A mixed methods programme of study on the determinants and health outcomes of home food preparation

Abstract

Diet-related diseases are the greatest cause of morbidity and mortality worldwide. Food preparation methods are linked to diet and health. The aim of this thesis was to study the determinants and outcomes of home food preparation, using mixed methods. The first research phase was a systematic review of observational studies on the health and social determinants and outcomes of home cooking. Key determinants included female gender, greater leisure time availability, close personal relationships, and culture and ethnicity. Putative outcomes were mostly at an individual level and focused on potential dietary benefits. The second phase involved qualitative interviews exploring home food preparation practices, experiences and perceptions amongst adults from the United Kingdom (UK). Key emergent themes concerned the cook (identity), task (process of cooking) and context (situational drivers). Practices changed over the life course and reflected compromises between varied competing demands. Comparison with focus group data from Baltimore, United States, showed that ‘home cooking’ was distinct from other types of cooking at home. ‘Home cooking’ was defined as: preparing a meal from scratch; cooking with love and care; and nostalgia, and was not aligned closely with principles of healthy eating. The third phase comprised analyses of cross-sectional data on participants’ meal consumption patterns, sociodemographics, diet and markers of cardio-metabolic health, from a large population-based UK cohort study. Eating home cooked meals more frequently was significantly associated with being female, older, of higher socioeconomic status and not working overtime. Varying patterns of association were observed for consuming takeaways, ready meals and meals out. Eating home cooked meals more frequently was significantly associated with a range of healthier dietary indicators, and lower adiposity. Overall, preparing and eating meals cooked at home were found have complex and varied determinants, and to offer a range of putative benefits, indicating potential to enhance the public’s health.