Food preparation skills and obesity risk in European children aged 6–9 years: a cross-sectional study using WHO COSI 2022–2024’

Background

Preparing meals from raw ingredients has been linked to healthier diets, while developing cooking skills in childhood may foster lifelong healthy eating habits. In its 6th round (2021–2023), the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) added questions regarding food preparation skills.

Methods

Data from 19,736 participants across eight countries were analysed. Multilevel linear regression models examined the relationship between food preparation skills practiced at home and school and daily vegetable intake, accounting for individuals nested within schools. Logistic regression was used to assess associations between experience of these skills and obesity risk. Minimally adjusted models included random intercepts for schools, while fully adjusted models also controlled for child sex and mother’s education level.

Results

Increased experience of food preparation skills at home was associated with a small increase in daily fruit and vegetable intake; each one-point increment on the skills scale corresponded to a 0.09-point rise on a 5-point ordinal measure. Overall, food preparation experience at home was associated with a marginally higher odds of having obesity (OR = 1.02, 95% CI: 1.01, 1.03). Notably, experience of peeling skills was associated with lower odds of having obesity (OR = 0.84, 95% CI: 0.82, 0.86). Additionally, significant sex differences were observed: girls were more likely than boys to engage in tasks such as washing, mashing, peeling, and chopping, whereas boys more frequently reported involvement in weighing and measuring.

Conclusion

Experience of food preparation skills, especially those practiced at home, is modestly associated with increased dietary intake of fruit and vegetables. Although most food preparation skills were associated with a slight increase in obesity risk, experience of peeling was linked to a 15% reduced risk. The observed sex differences in food preparation skills underline the need for targeted educational strategies. Further prospective research is needed to determine whether promoting specific food preparation skills could support healthy dietary behaviours and weight in children.