PLANT-FORWARD CULINARY MEDICINE FOR THE PREVENTION OF CARDIOVASCULAR DISEASE FOR PRIMARY CARE RESIDENTS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Therapeutic Area

Nutrition/Exercise

Background

In the United States, cardiovascular disease (CVD) is the leading cause of death, and nutrition is the leading risk factor. However, fewer than a third of internal medicine residents feel confident discussing nutrition with patients. “Culinary medicine,” by combining didactics with hands-on cooking instruction, empowers medical trainees to prevent and treat diet-related disease with their patients.

Methods

All 51 primary care residents at an academic medical center in New England participated in this randomized controlled study. Twenty-five residents were randomized to the intervention group and 26 to the control group. Both groups participated in 3 hours of cased-based learning, group discussion, lecture, and dietitian Q&A sessions. The intervention group also received 1 hour of culinary medicine instruction in a “virtual teaching kitchen,” cooking together on Zoom and learning strategies for modifying recipes for heart-healthiness. The control group watched 1 hour of videos from the Nutrition Made Clear curriculum. Nutrition knowledge was assessed via multiple-choice questions. Confidence was measured on 6-point Likert scales. Attitudes were measured via a subscale of the Nutrition in Patient Care Survey (NIPS).

Results

NIPS subscale scores did not differ from baseline to immediate post in the control group (mean score 33.1 to 34.3, p=0.08) but did in the intervention group (34.7 to 36.1, p=0.04). Nutrition knowledge scores increased significantly from baseline to immediate post in both groups (mean % correct 53.6% to 93.7%, p=0.001 for control vs. 60.0% to 92.2%, p=0.001 for intervention). Percent of residents who felt confident providing patient-accessible dietary counseling for CVD increased significantly in the intervention group (8.3% to 52.2%, p=0.002) but did not in the control group (36.4% to 63.2%, p=0.453). At 8 weeks post, 96% of all residents reported implementing something they had learned from the curriculum into caring for patients, and their nutrition knowledge scores remained high. All residents said they would recommend the curriculum to colleagues and wanted additional nutrition education.

Conclusions

Both culinary medicine and didactics-only nutrition education can be feasible, well-received, and effective in improving nutrition knowledge. Culinary medicine may be superior in improving learners’ attitudes about nutrition and confidence in providing dietary counseling.