Reported associations between preparing and eating home cooked food, and both diet and health, are inconsistent. Most previous research has focused on preparing, rather than eating, home cooked food; used small, non-population based samples; and studied markers of nutrient intake, rather than overall diet quality or health. We aimed to assess whether frequency of consuming home cooked meals was cross-sectionally associated with diet quality and cardio-metabolic health. We used baseline data from a United Kingdom population-based cohort study of adults aged 29 to 64 years (n = 11,396). Participants self-reported frequency of consuming home cooked main meals. Diet quality was assessed using the Mediterranean Diet Score, Dietary Approaches to Stop Hypertension (DASH) score, fruit and vegetable intake calculated from a 130-item food frequency questionnaire, and plasma vitamin C. Markers of cardio-metabolic health were researcher-measured body mass index (BMI), percentage body fat, haemoglobin A1c (HbA1c), cholesterol and hypertension. Differences across the three exposure categories were assessed using linear regression (diet variables) and logistic regression (health variables). Eating home cooked meals more frequently was associated with greater adherence to DASH and Mediterranean diets, greater fruit and vegetable intakes and higher plasma vitamin C, in adjusted models. Those eating home cooked meals more than five times, compared with less than three times per week, consumed 62.3 g more fruit (99% CI 43.2 to 81.5) and 97.8 g more vegetables (99% CI 84.4 to 111.2) daily. More frequent consumption of home cooked meals was associated with greater likelihood of having normal range BMI and normal percentage body fat. Associations with HbA1c, cholesterol and hypertension were not significant in adjusted models. Those consuming home cooked meals more than five times, compared with less than three times per week, were 28% less likely to have overweight BMI (99% CI 8 to 43%), and 24% less likely to have excess percentage body fat (99% CI 5 to 40%). In a large population-based cohort study, eating home cooked meals more frequently was associated with better dietary quality and lower adiposity. Further prospective research is required to identify whether consumption of home cooked meals has causal effects on diet and health.

Many dietary interventions assume a positive influence of home cooking on diet, health and social outcomes, but evidence remains inconsistent. We aimed to systematically review health and social determinants and outcomes of home cooking. Given the absence of a widely accepted, established definition, we defined home cooking as the actions required for preparing hot or cold foods at home, including combining, mixing and often heating ingredients. Nineteen electronic databases were searched for relevant literature. Peer-reviewed studies in English were included if they focussed mainly on home cooking, and presented post 19th century observational or qualitative data on participants from high/very high human development index countries. Interventional study designs, which have previously been reviewed, were excluded. Themes were summarised using narrative synthesis. From 13,341 unique records, 38 studies - primarily cross-sectional in design - met the inclusion criteria. A conceptual model was developed, mapping determinants of home cooking to layers of influence including non-modifiable, individual, community and cultural factors. Key determinants included female gender, greater time availability and employment, close personal relationships, and culture and ethnic background. Putative outcomes were mostly at an individual level and focused on potential dietary benefits. Findings show that determinants of home cooking are more complex than simply possessing cooking skills, and that potential positive associations between cooking, diet and health require further confirmation. Current evidence is limited by reliance on cross-sectional studies and authors' conceptualisation of determinants and outcomes.

Cooking at home is likely to be associated with benefits to diet and health. However, the nuanced perceptions and practices linked to different types of cooking are not yet fully understood. This research aimed to explore the specific concept of ‘home cooking’, using qualitative research from the UK and US. Data from two previously completed studies exploring cooking at home were combined and a new secondary analysis was undertaken using the Framework Method. Data in the first study were drawn from participants in the North East of the UK who were interviewed. Data in the second study were drawn from participants in Baltimore, US, who took part in focus groups. Data from a total of 71 adults (18 UK and 53 US), with diverse sociodemographic characteristics and experiences of cooking, were analysed. In both countries, participants distinguished ‘home cooking’ as a distinct subtype of cooking at home. ‘Home cooking’ was defined in terms of preparing a meal from scratch, cooking with love and care, and nostalgia. Cooking at home had a range of dimensions, and perceptions of ‘home cooking’ tended to focus on social and emotional associations. In future, public health initiatives might, therefore, highlight the potential social and emotional benefits of ‘home cooking’, rather than emphasising implications for physical health.

Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach.

Objective: To evaluate the impact on food purchasing behaviour of the ‘Change4Life Smart Swaps’ campaign to encourage families to make small changes to lower-fat or lower-sugar versions of commonly eaten foods and drinks.Design: Quasi-experimental study comparing the proportion of swaps made by an intervention group (267 families who had signed up to the ‘Smart Swaps’ campaign promoted through various media, including television and radio advertising in early 2014) and a comparison group (135 families resident in Wales, signed up for ‘Change4Life’ materials, but not directly exposed to the ‘Smart Swaps’ campaign). During weeks 1, 2 and 3 of the campaign participants were asked to record their purchases of dairy products, carbonated drinks and breakfast cereals, using a mobile phone app questionnaire, when making a purchase within the category.Setting: England and Wales.Subjects: Families registered with ‘Change4Life’.Results: In weeks 2 and 3 a significantly higher percentage of the intervention group had made ‘smart swaps’ than the comparison group. After week 3, 58 % of participants had swapped to a lower-fat dairy product compared with 26 % of the comparison group (P<0·001), 32 % of the intervention group had purchased a lower-sugar drink compared with 19 % of the comparison group (P=0·01), and 24 % had made a change to a lower-sugar cereal compared with 12 % of the comparison group (P=0·009).Conclusions: In the short term a national campaign to change purchase habits towards healthier products may have some merit but the sustainability of change requires further investigation.

Evidence on the relationship between alcohol consumption and body mass index (BMI) is mixed, particularly for young adults. This study explored the relationship between energy obtained from alcoholic beverages and BMI using data for 18–25 year-olds (n = 7691) from pooled cross-sections of the 2008–2014 Health Survey for England and the Scottish Health Survey. Energy obtained from alcoholic beverages (excluding mixers) on the heaviest drinking day in the past week was expressed as percentage of total recommended dietary allowance (RDA) of energy (% RDA Energy). Linear regressions were estimated of BMI on alcohol intake categories controlling for intake frequency, physical activity, longstanding illness and other covariates, with separate analyses for men and women, and by beverage type. Significant associations with BMI were observed with the ‘Very High’ category of alcohol intake (>75% RDA Energy) for men (p < 0.001, 1.74, 95% confidence interval (CI) 0.98, 2.49) and with the “High” (>50% to 75% RDA Energy) (p < 0.001, 1.67, 95% CI 0.26, 2.58) and above category for women, when compared with the Low (>0–25% RDA Energy) category. Young adults drinking the highest levels of alcohol on a single occasion were more likely to be obese than those with the lowest intake. Interventions to address internationally rising youth obesity rates should also consider reducing alcohol consumption by increasing alcohol prices, and reducing availability and marketing exposure.