Cooking, Diabetes Self Management Education, | EurekAlert!


COLUMBUS, Ohio—Researchers at Ohio State University Wexner Medical Center and medical college has partnered with Local Matters on a study testing whether a cooking intervention that provides food along with diabetes self-management education to promote healthy eating and physical activity would improve A1C hemoglobin levels and diabetes management.

In this randomized wait-list control study, 48 adults with either type 1 or type 2 diabetes completed the six-week Cooking Matters for Diabetes intervention.

“This study demonstrated that Cooking Matters for Diabetes can be an effective way to improve dietary self-care and health-related quality of life, particularly in people living with food insecurity, and should be tested in larger randomized controlled trials,” said co-author Amaris Williams, a postdoctoral researcher in Ohio State’s Department of Endocrinology, Diabetes and Metabolism.

Study results will be published in Journal of the Academy of Nutrition and Dietetics.

Cooking Matters for Diabetes was adapted from Cooking is important and the American Diabetes Association’s Diabetes Self-Management Education and Support Program into a 6-week intervention with weekly feedings. Cooking Matters is a program by Share our strengtha nonprofit organization dedicated to solving hunger and poverty issues in the United States and around the world.

Local Affairs, a Columbus-area nonprofit dedicated to creating healthy communities through nutrition education, access, and advocacy, was a partner in designing and delivering the intervention, including the cooking instructor, cooking equipment, food supply, and local affairs volunteer. The Ohio State Wexner Medical Center Diabetes Education Team provided the community facility for the program and certified diabetes care and education specialists.

The weekly courses included cooking demonstrations and lessons on diabetes and treatment options; to eat healthy food; physical activity; taking medication; monitoring and use of patient-generated health data; prevention, detection and treatment of acute complications; healthy handling of psychosocial problems and concerns and problem solving. In addition, one class was devoted to an interactive visit to a grocery store.

The cooking portion offered lessons in food safety, knife techniques, nutritional information and ingredient label reading, meal planning, budgeting, and shopping. In each course, with the exception of the grocery tour, participants cooked a meal in small groups. All participants then sat down and shared the meal with the aim of building a sense of community.

“Teaching culinary skills has been shown to help reduce the burden of food insecurity. But broader skills required to put food on the table, such as meal planning, shopping, budgeting, food safety and nutrition, are also critical,” said Michelle Moskowitz Brown, executive director of Local Matters.

Participants completed surveys on their diabetes self-care activities along with health surveys on medical outcomes, nutritional history, and a food security questionnaire. In addition, participants’ A1C was measured at baseline, post-intervention, and at the 3-month follow-up.

A1C is an important predictor of who will have poor long-term outcomes in diabetes such as heart disease, stroke, kidney disease (nephropathy), eye disease (retinopathy), and nerve disease (neuropathy). Keeping A1c below 7% in most people with diabetes is key to reducing risk, the senior author said dr Joshua J JosephEndocrinologist and Assistant Professor in the Ohio State Department of Endocrinology, Diabetes and Metabolism.

Diabetes remains one of the most common chronic diseases in the United States, affecting more than 34 million adults. Education and support for diabetes self-management are cornerstones of diabetes care, yet only one in two adults with diabetes achieve healthy target hemoglobin A1C levels of less than 7%.

“We found that study participants ate more vegetables and fewer carbohydrates. We saw improvements, including significant changes in diabetes self-management activities and a numerical reduction in A1C in study participants with food insecurity. This is important because food insecurity and lack of access to nutritious food can complicate diabetes management and A1C control,” said study co-investigator Jennifer C. Shrodes, a registered and licensed dietitian and board-certified diabetes care and education specialist Ohio State Department of Endocrinology, Diabetes and Metabolism.

In 2018, 11.5% of US households experienced year-round food insecurity. Several studies have found a greater prevalence of food insecurity among people with type 2 diabetes compared to the national average, the researchers noted.

“Many outcomes improved significantly more for people with food insecurity than for people without food insecurity. But during the post-intervention follow-up period, the food-insecure group experienced greater regression, emphasizing the importance of sustained follow-up in populations that have become vulnerable in relation to one or more social determinants of health,” said Joseph.

The research team included members of Ohio State Medical Dietetics; Center for Biostatistics; Institute for Biomedical Informatics; College of Nursing; Faculty of Health and Rehabilitation Sciences; The John Glenn College of Public Affairs and the Wake Forest School of Medicine.

This study was funded by the Diabetes Dietetic Practice Group Karen Goldstein Memorial Grant for Diabetes Medical Nutrition Therapy administered by the Academy of Nutrition and Dietetics Foundation. Joseph’s time was funded by the National Institutes of Health K23 DK117041.

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