Home cooking helps our health and our wallet – so what stops us and our patients?
As Lifestyle Medicine professionals we know eating whole, mostly plant-based foods is associated with numerous health benefits. Research also shows that people who cook at home generally eat higher quality food, consume less kilojoules, spend less money on food, and experience less weight gain over time than those who dine out and eat pre prepared meals on a regular basis.
Whilst ourselves and patients may have the best intentions when it comes to eating healthy food and cooking at home many of us struggle to follow through with this change in behaviour. Known as the intention-behaviour gap, it is a concept that can apply whether it is losing weight, exercising, or drinking less alcohol.
Some of the barriers that may prevent patients from achieving their aspirations include:
- “Nudging” by food marketers
- Lack of time to prepare meals
- Lack of understanding about nutrition and cooking skills
- Our underlying perceptions and beliefs that eating healthy food is expensive or boring and tasteless
The good news is that as they start to become aware and recognise these barriers, they can start to bridge the gap between good intentions and healthy behaviours. The latest science demonstrates that when it comes to changing behaviours and bad habits, small consistent steps are the order of the day to overcome the current habits which may not be helping their health in the long term.
Let’s look at some of the home cooking barriers in further detail.
The power of a nudge
“Nudging” is a term used in behavioural science that suggests changing an environment can leverage changes in behaviour. The concept is heavily used by food marketers to encourage consumer spending, for example, placing junk food at checkouts, and placing discretionary foods and specials at the beginning of supermarket catalogues to encourage spending.
Patients can be one jump ahead of the marketers and use this technique to help drive change in our own behaviour. For example, placing discretionary or “sometimes” foods out of sight and positioning healthier choices front and centre helps “nudge” us towards positive health behaviours.
Other examples of “nudging” include having all recipe ingredients chopped and prepared at the front of the fridge. Or a copy of the recipe that they are planning to cook, attached to the front of the fridge.
What nudges could patients put in place to help support them in their home environment?
Time management
The explosive growth of on-line shopping has given us the ability to have greater control over our spending as well saving time by not physically having to go to the supermarket. Plus, online shopping platforms have the functionality to be able to create lists, save commonly bought products etc. Adopting online shopping could be a way of allowing patients to spend more time cooking and less time shopping.
Have they explored meal preparation services where ingredients are portion controlled and ready to go? This may also help save time and manage costs. These services reduce meal preparation time and are delivered to your front door, fresh and ready to go. Using a service like this is a great example of positive nudging with the ingredients ready sitting in the fridge at the end of the day. Some now offer vegan options. The vegetable content could also be bolstered with some additional steamed vegetables or a salad.
Another option is taking some time to investigate recipe websites with direct links to online supermarkets. Using apps, for example, Paprika, can allow you to download recipes, create your own meal plans and shopping lists.
Spending some extra time on the weekend doing some meal preparation can be an excellent time saving solution. Ensuring that a variety of ingredients that are chopped up and ready to go when lunch time hunger hits especially when working at home. Having pre-prepared meals in sight during stressful times is another good example of nudging.
When planning for the week could you look for common ingredients (particularly vegetables) that can be used in multiple dishes? Are there ways the ingredients can be repurposed or be cooked in batches and frozen? Cooking up ingredients and freezing them could also be an option. For example, did you know you can cook and freeze lentils? They can be frozen and portion controlled, like you might have your meat in the freezer.
Learning new cooking tricks and understanding nutrition
There is growing awareness about plant-based eating due to documentaries such as, “Forks Over Knives” and the variety of vegan options available in the market is increasing, however these options are often highly processed. Most Australian consumers rarely meet the Australian Healthy Eating guidelines’ recommended servings of fruit and vegetables. Many people overconsume processed meat and dairy products, and discretionary food that has little or no nutritional value, often accounts for a third of an individual’s total energy intake.
It has been demonstrated that the better cooking skills someone has, the greater the probability that they will consume more fruit and vegetables.
Recognizing this, a concept known as “Culinary Medicine” has evolved within the healthcare community in the US and UK where doctors, dietitians, health coaches, and chefs work together to coach clients to improve their nutrition by upskilling their culinary abilities.
Are there skills that you could learn or courses that you could attend to improve your culinary skills and nutrition knowledge? For example, ensuring a vegetarian dish or meal has some form of vitamin C helps improve the absorption of iron from vegetables. A spinach salad with a salad dressing made with lemon juice and capsicum would fit the bill.
Another nutrition hack involves using your freezer. Freezing fruit like plums, mangoes and berries in season can then be added to smoothies or served on top of cereal or yoghurt. Freezing vegetables and adding them with the fruit to smoothies can boost the nutrient content without the sweetness.
Smashing the perception that healthy food is expensive and tasteless
If you compare the cost per kilogram of protein from plant source versus an animal source, there is a sizeable cost difference. Plant based protein sources are generally cheaper, and when swap some of our animal sources of protein with plant-based sources, we can lower the overall cost of our meals as well as improving our health.
Could your patient start to add more plant protein to your intake and reduce the portion of animal protein used on your plate to start? The addition of plant protein such as lentils and beans to meals such as bolognaise, Mexican dishes etc. improves the fibre content and phytonutrient profile of these dishes. The addition of plant protein improves satiety and feelings of “fullness” after a meal, therefore promoting weight control as less calories are consumed.
Another way to incorporate more plants into your diet is have one meat free day per week. For example, replacing the animal protein component of a stir fry and using tofu, chickpeas or lentils with your favourite stir fry sauce can be a great way to get started. Topping with some lightly roasted nuts amps up the flavour and texture even more.
Making such changes in small steps, helps your brain and taste buds adjust over time and start to create new habits. This will help to make such changes sustainable over the longer term, with the added bonus of reducing the cost of their butchery bill.
How to make it work
The ideas above are ‘food for thought’ on how to address some of the potential barriers. It’s worth taking the opportunity to explore these challenges with eating well and cooking at home in your own home environment to start and see if any of these barriers resonate with yourself. Instead of jumping straight to a quick solution or recommendation, take time and plan through how you would implement any of these ideas.
What resources and support do you need to make it happen? What steps are needed? When you explore and understand what these barriers are and plan how you will address them you are likely to be more successful in the long term. This where an interdisciplinary approach can help and referring patients to a Health Coach and a Dietitian can help.
The Dietitian/Nutritionist can help the patient to ensure they meet their nutritional requirements and the Health Coach through the use of appreciative enquiry can explore the barriers and help develop strategies to overcome the barriers. It can take a few sessions to uncover what these barriers are and develop a plan to move forward and create long-term sustainable change.
- Mills S et al. Int J Behav Nutr Phys Act 2017 Aug 17;14(1):109
- Polak, R . “Introduction to Culinary Coaching -Improving Nutrition through Culinary Training Combined with Coaching”. CHEF Coaching, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital
This article has been written for the Australasian Society of Lifestyle Medicine (ASLM) by the documented original author. The views and opinions expressed in this article are solely those of the original author and do not necessarily represent the views and opinions of the ASLM or its Board. The views and opinions expressed in this article are solely those of the documented original author and do not necessarily represent the views and opinions of the ASLM or its Board.