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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Nutr.</journal-id>
<journal-title>Frontiers in Nutrition</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Nutr.</abbrev-journal-title>
<issn pub-type="epub">2296-861X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fnut.2025.1653406</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Nutrition</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>From kitchen to health: how culinary workshops influence eating habits, autonomy, and wellbeing in adults&#x02013;A scoping review</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>da Fonseca</surname> <given-names>P&#x000E2;mela Gracielle</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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<contrib contrib-type="author">
<name><surname>Siqueira</surname> <given-names>Lucas de Carvalho</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Raposo</surname> <given-names>Ant&#x000F3;nio</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
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<name><surname>Alslamah</surname> <given-names>Thamer</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
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<contrib contrib-type="author">
<name><surname>Albaridi</surname> <given-names>Najla A.</given-names></name>
<xref ref-type="aff" rid="aff5"><sup>5</sup></xref>
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<name><surname>Saraiva</surname> <given-names>Ariana</given-names></name>
<xref ref-type="aff" rid="aff6"><sup>6</sup></xref>
<xref ref-type="aff" rid="aff7"><sup>7</sup></xref>
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<name><surname>Guimar&#x000E3;es</surname> <given-names>Nathalia Sernizon</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c002"><sup>&#x0002A;</sup></xref>
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<aff id="aff1"><sup>1</sup><institution>Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte</institution>, <addr-line>Minas Gerais</addr-line>, <country>Brazil</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Primary Health Care, University Center of Patos (Centro Universit&#x000E1;rio de Patos), Patos</institution>, <addr-line>Para&#x000ED;ba</addr-line>, <country>Brazil</country></aff>
<aff id="aff3"><sup>3</sup><institution>CBIOS (Research Center for Biosciences and Health Technologies), ECTS (School of Health Sciences and Technologies), Lus&#x000F3;fona University</institution>, <addr-line>Lisboa</addr-line>, <country>Portugal</country></aff>
<aff id="aff4"><sup>4</sup><institution>Department of Public Health, College of Applied Medical Sciences, Qassim University</institution>, <addr-line>Buraydah</addr-line>, <country>Saudi Arabia</country></aff>
<aff id="aff5"><sup>5</sup><institution>Department of Health Science, College of Health and Rehabilitation, Princess Nourah bint Abdulrahman University</institution>, <addr-line>Riyadh</addr-line>, <country>Saudi Arabia</country></aff>
<aff id="aff6"><sup>6</sup><institution>Research in Veterinary Medicine (I-MVET), Faculty of Veterinary Medicine, Lisbon University Centre, Lus&#x000F3;fona University</institution>, <addr-line>Lisboa</addr-line>, <country>Portugal</country></aff>
<aff id="aff7"><sup>7</sup><institution>Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lisbon University Centre, Lus&#x000F3;fona University</institution>, <addr-line>Lisboa</addr-line>, <country>Portugal</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Zumin Shi, Qatar University, Qatar</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Carla Gon&#x000E7;alves, Universidade de Tr&#x000E1;s-os-Montes e Alto Douro, Portugal</p>
<p>Emanuel Orozco, National Institute of Public Health, Mexico</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Ant&#x000F3;nio Raposo <email>antonio.raposo&#x00040;ulusofona.pt</email></corresp>
<corresp id="c002">Nathalia Sernizon Guimar&#x000E3;es <email>nasernizon&#x00040;gmail.com</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>29</day>
<month>08</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>12</volume>
<elocation-id>1653406</elocation-id>
<history>
<date date-type="received">
<day>25</day>
<month>06</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>08</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2025 da Fonseca, Siqueira, Raposo, Alslamah, Albaridi, Saraiva and Guimar&#x000E3;es.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>da Fonseca, Siqueira, Raposo, Alslamah, Albaridi, Saraiva and Guimar&#x000E3;es</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>Inadequate dietary patterns have significantly contributed to the rise of chronic diseases, highlighting the need for effective interventions. Culinary workshops have emerged as a promising strategy by offering practical and interactive food and nutrition education that may enhance food choice autonomy and promote healthier eating behaviors. This scoping review was conducted according to the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist, with a protocol registered in the Open Science Framework. Searches were performed in PubMed, Embase, Cochrane Library, and the Virtual Health Library, including intervention studies published between 2005 and 2025. Study selection and data extraction were independently performed by three reviewers. A total of 30 studies were included, most from the United States (67.6%) and Australia (23.5%), with in-person workshops lasting 4&#x02013;12 weeks. Improvements were reported in food autonomy, self-efficacy, and culinary practices in 81% of studies. Over 90% reported increased consumption of fruits, vegetables, and whole grains, along with reductions in ultra-processed foods. 15 studies noted improvements in anthropometric parameters, while 14 reported clinical benefits. Quality of life was evaluated in seven studies, with significant improvements in three. Culinary workshops appear to be effective in promoting health, though more standardized studies in diverse populations are warranted.</p></abstract>
<kwd-group>
<kwd>culinary workshops</kwd>
<kwd>dietary intake</kwd>
<kwd>feeding behavior</kwd>
<kwd>nutrition education</kwd>
<kwd>public health</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="63"/>
<page-count count="17"/>
<word-count count="11432"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Nutritional Epidemiology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1 Introduction</title>
<p>The global dietary pattern demonstrates significant disparities, with substantial segments of the population consuming food quantities either below or exceeding established nutritional recommendations (<xref ref-type="bibr" rid="B1">1</xref>). Globally, the intake of whole grains, fruits, and vegetables remains consistently below recommended levels, notably in North America and Asia. In contrast, excessive consumption of red and processed meats is particularly prevalent in Oceania (<xref ref-type="bibr" rid="B2">2</xref>). Such dietary imbalances have direct implications for public health, substantially contributing to the escalating prevalence of non-communicable chronic diseases (NCDs), including obesity, type 2 diabetes, cardiovascular diseases, and cancer (<xref ref-type="bibr" rid="B3">3</xref>).</p>
<p>In response to this context, it is imperative to enhance educational strategies aimed at promoting healthier, sustainable, and culturally relevant dietary choices. Culinary workshops represent one such strategy, providing an experiential, participatory, and sensory-rich environment conducive to developing culinary skills, enhancing dietary autonomy, and appreciating food consumption as both a social and political act. Existing research indicates that participation in culinary workshops correlates with improved dietary quality, reduced consumption of ultraprocessed foods, and increased intake of fresh foods (<xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B5">5</xref>). Additionally, culinary workshops can foster communal interaction and knowledge exchange, thereby strengthening social bonds and encouraging more mindful and emotionally engaged dietary practices (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>).</p>
<p>In recent years, the concept of adequate and healthy eating has expanded beyond nutritional considerations, encompassing social, cultural, environmental, and economic dimensions. This comprehensive approach aligns with principles advocated by the World Health Organization and the Brazilian Dietary Guidelines, emphasizing health promotion and sustainable development. The intersection of health promotion and sustainable development is increasingly recognized in academic research, highlighting the necessity for an integrated understanding of social determinants influencing dietary behaviors and decisions (<xref ref-type="bibr" rid="B8">8</xref>).</p>
<p>Furthermore, the escalating concern regarding socio-environmental impacts of current food systems underscores the importance of interventions that advocate the preparation and consumption of fresh and minimally processed foods, rather than ultraprocessed alternatives. Ultraprocessed foods, characterized by their nutritional inferiority, are linked to environmental degradation, biodiversity loss, and the erosion of traditional dietary practices (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>).</p>
<p>Despite documented experiences in existing literature, comprehensive systematic reviews addressing the impact of culinary workshops across multiple health outcomes remain limited. Therefore, this scoping review aims to systematically map the existing scientific literature concerning the influence of culinary workshops on dietary autonomy, habitual food consumption, anthropometric measures, clinical conditions, and biochemical parameters. In this review, the term dietary autonomy is understood in a broad sense, encompassing related constructs such as culinary self-efficacy, confidence in food preparation, and the ability to make informed and independent food choices. Although few studies directly assessed autonomy through validated tools, many reported improvements in participants&#x00027; capacities to plan, prepare, and select foods, which we interpret as indicative of increased autonomy in practice. By consolidating and systematically evaluating these findings, this review seeks to reinforce culinary workshops as a strategic tool for promoting public health and dietary equity.</p>
</sec>
<sec id="s2">
<title>2 Materials and methods</title>
<p>We conducted a scoping review based on guidelines from the Joanna Briggs Institute (JBI). This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRIS-MA-ScR) checklist. The scoping review protocol was previously registered and published in the Open Science Framework (OSF; <ext-link ext-link-type="uri" xlink:href="https://osf.io/3zxn2/">https://osf.io/3zxn2/</ext-link>).</p>
<p>Given the heterogeneity of the interventions, populations, and outcomes across the included studies, and the exploratory nature of our research question, a scoping review was considered more appropriate than a systematic review or meta-analysis. Furthermore, the lack of standardized outcome measures limited the feasibility of conducting a meta-analysis, particularly for BMI-related data.</p>
<sec>
<title>2.1 Identification of the research question</title>
<p>The PCC acronym (Population, Context, and Concept) was used to structure the research question. The population (P) included nutritional intervention programs and strategies; the context (C) was culinary workshops; and the concept (C) encompassed food services, public policy actions and strategies related to health and nutrition, community projects, or sustainable public initiatives.</p>
</sec>
<sec>
<title>2.2 Information search</title>
<p>To identify eligible studies on characteristics of nutritional intervention programs that focused on using fresh and minimally processed foods for culinary preparations, we searched primary scientific research from four electronic databases (PubMed, Embase, Cochrane Library, and the Virtual Health Library platform, reporting to Lilacs) on February 13, 2025. Local studies were identified through gray literature searches, including Connect Papers, and manual searches of reference lists of selected studies.</p>
<p>Search strategies were developed by an expert and refined through team discussions. Databases such as Medical Subject Headings (MeSH), Emtree, and Health Sciences Descriptors (DeCS) were consulted, and the approach was tailored to each database. The finalized PubMed search strategy and its adaptations for other databases are detailed in <xref ref-type="supplementary-material" rid="SM1">Appendix 1</xref>. Filters validated for intervention studies (McMaster) and publication years (2005&#x02013;2025) were applied.</p>
<p>Following the search, studies were imported into Rayyan Qatar Computing Research Institute (Rayyan<sup>&#x000AE;</sup>) a collaborative tool for article screening, and blindly reviewed by two reviewers (PGdF and LdCS). Discrepancies were resolved by a third reviewer (NSG).</p>
</sec>
<sec>
<title>2.3 Eligibility criteria</title>
<p>Studies included were intervention studies (randomized and/or non-randomized clinical trials), quasi-experimental research, experimental trials, or mixed-methods research. Eligible studies evaluated culinary workshops aimed at enhancing dietary autonomy, dietary practices (participants&#x00027; habitual food consumption), and health outcomes. Exclusion criteria comprised literature reviews, pilot studies, protocols, conference abstracts, editorials without initial results, studies involving children and adolescents, and culinary workshops not explicitly designed to promote the consumption of fresh and minimally processed foods.</p>
</sec>
<sec>
<title>2.4 Study selection and data extraction</title>
<p>To ensure consistency, two reviewers (PGdF and LdCS) participated in both the initial screening of titles and abstracts and the full-text evaluation. Disagreements were resolved by a third reviewer (NSG). Data extraction was conducted by three reviewers using an Excel spreadsheet, capturing variables detailed in <xref ref-type="table" rid="T1">Tables 1</xref>&#x02013;<xref ref-type="table" rid="T3">3</xref>.</p>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption><p>Study information: journal, location, population, setting, mode of delivery, frequency, and follow-up duration.</p></caption>
<table frame="box" rules="all">
<thead>
<tr style="background-color:#919498;color:#ffffff">
<th valign="top" align="left"><bold>References</bold></th>
<th valign="top" align="left"><bold>Journal</bold></th>
<th valign="top" align="left"><bold>Location</bold></th>
<th valign="top" align="left"><bold>Population</bold></th>
<th valign="top" align="left"><bold>Setting</bold></th>
<th valign="top" align="left"><bold>Mode of delivery</bold></th>
<th valign="top" align="left"><bold>Frequency</bold></th>
<th valign="top" align="left"><bold>Follow-up duration</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Castagnetta et al. (<xref ref-type="bibr" rid="B11">11</xref>)</td>
<td valign="top" align="left">Annals of the New York Academy of Sciences</td>
<td valign="top" align="left">Palermo, Sicily, Italy</td>
<td valign="top" align="left">Postmenopausal women</td>
<td valign="top" align="left">Tourism school in Palermo</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly over 1 year</td>
<td valign="top" align="left">1 year, divided into two phases</td>
</tr>
<tr>
<td valign="top" align="left">Pierce et al. (<xref ref-type="bibr" rid="B12">12</xref>)</td>
<td valign="top" align="left">The Journal of American Medical Association (JAMA)</td>
<td valign="top" align="left">Various locations, California, USA</td>
<td valign="top" align="left">Women with early-stage invasive breast cancer</td>
<td valign="top" align="left">Multisite clinical study</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Monthly for 12 months</td>
<td valign="top" align="left">12 months</td>
</tr>
<tr>
<td valign="top" align="left">Newman et al. (<xref ref-type="bibr" rid="B13">13</xref>)</td>
<td valign="top" align="left">Journal of the American Dietetic Association</td>
<td valign="top" align="left">La Jolla, California, USA</td>
<td valign="top" align="left">Women previously treated for breast cancer</td>
<td valign="top" align="left">University</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Monthly, 12 total classes</td>
<td valign="top" align="left">12 months</td>
</tr>
<tr>
<td valign="top" align="left">Brown et al. (<xref ref-type="bibr" rid="B63">63</xref>)</td>
<td valign="top" align="left">Journal of Nutrition Education and Behavior</td>
<td valign="top" align="left">Stillwater, Oklahoma, USA</td>
<td valign="top" align="left">Youth and adults</td>
<td valign="top" align="left">Community kitchens</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, eight classes over 2 months</td>
<td valign="top" align="left">2 months</td>
</tr>
<tr>
<td valign="top" align="left">Wrieden et al. (<xref ref-type="bibr" rid="B14">14</xref>)</td>
<td valign="top" align="left">Public Health Nutrition</td>
<td valign="top" align="left">Dundee, Scotland, United Kingdom</td>
<td valign="top" align="left">Adults living in socially deprived areas</td>
<td valign="top" align="left">Community</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 7 weeks</td>
<td valign="top" align="left">6 months</td>
</tr>
<tr>
<td valign="top" align="left">Cutler et al. (<xref ref-type="bibr" rid="B15">15</xref>)</td>
<td valign="top" align="left">Journal of Primary Health Care</td>
<td valign="top" align="left">Various regions, New Zealand</td>
<td valign="top" align="left">Overweight women</td>
<td valign="top" align="left">Not specified</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 6 weeks, 2 h/session</td>
<td valign="top" align="left">12 months, with four evaluations</td>
</tr>
<tr>
<td valign="top" align="left">Flynn et al. (<xref ref-type="bibr" rid="B16">16</xref>)</td>
<td valign="top" align="left">Journal of Hunger &#x00026; Environmental Nutrition</td>
<td valign="top" align="left">Providence, Rhode Island, USA</td>
<td valign="top" align="left">Clients of community organizations</td>
<td valign="top" align="left">Community food distribution organizations</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, &#x0007E;2 h</td>
<td valign="top" align="left">6 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Cuy Castellanos et al. (<xref ref-type="bibr" rid="B17">17</xref>)</td>
<td valign="top" align="left">Journal of Hunger &#x00026; Environmental Nutrition</td>
<td valign="top" align="left">Scranton, Pennsylvania, USA</td>
<td valign="top" align="left">Low-income adults attending farmers&#x00027; markets</td>
<td valign="top" align="left">Farmers&#x00027; market</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, &#x0007E;4 h</td>
<td valign="top" align="left">15 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Bennett et al. (<xref ref-type="bibr" rid="B18">18</xref>)</td>
<td valign="top" align="left">Journal of Intellectual Disabilities</td>
<td valign="top" align="left">Dublin, Ireland</td>
<td valign="top" align="left">Adults with mild to moderate intellectual disability</td>
<td valign="top" align="left">Community center</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Six sessions of 2.5 h; five courses total</td>
<td valign="top" align="left">&#x0007E;6 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Dannefer et al. (<xref ref-type="bibr" rid="B19">19</xref>)</td>
<td valign="top" align="left">Journal of Nutrition and Behavior</td>
<td valign="top" align="left">New York, USA</td>
<td valign="top" align="left">Low-income adults attending farmers&#x00027; markets</td>
<td valign="top" align="left">Farmers&#x00027; market</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly from July to November</td>
<td valign="top" align="left">5 months</td>
</tr>
<tr>
<td valign="top" align="left">Greenlee et al. (<xref ref-type="bibr" rid="B20">20</xref>)</td>
<td valign="top" align="left">Journal of the Academy of Nutrition and Dietetics</td>
<td valign="top" align="left">New York, USA</td>
<td valign="top" align="left">Hispanic breast cancer survivors</td>
<td valign="top" align="left">University teaching kitchen</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, nine sessions</td>
<td valign="top" align="left">12 months (0, 3, 6, and 12 m evaluations)</td>
</tr>
<tr>
<td valign="top" align="left">Hutchinson et al. (<xref ref-type="bibr" rid="B21">21</xref>)</td>
<td valign="top" align="left">Public Health Nutrition</td>
<td valign="top" align="left">Leeds, United Kingdom</td>
<td valign="top" align="left">Adults with limited culinary skills</td>
<td valign="top" align="left">Teaching kitchen</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 8 weeks, 90 min/session</td>
<td valign="top" align="left">Post-course and 6 months follow-up</td>
</tr>
<tr>
<td valign="top" align="left">Bernardo et al. (<xref ref-type="bibr" rid="B22">22</xref>)</td>
<td valign="top" align="left">Appetite</td>
<td valign="top" align="left">Florian&#x000F3;polis, Santa Catarina, Brazil</td>
<td valign="top" align="left">University students</td>
<td valign="top" align="left">University teaching kitchen</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, five culinary classes</td>
<td valign="top" align="left">Before, after, and 6 months</td>
</tr>
<tr>
<td valign="top" align="left">Turner-McGrievy et al. (<xref ref-type="bibr" rid="B23">23</xref>)</td>
<td valign="top" align="left">Current Developments in Nutrition</td>
<td valign="top" align="left">Columbia, South Carolina, USA</td>
<td valign="top" align="left">Overweight adults</td>
<td valign="top" align="left">Clinic</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 12 weeks &#x0002B; monthly reinforcement</td>
<td valign="top" align="left">12 months</td>
</tr>
<tr>
<td valign="top" align="left">Derose et al. (<xref ref-type="bibr" rid="B24">24</xref>)</td>
<td valign="top" align="left">American Journal of Health Promotion</td>
<td valign="top" align="left">South Los Angeles, California, USA</td>
<td valign="top" align="left">African American and Latino adults</td>
<td valign="top" align="left">Churches</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, 5 weeks</td>
<td valign="top" align="left">5 months</td>
</tr>
<tr>
<td valign="top" align="left">Diallo et al. (<xref ref-type="bibr" rid="B25">25</xref>)</td>
<td valign="top" align="left">Public Health Nursing</td>
<td valign="top" align="left">Richmond, Virginia, USA</td>
<td valign="top" align="left">Adults and elderly</td>
<td valign="top" align="left">Activity center</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 8 weeks</td>
<td valign="top" align="left">8 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Miller et al. (<xref ref-type="bibr" rid="B26">26</xref>)</td>
<td valign="top" align="left">Nutrients</td>
<td valign="top" align="left">Glenside, Pennsylvania, USA</td>
<td valign="top" align="left">Adult cancer survivors</td>
<td valign="top" align="left">Clinic/university</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 8 weeks</td>
<td valign="top" align="left">15 weeks</td>
</tr>
<tr>
<td valign="top" align="left">West et al. (<xref ref-type="bibr" rid="B27">27</xref>)</td>
<td valign="top" align="left">Nutrients</td>
<td valign="top" align="left">Sydney, Newcastle, Melbourne, Australia</td>
<td valign="top" align="left">Low SES adults</td>
<td valign="top" align="left">Community services</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 6 weeks, 15 h total</td>
<td valign="top" align="left">6 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B28">28</xref>)</td>
<td valign="top" align="left">International Journal of Environmental Research and Public Health</td>
<td valign="top" align="left">Perth, Australia</td>
<td valign="top" align="left">Low to medium-income adults</td>
<td valign="top" align="left">Online sessions</td>
<td valign="top" align="left">Virtual</td>
<td valign="top" align="left">Four sessions of 2.5 h</td>
<td valign="top" align="left">Pre, post, and 3 months</td>
</tr>
<tr>
<td valign="top" align="left">Reicks et al. (<xref ref-type="bibr" rid="B29">29</xref>)</td>
<td valign="top" align="left">Journal of Nutrition Education and Behavior</td>
<td valign="top" align="left">St. Paul, Minnesota, USA</td>
<td valign="top" align="left">General adults</td>
<td valign="top" align="left">Community and health centers</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, six classes</td>
<td valign="top" align="left">6 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Asher et al. (<xref ref-type="bibr" rid="B31">31</xref>)</td>
<td valign="top" align="left">Journal of Human Nutrition and Dietetics</td>
<td valign="top" align="left">Callaghan, NSW, Australia</td>
<td valign="top" align="left">Professionals in health, education, horticulture</td>
<td valign="top" align="left">Online course</td>
<td valign="top" align="left">Virtual</td>
<td valign="top" align="left">Weekly, five modules</td>
<td valign="top" align="left">5 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Rainville et al. (<xref ref-type="bibr" rid="B32">32</xref>)</td>
<td valign="top" align="left">Journal of Hunger &#x00026; Environmental Nutrition</td>
<td valign="top" align="left">Hamtramck, Michigan, USA</td>
<td valign="top" align="left">Low-income residents</td>
<td valign="top" align="left">University health center</td>
<td valign="top" align="left">Virtual</td>
<td valign="top" align="left">Weekly, four classes</td>
<td valign="top" align="left">4 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Ylitalo et al. (<xref ref-type="bibr" rid="B33">33</xref>)</td>
<td valign="top" align="left">Nutrients</td>
<td valign="top" align="left">McLennan County, Texas, USA</td>
<td valign="top" align="left">Low-income adults</td>
<td valign="top" align="left">Clinic</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Four to six sessions</td>
<td valign="top" align="left">6 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B30">30</xref>)</td>
<td valign="top" align="left">Journal of Nutrition Education and Behavior</td>
<td valign="top" align="left">Perth, Australia</td>
<td valign="top" align="left">General adults</td>
<td valign="top" align="left">Mixed (not specified)</td>
<td valign="top" align="left">Hybrid</td>
<td valign="top" align="left">Weekly, four classes</td>
<td valign="top" align="left">3 months follow-up</td>
</tr>
<tr>
<td valign="top" align="left">Williams et al. (<xref ref-type="bibr" rid="B34">34</xref>)</td>
<td valign="top" align="left">Journal of the Academy of Nutrition and Dietetics</td>
<td valign="top" align="left">Columbus, Ohio, USA</td>
<td valign="top" align="left">Adults with diabetes</td>
<td valign="top" align="left">University</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly for 6 weeks</td>
<td valign="top" align="left">6 weeks &#x0002B; 3-month evaluation</td>
</tr>
<tr>
<td valign="top" align="left">Kearsey et al. (<xref ref-type="bibr" rid="B35">35</xref>)</td>
<td valign="top" align="left">Journal of Human Nutrition and Dietetics</td>
<td valign="top" align="left">Australia (multiple locations)</td>
<td valign="top" align="left">Low-income adults at risk of food insecurity</td>
<td valign="top" align="left">Community centers</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, 2.5 h for 6 weeks</td>
<td valign="top" align="left">Immediate and 6 months</td>
</tr>
<tr>
<td valign="top" align="left">Barr-Porter et al. (<xref ref-type="bibr" rid="B36">36</xref>)</td>
<td valign="top" align="left">International Journal of Environmental Research and Public Health</td>
<td valign="top" align="left">Lexington, Kentucky, USA</td>
<td valign="top" align="left">University students</td>
<td valign="top" align="left">Teaching kitchens</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Four sessions, 90 min each</td>
<td valign="top" align="left">16 weeks</td>
</tr>
<tr>
<td valign="top" align="left">French et al. (<xref ref-type="bibr" rid="B37">37</xref>)</td>
<td valign="top" align="left">Nutrients</td>
<td valign="top" align="left">Berkeley, California, USA</td>
<td valign="top" align="left">University students</td>
<td valign="top" align="left">Teaching kitchen</td>
<td valign="top" align="left">In-person</td>
<td valign="top" align="left">Weekly, 14 classes</td>
<td valign="top" align="left">14 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Domper et al. (<xref ref-type="bibr" rid="B38">38</xref>)</td>
<td valign="top" align="left">Nutrients</td>
<td valign="top" align="left">San Sebastian, Spain</td>
<td valign="top" align="left">Overweight and obese adults</td>
<td valign="top" align="left">Online sessions</td>
<td valign="top" align="left">Virtual</td>
<td valign="top" align="left">4 weeks, two sessions per week</td>
<td valign="top" align="left">4 weeks</td>
</tr>
<tr>
<td valign="top" align="left">Heredia et al. (<xref ref-type="bibr" rid="B39">39</xref>)</td>
<td valign="top" align="left">Journal of Nutrition Education and Behavior</td>
<td valign="top" align="left">Houston and Dallas, Texas, USA</td>
<td valign="top" align="left">Adults with type 2 diabetes</td>
<td valign="top" align="left">Videoconference</td>
<td valign="top" align="left">Virtual</td>
<td valign="top" align="left">Biweekly or weekly, five sessions</td>
<td valign="top" align="left">6 months</td>
</tr></tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>2.5 Synthesis of results</title>
<p>A narrative synthesis was conducted, summarizing study characteristics and organizing results by year of publication. Data were systematically presented in <xref ref-type="table" rid="T1">Tables 1</xref>&#x02013;<xref ref-type="table" rid="T3">3</xref>. <xref ref-type="table" rid="T1">Table 1</xref> provides an overview of the general study information, including study references, publication period, country, workshop setting, presentation mode (in-person, virtual, or hybrid), target population, frequency of workshops, and follow-up duration. <xref ref-type="table" rid="T2">Table 2</xref> focuses on the specifics of the culinary interventions, such as the fresh foods used, culinary preparations, food consumption patterns, and dietary autonomy, with measures like self-reports and Food Frequency Questionnaires (FFQ). <xref ref-type="table" rid="T3">Table 3</xref> summarizes the health outcomes, including changes in anthropometric measures, quality of life, and clinical indicators, alongside the tools used for these assessments, such as self-reported questionnaires and the SF-36.</p>
<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption><p>Study information: foods, culinary preparations, food consumption, autonomy in food choices, and main results.</p></caption>
<table frame="box" rules="all">
<thead>
<tr style="background-color:#919498;color:#ffffff">
<th valign="top" align="left"><bold>References</bold></th>
<th valign="top" align="left"><bold>Foods</bold></th>
<th valign="top" align="left"><bold>Culinary preparations</bold></th>
<th valign="top" align="left"><bold>Food consumption</bold></th>
<th valign="top" align="left"><bold>Main results</bold></th>
<th valign="top" align="left"><bold>Autonomy in food choices</bold></th>
<th valign="top" align="left"><bold>Main results</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Castagnetta et al. (<xref ref-type="bibr" rid="B11">11</xref>)</td>
<td valign="top" align="left">Ingredients from the mediterranean diet were used, such as whole grains, fish, vegetables, olive oil, cheeses, and dairy products, and the participants were instructed to avoid refined carbohydrates, salt, and animal fats</td>
<td valign="top" align="left">The culinary preparations incorporated typical mediterranean diet recipes, featuring dishes based on legumes, whole grains, vegetables, and fish; however, specific recipes were not detailed</td>
<td valign="top" align="left">Assessed through a food frequency questionnaire and 24-h dietary recalls</td>
<td valign="top" align="left">There were significant improvements in the consumption of healthy foods, such as fruits, vegetables, and fish (<italic>p</italic> &#x0003C; 0.001)</td>
<td valign="top" align="left">Culinary skills were analyzed, but there is no mention of the use of specific instruments for their assessment</td>
<td valign="top" align="left">The participants acquired culinary skills and knowledge to independently follow the mediterranean diet</td>
</tr>
<tr>
<td valign="top" align="left">Pierce et al. (<xref ref-type="bibr" rid="B12">12</xref>)</td>
<td valign="top" align="left">A wide variety of vegetables and fruits was encouraged, aiming for a high-fiber, low-fat diet, although the study did not specifically detail the ingredients</td>
<td valign="top" align="left">Specific preparations were not described, but the focus was on promoting a diet rich in vegetables and fruits with a low fat content</td>
<td valign="top" align="left">Assessed through 24-h dietary recall</td>
<td valign="top" align="left">An increase in vegetables, fruit, and fiber intake and a reduction in fat intake were observed</td>
<td valign="top" align="left">Not reported.</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Newman et al. (<xref ref-type="bibr" rid="B13">13</xref>)</td>
<td valign="top" align="left">Vegetables, fruits, whole grains, and high-fiber foods (e.g., dark leafy greens, citrus fruits)</td>
<td valign="top" align="left">Quick meal recipes, healthy dishes, use of nutrition labels, preparation of potlucks, and healthy eating at parties</td>
<td valign="top" align="left">Measured through self-reports and 24-h dietary recalls validated with tools such as NDS-R</td>
<td valign="top" align="left">The intervention resulted in increased intake of vegetables, fruits, and fiber, as reported by participants. There was also a reduction in fat consumption</td>
<td valign="top" align="left">Assessed by adherence to the protocol, attendance at cooking classes, and diet adherence scores (WHEL adherence Score)</td>
<td valign="top" align="left">Higher diet adherence was associated with greater participation in cooking classes. The average adherence score increased from 249 to 419 points over 12 months</td>
</tr>
<tr>
<td valign="top" align="left">Brown et al. (<xref ref-type="bibr" rid="B63">63</xref>)</td>
<td valign="top" align="left">Fruits and vegetables</td>
<td valign="top" align="left">Included salads, soups, vegetable dishes, smoothies, and healthy snacks</td>
<td valign="top" align="left">Measured through self-reported questionnaires</td>
<td valign="top" align="left">The study showed a significant increase in the consumption of fruits and vegetables. The average number of servings consumed daily increased for both youth and adults</td>
<td valign="top" align="left">Measured through self-reported questionnaires before and after the intervention</td>
<td valign="top" align="left">There was an increase in participants confidence to prepare food safely and healthily</td>
</tr>
<tr>
<td valign="top" align="left">Wrieden et al. (<xref ref-type="bibr" rid="B14">14</xref>)</td>
<td valign="top" align="left">Fruits and vegetables</td>
<td valign="top" align="left">Preparations included pasta bake, soup, minced meat-based dishes, rice, pizza, chicken curry, and healthy cakes</td>
<td valign="top" align="left">Measured through food diaries and food frequency questionnaires (FFQ)</td>
<td valign="top" align="left">Increase in the frequency of fruit consumption, but not sustained at 6 months</td>
<td valign="top" align="left">Measured through questionnaires assessing confidence in preparing and using basic ingredients</td>
<td valign="top" align="left">Significant increase in kitchen confidence, with reports of preparing more meals from basic ingredients and new recipes</td>
</tr>
<tr>
<td valign="top" align="left">Cutler et al. (<xref ref-type="bibr" rid="B15">15</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, whole grains, low-fat dairy products, and healthy fats such as olive oil</td>
<td valign="top" align="left">Healthy dishes, including salads, healthy desserts, snacks, and balanced meals based on vegetables and other foods recommended by a healthy diet</td>
<td valign="top" align="left">Measured through food frequency questionnaire (FFQ)</td>
<td valign="top" align="left">Increased consumption of fruits and vegetables and reduced fat intake in the intervention group</td>
<td valign="top" align="left">Confidence in adopting a healthy diet, measured through self-assessment questionnaires</td>
<td valign="top" align="left">Reported increase in confidence to adopt a healthy diet</td>
</tr>
<tr>
<td valign="top" align="left">Flynn et al. (<xref ref-type="bibr" rid="B16">16</xref>)</td>
<td valign="top" align="left">Plant-based ingredients, such as vegetables, fruits, and extra virgin olive oil</td>
<td valign="top" align="left">Simple but unspecified plant-based recipes</td>
<td valign="top" align="left">Measured through self-report, food habits questionnaire, and supermarket purchase records</td>
<td valign="top" align="left">Significant increase in the consumption of vegetables and fruits, with 78% of participants reporting higher vegetable intake and 44% reporting higher fruit intake after follow-up</td>
<td valign="top" align="left">Measured through self-report and questionnaire on changes in food purchases and consumption after the program</td>
<td valign="top" align="left">68% of participants reported using a food pantry at the beginning of the program, decreasing to 54% at follow-up. The food insecurity score (FIS) improved, with a significant reduction in the number of participants classified as food insecure</td>
</tr>
<tr>
<td valign="top" align="left">Cuy Castellanos et al. (<xref ref-type="bibr" rid="B17">17</xref>)</td>
<td valign="top" align="left">Fruits and vegetables</td>
<td valign="top" align="left">Various preparations, but not specified</td>
<td valign="top" align="left">Measured through a block fruit and vegetable screener, estimating the frequency of fruit and vegetable consumption</td>
<td valign="top" align="left">Fruit and vegetable consumption increased from a &#x0201C;good&#x0201D; to an &#x0201C;excellent&#x0201D; score based on the Screener</td>
<td valign="top" align="left">Measured through an adapted questionnaire assessing the ability to access and prepare foods</td>
<td valign="top" align="left">Participants reported an increased ability to prepare healthy foods and incorporate them into their daily diet</td>
</tr>
<tr>
<td valign="top" align="left">Bennett et al. (<xref ref-type="bibr" rid="B18">18</xref>)</td>
<td valign="top" align="left">Ingredients not specified in detail but referring to healthy foods</td>
<td valign="top" align="left">Preparation of healthy meals, including learning to cook simple dishes</td>
<td valign="top" align="left">Not specified; evaluation was mainly based on qualitative interviews</td>
<td valign="top" align="left">Participants mentioned they began eating more fresh foods and making healthier food choices</td>
<td valign="top" align="left">Measured through self-report, where participants reported their ability to cook independently</td>
<td valign="top" align="left">Increase in perceived autonomy in meal preparation</td>
</tr>
<tr>
<td valign="top" align="left">Dannefer et al. (<xref ref-type="bibr" rid="B19">19</xref>)</td>
<td valign="top" align="left">Fresh seasonal produce, focusing on local fruits and vegetables</td>
<td valign="top" align="left">Preparations consisted of simple and healthy dishes emphasizing the use of fruits and vegetables, without specific names provided</td>
<td valign="top" align="left">Measured through food frequency questionnaire (FFQ) and participants&#x00027; self-reports on the number of fruits and vegetables consumed</td>
<td valign="top" align="left">There was an increase in daily fruit and vegetable consumption among participants who attended the workshops</td>
<td valign="top" align="left">Measured through a self-efficacy scale</td>
<td valign="top" align="left">Participants showed greater self-confidence in preparing and consuming fruits and vegetables after the classes</td>
</tr>
<tr>
<td valign="top" align="left">Greenlee et al. (<xref ref-type="bibr" rid="B20">20</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, and lean proteins</td>
<td valign="top" align="left">Traditional dishes adapted with a focus on vegetables and fat reduction, using healthier cooking methods</td>
<td valign="top" align="left">Measured by 24-h dietary recalls</td>
<td valign="top" align="left">Increased intake of fruits and vegetables</td>
<td valign="top" align="left">Not reported</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Hutchinson et al. (<xref ref-type="bibr" rid="B21">21</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, whole grains, and lean proteins</td>
<td valign="top" align="left">Healthy and simple preparations, such as soups, salads, and vegetable-based dishes, with an emphasis on reducing salt, fat, and sugar in recipes</td>
<td valign="top" align="left">Measured through food frequency questionnaires (FFQ) and self-assessment questionnaires</td>
<td valign="top" align="left">There was an increase in the consumption of fruits, vegetables, and water, and a decrease in the consumption of ultra-processed foods</td>
<td valign="top" align="left">Confidence in preparing healthy foods assessed through self-assessment questionnaires</td>
<td valign="top" align="left">Participants showed an increase in their confidence to prepare healthy foods</td>
</tr>
<tr>
<td valign="top" align="left">Bernardo et al. (<xref ref-type="bibr" rid="B22">22</xref>)</td>
<td valign="top" align="left">The study did not specify the exact ingredients used during the culinary sessions</td>
<td valign="top" align="left">Preparations were not specified</td>
<td valign="top" align="left">Self-assessment questionnaires</td>
<td valign="top" align="left">Increased self-efficacy in using fruits and vegetables and increased accessibility and availability of these foods at home</td>
<td valign="top" align="left">Cooking confidence measured on a five-point scale from &#x0201C;not confident&#x0201D; to &#x0201C;extremely confident&#x0201D;. Culinary techniques knowledge assessed by eight multiple-choice questions. Attitudes toward healthy eating assessed using a five-point likert scale from &#x0201C;strongly disagree&#x0201D; to &#x0201C;strongly agree&#x0201D;</td>
<td valign="top" align="left">Improvements were reported in cooking confidence, culinary knowledge, and attitudes toward healthy eating</td>
</tr>
<tr>
<td valign="top" align="left">Turner-McGrievy et al. (<xref ref-type="bibr" rid="B23">23</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, legumes</td>
<td valign="top" align="left">Low-inflammatory index recipes</td>
<td valign="top" align="left">24-h dietary recalls applied on weekdays and weekends, with interviews conducted by nutritionists, including visual evaluation of food portions validated by NDSR software</td>
<td valign="top" align="left">The study showed that participants in the intervention group, following an anti-inflammatory diet, had a significant reduction in the Dietary Inflammatory Index (DII) after 3 months, indicating temporary improvement in food choices toward healthier options</td>
<td valign="top" align="left">Measurement of food autonomy was carried out through self-reported questionnaires covering eating habits, preferences, and food preparation skills</td>
<td valign="top" align="left">Participants&#x00027; food autonomy, promoted through cooking classes and nutrition education, led to healthier food choices and a reduction in DII scores</td>
</tr>
<tr>
<td valign="top" align="left">Derose et al. (<xref ref-type="bibr" rid="B24">24</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, whole grains, and lean proteins</td>
<td valign="top" align="left">Healthy meals such as salads, soups, vegetable dishes, and healthy snack options</td>
<td valign="top" align="left">Measured by food frequency questionnaires (FFQ) and self-assessment questionnaires</td>
<td valign="top" align="left">Significant increase in fruit and vegetable consumption and improvement in diet quality among participants in the intervention group</td>
<td valign="top" align="left">Measurement was carried out through self-assessment questionnaires</td>
<td valign="top" align="left">Increased self-efficacy and confidence in preparing healthy foods and maintaining a balanced diet were observed</td>
</tr>
<tr>
<td valign="top" align="left">Miller et al. (<xref ref-type="bibr" rid="B26">26</xref>)</td>
<td valign="top" align="left">Whole grains, vegetables, fruits, beans</td>
<td valign="top" align="left">Salads (e.g., Quinoa salad, southwestern bean salad), smoothies (e.g., everyday green smoothie), practical meals (one-pot meals), and other vegetarian dishes</td>
<td valign="top" align="left">Measured using the dietary screener questionnaire (DSQ), reduced NHANES version, estimating daily intake of fruits, vegetables, whole grains, and processed meats</td>
<td valign="top" align="left">Significant reduction in processed meat intake (<italic>p</italic> &#x0003C; 0.05) and increased consumption of plant-based foods and grains</td>
<td valign="top" align="left">Indirectly measured through three scales: confidence in preparing healthy foods, skills for maintaining a plant-based diet, perceived control over cancer progression</td>
<td valign="top" align="left">Significant increase in confidence by week 15 (<italic>p</italic> &#x0003C; 0.05); culinary skills also significantly improved (<italic>p</italic> &#x0003C; 0.05); trend toward improved perceived control over cancer</td>
</tr>
<tr>
<td valign="top" align="left">Diallo et al. (<xref ref-type="bibr" rid="B25">25</xref>)</td>
<td valign="top" align="left">Vegetables, fruits, whole grains, and lean proteins</td>
<td valign="top" align="left">Preparation of recipes focused on low salt, sugar, and fat content, though specific preparations were not detailed</td>
<td valign="top" align="left">Measured by food frequency questionnaires (FFQ)</td>
<td valign="top" align="left">Significant increase in fresh vegetable consumption among participants</td>
<td valign="top" align="left">Measured through self-assessment questionnaires</td>
<td valign="top" align="left">Participants reported increased confidence in preparing healthy foods</td>
</tr>
<tr>
<td valign="top" align="left">West et al. (<xref ref-type="bibr" rid="B27">27</xref>)</td>
<td valign="top" align="left">Unprocessed ingredients (not specifically detailed)</td>
<td valign="top" align="left">Preparation of healthy meals not specified</td>
<td valign="top" align="left">Measured through self-report and 24-h dietary recall</td>
<td valign="top" align="left">Significant increase in vegetable consumption and significant reduction in the intake of sugary beverages and salty snacks</td>
<td valign="top" align="left">Measured through self-report</td>
<td valign="top" align="left">Participants felt greater control over their food choices</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B28">28</xref>)</td>
<td valign="top" align="left">Ingredients not specified</td>
<td valign="top" align="left">Recipes prepared were not detailed</td>
<td valign="top" align="left">Self-reported dietary behavior questionnaires</td>
<td valign="top" align="left">Reported improvements in vegetable consumption</td>
<td valign="top" align="left">Food literacy and culinary confidence were assessed through self-report questionnaires at the beginning, end, and 3 months after the program</td>
<td valign="top" align="left">Improvements or maintenance in food literacy skills and improvements in culinary confidence were reported</td>
</tr>
<tr>
<td valign="top" align="left">Reicks et al. (<xref ref-type="bibr" rid="B29">29</xref>)</td>
<td valign="top" align="left">Plant-based foods, including leafy greens, whole grains, beans, and tubers</td>
<td valign="top" align="left">Two to three recipes per lesson, focusing on food groups from the African heritage diet pyramid</td>
<td valign="top" align="left">Measured through food frequency questionnaire (FFQ) and self-reported food intake</td>
<td valign="top" align="left">Significant increase in the frequency of fruit, vegetable, and greens consumption after participation in the program</td>
<td valign="top" align="left">Measured through direct and open-ended questions on the frequency of food preparation and consumption</td>
<td valign="top" align="left">Increased confidence and creativity: greater use of natural seasonings, reduction in salt, preparation of vegetable and Afrocentric dishes. 98% reported cultural motivation</td>
</tr>
<tr>
<td valign="top" align="left">Asher et al. (<xref ref-type="bibr" rid="B31">31</xref>)</td>
<td valign="top" align="left">Emphasized different methods of vegetable preparation, but specific ingredients were not detailed</td>
<td valign="top" align="left">Preparations not specifically described</td>
<td valign="top" align="left">Pre- and post-program questionnaires</td>
<td valign="top" align="left">Statistically significant increases observed in vegetable, fruit, and bread/cereal consumption after the intervention</td>
<td valign="top" align="left">Confidence in food skills and nutritional knowledge measured through pre- and post-program questionnaires</td>
<td valign="top" align="left">Significant increases and large effects observed in confidence in food skills and nutritional knowledge scores</td>
</tr>
<tr>
<td valign="top" align="left">Rainville et al. (<xref ref-type="bibr" rid="B32">32</xref>)</td>
<td valign="top" align="left">Quinoa, spinach, assorted vegetables, ingredients for spinach and feta dips, potatoes, etc.</td>
<td valign="top" align="left">Toasted mediterranean quinoa and spinach, chopped colorful vegetable salad, green beans and red potatoes, creamy spinach and feta dip</td>
<td valign="top" align="left">Measured through self-report</td>
<td valign="top" align="left">Increased consumption of fruits, vegetables, and whole grains, with 100% of participants adopting the habit of reading food labels</td>
<td valign="top" align="left">Measured through self-report</td>
<td valign="top" align="left">At the end of the program, participants reported increased confidence and cooking skills</td>
</tr>
<tr>
<td valign="top" align="left">Williams et al. (<xref ref-type="bibr" rid="B34">34</xref>)</td>
<td valign="top" align="left">Fresh fruits and vegetables, including leafy greens</td>
<td valign="top" align="left">Healthy dishes such as salads and cooked meals</td>
<td valign="top" align="left">Measured through self-report and 24-h dietary recall</td>
<td valign="top" align="left">Significant increase in vegetable consumption and significant reduction in sugary beverage and salty snack intake</td>
<td valign="top" align="left">Indirectly evaluated through dietary self-care scores (SDSCA, DSMQ) and perceived control via the self-efficacy scale; questions on recipe preparation and label reading</td>
<td valign="top" align="left">Significant increase in SDSCA diet score post-intervention (&#x0002B;1.49, <italic>p</italic> = 0.014); DSMQ diet control score also increased (&#x0002B;0.72, <italic>p</italic> = 0.013)</td>
</tr>
<tr>
<td valign="top" align="left">Ylitalo et al. (<xref ref-type="bibr" rid="B33">33</xref>)</td>
<td valign="top" align="left">Fresh produce (fruits and vegetables)</td>
<td valign="top" align="left">Food preparation (including shared meals)</td>
<td valign="top" align="left">Measured through self-report on fruit and vegetable consumption with visual aids</td>
<td valign="top" align="left">Increase in vegetable intake to &#x02265;2 cups/day from 25 to 38% of participants (<italic>p</italic> &#x0003C; 0.001); fruits: increase from 19 to 38% (not statistically significant)</td>
<td valign="top" align="left">Measured through validated scales: behavior change strategies for healthy eating scale (BCSHES) and culinary self-efficacy (12 items assessing confidence, skills, and attitudes toward healthy meal preparation)</td>
<td valign="top" align="left">Significant increases observed: culinary self-efficacy (&#x00394; = &#x0002B;0.6 points, <italic>p</italic> &#x0003C; 0.001); Dietary management (&#x00394; = &#x0002B;0.7 points, <italic>p</italic> &#x0003C; 0.001)</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B30">30</xref>)</td>
<td valign="top" align="left">Vegetables were used as ingredients, but not specified</td>
<td valign="top" align="left">Preparations were not detailed, only mentioned the use of vegetables for main meals and snacks</td>
<td valign="top" align="left">Measured by the food literacy behavior checklist (FLBC) and semi-structured questionnaire</td>
<td valign="top" align="left">Participants increased their average daily vegetable consumption by 22.6% (0.5 servings)</td>
<td valign="top" align="left">Food literacy assessed through the FLBC, evaluating behaviors related to planning, selecting, and preparing foods; increase in vegetable consumption measured by questions on fruit and vegetable portions consumed, recorded during program assessments</td>
<td valign="top" align="left">Participants reported significant improvements in two food literacy domains: planning and management (&#x0002B;12.4%) and preparation (&#x0002B;9.8%)</td>
</tr>
<tr>
<td valign="top" align="left">Barr-Porter et al. (<xref ref-type="bibr" rid="B36">36</xref>)</td>
<td valign="top" align="left">Ingredients not specifically detailed</td>
<td valign="top" align="left">Prepared recipes were not detailed</td>
<td valign="top" align="left">Healthy eating index &#x0201C;short healthy eating index&#x0201D; (sHEI)</td>
<td valign="top" align="left">Increase in total vegetable consumption and general improvements in diet quality</td>
<td valign="top" align="left">Not reported</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">French et al. (<xref ref-type="bibr" rid="B37">37</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, and lean proteins</td>
<td valign="top" align="left">Participants prepared vegetable-based dishes, soups, salads, and quick meals</td>
<td valign="top" align="left">Measured by food frequency questionnaires (FFQ)</td>
<td valign="top" align="left">Increase in vegetable and fruit consumption among participants in the intervention group</td>
<td valign="top" align="left">Measured through self-assessment questionnaires</td>
<td valign="top" align="left">Increased food confidence observed among participants, with improvements in the ability to prepare meals and adopt healthy eating habits</td>
</tr>
<tr>
<td valign="top" align="left">Kearsey et al. (<xref ref-type="bibr" rid="B35">35</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, lean proteins, and whole grains</td>
<td valign="top" align="left">Preparations included simple and healthy dishes such as soups, salads, vegetable meals, and whole grain-based dishes</td>
<td valign="top" align="left">Measured by food frequency questionnaires (FFQ) and self-assessment questionnaires</td>
<td valign="top" align="left">Increase in fruit, vegetable, and water consumption and decrease in ultra-processed food intake</td>
<td valign="top" align="left">Culinary confidence and meal planning confidence measured through self-assessment questionnaires</td>
<td valign="top" align="left">Increased culinary confidence among participants, with greater confidence in cooking and meal planning</td>
</tr>
<tr>
<td valign="top" align="left">Domper et al. (<xref ref-type="bibr" rid="B38">38</xref>)</td>
<td valign="top" align="left">Mediterranean diet ingredients, such as legumes, fruits, proteins, olive oil, and whole grains</td>
<td valign="top" align="left">Preparations included typical Mediterranean dishes such as pesto, green curry, baba ganoush, vegetable salmorejo, and fruit ceviche</td>
<td valign="top" align="left">Measured by food frequency questionnaires (FFQ)</td>
<td valign="top" align="left">Reported increase in the consumption of vegetables, legumes, and nuts among participants in the culinary intervention group (CIG)</td>
<td valign="top" align="left">Culinary self-confidence and attitudes toward cooking measured through self-assessment questionnaires</td>
<td valign="top" align="left">Observed increase in confidence to cook at home and modify recipes to make them healthier</td>
</tr>
<tr>
<td valign="top" align="left">Heredia et al. (<xref ref-type="bibr" rid="B39">39</xref>)</td>
<td valign="top" align="left">Fruits, vegetables, whole grains, lean proteins, and healthy fats</td>
<td valign="top" align="left">Soups, salads, vegetable-based dishes, and healthy recipes</td>
<td valign="top" align="left">Measured through food frequency questionnaires (FFQ) and 24-h food records</td>
<td valign="top" align="left">Observed increase in the consumption of fruits and vegetables among participants, particularly in whole grains and lean proteins</td>
<td valign="top" align="left">Confidence in cooking healthy foods, culinary skills, and diet control measured through self-assessment questionnaires</td>
<td valign="top" align="left">Participants reported increased confidence in preparing healthy foods and managing their diets</td>
</tr></tbody>
</table>
</table-wrap>
<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption><p>Study information: health outcomes, anthropometric measures, quality of life, and main results.</p></caption>
<table frame="box" rules="all">
<thead>
<tr style="background-color:#919498;color:#ffffff">
<th valign="top" align="left"><bold>References</bold></th>
<th valign="top" align="left"><bold>Health outcomes</bold></th>
<th valign="top" align="left"><bold>Main results</bold></th>
<th valign="top" align="left"><bold>Anthropometric measures</bold></th>
<th valign="top" align="left"><bold>Main results</bold></th>
<th valign="top" align="left"><bold>Quality of life</bold></th>
<th valign="top" align="left"><bold>Main results</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Castagnetta et al. (<xref ref-type="bibr" rid="B11">11</xref>)</td>
<td valign="top" align="left">Control of cholesterol levels</td>
<td valign="top" align="left">A reduction in cholesterol levels among participants was observed</td>
<td valign="top" align="left">Body weight, waist circumference, and hip circumference were measured before and at the end of the study</td>
<td valign="top" align="left">A significant weight loss was observed in the group that followed the Mediterranean diet during the follow-up period</td>
<td valign="top" align="left">Self-report</td>
<td valign="top" align="left">Participants reported an increased sense of psychophysical wellbeing after the intervention</td>
</tr>
<tr>
<td valign="top" align="left">Pierce et al. (<xref ref-type="bibr" rid="B12">12</xref>)</td>
<td valign="top" align="left">Occurrence of new breast cancer events and survival of previously treated participants</td>
<td valign="top" align="left">No significant differences were found in breast cancer recurrence or mortality between the intervention and comparison groups. Rates of invasive cancer events were similar across groups</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Quality of life was assessed using the &#x0201C;thoughts and feelings questionnaire,&#x0201D; focusing on psychosocial functioning, although the main focus of the study was on health outcomes related to cancer recurrence and mortality</td>
<td valign="top" align="left">Quality of life results were not detailed in the results section, possibly because they were not a priority outcome or did not show significant differences considered worthy of highlight by the authors</td>
</tr>
<tr>
<td valign="top" align="left">Newman et al. (<xref ref-type="bibr" rid="B13">13</xref>)</td>
<td valign="top" align="left">Blood carotenoid levels</td>
<td valign="top" align="left">Results validated by an increase in blood carotenoid levels</td>
<td valign="top" align="left">BMI and nutritional risk assessed through the elderly nutrition screening questionnaire</td>
<td valign="top" align="left">Mean BMI at baseline: 26.7 kg/m<sup>2</sup>. Weight change was not reported as a main outcome nor analyzed in detail in the results</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Brown et al. (<xref ref-type="bibr" rid="B63">63</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Wrieden et al. (<xref ref-type="bibr" rid="B14">14</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Cutler et al. (<xref ref-type="bibr" rid="B15">15</xref>)</td>
<td valign="top" align="left">Cholesterol levels</td>
<td valign="top" align="left">A reduction in LDL cholesterol and total cholesterol levels was recorded</td>
<td valign="top" align="left">Body weight and waist circumference</td>
<td valign="top" align="left">No significant changes were found in body weight or waist circumference during the follow-up period</td>
<td valign="top" align="left">Self-report</td>
<td valign="top" align="left">Improvements were observed in aspects related to quality of life, such as psychological wellbeing and satisfaction with exercise practices</td>
</tr>
<tr>
<td valign="top" align="left">Flynn et al. (<xref ref-type="bibr" rid="B16">16</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Weight and Height/BMI; Waist circumference</td>
<td valign="top" align="left">There was a significant reduction in BMI (from 33.3 &#x000B1; 8.5 to 32.9 &#x000B1; 8.4, <italic>p</italic> = 0.05) and in waist circumference (from 96.2 &#x000B1; 16.8 cm to 95.3 &#x000B1; 16.2 cm, <italic>p</italic> = 0.05). Forty-nine percent of participants lost an average of 5.0 kg (<italic>p</italic> = 0.04)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Cuy Castellanos et al. (<xref ref-type="bibr" rid="B17">17</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Bennett et al. (<xref ref-type="bibr" rid="B18">18</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Indirectly measured through participant feedback on satisfaction and self-efficacy</td>
<td valign="top" align="left">Participants reported feeling more capable and satisfied with their culinary skills and social life</td>
</tr>
<tr>
<td valign="top" align="left">Dannefer et al. (<xref ref-type="bibr" rid="B19">19</xref>)</td>
<td valign="top" align="left">Diabetes and cholesterol control and improved digestion</td>
<td valign="top" align="left">Participants reported health improvements as a result of participating in the program workshops, including better control of diabetes and cholesterol, improved digestion, and weight loss</td>
<td valign="top" align="left">Body weight and BMI</td>
<td valign="top" align="left">The study did not report significant changes in anthropometric measures such as weight or BMI</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Greenlee et al. (<xref ref-type="bibr" rid="B20">20</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Body weight, BMI, and waist circumference</td>
<td valign="top" align="left">A reduction in waist circumference was observed among participants in the intervention group, but no significant changes were found in body weight or BMI</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Hutchinson et al. (<xref ref-type="bibr" rid="B21">21</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Self-report</td>
<td valign="top" align="left">Participants reported improvements in overall wellbeing due to increased culinary confidence and improved eating habits</td>
</tr>
<tr>
<td valign="top" align="left">Bernardo et al. (<xref ref-type="bibr" rid="B22">22</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Turner-McGrievy et al. (<xref ref-type="bibr" rid="B23">23</xref>)</td>
<td valign="top" align="left">Dietary inflammatory index (DII), inflammatory biomarkers (CRP, interleukin-6, and TNF-alpha), lipid profile (total cholesterol, LDL, HDL, triglycerides)</td>
<td valign="top" align="left">The intervention group had a reduction in DII at 3 months, but no significant difference at 12 months. After 12 months, a 0.65 mg/L decrease in CRP and improvements in total cholesterol (&#x02212;9.38 mg/dl) and LDL (&#x02212;11.99 mg/dl) were observed among participants with greater DII reduction</td>
<td valign="top" align="left">Weight, height, BMI</td>
<td valign="top" align="left">Participants were overweight or obese; differences after the intervention were not highlighted</td>
<td valign="top" align="left">Health and lifestyle habits data collected via self-report and the perceived stress scale to measure stress levels</td>
<td valign="top" align="left">Stress and physical activity did not change significantly between groups. Observed changes in biomarkers were not mediated by these factors but rather by changes in DII</td>
</tr>
<tr>
<td valign="top" align="left">Derose et al. (<xref ref-type="bibr" rid="B24">24</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Body weight and BMI</td>
<td valign="top" align="left">A reduction in BMI and decreased weight gain were observed among participants in the intervention group compared to the control group</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Miller et al. (<xref ref-type="bibr" rid="B26">26</xref>)</td>
<td valign="top" align="left">PHQ-4 (four items for depression and anxiety)</td>
<td valign="top" align="left">A slight reduction in distress was observed in the intervention group by week 9, but the effect was not sustained by week 15. The variation did not reach statistical significance</td>
<td valign="top" align="left">Self-reported weight, height, and BMI</td>
<td valign="top" align="left">The majority of participants were observed to be overweight or obese (65%)</td>
<td valign="top" align="left">Evaluated using the rapid version of the functional assessment of cancer therapy-general (FACT-G7)</td>
<td valign="top" align="left">Improvement in participants&#x00027; quality of life after the interventions, with a positive impact on reducing fatigue and improving FACT-G7 scores</td>
</tr>
<tr>
<td valign="top" align="left">Diallo et al. (<xref ref-type="bibr" rid="B25">25</xref>)</td>
<td valign="top" align="left">Management of chronic diseases such as hypertension, diabetes, obesity, cardiovascular disease, and chronic obstructive pulmonary disease</td>
<td valign="top" align="left">Participants self-reported improvements in the management of chronic diseases</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Self-report</td>
<td valign="top" align="left">Improvements in overall wellbeing and quality of life were reported, associated with increased intake of healthy foods and reduced social isolation</td>
</tr>
<tr>
<td valign="top" align="left">West et al. (<xref ref-type="bibr" rid="B27">27</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not directly evaluated; explored qualitatively through interviews about wellbeing and self-esteem</td>
<td valign="top" align="left">Participants reported feeling more confident, proud, and motivated after the intervention. Many expressed improvements in psychological and social wellbeing</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B28">28</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Reicks et al. (<xref ref-type="bibr" rid="B29">29</xref>)</td>
<td valign="top" align="left">Systolic and diastolic blood pressure</td>
<td valign="top" align="left">Significant improvement in systolic and diastolic blood pressure outcomes (<italic>p</italic> &#x0003C; 0.0001)</td>
<td valign="top" align="left">BMI and waist circumference</td>
<td valign="top" align="left">Significant weight loss and waist circumference reduction (<italic>p</italic> &#x0003C; 0.0001), with 54.1% of participants reducing their waist circumference</td>
<td valign="top" align="left">Qualitative self-report on wellbeing, satisfaction, overcoming obstacles, and motivation linked to food culture</td>
<td valign="top" align="left">Participants reported greater food awareness, enjoyment in cooking, and preparing meals with less salt and more vegetables. Reports indicated subjective improvements in wellbeing</td>
</tr>
<tr>
<td valign="top" align="left">Asher et al. (<xref ref-type="bibr" rid="B31">31</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Rainville et al. (<xref ref-type="bibr" rid="B32">32</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Williams et al. (<xref ref-type="bibr" rid="B34">34</xref>)</td>
<td valign="top" align="left">HbA1c levels, and self-care efficacy measures through SDSCA, DSMQ, and DTSQ</td>
<td valign="top" align="left">Improvement in diabetes management and quality of life among participants</td>
<td valign="top" align="left">Self-reported BMI and waist circumference</td>
<td valign="top" align="left">Reduction in BMI correlated with HbA1c reduction</td>
<td valign="top" align="left">Evaluated by the short form health survey (SF-12)</td>
<td valign="top" align="left">Improvement in the mental component score of quality of life</td>
</tr>
<tr>
<td valign="top" align="left">Ylitalo et al. (<xref ref-type="bibr" rid="B33">33</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not specifically detailed, but related to the sense of community and belonging</td>
<td valign="top" align="left">Participants reported high levels of belonging and social support during the cooking classes</td>
</tr>
<tr>
<td valign="top" align="left">Begley et al. (<xref ref-type="bibr" rid="B30">30</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Barr-Porter et al. (<xref ref-type="bibr" rid="B36">36</xref>)</td>
<td valign="top" align="left">Mental health, measured using items from the CDC healthy days module (centers for disease control and prevention)</td>
<td valign="top" align="left">The study observed significant improvements in &#x0201C;days per month with poor mental health&#x0201D; and &#x0201C;days per month feeling worried, tense, or anxious&#x0201D;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Health-related quality of life (HRQOL) instrument was used to measure participants&#x00027; quality of life</td>
<td valign="top" align="left">The study reported improvements in health-related quality of life, specifically in domains involving mental health such as sadness, depression, worry, tension, or anxiety</td>
</tr>
<tr>
<td valign="top" align="left">French et al. (<xref ref-type="bibr" rid="B37">37</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Kearsey et al. (<xref ref-type="bibr" rid="B35">35</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Food security measured by the household food security survey module (HFSSM)</td>
<td valign="top" align="left">Improvement in participants&#x00027; level of food security was observed</td>
</tr>
<tr>
<td valign="top" align="left">Domper et al. (<xref ref-type="bibr" rid="B38">38</xref>)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
<td valign="top" align="left">Body weight, BMI, waist circumference, and hip circumference</td>
<td valign="top" align="left">The culinary intervention group (CIG) showed significant reductions in all anthropometric parameters compared to the nutritional intervention group (NIG)</td>
<td valign="top" align="left">Not available</td>
<td valign="top" align="left">&#x02014;</td>
</tr>
<tr>
<td valign="top" align="left">Heredia et al. (<xref ref-type="bibr" rid="B39">39</xref>)</td>
<td valign="top" align="left">HbA1c levels, self-perception of health, and diabetes self-management skills; diastolic blood pressure</td>
<td valign="top" align="left">There was a significant reduction in HbA1c levels among participants, indicating improvements in diabetes control. Additionally, there were improvements in self-perception of health and diabetes self-management skills. No significant reduction in diastolic blood pressure was observed</td>
<td valign="top" align="left">Body weight and BMI</td>
<td valign="top" align="left">No significant changes in weight or BMI were reported</td>
<td valign="top" align="left">Self-report</td>
<td valign="top" align="left">Participants reported an improvement in quality of life, especially regarding mental wellbeing and self-perception of health</td>
</tr></tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>2.6 Outcomes</title>
<p>To characterize comprehensive food utilization, culinary workshops promoting the full use of fresh foods were considered, prioritizing healthier dietary habits. Identified strategies included culinary workshops that taught techniques for recipes using fresh foods.</p>
<p>These workshops also featured educational actions such as meal planning, safe and proper food storage guidelines, and practical recipes and techniques involving fresh and minimally processed foods.</p>
</sec>
</sec>
<sec id="s3">
<title>3 Results</title>
<p>The database search yielded 1,658 articles (<xref ref-type="fig" rid="F1">Figure 1</xref>). After removing duplicate manuscripts (<italic>n</italic> = 261), 1,397 titles and abstracts were screened, resulting in the exclusion of 1,372 studies. An initial full-text analysis was conducted on 25 studies, of which seven were excluded for the following reasons: absence of health outcomes (<italic>n</italic> = 2), cross-sectional design without pre- and post- culinary workshop measurements (<italic>n</italic> = 2), inclusion of children as part of the population (<italic>n</italic> = 2), and being study protocols (<italic>n</italic> = 1). The Google Scholar search returned numerous results, sorted by relevance; only the first 100 entries were analyzed for inclusion. Following a careful review, 88 studies were excluded due to lack of data on dietary preferences or involving child populations. Ultimately, 30 studies were included for full-text analysis (<xref ref-type="bibr" rid="B11">11</xref>&#x02013;<xref ref-type="bibr" rid="B40">40</xref>). The selected studies were published between 2002 and 2025, all of which were written in English.</p>
<fig position="float" id="F1">
<label>Figure 1</label>
<caption><p>Flowchart of search and selection of studies for inclusion in the scoping review, based on the PRISMA-ScR.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fnut-12-1653406-g0001.tif">
<alt-text>Flowchart illustrating the study selection process for a review. Identification phase shows 1,658 records from various databases, with 261 duplicates and 1,372 ineligible records removed. Screening phase examines 25 records; 18 progress as eligible, while 7 are excluded for specific reasons. An additional hand search identifies 100 records from Google Scholar, with 88 excluded. Ultimately, 30 studies are included in the review: 18 from databases and 12 from the hand search. The process involves stages of identification, screening, and inclusion.</alt-text>
</graphic>
</fig>
<p>Among the selected studies, the majority were conducted in the United States (60%) and Australia (16.66%), likely reflecting the research funding and infrastructure available in these countries. The United Kingdom (6.66%), Spain, Italy, Ireland, New Zealand, and Brazil each accounted for 3.33% of the studies (<xref ref-type="table" rid="T1">Table 1</xref>).</p>
<p>Analysis of the target groups revealed a strong focus on vulnerable populations, including individuals with low socioeconomic status, adults with preexisting health conditions (such as diabetes, cancer, and obesity), and ethnically diverse communities, notably Indigenous, African American, and Hispanic groups. Culinary and nutritional interventions were primarily implemented in community and healthcare settings, such as community centers, clinics, and food distribution organizations.</p>
<p><xref ref-type="table" rid="T1">Table 1</xref> summarizes the key characteristics of the studies included in this review, highlighting important details such as the location of the workshops, the populations involved, the delivery modes (whether in-person, virtual, or hybrid), and the frequency and duration of each intervention (<xref ref-type="table" rid="T1">Table 1</xref>).</p>
<p>Educational contexts, both formal (universities and hospitality schools) and informal (online courses), as well as farmers&#x00027; markets and rural extension services, were also utilized, reflecting efforts to adapt interventions to local resources and emerging technologies. However, some studies lacked detailed descriptions of their intervention settings, highlighting a need for more contextual information in future research.</p>
<p>Regarding the format of the workshops, 80% were conducted in person, suggesting a preference for direct interaction, while 16.6% were delivered virtually and 3.3% used a hybrid format. This distribution reflects the growing adaptation to digital technologies, potentially accelerated by the COVID-19 pandemic. Sessions typically occurred weekly, lasting from 30 min to 3 h, with most programs spanning 4&#x02013;8 weeks, although some extended up to 12 months or longer (<xref ref-type="table" rid="T1">Table 1</xref>).</p>
<p>In <xref ref-type="table" rid="T2">Table 2</xref>, we present the types of foods used in the workshops and the specific culinary preparations participants engaged with. Additionally, the table includes insights into food consumption patterns and participants&#x00027; autonomy in making food choices (<xref ref-type="table" rid="T2">Table 2</xref>).</p>
<p>The analysis of ingredients used in interventions revealed a predominant focus on fruits and vegetables (83.3%), followed by whole grains (36.6%) and lean proteins (23.3%), with some studies referencing specific dietary patterns such as the Mediterranean and Atlantic diets. However, 16.6% of the studies did not provide detailed ingredient information, limiting the scope of analysis. The most common culinary preparations included salads (36.6%), soups (23.3%), and vegetable dishes (17.9%; <xref ref-type="table" rid="T2">Table 2</xref>).</p>
<p><xref ref-type="table" rid="T3">Table 3</xref> summarizes the health outcomes observed across the studies, focusing on changes in anthropometric measures, quality of life, and other clinical indicators. This overview is essential for understanding the broader impact of the culinary workshops, showing how they can contribute to improvements in both physical health and mental wellbeing (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
<p>Among the studies included in this review, only fourteen reported clinical health outcomes. A significant reduction in glycated hemoglobin (HbA1c) levels and improved management of type 2 diabetes mellitus were observed following 6&#x02013;12 weeks of culinary workshops (<xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B40">40</xref>). A decrease in C-reactive protein (CRP) levels was also reported, associated with increased consumption of anti-inflammatory foods (<xref ref-type="bibr" rid="B24">24</xref>). Improvements in lipid profiles, particularly reductions in total cholesterol and LDL cholesterol, were identified in two studies (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B16">16</xref>). Only one study directly measured blood pressure as a primary outcome, demonstrating statistically significant reductions in both systolic and diastolic blood pressure values (<italic>p</italic> &#x0003C; 0.0001) after a 6-week in-person intervention based on plant-based foods. Regarding mental health and wellbeing, several studies reported significant improvements, including reductions in the number of days experiencing feelings of sadness or anxiety (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B26">26</xref>, <xref ref-type="bibr" rid="B37">37</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
<p>Reductions in anthropometric parameters, such as body weight, BMI, and waist/hip circumference, were reported in 15 of the 33 studies. These outcomes were more commonly observed in interventions lasting 6 weeks or longer, with 53% showing statistically significant changes (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B25">25</xref>, <xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B39">39</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
<p>Dietary autonomy was assessed in 81% of the studies, with robust and statistically significant evidence of improvements in confidence, culinary self-efficacy, dietary management, practical skills, and attitudes toward healthy eating (<xref ref-type="bibr" rid="B24">24</xref>, <xref ref-type="bibr" rid="B27">27</xref>, <xref ref-type="bibr" rid="B31">31</xref>, <xref ref-type="bibr" rid="B34">34</xref>, <xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B39">39</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
<p>Regarding dietary intake, more than 90% of the studies demonstrated significant improvements in eating patterns, particularly with increased consumption of fruits, vegetables, whole grains, and minimally processed foods. Additionally, the interventions had a direct impact on reducing the consumption of added sugars, total calories, and ultra-processed foods (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B20">20</xref>, <xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B23">23</xref>, <xref ref-type="bibr" rid="B41">41</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
<p>Quality of life was assessed in seven studies, with statistically significant results observed in only three of them (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B26">26</xref>), which reported improvements in mental, functional, and emotional domains. The remaining studies provided qualitative evidence of enhanced wellbeing, health perception, and social engagement, particularly among vulnerable populations (<xref ref-type="table" rid="T3">Table 3</xref>).</p>
</sec>
<sec id="s4">
<title>4 Discussion</title>
<p>Culinary workshops have expanded their reach as an effective means to promote healthy eating habits and strengthen food and nutrition education (FNE). The results of this review directly corroborate this trend, highlighting that this type of intervention encompasses not only technical-cooking instruction but also a space for critical learning about food and its myriad possibilities, including the exchange of knowledge and cultural particularities that impact health, eating behavior, autonomy, and wellbeing.</p>
<p>In particular, although autonomy was not always directly measured, several studies documented improvements in culinary self-efficacy, confidence in food preparation, and greater independence in dietary choices. These findings support the interpretation of dietary autonomy as a multidimensional construct, often indirectly captured through behavioral and self-perception changes.</p>
<p>This analysis identified that eight studies reported statistically significant reductions in anthropometric parameters, such as body weight, BMI, and waist circumference. These findings reinforce the experiences reported by Freitas et al. (<xref ref-type="bibr" rid="B40">40</xref>), who used workshops as a training strategy for Nutrition students, evidencing that applied knowledge has the potential to positively influence participants&#x00027; physical health. However, more robust clinical effects tend to emerge when workshops are combined with other systematic nutrition education actions and multidisciplinary approaches (<xref ref-type="bibr" rid="B41">41</xref>).</p>
<p>Although the presented data suggest the potential of workshops to positively influence metabolic health, the magnitude of the effects varies widely, as sustainability over the long term is often a determining factor (<xref ref-type="bibr" rid="B42">42</xref>). Therefore, there is a need to standardize protocols and assessments that address clinical and anthropometric parameters.</p>
<p>The results related to significant improvements in dietary intake are largely consistent with other studies found in the literature (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B43">43</xref>), which describe culinary workshops as &#x0201C;sensitizing settings&#x0201D; capable of encouraging more conscious and sustainable eating practices. The study by Begley et al. (<xref ref-type="bibr" rid="B30">30</xref>), included in this review, showed significant gains in meal planning and preparation domains, reinforcing the idea that culinary practice is indeed a mechanism for food empowerment.</p>
<p>Moreover, as indicated by the data obtained from this synthesis and in line with the studies by Vaughan et al. (<xref ref-type="bibr" rid="B44">44</xref>) and Luz et al. (<xref ref-type="bibr" rid="B45">45</xref>), longer interventions tend to generate more consistent effects on eating behavior, as well as increased acceptance of new foods through repeated exposure and sensory engagement, favoring changes in food preferences.</p>
<p>Although data on quality of life were scarce among the included studies, the subjective effects reported on mental wellbeing, self-esteem, and positive health perception align harmoniously with findings related to the recovery of affective memories associated with cooking, the strengthening of social bonds, and the appreciation of culinary practices (<xref ref-type="bibr" rid="B46">46</xref>).</p>
<p>Among the aspects addressed in this review, it is confirmed that the duration of workshops is a fundamental factor for their effectiveness. Longer interventions, going beyond one-off meetings and offering follow-up or reinforcement of content, were associated with greater adherence, improvements in food consumption, and autonomy. Additionally, continuous approaches adapted to the realities of participants have proven to be much more effective, as they strengthen bonds and cultural appreciation (<xref ref-type="bibr" rid="B47">47</xref>). However, few studies conducted follow-up assessments, limiting the understanding of the long-term sustainability of the effects.</p>
<p>In Brazil, the promotion of healthy eating is supported by a robust set of public policies and structural programs. Among the most prominent are the National School Feeding Program (PNAE), which ensures balanced meals and nutrition education activities in public schools (<xref ref-type="bibr" rid="B48">48</xref>); the Dietary Guidelines for the Brazilian Population, an internationally recognized reference for its emphasis on fresh and minimally processed foods (<xref ref-type="bibr" rid="B49">49</xref>); and the Health in Schools Program (PSE), which integrates intersectoral actions focused on health and nutrition (<xref ref-type="bibr" rid="B50">50</xref>).</p>
<p>Additionally, local initiatives such as community gardens, solidarity kitchens, and university extension projects expand access to healthy foods and reinforce sustainable practices (<xref ref-type="bibr" rid="B51">51</xref>&#x02013;<xref ref-type="bibr" rid="B53">53</xref>). These actions form an ecosystem of strategies aimed at improving food quality and promoting food and nutritional security, in which culinary workshops emerge as an educational and community tool with high potential for impact.</p>
<p>Despite growing interest in cooking workshops as a tool for improving eating habits and promoting health, there is still a significant gap in research focused on the impact of these interventions in developing countries such as Brazil. Most existing studies have mainly involved university students, a population that, although it shows beneficial results with these interventions, does not accurately reflect the broader demographic characteristics of most developing countries (<xref ref-type="bibr" rid="B22">22</xref>, <xref ref-type="bibr" rid="B54">54</xref>). University students generally represent a more educated and higher-income group, which contrasts with the socioeconomic reality of the general population in countries such as Brazil, where lower levels of education, income disparity, and limited access to resources prevail (<xref ref-type="bibr" rid="B55">55</xref>).</p>
<p>While many successful interventions have been conducted in developed countries, the approach to culinary workshops can be adapted to the Brazilian context by considering local food habits, cultural diversity, and available resources. Workshops in Brazil, for example, could emphasize the use of traditional and locally available foods, making them more accessible and relevant to local populations. Additionally, adapting recipes to incorporate affordable ingredients and leveraging local knowledge on food preparation can increase the effectiveness and sustainability of these interventions (<xref ref-type="bibr" rid="B56">56</xref>).</p>
<p>Considering their multiple facets&#x02014;from physical health to emotional wellbeing&#x02014;culinary workshops should be integrated into public food and nutrition policies. Programs mentioned in the scope of the studies, such as &#x0201C;Cooking Matters&#x0201D; conducted in the United States, have already demonstrated applicability in vulnerable populations, while in Brazil, reported experiences (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B46">46</xref>) highlight the potential of workshops to strengthen fairer, more inclusive, and sustainable eating practices. It is essential to foster collaboration among universities, research centers, healthcare services, and social movements to support the implementation of culinary workshops as a health promotion tool, as they can become powerful pedagogical, community, and political instruments to tackle non-communicable chronic diseases and food insecurity.</p>
<p>Incorporating culinary workshops into public health initiatives in Brazil and similar countries requires a broader and more inclusive approach. Future studies should aim to include diverse populations, such as low-income communities, rural areas, and individuals with lower levels of formal education, to better capture the challenges and potential benefits for these groups. Additionally, adapting the content and delivery of culinary workshops to the specific needs and preferences of these populations, considering factors such as local food availability, cultural relevance, and economic constraints will be key to ensuring the success and sustainability of these interventions (<xref ref-type="bibr" rid="B57">57</xref>).</p>
<p>The standardization of culinary workshops can be achieved by establishing clear guidelines to ensure consistency across interventions. This includes defining specific objectives for each workshop, such as enhancing food autonomy or increasing the consumption of fresh and minimally processed foods. Moreover, it is essential to set recommended durations and frequencies for the workshops, with most programs running between 4 and 8 weeks to facilitate adherence and the practical application of learned concepts (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B19">19</xref>, <xref ref-type="bibr" rid="B24">24</xref>&#x02013;<xref ref-type="bibr" rid="B26">26</xref>, <xref ref-type="bibr" rid="B29">29</xref>, <xref ref-type="bibr" rid="B31">31</xref>, <xref ref-type="bibr" rid="B33">33</xref>&#x02013;<xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B38">38</xref>).</p>
<p>In addition, standardization should encompass the use of consistent assessment methods, such as self-report questionnaires and food diaries, which allow for comparability across different studies and contexts. Embracing digital platforms, increasingly prominent in the 21st century, is also a key strategy for expanding access to culinary workshops. Virtual and hybrid models offer flexible alternatives, particularly for individuals in remote areas or those with mobility challenges. The use of digital tools, such as apps and online videos, can further enhance the accessibility and adaptability of these interventions (<xref ref-type="bibr" rid="B58">58</xref>, <xref ref-type="bibr" rid="B59">59</xref>).</p>
<p>Encouraging the participation of health professionals, such as nutritionists, during culinary workshops to provide accurate and personalized information is a way to ensure that participants receive appropriate and safe dietary guidance. Nutritionists can also play a key role in adapting recipes for specific health conditions, such as diabetes or hypertension, promoting healthy and safe eating. Integrating culinary workshops with other health services can enhance results and ensure continuity of care (<xref ref-type="bibr" rid="B60">60</xref>).</p>
<p>Another important aspect is the need to address food safety issues in culinary workshops, offering information about accessible and safe ingredients for consumption, as well as emphasizing food hygiene practices and allergy prevention (<xref ref-type="bibr" rid="B61">61</xref>, <xref ref-type="bibr" rid="B62">62</xref>).</p>
<p>To incorporate culinary workshops into public policies in Brazil and similar countries, several mechanisms should be considered. First, integrating these workshops into existing programs such as PNAE or PSE could provide a framework for reaching large-scale populations. Workshops could be offered as part of nutrition education and health promotion initiatives, particularly in low-income and vulnerable communities, where access to nutritional education and healthy food is limited.</p>
<p>Another key mechanism would be aligning culinary workshops with local health and nutrition policies, ensuring they are incorporated into the broader strategy for improving diet quality and food security. Partnerships between universities, community organizations, and local governments could facilitate the implementation and scaling up of these workshops, while also considering the cultural, social, and economic realities of different regions.</p>
</sec>
<sec id="s5">
<title>5 Conclusions</title>
<p>Culinary workshops have shown positive impacts on health, but methodological limitations&#x02014;such as short follow-ups and underrepresentation of studies in vulnerable settings&#x02014;affect the generalizability of findings. Integrating these workshops into public policies through interdisciplinary, intersectoral, and community-based approaches can enhance their social relevance and long-term impact. Beyond cooking skills, workshops that embrace social and educational dimensions contribute to healthier, more equitable, and sustainable food practices.</p>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="s6">
<title>Author contributions</title>
<p>PF: Conceptualization, Software, Validation, Visualization, Investigation, Data curation, Writing &#x02013; review &#x00026; editing, Formal analysis, Resources, Writing &#x02013; original draft. LS: Writing &#x02013; review &#x00026; editing, Formal analysis, Software, Data curation, Writing &#x02013; original draft, Resources, Investigation, Visualization, Conceptualization, Validation. AR: Project administration, Investigation, Supervision, Writing &#x02013; review &#x00026; editing, Funding acquisition. TA: Investigation, Funding acquisition, Writing &#x02013; review &#x00026; editing. NA: Writing &#x02013; review &#x00026; editing, Investigation, Funding acquisition. AS: Funding acquisition, Writing &#x02013; review &#x00026; editing, Investigation. NG: Methodology, Supervision, Investigation, Conceptualization, Validation, Data curation, Writing &#x02013; review &#x00026; editing, Writing &#x02013; original draft, Formal analysis, Visualization, Resources.</p>
</sec>
<sec sec-type="funding-information" id="s7">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research and/or publication of this article. The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the project UIDB/00772/2020 (doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.54499/UIDB/00772/2020">10.54499/UIDB/00772/2020</ext-link>) funded by the Portuguese Foundation for Science and Technology (FCT). This work was also funded by the Funda&#x000E7;&#x000E3;o para a Ci&#x000EA;ncia e a Tecnologia (FCT) through the CBIOS projects UIDB/04567/2025 and UIDP/04567/2025.</p>
</sec>
<ack><p>The author NA would like to thank the Princess Nourah bint Abdulrahman University Researchers Supporting Project (number PNURSP2025R130), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The author NG would like to thank the National Council for Scientific and Technological Development of Brazil (Conselho Nacional de Desenvolvimento Cient&#x000ED;fico e Tecnol&#x000F3;gico) 309183/2025-1 for the provided funds.</p>
</ack>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="s8">
<title>Generative AI statement</title>
<p>The author(s) declare that no Gen AI was used in the creation of this manuscript.</p>
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</sec>
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<title>Publisher&#x00027;s note</title>
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</sec>
<sec sec-type="supplementary-material" id="s10">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fnut.2025.1653406/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fnut.2025.1653406/full#supplementary-material</ext-link></p>
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