Wood Nathan Isaac, Fussell Maya, Benghiat Erica, Silver Lora, Goldstein Max, Ralph Amy, Mastroianni Lisa, Spatz Erica, Small Dana, Fisher Rosemarie, Windish Donna
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Preventive Cardiovascular Health Program, Yale New Haven Health, New Haven, CT, USA.
J Gen Intern Med. 2025 Jun 25. doi: 10.1007/s11606-025-09652-x.
For decades, physicians have received inadequate nutrition education. "Culinary medicine," an emerging pedagogy in medical education, seeks to address this by integrating hands-on cooking to enhance nutrition training. While cohort and cross-sectional studies have demonstrated culinary medicine's efficacy, no randomized controlled trials to date have been conducted among medical trainees.
To evaluate the efficacy of a hands-on culinary medicine curriculum compared to didactics-only nutrition education.
Two versions of a nutrition education curriculum were developed: a culinary medicine curriculum (intervention) and a didactics-only curriculum (control). The curricula were assessed using a non-inferiority randomized controlled trial design.
All active Yale Primary Care residents were randomized to receive either the intervention curriculum or the control curriculum.
Residents completed surveys at baseline, immediately post-session, and 8 weeks post-session assessing nutrition knowledge, attitudes regarding providing dietary counseling, and behavior in providing nutrition resources to patients.
Nutrition knowledge increased from baseline to immediately post-session in both groups (control (mean percent correct 54% to 94%, P = 0.001), intervention (60% to 92%, P = 0.001)). Compared to the control group, the intervention group gained more confidence in counseling patients on a plant-forward diet (F = 5.44, P = 0.03). Residents in the intervention group reported providing nutrition resources to their patients significantly more frequently at 8 weeks post-session than at baseline (mean frequency per week 0.1 to 0.9, P = 0.002), a change that was not demonstrated among control group participants (0.1 to 0.5, P = 0.35).
Both culinary medicine and didactics-only pedagogies can be effective approaches to teaching nutrition. Culinary medicine was found in this trial to be non-inferior to a didactics-only approach and may be superior in improving participants' confidence in providing dietary counseling to patients.
几十年来，医生接受的营养教育不足。“烹饪医学”是医学教育中一种新兴的教学方法，旨在通过将实践烹饪融入其中来加强营养培训。虽然队列研究和横断面研究已经证明了烹饪医学的功效，但迄今为止尚未在医学实习生中进行随机对照试验。
评估实践烹饪医学课程与仅采用说教式营养教育相比的效果。
开发了两个版本的营养教育课程：烹饪医学课程（干预组）和仅采用说教式的课程（对照组）。使用非劣效性随机对照试验设计对课程进行评估。
所有活跃的耶鲁初级保健住院医师被随机分配接受干预课程或对照课程。
住院医师在基线、课程结束后立即以及课程结束后8周完成调查问卷，评估营养知识、提供饮食咨询的态度以及向患者提供营养资源的行为。
两组从基线到课程结束后立即营养知识均有所增加（对照组（正确百分比均值从54%提高到94%，P = 0.001），干预组（从60%提高到92%，P = 0.001））。与对照组相比，干预组在为患者提供以植物为主的饮食咨询方面更有信心（F = 5.44，P = 0.03）。干预组的住院医师报告在课程结束后8周向患者提供营养资源的频率明显高于基线（每周平均频率从0.1提高到0.9，P = 0.002），而对照组参与者未出现这种变化（从0.1到0.5，P = 0.35）。
烹饪医学和仅采用说教式的教学方法都是有效的营养教学方法。在本试验中发现烹饪医学不劣于仅采用说教式的方法，并且在提高参与者为患者提供饮食咨询的信心方面可能更具优势。
