Article Text
Abstract
Background Poor quality diets high in fat, salt and sugar and low in fruit and vegetables play important roles in the aetiology of obesity and chronic diseases. Many dietary interventions assume relationships between cooking, diet and health, and surmise that a key solution for promoting health is developing cooking skills. However, evidence to support this proposition is lacking, as is evidence regarding the most appropriate targeting of such interventions. This study aimed to systematically review the health and social determinants and outcomes of home cooking.
Methods Home cooking was defined as the combination of actions required for preparing hot or cold foods at home, including combining, mixing and often heating ingredients. Studies were included if they were published in English in a peer-reviewed journal; focussed mainly on home cooking; and presented post 20th Century data on participants from high/very high human development index countries. Interventional study designs, which have previously been reviewed, were excluded. Nineteen electronic databases covering health, psychology, economics and social sciences were searched, using systematically devised search strings. Key journals and websites were hand searched. 10% records retrieved were independently double screened at title/abstract, and all at full text. Data extraction and quality appraisal were undertaken in duplicate. Quality appraisal was carried out using the Effective Public Health Project tool (quantitative) and a checklist by Smith et al., 2009 (qualitative) and themes summarised using narrative synthesis.
Results A total of 13,341 unique records were retrieved, and 853 full texts screened. Overall 38 studies met the inclusion criteria, the majority cross-sectional in design. All quantitative studies were rated overall weak in quality appraisal; qualitative studies were rated more highly. A conceptual model was developed, mapping determinants of home cooking to layers of influence including non-modifiable, individual, community and cultural factors. Evidence suggested links between key determinants, which included gender, time availability, personal relationships, and culture/ethnicity. Putative outcomes of home cooking were at an individual level and largely related to dietary benefits, with potential health impacts.
Conclusion Determinants of home cooking appear more complex than simple skill acquisition, and potential positive associations between cooking, diet and health require further longitudinal research to establish cause and effect. The current evidence base is limited by reliance on primarily cross-sectional studies; high risk of bias; and authors’ relatively limited conceptualisation of potential determinants and outcomes of home cooking. Public health policy makers and practitioners should avoid focussing exclusively on cooking skills whilst researchers explore these uncertainties.