Abstract
Teaching kitchens, as currently designed and implemented across the United States and globally, have been designed as learning environments that include a kitchen; however, they are more than culinary instruction sites.
Teaching kitchens typically include instruction in most, if not all, of the following: (1) nutrition education, specifically what to eat more of or less of and why; (2) hands-on culinary instruction, that is, basic cooking skills for the home cook; (3) information about physical activity and its critical importance in health optimization; (4) mindfulness and its critical relationship to diet, portion control, satiety, and resilience; (5) the judicious use of web-based resources and information technologies; (6) the relationship between food choices and the environment; and (7) motivational interviewing strategies and health coaching techniques whereby personal motivations can be identified and leveraged to successfully achieve sustained behavioral change. 1
Emerging teaching kitchen models serve as in-person or virtual life skills learning laboratories intended to promote health and wellness, and as clinical research centers whereby the impact of diet and lifestyle change on a range of behavioral, metabolic, genetic, clinical, and financial variables can be rigorously evaluated.
The conceptual origins of teaching kitchens include two philosophical tenets from both ancient China and ancient Greece: Prevention is always superior to intervention.
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In The Yellow Emperor's Classic of Internal Medicine,
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attributed to the Legendary Yellow Emperor—who was believed to have lived from 2700 BC to 2600 BC—this tenant is conveyed poetically as follows: “To administer medicine to diseases which have already developed and thereby suppress bodily chaos, which has already occurred, is comparable to the behavior of those who would begin to dig a well after they had grown thirsty or those who would begin to cast weapons after they have engaged in battle. Would these actions not be too late.”
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The way we eat, move, and think impacts our health, and determines our recuperative capacity.
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In addition, both Chinese and Greek medical thought leaders of the 5th century B.C. appreciated that one's “constitution,” as referenced by Hippocrates, and one's “ancestral Qi” also known as “vital energy” in Chinese theory, are also determinants of one's health and resilience. Accordingly, modern teaching kitchens can be viewed as “learning laboratories” and “translational research centers” where the relationships between food, health, our environment, and the regulation of our genes (and microbiota) can be rigorously studied.
The first ever Teaching Kitchen Research Conference (TKRC) was held in February 2018,
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hosted by the Harvard T. H. Chan School of Public Health (Harvard Chan School) in association with the Teaching Kitchen Collaborative (
The second TKRC recently took place November 11–12, 2020. Due to generous support from a grant from the National Institutes of Health (NIH; R13AT010554-01 from the National Center for Complementary and Integrative Health) and from unrestricted grants from the Meshewa Farm Foundation and the Campus for Health, LTD (Japan), the conference had the resources to provide free registration to anyone interested in participating. In addition, this conference was formally endorsed by both the Academic Consortium for Integrative Medicine and Health and by the American College of Lifestyle Medicine.
While the 2018 in-person TKRC was held in California and attracted 125 registrants from the United States and a small number of registrants from abroad, 3 this second TKRC was held virtually due to the COVID-19 pandemic and attracted >2500 registrants from 79 countries. More than 900 registrants confirmed the existence of teaching kitchens within their respective institutions. This highlights how teaching kitchens are becoming more ubiquitous and are being designed and implemented for educational and research purposes across the international community. These figures also demonstrate that the desire to share “best practices,” novel educational models, and emerging research findings within and across teaching kitchens has increased considerably since 2018.
The 2020 TKRC included presentations from five speakers in addition to 24 oral abstract presentations, 37 poster presentations, and 2 panel discussions.
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The panel discussions focused on (1) methods currently in place to use teaching kitchens to educate health care professionals and (2) research challenges and opportunities involving the evaluation of teaching kitchens during and after the COVID-19 pandemic. Importantly, each keynote presentation was recorded and can be publicly viewed on demand (please visit
Highlights of the TKRC welcome and keynote presentations, and a selection of oral abstracts, are briefly summarized hereunder.
A number of original scientific abstracts included in the TKRC are noteworthy. These include:
The abstract by Berquist et al. (original abstract [OA]1.01) describes the evaluation of Emory University's “Healthy Kitchen Collaborative's Multi-Disciplinary Teaching Kitchen Self-Care Curriculum.” In this study, benefits-eligible Emory employees (n = 37) were offered a multi-disciplinary teaching kitchen educational intervention in the form of five 4-hour classes. This teaching kitchen model was feasible and effective as a strategy to increase health-promoting behaviors among an employee population.
The abstract by Luchsinger et al. (OA2.04) describes a “Collaborative Enhanced Nutrition Care Program for Adults with Serious and Persistent Mental Illness” at the Kalamazoo Valley Community College. This program, which integrates culinary medicine into behavioral health services and includes the incorporation of culinary training using a mobile kitchen unit, was found to have multiple positive impacts on subjects (n = 27) with serious and persistent mental illness. As an editorial note, this study suggests the need for future studies involving teaching kitchens as applied to a range of patient populations treated by behavioral, mental health, and rehabilitation specialists.
The abstract by LaCroix et al. (OA4.02) describes “Baseline Knowledge, Habits and Confidence of the Veterans Health Administration (VHA) Healthy Teaching Kitchen Participants.” Data from 1373 participants from 36 VHA Healthy Teaching Kitchen sites suggest that most U.S. veterans who participate in teaching kitchen programs are older males with obesity who do not meet the recommended daily requirements with regard to vegetable, fruit, bean, and nut consumption, and who could benefit from enhanced meal planning and teaching kitchen-related instruction.
The abstract by Jacobs et al. (OA4.03) described “Innovative Food Procurement Guidelines” applied to 10 hospitals within the Northwell Health System, the largest health system in the Greater New York region. These novel “healthy quality food initiatives,” based on explicit Northwell Health food procurement guidelines, were initiated in June 2016. Between 2016 and 2020, Press Gainey Scores relating to the question: “How would you rate the quality of your food” rose from 9% (2016) to 56% (2019); total food purchases of $35 million at baseline rose by only 3% (identical to the cost of living increase over this same period); standards were raised with regard to the purchase of meats and fish; and a range of healthier—and well received—food items, including healthier (non-prefried) potatoes, artisanal (whole grain) breads, and healthier desserts were incorporated into standard hospital dining programs. The authors conclude “It is possible to apply evidence-based food procurement policies to improve nutritional value and quality of hospital-based foods while increasing customer/patient satisfaction without significant increases in food expenditures.”
The abstract by Steinberg et al. (OA4.04) entitled, “Evaluating the Impact of Kaiser Permanente's Thrive Kitchen Culinary Medicine Program on Healthy Eating and Cooking Confidence and Behaviors,” describes changes in cooking confidence and health-related behaviors among 362 participants who attended teaching kitchen classes at the mobile teaching kitchen at Kaiser Permanente, San Francisco, between 2017 and 2019. The majority found these classes to be useful, learned new skills, gained confidence, and were inspired to improve their eating and cooking habits.
The abstract by Westfall et al. (OA5.03) entitled, “Teaching Kitchen Improves Health Professional Students' Nutrition Knowledge, Perceived Culinary Skills, and Confidence Providing Nutritional Counseling” describes a study in which UCLA students of medicine, nursing, dentistry, and public health were recruited through e-mail to participate in a “Teaching Kitchen Intervention.” Based on pre–post data from 85 participants, this educational intervention resulted in significant improvement in students' nutrition knowledge, culinary skills, and confidence-providing nutritional counseling.
Additional abstracts offer a sense of the diversity of teaching kitchen applications being evaluated in 2020 and include abstracts describing teaching kitchen programs in:
A publicly funded city library (the Philadelphia Free Library Culinary Literacy Center) where teaching kitchen programs are offered to new immigrants using teaching kitchen classes to learn English as a second language, to teach cooking skills to adults with disabilities, and to teach nutrition facts and culinary skills to inner city youth and others (i.e., >6200 students per year in 2019) (poster abstract [P]-4.08);
an OB/GYN practice in Boston (at Brigham and Women's Hospital) for pregnant women with a history of gestational diabetes (OA2.02);
an RD training program at the University of Texas School of Public Health that requires evidence of competencies involving both culinary instruction and instruction in the design and implementation of family home vegetable gardens (P-5.10);
a public Botanical Garden (Phipps Botanical Gardens in Pittsburgh) whose teaching kitchen provides information on nutrition basics, culinary instruction, and Motivational Interviewing to University of Pittsburgh medical students, as well as >1000 adults and 400 children per year (OA3.02); and
a program in Alberta, Canada, where a teaching kitchen program has been successfully customized for senior citizens in an effort to enhance health behaviors and quality of life (P-1.02).
An additional abstract by Massa et al. (OA 4.01) entitled, “Global Estimates of Cooking Frequency Prior to COVID-19” summarizes results from a Gallup Poll survey of 152,974 adults across 142 countries around the world with respect to cooking frequency. Data are based on a novel series of questions (Cooking Frequency Questionnaire) that was embedded within the Gallup Poll Survey in 2019, to assess the frequency of “cooking from scratch,” and provides information on cooking frequency variability worldwide, gender disparities in cooking frequency, and the relationship between cooking frequency and life evaluation and positive experiences. This research provides a novel replicable measure of “cooking from scratch” and global baseline data regarding cooking frequencies, by country, pre- COVID-19.
Lastly, subject matter experts facilitated eight breakout sessions. These included discussions with respect to teaching kitchens as applied to (1) precision nutrition; (2) international collaborations; (3) integrative and lifestyle medicine; (4) educating health professionals; (5) clinical practice and research; (6) agriculture and sustainable food systems; (7) inter-professional synergies of registered dietitian-nutritionists, chefs, mind–body, and other teaching kitchen instructors; and (8) challenges and opportunities relating to enhancing health equity. The goal of each breakout was to identify (1) topics that are missing from the current list of teaching kitchen research priorities, (2) organizations and thought leaders who are currently missing from this multi-disciplinary line of inquiry, and (3) collaborations that do not yet exist but should be explored and nurtured to advance research involving teaching kitchens worldwide.
Our shared circumstances in the year 2020 as related to the COVID-19 pandemic; rising rates of noncommunicable chronic disease (e.g., obesity and diabetes); global climate change; and systemic racism informed many aspects of this scientific meeting. Most agreed that we will not—and cannot—return to “normal life pre-COVID 19,” but rather, will need to collectively “build back better” in the years ahead. This conference made a strong case for the inclusion of teaching kitchens in the development of cocreated future plans and research opportunities intended to encourage a culture of health. Moreover, the involvement of so many individuals and organizations with teaching kitchens from around the globe suggests that there will need to be more TKRCs in the years ahead.
Footnotes
Author Disclosure Statement
The author declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: David Eisenberg, MD, is the executive director of the Teaching Kitchen Collaborative; co-director of the Harvard-Culinary Institute of America Healthy Kitchens, Healthy Lives educational conference; scientific adviser to Campus for Health, LTD, Japan; scientific adviser to Cookpad, Inc., Japan; scientific adviser to Better Therapeutics, Inc.; and a member of the Health and Wellness Advisory Board of Barilla, Inc., Italy.