https://orcid.org/0000-0002-1872-4088
Figures
Abstract
Cooking skills are defined as the individual knowledge, confidence, and attitude necessary to perform culinary tasks.. Despite the growing number of primary studies investigating culinary skills and dietary outcomes, there remains a significant gap in systematic reviews synthesizing the evidence regarding their impact on the nutritional status and diet of healthy adults. The aim of this systematic review was to assess whether the development of culinary skills influences nutritional status and diet. A systematic search of studies was conducted in PubMed, Embase, Scopus, Web of Science, and SciELO. The methodological quality of the studies was assessed using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-randomized intervention studies and the Cochrane Risk of Bias for Randomized Studies (RoB 2) tool for randomized intervention studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the quality of the evidence. Fifteen studies were included, most of which were classified as having a serious risk of methodological bias, such as the absence of randomization of participants and control groups. The results highlighted the importance of cooking skills and increased cooking frequency in improving diet quality among adults. However, no evidence of an association with nutritional status was found. Thus, this systematic review suggests that the development of cooking skills in healthy adults is associated with improvements in selected self-reported dietary behaviors, especially fruit and vegetable intake and cooking confidence, but the certainty of evidence is low or very low, and no reliable conclusion can be drawn regarding nutritional status. Further clinical trials are needed to strengthen the evidence base.
Citation: Andrade EDdO, Freitas ÉPS, Nascimento DdSMd, Pelonha RNdC, Galvão LLP, Nascimento ABd, et al. (2026) Can the development of cooking skills influence nutritional status and diet? A systematic review. PLoS One 21(8): e0355940. https://doi.org/10.1371/journal.pone.0355940
Editor: António Raposo, Lusofona University of Humanities and Technologies: Universidade Lusofona de Humanidades e Tecnologias, PORTUGAL
Received: May 11, 2026; Accepted: July 23, 2026; Published: August 19, 2026
Copyright: © 2026 Andrade et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript.
Funding: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Introduction
Cooking skills are understood as the set of knowledge, attitudes, and confidence required to carry out tasks related to food preparation [1,2]. These skills encompass not only the ability to cook but also competencies such as meal planning, careful food selection, mindful purchasing according to the available budget, and knowledge of techniques that minimize food waste and optimize the time dedicated to pre-preparation and meal preparation processes [3].
Evidence indicates that the development of cooking skills is strongly influenced by early exposure to culinary practices within the family environment, with greater involvement in food preparation during childhood and adolescence associated with higher skill levels in adulthood [4]. Historically, in many cultural contexts, these skills have been transmitted across generations and have often been associated with women's traditional roles in food preparation and caregiving [3,5].
Beyond their cultural dimension, cooking skills are increasingly recognized as a determinant of dietary quality. However, much of this evidence has been generated in specific population groups and contexts. In general population studies, greater proficiency and frequency of home cooking are associated with higher consumption of unprocessed and minimally processed foods, particularly fruits and vegetables [6–9]. According to the NOVA food classification system, ultra-processed foods are industrial formulations predominantly composed of substances extracted from foods and additives, with little or no whole foods remaining [10]Accordingly, higher consumption of unprocessed and minimally processed foods has been associated with higher intakes of fiber, micronutrients, and unsaturated fats [5,7,11].
In more specific contexts, such as clinical settings, cooking skills have also been identified as a relevant therapeutic and supportive strategy for improving nutritional status and quality of life, particularly among individuals with chronic noncommunicable diseases, including cancer [12–15], diabetes [16–20], cardiovascular diseases [21–24], and obesity [11,12,25]. Furthermore, evidence from targeted interventions highlights their positive influence on dietary behaviors and health outcomes in defined population groups, such as children [26–30], adolescents [31–35], and pregnant women [36–40].
Recent evidence has further reinforced the importance of dietary quality and food-related behaviors in the prevention and management of metabolic and chronic diseases. The quality of dietary fat intake has been associated with chronic disease prevention [41], while diet-derived nutrients have been linked to diabetes-related microvascular outcomes [42]. Additionally, metabolic disorders influenced by nutritional factors have been recognized as important determinants of adverse health outcomes [43]. In this context, food preparation practices and cooking skills may represent relevant upstream factors that influence dietary quality and, consequently, long-term health outcomes.
Although the body of primary research investigating culinary skills and dietary outcomes has grown in recent years, the available evidence has not yet been comprehensively synthesized in systematic reviews addressing their impact on the nutritional status and dietary patterns of healthy adults. Given that strengthening cooking skills may be a feasible strategy for health promotion and the primary prevention of chronic noncommunicable diseases, this systematic review aims to evaluate whether the development of cooking skills influences the nutritional status and diet of healthy adults.
Materials and methods
Protocol registration
This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) [44] – checklist in supporting information S1 File. The review protocol was previously developed following the PRISMA-P recommendations and registered in PROSPERO (CRD42022385234), available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385234.
Review question
This protocol was developed to address the following research question: Can the development of culinary skills influence nutritional status and diet in healthy adults? The question was structured according to the PECOS framework: Population (P), Exposure (E), Comparators (C), Outcomes (O), and Study Design (S), previously published in the protocol article of this review [45].
Inclusion and exclusion criteria
This review included intervention studies published without language restrictions in scientific journals that met the eligibility criteria and involved a healthy adult population. The eligibility criteria were as follows: intervention studies that investigated cooking skills, cooking confidence, culinary and/or nutritional knowledge, nutritional status, diet quality, and dietary habits in healthy adult populations. For the purposes of this review, cooking skills interventions were defined as interventions aimed at developing at least one domain related to cooking skills, including culinary knowledge, confidence in food preparation, attitudes toward cooking, meal planning, food selection, or practical food preparation skills.
Only studies involving healthy adults were included. For this review, healthy adults were defined as individuals without diagnosed chronic diseases or clinical conditions requiring nutritional or medical treatment. Eligibility was confirmed through a full-text assessment of the studies included.
This review included both randomized controlled trials (RCTs) and quasi-experimental or non-randomized studies. The methodological distinctions among these designs were systematically considered in the assessment of risk of bias and in the stratification of studies into subgroups based on their methodological characteristics. These distinctions also informed the analytical approach adopted in synthesizing the findings. Regarding the assessment of nutritional status, data on Body Mass Index (BMI) were considered, as this parameter enabled the synthesis and comparison of outcomes across the studies included in the review.
Systematic reviews, case reports, books, conference proceedings, short communications, editorials, letters to the editor, theses, cross-sectional studies, dissertations, animal studies, and studies involving children and adolescents were excluded.
Sources of information and literature search
The research was conducted in accordance with the protocol registered in PROSPERO to determine whether the development of cooking skills could influence the nutritional status and diet of healthy adults.
A comprehensive search strategy was developed using combinations of keywords and Boolean operators (AND and OR) in electronic databases, PubMed, Embase, Scopus, Web of Science, and SciELO, without language restrictions. The search terms were selected based on the terminology most frequently identified in studies related to cooking skills and associated constructs during the literature review and protocol development stages. MESH terms were not used in the search equations because “cooking skills,” “culinary skills”, and related terms are relatively recent in the scientific literature and do not have associated MESH terms [3,8].
The search equation was defined as: (healthy adults OR healthy people OR adults) AND (culinary skills OR cooking skills OR cooking education OR food skills OR Cooking OR Food preparation) AND (nutritional status OR body mass index OR diet OR diet quality) AND (intervention study OR clinical trial).
Additionally, a manual search was performed to include articles that may not have been retrieved from the databases listed above. The search equation for the systematic review was defined based on the established elements of three items from the PECOS strategy and aimed to maximize the sensitivity of the search. The same search equation was applied across all databases. The manual search was conducted based on relevant studies and authors previously known by the review team and considered pertinent to the review topic, resulting in the identification of two additional studies that were subsequently assessed for eligibility and included in the review. The search was conducted and finalized in May 2025.
Study selection
The articles were uploaded to Rayyan (version 2022) [46], where duplicates were identified and removed. According to the eligibility criteria, two authors (EA and EF) performed an initial screening of the studies based on the information in their titles and abstracts. Subsequently, full-text screening was conducted by the same independent researchers Any disagreements regarding study selection were resolved through consensus meetings, with the support of the supervising researcher when necessary. A screening of the reference lists of relevant studies, as well as studies previously known by the review team, was performed to identify potentially eligible articles that had not been retrieved through the original database search. This process resulted in the identification of two additional studies that met the eligibility criteria and were included in the review.. The selection or exclusion of studies was reported using the PRISMA-P flowchart (Fig 1) in May 2025.
A total of 3964 records were identified through searches in PubMed, Embase, Scopus, Web of Science, and SciELO. After duplicate removal and screening procedures, 20 full-text articles were assessed for eligibility, and 15 studies were included in the final review, including two studies identified through manual searching.
Data extraction
After selecting the studies to be included in the review, two reviewers independently prepared Microsoft Excel spreadsheets containing data from these articles in May 2025. The following information was extracted and summarized: study characteristics (title, author, year, and language of publication, study location, and study design); population characteristics (health status, sample size, age, and gender of participants); methodology; description of results; relevant conclusions; and reported limitations.
Data analysis and synthesis
For data analysis and synthesis, subgroups were defined according to the type and duration of the interventions implemented in the included studies. A narrative synthesis was conducted to summarize the findings related to nutritional status and dietary outcomes. Due to the substantial heterogeneity among studies regarding intervention characteristics, outcome assessment methods, follow-up duration, and study populations, quantitative pooling of results was considered inappropriate.
To assess the consistency of findings across studies, heterogeneity was evaluated qualitatively based on differences in study design, intervention format, outcome measures, and participant characteristics. These methodological and clinical differences were considered during the interpretation of the results and the assessment of the overall certainty of the evidence.
Risk of bias and quality of evidence
The risk of bias was assessed by two trained independent reviewers (EA and EF) in May 2025. Non-randomized intervention studies were assessed using the Cochrane Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) [47]. Randomized intervention studies were assessed using the Cochrane Risk of Bias tool for randomized trials (RoB 2) [48].
The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used to assess the level of certainty of the evidence. GRADE is a systematic approach for rating the certainty of evidence in systematic reviews and other evidence syntheses. GRADE classifies the certainty of evidence as high (very unlikely to change), moderate (may change), low (likely to change), or very low (very uncertain and likely to change) [49].
Results
Research selection
The database search conducted in PubMed, Embase, Scopus, Web of Science, and SciELO retrieved a total of 3964 records. After removal of duplicates (n = 687), 3277 records remained for screening. Of these, 3173 were excluded using Rayyan’s automated screening tools for not meeting the predefined inclusion criteria. An additional 84 records were excluded because they did not report outcomes related to diet or nutritional status.
Twenty articles were subsequently assessed for full-text eligibility, of which seven were excluded: two were conference abstracts, one focused exclusively on calcium-rich foods, and four included populations with pre-existing health conditions. As a result, 13 studies were included in the review. Two additional studies were identified through manual searching, yielding a final sample of 15 articles. The study selection process is illustrated in Fig 1.
Characterization of the included studies
The characterization of the included studies is presented in Table 1. Of the included studies, 6 were non-randomized intervention studies, 5 were quasi-experimental studies, and 4 were randomized clinical trials, all published in English. Of the extracted studies, only 1 had a sample size greater than 1000 participants [50]. Nine studies were conducted in the United States [51–59], three studies were conducted in Australia [50,60,61], two in European countries [62,63], and one in Kenya [64]. All studies included both men and women.
The interventions included in the review exhibited substantial heterogeneity in total duration and session length. Programs of moderate duration, ranging from 5 to 14 weeks, with weekly sessions lasting between 60 and 150 minutes, were the most common, particularly in community-based and university settings [50–56,59,61,63]. Interventions conducted in academic environments frequently combined theoretical and practical components, resulting in higher weekly time commitments, such as 50 minutes of theoretical instruction combined with 120 minutes of hands-on culinary practice [51,54,55].
In contrast, community-based interventions predominantly adopted single weekly sessions lasting 90–120 minutes [50,53,56,59,62]. Short-term intensive formats were also identified, including a 4-week program with extended sessions lasting up to 480 minutes, targeted at healthcare professionals [62], as well as longer-duration interventions lasting up to 12 months, in which in-person sessions occurred periodically over time [64]. Finally, one study evaluated a brief intervention, consisting of a single session of approximately 15 minutes, followed by short-term follow-up [58], highlighting the wide variability in temporal formats across the included studies.
Among the studies included in this review, only one assessed nutritional status using body mass index (BMI). Although BMI was measured before and after the intervention, the results did not show a statistically significant impact on BMI [55] (Table 1).
Regarding the participants’ diet, an increase in the consumption of fruits, vegetables [51], and whole grains was observed [52], as well as a reduction in the intake of sugar-sweetened beverages and the frequency of skipping meals [55]. Moreover, two studies reported enhancements in overall diet quality, as evidenced by higher scores on healthy eating indices such as the HEI-2010 [52,56]. These changes were also accompanied by an increased frequency of home-cooked meals [52,56], indicating that culinary practice contributed to more structured and healthier food choices.
Another consistent finding was the improvement in cooking self-efficacy and the use of dietary self-management strategies following the interventions, promoting a more positive and conscious relationship with food [53,56,62]. Across different settings, including food-insecure populations [61], university students [60], and small-scale producers [64], participants reported greater confidence in preparing healthy meals and increased consumption of fresh and minimally processed foods.
Quality assessment and risk of bias
The risk of bias assessment for included studies was performed using tools specific to each design (Table 2). We did not merge the risk of bias classifications from RoB 2 and ROBINS-I, as methodological literature strongly advises against this practice due to inherent differences in study types and the bias sources evaluated [47,48]. RoB 2 was applied to randomized controlled trials (RCTs), focusing on randomization-related biases, while ROBINS-I assessed non-randomized studies of interventions (NRSIs), prioritizing confounding bias [47,48]. This distinction is crucial, as even an NRSI with a low risk of bias doesn't hold the same strength of causal evidence as an RCT [47,65]. Consequently, risk of bias classifications were presented according to the instrument used.
Among the non-randomized studies, most were classified as presenting a serious risk of bias, primarily due to the lack of blinding of participants and researchers, the use of convenience sampling, and losses to follow-up, all of which may compromise internal validity and increase the risk of selection bias and residual confounding. Ylitalo et al. [53] was the only exception, classified as having a moderate risk of bias due to the more rigorous control of confounding variables, although limitations related to missing data were still observed.
Regarding the randomized controlled trials, two studies [57,64] were classified as having a high risk of bias, mainly due to incomplete or missing outcome data, which may substantially affect the robustness and validity of the reported findings.
For the analysis of the quality of evidence, the certainty of the findings was assessed using the GRADE method, grouped by study type and outcome, recognizing the specific characteristics of each design and the specific nature of the results for each outcome [49,65,66]. The GRADE assessment for the nutritional status outcome also resulted in very low certainty, due to high risk of bias and an extremely small sample size, severely compromising the precision and confidence in the findings (Table 2). Regarding the dietary outcome, the certainty of the evidence was very low for non-randomized and quasi-experimental studies, mainly due to the high risk of bias and the lack of comparability between groups. For randomized clinical trials, the certainty was low, despite a more favorable starting point, still affected by the high risk of bias prevalent in most studies.
Association of nutritional status and diet with cooking skills
The summary of the association between nutritional status and diet and cooking skills is shown in Table 3.
Analysis of the included studies revealed no evidence of an association between the development of culinary skills and nutritional status. The only non-randomized intervention study, conducted with 110 participants, found no statistically significant relationship between body mass index, culinary knowledge, cooking techniques, and eating habits. These findings indicate a lack of a direct association between the development of culinary skills and nutritional status. Furthermore, the evidence was classified as very low quality due to the study design, high risk of bias, and small sample size, which compromises the reliability of the results.
Regarding dietary outcomes, the studies reported more consistent findings. Non-randomized interventions, comprising six investigations [51–55,62] with 528 participants suggested that a higher frequency of meal preparation and greater confidence in cooking were associated with increased consumption of fruits [51–53], vegetables [54,62], fresh, and whole foods, as well as reductions in sugar-sweetened beverage intake and meal skipping [55].
Despite these positive findings, the overall certainty of the evidence was rated as very low, largely due to the predominance of studies at high risk of bias, including non-randomized designs with inadequate control of confounding factors [51,52,54,55,62].
Similar results were observed in five quasi-experimental studies (n = 3106), in which culinary interventions were associated with improvements in overall diet quality [56,50], increased fruit and vegetable consumption [60,61], and reduced intake of unhealthy snacks and ready-to-eat ultra-processed foods [63]. However, the certainty of the evidence from these studies was also classified as very low, given the substantial risk of bias, particularly due to insufficient control for confounding variables and limited comparability between the intervention and control groups.
Finally, four randomized controlled trials (n = 843) reported that participants who attended cooking classes demonstrated higher fruit and vegetable intake and greater frequency of home meal preparation [57–59,64]. Although these findings suggest potential benefits, the certainty of evidence was rated as low, primarily due to the high risk of bias in some trials, including incomplete control of confounding factors and missing follow-up outcome data [57,64], which limit the robustness and reliability of the conclusions
Discussion
This systematic review aimed to critically examine the influence of developing cooking skills on nutritional status and diet in healthy adults from different populations and study designs. Overall, no evidence was found to support a direct association between culinary skills and nutritional status, as only one non-randomized study assessed BMI and found no statistically significant effects. In contrast, more consistent positive associations were observed for dietary outcomes, with interventions generally linked to increased fruit and vegetable consumption, improved overall diet quality, and more frequent home meal preparation. However, despite these favorable results, the certainty of the evidence ranged from very low to low, mainly due to the high risk of bias, non-randomized designs, incomplete control of confounding factors, and substantial heterogeneity among studies.
These findings are consistent with previous literature, which suggests that the effects of culinary interventions on BMI are neither immediate nor linear [67–69]. Nutritional status is influenced by a complex interaction of determinants that go beyond culinary skills, including physical activity, socioeconomic context, access to food, social environment, and sleep patterns [67,70]. Consequently, detecting measurable changes in anthropometric outcomes may require longer intervention durations and more robust methodological designs, particularly well-conducted randomized controlled trials with larger and more diverse samples. Such designs would increase internal validity, reduce bias, and improve the generalizability of results [68,69,71].
Furthermore, the lack of significant findings regarding BMI in this review may also be attributed to the characteristics of the included studies, which comprised healthy adult populations, a group in which substantial variations in this parameter are less expected [68]. It is also plausible that interventions exclusively delivered at the group level may not be sufficient to produce measurable changes in anthropometric outcomes. In this regard, incorporating individualized strategies alongside collective interventions could enhance effectiveness by addressing specific needs, motivations, and behavioral patterns of participants [71,72].
Moreover, the absence of associations observed in the present analysis may be related to the profile of the included population. Studies targeting individuals with overweight or obesity, combined with individualized approaches in addition to cooking skills interventions, may be more likely to demonstrate significant impacts on BMI and other anthropometric indicators [72,73].
Regarding diet, results consistently showed that interventions focused on cooking skills led to significant improvements in eating habits, underscoring the importance of these skills for promoting healthier eating. An increase in the consumption of fruits [50], vegetables [52], and whole grains was observed [56–58], as well as a reduction in the intake of sugar-sweetened beverages [55]and the frequency of meal skipping [51]. These results are consistent with the literature indicating that cooking ability is a predictor of higher-quality diets. Previous studies suggest that individuals with greater cooking skills tend to prepare more home-cooked meals, consume fewer ultra-processed foods, and have a higher intake of fruits and vegetables [4,5].
Although the certainty of the evidence remains limited, the observed improvements in dietary behaviors may be relevant from a public health perspective. Previous studies have demonstrated associations between dietary quality, metabolic health, and chronic disease prevention [41–43]. Therefore, interventions that promote healthier eating behaviors by developing cooking skills may help improve dietary patterns among healthy adults.
Despite these consistent findings, the risk of bias analysis identified significant methodological limitations in the available studies. Most non-randomized studies presented a serious risk of bias, mainly due to confounding, selection bias, and insufficient adjustment for relevant covariates. Similarly, most randomized controlled trials (RCTs) demonstrated a high risk of bias, often related to deviations from intended interventions, lack of blinding, and incomplete outcome reporting. Consequently, the certainty of the evidence, as assessed using the GRADE system, was rated as very low for non-randomized and quasi-experimental studies, and low for RCTs on dietary outcomes. For nutritional status, the certainty of evidence was also considered very low, since it relied on a single non-randomized study with a serious risk of bias and a very limited sample size [47–49,66].
This scenario underscores the urgent need for studies with more rigorous methodological designs, particularly well-conducted RCTs with representative samples and standardized intervention protocols, to strengthen the reliability and applicability of the findings [68,69,71]. However, it is important to recognize that, in dietary interventions, certain methodological limitations are inherent to the study design. Blinding, for example, is often not feasible, since participants are generally aware of the foods they consume or the behaviors they adopt, and the professionals conducting the intervention are also not blinded. This limitation has already been addressed and discussed in the literature and may increase the risk of performance and detection bias, especially in studies that rely on self-reported results [74].
Although the certainty of the evidence for dietary outcomes was rated as low or very low, mainly due to risk of bias and limited comparability between groups, the findings are consistent with cross-sectional evidence. In this context, Tani et al. (2020) demonstrated that higher cooking skills were associated with healthier food choices among adults, reinforcing the idea that the development of such skills can act as mediators of eating behavior, promoting a more mindful, positive relationship with food. The literature also reinforces that a higher frequency of home meal preparation is associated with better diet quality [68,69], supporting the notion that mastering cooking skills represents an effective strategy for the prevention and management of non-communicable chronic diseases. Accordingly, interventions aimed at strengthening these skills may be regarded as a feasible and effective public health approach to promoting healthy and adequate diets.
The main methodological limitation of this review was the high heterogeneity among the included studies, which prevented the meta-analysis. This challenge is recognized in the literature and stems primarily from the lack of standardization in the definition of interventions and the measurement of outcomes. Another limitation is that the restriction to peer-reviewed studies indexed in bibliographic databases may have excluded relevant grey literature.
Among its strengths, this review is one of the first to specifically examine the influence of cooking skills interventions on nutritional status and diet in healthy adults, thereby addressing a relevant gap in the literature. Previous systematic reviews have predominantly focused on specific populations, such as children [26–30], individuals with chronic diseases [12–24], vulnerable groups, or broader nutrition education programs [31–35] without positioning cooking skills as the primary intervention. Thus, the main contribution of the present review lies in consolidating and critically appraising the available evidence specifically for healthy adults.
Importantly, although several years have passed since Reicks et al.’s systematic review was published. [75], many of the methodological limitations previously identified persist in the current body of evidence. Like the concerns raised by Reicks et al., the literature remains characterized by small sample sizes, a predominance of non-randomized designs, short follow-up periods, reliance on self-reported dietary measures, and insufficient control for confounding factors. These recurring limitations indicate that, despite growing interest in culinary interventions, advances in methodological rigor have been limited. Unlike Reicks et al., which included both healthy adults and individuals with health conditions, the present review narrowed its focus exclusively to healthy adults, yet the same structural weaknesses in study design and reporting remain evident.
This approach enabled a broader search and the inclusion of more relevant studies. Such delimitation strengthened the robustness of the findings, provided a more consistent basis for future research, and may support the development of public policies aimed at promoting health by enhancing cooking skills among healthy adults. To further advance this field of knowledge, future investigations should prioritize high-quality randomized clinical trials conducted with representative samples and long-term follow-up to increase the reliability and applicability of the results.
Conclusions
This systematic review indicated that the development of cooking skills in healthy adults may be associated with improvements in selected dietary behaviors, especially fruit and vegetable intake and cooking confidence, but the certainty of evidence is low or very low. Considering nutritional status, no reliable conclusion can be drawn, considering the lack of available data. The methodological heterogeneity of interventions and the low certainty of some outcomes highlight the need for more rigorous and well-designed studies. Thus, this review suggests that cooking skills interventions may contribute to promoting healthier dietary behaviors, while also underscoring the urgency of high-quality clinical trials to provide a stronger evidence base regarding their effects on diet and nutritional status.
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