the current healthcare system fails to apply these guidelines. To bridge that gap, improve accessibility and equity and reduce costs in healthcare, we developed a therapeutic lifestyle intervention to promote optimal self-care through a model covered by most third-party payers.Methods: “Lifestyle Essentials” is a series of 7 bi-weekly 2 hour-long Shared Medical Appointments that provide lifestyle-related therapeutic interventions and self-care education for patients with hypertension, hyperlipidemia, pre-diabetes and/or type 2 diabetes. The intervention includes both discussion and practical experience focused on nutrition, stress relief, physical activity and two culinary medicine visits in the teaching kitchen focused on technique-driven demonstrations and education.Results: 98 patients participated (defined as attending 4 or more visits). Diagnosis of hyperlipidemia, hypertension, diabetes and prediabetes was present in 83%, 76%, 31% and 25% of patients, respectively. 78% of patients were obese and 20% were overweight. Pre-post (visit 1 vs. visit 7) analysis revealed significantly decreased weight, BMI (mean −3.8 pounds and −0.6 kg/m2, respectively; p < 0.001; n = 88) and body fat mass (mean 6.3 pounds, p < 0.001; n = 31). Significant decreases from even well-managed levels pre-intervention also occurred in lipids and fasting blood glucose levels (mean change: triglycerides −31.9 mg/dL, p < 0.001; LDL −20.0 mg/dL, p = 0.008; glucose −28.8 mg/dL, p < 0.05; n = 24). Follow-up analysis (mean 2 years from visit 1; n = 72) revealed sustained decreases in mean weight (−3.7 pounds, p < 0.05) and BMI (−0.8 kg/m2, p = 0.005), mean diastolic blood pressure decrease (−4.3 mmHg, p = 0.01) and triglyceride (−19.5 mg/dL, p = 0.01, n = 21).Conclusion: Lifestyle-medicine focused SMAs that include culinary medicine may represent an optimal way for an interdisciplinary team of health care professionals to help patients with chronic diseases implement evidence-based, individualized and effective lifestyle prescription.Contact: Mladen Golubic, golubim@ccf.orgO1.04 MEAT COOKING METHODS AND RISK OF TYPE 2 DIABETES: RESULTS FROM THREE PROSPECTIVE COHORT STUDIESGang Liu, Geng Zong, Kana Wu, Yang Hu, Yanping Li, Walter Willett, David Eisenberg, Frank Hu, Qi SunHarvard T.H. Chan School of Public Health, Boston, MA, USAPurpose: This study aimed to examine open-flame and/or high-temperature cooking (grilling/barbequing, broiling, or roasting) and doneness preferences (rare, medium, or well-done) for red meats, chicken, and fish in relation to type 2 diabetes (T2D) risk among U.S. men and women who consumed meats regularly (≥2 servings/week).Methods: The prospective studies included 52,752 women from Nurses' Health Study (NHS 1996–2012), 60,809 women from NHSII (2001–2013), and 24,679 men from Health Professionals Follow-Up Study (1996–2012), who were free of diabetes, cardiovascular disease, and cancer at baseline. Incident cases of T2D were confirmed by validated supplementary questionnaires.Results: We documented 7,895 incident T2D cases during 1.74 million person-years of follow up. After multivariate adjustments including total consumption of red meats, chicken, and fish, a higher frequency of open-flame and/or high-temperature cooking and higher meat doneness level were each independently associated with an elevated risk of developing T2D. When comparing open-flame and/or high-temperature cooking >15 times/month with <4 times/month, the pooled hazard ratio (HR) and 95% confidence interval (CI) of T2D was 1.33 (1.24, 1.43; P trend <0.001). When comparing the extreme quartiles of meat doneness level score, the pooled HR (95% CI) of T2D was 1.39 (1.30, 1.49; P trend <0.001). These associations did not materially change when further adjusting for BMI or analyzed by different types of meats (red meats, chicken, and fish). Moreover, levels of estimated intake of heterocyclic aromatic amines (HAAs) were also independently associated with an increased risk of T2D. Comparing extreme quintiles of HAAs, the pooled HR (95% CI) of T2D was 1.38 (1.28, 1.50; P trend 5,500 employees in Northwell Health's Teaching Kitchens.Conclusion: It is possible to apply evidence based food procurement policies to improve the quality of and satisfaction with hospital based foods without a significant increase in overall food expenditures.Contact: Jeffrey Jacobs, jeffreyjacobshv@aol.comO2.04 DOES LEARNING HOW TO COOK AS AN ADOLESCENT IMPROVE DIET, LIFESTYLE AND WEIGHT MANAGEMENT OVER TIME? OBSERVATIONS FROM THE “TEEN BATTLE CHEF” PROGRAMLynn Fredericks (1), Anjuman Shah (2), Pamela Koch (2), Mercedes Sanchez (1)(1) Family Cook Productions, New York, NY, USA(2) Teachers College, Nutrition Department, Columbia University, New York, NY, USAPurpose: This study examined potential for long-term, sustained effects among alumni who participated in a nationally disseminated hands-on nutrition education program, Teen Battle Chef (TBC). TBC develops adolescents' skills in nutrition, cooking, and leadership, based on social cognitive, social ecological and empowerment theories. Prior research on TBC found improvements in food/activity behaviors (Bukhari et al 2011).Methods: Mixed-methods study inviting over 75 TBC alumni from 33 low-resource NYC high schools to participate; recruited 30 participants (6 months to 7 years post program) representing (N = 14) schools Qualitative interviews conducted with questions about participants' TBC cooking experiences, which program components supported sustained dietary change. Multiple-choice questions asked about food and physical activity behaviors. Pre-/post program heights and weights were obtained via self-report. Interviews were audio-recorded, transcribed, and coded using NVivo Pro 11; descriptive statistics analyzed behavior questions; and a T-test compared pre versus post BMIs.Results: Seventeen participants (57%) identified as female and 13 (43%) as male. Four themes emerged as behavior change drivers: positive peer influence (50%); skill development (30%); knowledge (30%); and being pushed out of one's comfort zone to try new foods (27%). Multiple choice questions revealed: 90% drank water over sugary beverages, 80% exercised most days, 80% ate vegetables daily, 70% ate fruits daily, 53% ate breakfast most days, and 47% rarely ate junk/fast food. Additionally, 90% supported friends and family to improve eating behavior. BMI (n = 27) decreased from 26.2 kg/m2 (pre-program) to 24.5 kg/m2 (p = .01) since participation in TBC.Conclusion: Most participants mentioned 2 of the 4 behavior change drivers, with different combinations and different application strategies across participants. Responses indicate strong links between development of culinary skill to self-confidence/ self-actualization for long-term, self-care around eating patterns and physical activity. This research offers insight into the long-term, sustained program impacts, and creates precedence for studies on multi-year impacts of nutrition education.Contact: Lynn Fredericks, lynn@familycookproductions.comO3.01 IMPLEMENTING “WELLNESS AT THE FARM”: AN INTEGRATIVE HEALTH COMMUNITY EDUCATION SERIES AT TURNER FARM'S TEACHING KITCHENSian Cotton (1), Kelly Lyle (1), Harini Pallerla (2), Emily Moss (1), Stephanie Michalak (3)(1) Center for Integrative Health and Wellness, Cincinnati, OH, USA(2) Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA(3) Turner Farm, Cincinnati, OH, USAPurpose: An organic farm with a state-of-the-art teaching kitchen (TK) provides a unique platform for education about integrative health, disease prevention, and lifestyle modification. In collaboration with the local academic health center and the expertise of the Integrative Medicine faculty, a wellness series (i.e., “Wellness at the Farm”) was launched to provide community opportunities for combining culinary skills with nutritional literacy in a relaxing farm environment.Methods: Monthly 2-hour sessions were initiated in 2016. Integrative Medicine faculty taught on key health topics such as: “Food as Medicine for Healthy Weight,” “Integrative Nutrition for Cancer,” and “Nutrition/Mindfulness for Heart Health.” Afternoon lunch sessions included 30-minute didactics with faculty followed by Q&A, and a 1-hour TK session with the executive chef. Concepts of translating for home, take-home recipes, mindful eating, and discussion/reflection were included.Results: All 33 attendees from 3 sessions reported that the quality of the faculty and chef presentations was excellent and 73% felt the information was very useful. 93% said that there was a high probability of changing the way they focus on personal wellness. Topic of interest (82%) and location (41%) were rated as top reasons for attending. The top things rated as likely to change because of this program included: embracing the notion of food as medicine, stocking a health-conscious pantry, and taking more “mindful moments.” 91% said that the program length was just right, 97% that the time/day works for their schedule, and 100% would recommend to others.Conclusion: This new community wellness series was well received and appeared to positively affect likelihood of personal wellness change. Future programming will include multiple series to build upon existing knowledge, and additional topics driven by public health need and expressed interest (e.g., pain, weight). TK prospective studies are needed to examine behavior change following participation in similar programs.Contact: Sian Cotton, cottons@ucmail.uc.eduO3.03 WHEN THE PRESCRIPTION IS A KITCHEN: IMPACT OF PHYSICIAN REFERRALS TO A COMMUNITY TEACHING KITCHENJill Christensen, MD, MPH (1), Charlotte Navarre, RN-BC (1), Heidi Davis, MSW (2), Aaron Curtis, RD (2)(1) Providence Milwaukie Family Medicine Residency Program, Milwaukie, Oregon, USA(2) Providence Milwaukie Hospital, Milwaukie, Oregon, USAPurpose: Examine the impact of using physician referrals to Cooking Matters classes on completion rates and long term nutritional attitudes and behavior change in low income and food insecure adults.Methods: Pilot cohort study. Patients with nutrition related chronic diseases (most common: obesity, diabetes and hypertension) were referred by their physician to a hospital-affiliated Community Teaching Kitchen using the Electronic Medical Record. Participants were then screened and consented by MSW to participate in 6 week Cooking Matters Classes with trained Chef, Registered Dietician and trained volunteers. Participants were administered validated, Pre, Post and 6 month Share Our Strength class surveys. Subjects: 7 cohorts with a total of 70 participants (70% female, 79% white, 14% Hispanic. 40% food insecure). Paired 2 sample t-tests were used to compare differences in pre and post class survey data.Results: Physician referrals were associated with higher graduation rates with 96% of referred participants completing the Cooking Matters class compared with 85% of self-referred participants in the state of Oregon 2015–2016. Statistically significant changes were observed in nutritional attitudes and behaviors that persisted at 6 months post intervention including increased cooking meals at home (p = 0.01) and confidence in cooking healthy food on a budget (p = 0.0001).Conclusion: Physician use of an electronic medical record referral with dietician feedback on attendance and education had a positive impact on both short term and long term nutritional attitudes and behavior change in patients referred to a community teaching kitchen.Contact: Jill Christensen, jill.christensen@providence.orgO3.04 LIVING WELL AFTER BREAST CANCER – SHARED MEDICAL APPOINTMENTS FOR CANCER SURVIVORS AT THE CLEVELAND CLINIC WELLNESS INSTITUTEMladen Golubic (1), Kenneth Weiss (2), Dana Schneeberger (1), Halle Moore (3), Jame Abraham (3), Alberto Montero (3), Jonathan Doyle (1), Michael Roizen (1)(1) Cleveland Clinic, Wellness Institute, Cleveland, Ohio, USA(2) Cleveland Clinic, Department of Regional Oncology, Cleveland, Ohio, USA(3) Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio, USAPurpose: Despite evidence demonstrating the benefits of healthy lifestyle practices, studies show that obesity, physical inactivity, unhealthy diets and inability to manage psychological stress remain common among cancer survivors. Unfortunately, the resources, support, and reinforcement required to achieve and sustain healthy lifestyles are not disseminated as standard-of-care, and they are not adequately reimbursed by insurance.Methods: Breast cancer survivors who have completed treatment, except for continued hormonal therapy, participated in a comprehensive lifestyle medicine intervention called “Living Well After Breast Cancer.” The intervention consisted of seven 120-minute group visits twice per month (Shared Medical Appointments, SMAs). Every visit included a physician, behavioral health specialist and experts who provided education and practical experience of nutrition, culinary medicine (visit 3 and 6 in the teaching kitchen led by Chef, focused on technique-driven education and demonstrations), physical activity and the stress relief practices of yoga and meditation. Biometrics and measures of health self-management (PAM), quality of life (QOL; PROMIS-10), mood (CES-D 10) and dietary intake (Block FFQ) were obtained at the start and end of the intervention.Results: Participants (22 women) who completed the intervention experienced an average weight loss of 5.1 pounds (−2.8%; p < 0.01), close to the 3% threshold associated with a clinically meaningful reduction in cardiovascular risk factors as defined by the AHA/ACC. Participants reported increased knowledge, skill and confidence for self-management of their health (PAM, p < 0.05) and significant improvements in physical quality-of-life (PROMIS-10, p < 0.05). Trends toward lower levels of depression (CES-D 10, p = 0.12) and decreased fat consumption (Block Food Frequency, p = 0.06) were also observed.Conclusion: Lifestyle-focused intervention via SMAs has enabled breast cancer survivors to incorporate the prescribed healthy self-care practices into their lives to a degree that produced clinically relevant health and quality-of-life benefits.Contact: Mladen Golubic, golubim@ccf.orgO3.05 LESSONS LEARNED FROM HEALTH PROFESSIONS STUDENT WELLNESS RETREATS AT TURNER FARM'S TEACHING KITCHENEmily Moss (1), Harini Pallerla (2), Kelly Lyle (1), Sian Cotton (1)(1) Center for Integrative Health and Wellness, Cincinnati, OH, USA(2) Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USAPurpose: Transforming a disease-care system into a wellness-care system relies on educating students early on about the benefits of healthy lifestyle and disease prevention. Interprofessional student wellness retreats focused on healthy change reinforce concepts needed to achieve optimal community health. An organic farm with a state-of-the-art teaching kitchen (TK) provides a transformative platform for such innovative educational experiences.Methods: Five student wellness retreats have been conducted at Turner Farm from 2016–2017. Seventy-five students from the Colleges of Medicine, Nursing, Allied Health, Pharmacy, and Health Promotion have attended. Students signed-up via e-mail and retreats hosted 16 students to accommodate TK space. Student cost was $10 with philanthropy augmentation. The 6-hour Saturday program included: farm tour, 2-hour of ‘Food as Medicine’ and ‘Mindfulness for Stress Reduction’ didactics, a 2-hour TK experience with a chef and dietitian/physician, mindful eating, and discussion/reflection. Program evaluations assessed quality, length, topics, and potential personal/professional changes following the retreat.Results: All participants rated the quality of presentations as excellent (95%) or good (5%). 93% reported high probability of changing the way they focus on personal wellness. Interest in topic (92%) and location (41%) influenced participation. Opportunities for professional change involved: advocating for patient lifestyle changes, nutrition counseling, and seeking more evidence-based knowledge regarding integrative health. Reported personal changes included: improving dietary habits, incorporating mindfulness in self-care, and practicing mindful eating. 85% reported that the information would be useful to them, 82% said the length was “just right,” 89% agreed with it being an interprofessional experience, 100% would recommend to other students, and close to 100% reported the environment/space to be excellent.Conclusion: Intending to generate interest in integrative health using an organic farm teaching kitchen platform, these weekend wellness retreats were highly successful. Future programming might include longitudinal TK sessions aimed at continued healthy behavior change and knowledge.Contact: Emily Moss, mossey@mail.uc.eduO3.06 COOKING UP HEALTH: ASSESSING THE EFFICACY OF A CULINARY MEDICINE ELECTIVE IN MEDICAL STUDENTSMelinda Ring (1), Elaine Cheung (1), Rupa Mahadevan (1), Stephanie Folkens (2), Neile Edens (2)(1) Osher Center for
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