Health cooking at home: can cooking skills reduce gastrointestinal symptoms, cross sectional study?

Abstract

Background

The acquisition of healthy nutrition habits plays an important role in the solution of gastrointestinal symptoms, and it was recently shown that the cooking skills were the main determinant in the development of these behaviors. Accordingly, this study was planned and conducted with an aim to investigate the relationship between gastrointestinal symptoms and cooking skills.

Methods

This cross-sectional study included 328 individuals aged 18–35 years with 84.1% female, 15.9% male. Descriptive information, food consumption records, cooking skills and gastrointestinal symptom scale scores of the individuals were recorded by the researchers by means of face-to-face interviews.

Results

The gastrointestinal symptoms and cooking skills scale scores were 38.75 ± 15.74 and 157.95 ± 37.18, respectively. Higher gastrointestinal symptom scale scores were associated with lower daily protein, dietary fiber, and vitamin B6, B12, and C intake (p < 0.05). Abdominal pain status was negatively associated with total score of cooking skills scale and cooking method, food preparation skills, and meal planning-preparation subscale scores, where reflux status were negatively associated with cooking skills total scale score and cooking method, meal planning-preparation, and label reading subscale scores, and diarrhea status was negatively associated with label reading subscale score (p < 0.05).

Conclusions

Gastrointestinal symptoms may affect daily protein, dietary fiber and vitamin B₆, B₁₂ and C intake, yet cooking skills may have a protective effect against gastrointestinal symptoms.

Introduction

Gastrointestinal (GI) symptoms are common in both gastrointestinal diseases and functional disorders, affecting a large proportion of the population worldwide [1]. The most prevalent clinical symptoms include abdominal pain, heartburn, nausea, vomiting, bloating, diarrhea, constipation, and gastrointestinal bleeding. The diagnosis and treatment of GI diseases are typically very difficult and require the cooperation of a multidisciplinary team of gastroenterologists, radiologists, oncologists, and surgeons [2].

High fiber consumption, which has been considered an important part of a balanced diet, is associated with improved gut functioning. Fiber can support normal peristalsis, prevent constipation, and help maintain healthy intestinal microflora [3]. It protects a healthy microflora by promoting the growth and development of beneficial bacteria in the gut, thereby help support in fighting pathogens and maintaining normal functioning of the immune system [4]. In this context, healthy eating habits have been reported to be associated with a lower risk of developing diseases, including obesity, which can be associated with certain GI diseases. Maintaining appropriate food intake and avoiding overeating are associated with lower gastric pressure and a lower prevalence of reflux and other GI disorders. A balanced diet can provide the body with all essential nutrients, including vitamins and minerals, which play a critical role in maintaining the normal structure and functioning of the digestive system [3]. A diet rich in antioxidants and vitamins developing has been reported to be associated with a lower prevalence of chronic diseases, including peptic ulcer, chronic gastritis, and irritable bowel syndrome [5]. A balanced diet can play a critical role in the prevention of GI problems and has been shown to maintain a positive effect on various aspects of the functioning of GI tract [6]. Avoiding irritating foods, moderate intake of sugar and salt, and regular water consumption are considered important aspects of a good care of the digestive system. These steps can help prevent irritation and maintain the balance of microflora in the gut [7]. A regular and moderate dietary change can have long-term positive effects on overall well-being and may help prevent various GI tract diseases [3].

Cooking skills are defined as the combination of self-confidence, attitude, and individual knowledge required for kitchen tasks, including meal planning, shopping, and preparing different types of food (fresh and/or processed) [8]. Previous studies on cooking interventions have typically reported that more frequent cooking at home and meal preparation based on improved skills are associated with a better diet quality and healthy eating habits [9, 10]. İndividuals with limited perceived self-efficacy in cooking show a higher tendency towards ready-to-eatpackaged foods due to ease of preparation [11, 12], whereas those with stronger cooking skills are more likely to make healthier food choices and consume higher amounts of fruits, vegetables, and dietary fiber [10, 13]. Additionally, homemade food has been reported to improve the nutritional quality of meals by encouraging vegetable consumption, emphasizing the importance of cooking skills in adopting healthy eating habits [12, 14]. Beyond influencing dietary quality, better cooking skills may also be linked to improved food hygiene behaviors, such as proper food storage, thorough cooking, and careful handling of raw ingredients, which could decrease the risk of foodborne illness and related gastrointestinal symptoms. This broader perspective suggests that cooking skills might have both nutritional and food safety relevance, providing a more comprehensive framework for investigating their relationship with gastrointestinal health in the present study. Accordingly, in this cross-sectional study aimed to evaluate the association between gastrointestinal symptoms, nutrient intake, and cooking skills among adults.

Methods and materials

Participants and recruitment

This cross-sectional study was conducted between October and December 2024 among adults in Ankara, Türkiye. Participants were recruited using convenience sampling through university campus announcements, social media posts, and bulletin boards in community centers. Individuals aged 18–37 years who were not diagnosed with a chronic gastrointestinal disease and who agreed to participate were included. Exclusion criteria were pregnancy, lactation, antibiotic use during the study, presence of menstruation and following a medically prescribed diet for a chronic condition. Since the total population size was unknown, the sample size was determined using the formula n = t²pq/d² [(1.96)² × (0.50) × (0.50) × (0.50) ÷ (0.05)²] (p:0.50, q:0.6–50) to ensure 85% confidence. Accordingly, the sample should have been comprised of at least 298 individuals, yet the study included 328 participants. Of 350 individuals initially approached, 328 provided complete data and were included in the analysis (response rate: 93.7%).

Data collection

Sociodemographic data, dietary habits, and anthropometric measurements were collected via face-to-face interviews conducted by trained researchers. Body weight and height were measured using a calibrated digital scale and stadiometer, and Body weight and height were measured using a calibrated digital scale and stadiometer, and Body mass index (BMI) was calculated as weight (kg) divided by the square of height (m²) in accordance with World Health Organization (WHO) standards (Geneva, 2000).

Assessment of cooking skills

Cooking skills were measured using the Likert-type “Cooking Skills Scale”, consisted of 33 items in 7 subgroups (cooking method, food preparation, meal planning and preparation, shopping, budgeting, skillfulness and label reading).The Turkish version of the scale was previously validated for reliability (Küçükkasap et al., 2023). Higher scores from the scale indicate higher cooking skills, and the highest possible score is 231 [15].

The cooking method & food preparation subscale assesses the frequency of using techniques such as boiling, grilling, or frying, as well as fruit and vegetable preparation habits (e.g. “How good do you think you are at frying or stir-frying foods on the stovetop, in a wok or frying pan, using animal or vegetable oil?”). Meal planning & preparation captures behaviors related to weekly meal planning, creating shopping lists, and preparing meals in advance (e.g. “How good are you at preparing meals in advance?”). Shopping & budgeting evaluates planning grocery shopping, comparing prices and labels, and managing food budgets (e.g. “How good are you at buying seasonal foods to save money?”). Skillfulness reflects participants’ self-efficacy in following recipes, portion control, and using kitchen equipment (e.g. “How good are you at preparing or cooking a healthy meal with just a few ingredients on hand?”). Finally, label reading measures the habit of reading nutrition labels and selecting products accordingly (e.g. “How good are you at reading storage and usage information on food packages?”). The scores obtained from these subscales were statistically analyzed in relation to gastrointestinal symptoms.

Assessment of Gastrointestinal (GI) symptoms

GI symptoms were evaluated using the validated Turkish version of the “GI Symptom Rating Scale” which includes 15 items across 5 subdomains (abdominal pain, reflux, diarrhea, indigestion, and constipation), the Turkish language validity and reliability of which was tested by Turan et al. [16]; higher scores indicated more severe symptoms, where the highest possible score was 105.

Dietary data collection

Food consumption was assessed using a single 24-hour dietary recall. Participants are asked to recall and report everything they ate and drank in the past 24 h, including meal times, portion sizes, ingredients, and preparation methods. Participants were asked to complete a 24-hour dietary recall, in which they were instructed to recall and report in detail everything they had eaten and drunk during the previous day. This included the exact meal times, portion sizes (using household measures where applicable), specific ingredients, brand names if known, and the methods of food preparation (e.g., boiling, frying, baking). Interviewers prompted participants to include snacks, beverages, condiments, and cooking oils, as well as to report any missed meals or atypical dietary patterns on that day. Data were entered and analyzed using the Nutrition Information System Software (Bebispro for Windows, Stuttgart, Germany; Turkish version, 2010) [17]. Energy, macro- and micronutrient intake values were calculated using the software’s food composition database. Data were checked for plausibility (e.g., energy intake < 800 kcal/day or >5000 kcal/day flagged for verification).

Ethics

The study protocol was approved by the Gülhane Scientific Research Ethics Committee, and all participants provided written informed consent before participation.

Statistical analysis

The Statistical Package for the Social Sciences (SPSS Inc, Chicago, IL, USA) software for Windows v. 22.0 was used for the analysis of study data. For descriptive statistics, mean, standard deviation, median, minimum, and maximum values were calculated and normality of distribution was assessed using the Kolmogorov–Smirnov test. The associations between GI symptoms scale total and subdomain scores and the daily energy, macro- and micro-nutrient intakes and the association between cooking skills total scale score and the GI symptoms scale score were analyzed by multiple regression analysis. To minimize the risk of Type II error, sample size was calculated a priori using a prevalence assumption of 50% to ensure maximum variance, yielding a minimum required sample size of 298; ultimately, 328 participants were included, which increases the study power. Effect sizes (β coefficients) and 95% confidence intervals are presented alongside p values to aid interpretation.

Given that multiple regression analyses were conducted, we considered the potential for bias due to multiple comparisons. To reduce false-positive findings, statistical significance was set at p < 0.05, and results were interpreted with attention to effect size magnitude and biological plausibility rather than relying solely on p values.

Results

The study included 328 individuals aged 18–37 years (mean ± SD age 21.06 ± 2.19 years, 84.1% female, 15.9% male), with a mean Body Mass Index of 22.35 ± 3.51 kg/m².

Table 1 summarizes the general characteristics of the study participants. 69.8% of the individuals had a normal BMI, 81.7% had no chronic diseases, 95.1% had less than 3 main meals, 68.2% had less than 3 intermediate meals per day, and 61.9% skipped the main meal of breakfast (Table 1).

Table 1.

General characteristics of the individuals (n:328)

Variable	n (%)
Age (year)
18–23	306 (93.3%)
>23	22 (6.7%)
BMI
Underweight	37 (11.3%)
Normal	229 (69.8%)
Overweight	49 (14.9%)
Obese	13 (4.0%)
Chronic Disease
Yes	60 (18.3%)
No	268 (81.7%)
Number of main meals
≤3	312 (95.1%)
>3	16 (4.9%)
Number of snacks
≤3	224 (68.2%)
>3	104 (31.7%)
Which meal was skipped?
Breakfast	203 (61.9%)
Lunch	103 (31.4%)
Dinner	22 (6.7%)

Table 2 presents the descriptive statistics (lower–upper limits, mean ± SD) of the cooking skills subscale scores and GI symptom subscale scores. The mean total scores from the cooking skills scale and GI symptoms rating scale were 157.95 ± 37.18 and 38.75 ± 15.74, respectively (Table 2).

Table 2.

Upper and lower means of cooking skills and GI symptoms scale scores of individuals (n:328)

Variable	Range (Min–Max)	Mean ± SD
Cooking method	8.00–57.00	42.60 ± 10.02
Food preparation	0.00–42.00	27.90 ± 8.04
Meal planning and preparation	0.00–21.00	13.41 ± 4.76
Shopping	3.00–24.00	15.18 ± 4.97
Budgeting	0.00–28.00	17.32 ± 6.48
Label Reading/Consumer Awareness	2.00–28.00	20.14 ± 6.36
Cooking skills total score	31.00–231.00.00.00	157.95 ± 37.18
Abdominal pain	3.00–19.00	8.81 ± 3.72
Reflux	2.00–14.00	5.40 ± 3.23
Diarrhea	3.00–21.00	6.42 ± 3.65
Indigestion	4.00–28.00	11.26 ± 4.96
Constipation	3.00–21.00	7.08 ± 4.13
GI symptoms total score	15.00–90.00	38.75 ± 15.47

Table 3 shows the multiple regression analysis results examining the association between total GI symptom scores and daily energy, macro- and micronutrient intake. GI symptoms rating scale score was negatively correlated with daily protein, dietary fiber, and Vitamin B6, B12 and C intake (p < 0.05) (Table 3).

Table 3.

Multiple regression analysis: GI symptoms total score and nutrient intake

Variable	β	t	p	95% CI
Energy (kcal/day)	,042	,666	,506	−0.001, 0.002
Protein (g/day)	-,607	−2,799	,004	−0.528, −0.092
Fat (g/day)	-,141	−1,334	,183	−0.144, 0.028
Carbohydrate (g/gün)	,200	2,109	,136	0.003, 0.073
Fiber (g/day)	-,355	−3,589	,000*	−0.831, −0.243
Vit A (µg/day)	,009	,150	,881	−0.003, 0.003
Vit E (mg/day)	-,002	-,034	,973	−0,075, 0.073
Vit B1 (mg/day)	,331	1,106	,275	−1.457, 4.982
Vit B6 (mg/day)	−1,019	−3,059	,004*	−3.874, −0.791
Vit B12 (mg/day)	− 0.2555	−1.016	0.001*	−2.030, −0.010
Vit C (mg/day)	-,858	−4,006	,000*	−0.012, −0.038
K (mg/day)	-,217	−1,284	,207	−0.007, 0.002
Ca (mg/day)	,098	1,386	,167	−0.002, 0.013
Mg (mg/day)	,277	1,823	,069	−0.002, 0.063
P (mg/day)	,384	1,555	,128	−0.001, 0.005
Fe (mg/day)	-,075	−1,397	,163	−0.109, 0.018
Zn (mg/day)	-,217	−1,284	,207	−0.007, 0.002

CI confidence interval, Ca Calcium, Mg Magnesium, P Phosphorus, Fe Iron, Zn Zinco

^*:p < 0.05

Table 4 summarizes the regression analyses assessing the association between cooking skills (total and subscale scores) and GI symptom scores (total and subscales). Abdominal pain subscale score was negatively correlated with total score from cooking skills scale and cooking method, food preparation, meal planning and preparation subscale scores (p < 0.05) (Table 4). Reflux subscale score was negatively correlated with the total score from cooking skills scale, and cooking method, meal planning and preparation, and label reading subscale scores (p < 0.05) (Table 4). In addition, diarrhea subscale score was also negatively correlated with label reading subscale scores (p < 0.05) (Table 4).

Table 4.

Multiple regression analysis: cooking skills and GI symptoms

Variable	β	t	p	95% CI
Cooking Skills Total → Abdominal pain	−0.533	−5.812	0.000*	−7.124, −3.521
Cooking Skills Total → Reflux	0.523	−2.766	0.006*	−10.787, −1.820
Cooking Method Subscale → Abdominal pain	−0.694	−7.930	0.000*	−2.330, −1.404
Cooking Method Subscale → Reflux	−0.551	−30,057	0.002*	−2.945, −0.639
Meal Planning & Preparation → Abdominal pain	−0.363	−30,842	0.000*	−0.701-0.226
Meal Planning & Preparation → Reflux	−0.467	−20,403	0.017*	−1.314, −0.131
Shopping Subscale → Abdominal pain	−0.314	−3.334	0.001*	−0.668, −0.172
Shopping Subscale → Reflux	−0.535	−2.757	0.006*	−1.482, −0.248
Shopping Subscale → Reflux	−0.558	−2.841	0.005*	−1.951, 0.355
Label Reading → Diarrhea	−0.160	−2.182	0.030*	−0.529, 0.027

^*p < 0.05

Discussion

Nutrition can both directly and indirectly change all physiological phenomena throughout life in addition to playing a fundamental role in the process of development and growth [18]. Previous studies on the effect of different dietary types on the onset of chronic diseases of GI tract reported that the epidemiology of certain diseases could be very different, depending on the region and the dominant dietary type in a given context [6].

This study comprehensively examined the association between gastrointestinal (GI) symptoms, nutrient intake, and cooking-related competencies, including cooking skills, cooking methods, meal planning, and label reading. Our findings showed that participants with higher GI symptom scores had significantly lower daily intakes of protein, dietary fiber, and vitamins B6, B12, and C. These results are consistent with previous studies reporting that inadequate protein and fiber intake can impair gut barrier integrity and delay mucosal healing, thereby contributing to functional GI disorders [19, 20]. By focusing on young adults without a confirmed GI diagnosis, our study adds new evidence that these associations may already be present in individuals with early, subclinical symptoms, potentially highlighting a window for early dietary intervention.

Another key contribution of this study is the observed association between cooking-related skills and GI symptom burden. We found that abdominal pain and reflux were negatively associated with overall cooking skills, cooking methods, and meal planning-preparation scores, while diarrhea was inversely associated with label reading scores. These results are in line with studies showing that individuals with higher cooking skills tend to consume diets richer in fruits, vegetables, and fiber and lower in ultra-processed foods [21, 22]. Our data strengthen this evidence base by directly linking cooking competence to symptom severity, suggesting that improved cooking skills may be associated with healthier meal composition and portion control, potentially mitigating symptom frequency.

Our results regarding label reading skills are also noteworthy. Participants with higher label literacy reported fewer diarrheal symptoms, which is consistent with evidence that poor food safety knowledge is associated with higher rates of foodborne illness and diarrhea [23, 24]. By identifying this association in a young, non-clinical population, our findings point to label reading as a modifiable behavioral factor that could be targeted in public health education programs.

Individuals with GI disorders are at increased risk of nutrient deficiencies, including micronutrient deficiencies, since most micronutrients are absorbed in the GI tract [25]. However, nutrient inadequacy may also occur in individuals without a diagnosed GI disorder, especially when GI symptoms lead to reduced food intake, dysphagia, malabsorption, poor digestion, and excessive gastrointestinal losses [26]. GI tract problems can also induce nutrient-related anemia (iron, folate, B12), and deficiencies of Vitamins (A, thiamine, riboflavin, niacin, pyridoxine, D, K) and trace elements (iron, copper, selenium, zinc) [27]. This study found that as GI symptoms increased, daily protein, dietary fiber, and Vitamin B₆, B₁₂ and C intake decreased. Upon a review of literature, there was no study which investigated nutrient consumption in individuals with GI problems, and that previous generally investigated serum micronutrient amounts in individuals diagnosed with a GI disease [28–30]. In this study, the amount of nutrient intake decreased with increasing symptoms in undiagnosed individuals during the early period, indicating the possible risk in that period.

Cooking skills can be critical to promote home cooking and improve the quality of meals [31]. It was reported that improved cooking skills were associated with lower consumption of ready-to-eat, convenience, and ultra-processed foods among adults [12, 21]. Intervention studies suggested that improved cooking skills increased vegetable and fruit intake [10, 32]. A number of governments and non-governmental organizations across the world promote home cooking as a key component of their strategy to combat obesity and poor quality nutrition [31].

A systematic review confirmed that home cooking had multiple benefits, including increased consumption of healthy food groups, increased self-efficacy in healthy eating, and better adherence to healthy eating recommendations [31]. A study on Japanese children and adolescents reported an association between reduced frequency of home cooking was associated with obesity, higher blood pressure, and lower high-density lipoprotein-cholesterol [33, 34].

Abdominal pain is considered a prevalent GI complaint and it was shown that the symptoms were exacerbated with meals, especially triggered by fatty, spicy, and large portions in many patients [35]. Skipping meals and maladaptive eating patterns have been reported to be associated with certain complexities, including reduced gastric relaxation, delayed gastric discharge, and delays in whole bowel transit times. These factors are also reported to be associated with symptoms such as early satiety, fullness, bloating, and constipation [36]. As suggested by the study results, the decrease in abdominal pain with increased cooking skills may be explained by healthier meal composition, reduced fat and spice intake, and better portion control among individuals with higher cooking competence, findings that are consistent with previous research showing that cooking interventions improve diet quality and are associated with fewer gastrointestinal complaints [21, 22, 37]. Higher cooking skills were linked with lower consumption of ultra-processed and supporting better portion control and reduced fat and spice intake [38].

A global prevalence study reported that approximately 14% of the world population experienced reflux symptoms at least weekly [39]. A meta-analysis of Nirvan et al. [40] reported that the same rate was likely as high as 22.4% in Turkey. Nutritional therapy is the recommended first-line treatment of choice for reflux. The National Institutes of Health and the American Gastroenterological Association recommended reduced intake of total fat, chocolate, alcohol, citrus and tomato products, coffee, tea and large meals and adopting other lifestyle changes, including smoking cessation and weight loss [41, 42]. It was also reported that total energy intake, excess body weight, meal times, macronutrient contents in meals and eating behaviors were among the risk factors for reflux symptoms [43]. It was reported that a high-carbohydrate diet might cause more acid exposure in the lower esophagus and more reflux symptoms in patients with gastroesophageal reflux disease (GERD) [44]. Tosetti et al. [45] reported that the foods more frequently associated with typical reflux symptoms included spicy foods (62%), chocolate (55%), pizza (55%), tomatoes (52%), fried foods (52%), alcoholic beverages (50%), citrus fruits (48%), sauces (48%), coffee (41%), processed meat, and fatty foods (34%). Similarly, heartburn due to spicy foods was reported in 88% of patients who presented with GERD symptoms. Spicy foods can induce an impairment of the esophageal mucosa without causing any physiological changes. Therefore, their intake should be limited [43].

In this study, reflux problems decreased as cooking skills, cooking methods, meal planning and label reading skills improved. Cooking skills include a set of skills and techniques required for planning and preparing meals with fresh ingredients, which can eliminate reflux-triggering choices from the diet [15].Clinical guidelines consistently recommend limiting certain dietary triggers—such as high-fat meals, spicy foods, chocolate, citrus products, and coffee—for individuals experiencing reflux or gastroesophageal reflux disease (GORD) [41, 42]. Although emerging research has examined the relationship between ultra-processed food consumption and various gastrointestinal outcomes, its specific role in reflux pathophysiology remains unclear and should be interpreted cautiously [46]. Our findings suggest that individuals with better cooking competence may select foods and meal patterns that align more closely with current dietary recommendations for reflux symptom management, but further research is needed to confirm this relationship.

Nutrition labels typically contain complete information on the nutrients (fats, proteins, cholesterol, salt, sugar and vitamins) and energy content of packed products. Today, various health problems occur due to the consumption of unhealthy packed foods, and raising awareness about reading food labels is more important than ever [47]. It was reported that most consumers were unaware of food labels or chose unhealthy products because of difficult-to-understand labels [48]. Consistently, the problem of diarrhea decreased as the level of label reading skills improved in this study.

Diarrhea is considered one of the most prevalent GI problems in adults. It was reported that higher consumption of carbohydrates, including fructose, and excessive consumption of ultra-processed foods were associated with chronic diarrhea [49, 50]. It was suggested that increasing the awareness of the above ingredients in label information might provide a protective effect against diarrhea.

Conclusion

The results of this study suggested that GI tract symptoms were associated with cooking skills and reduced intake of some nutrients. Our findings suggest an association between higher cooking skills and lower GI symptom severity. Cooking training programs may be a promising area for future interventional studies to examine their effect on GI symptoms. Given the cross-sectional design, causality cannot be inferred. Rather than establishing causality, our results highlight the potential role of these modifiable behaviors as early targets for future prospective and interventional research. Strengthening cooking skills and food label literacy may be promising components of nutrition education programs aimed at improving diet quality and gastrointestinal well-being. 

Abbreviations

GI

gastrointestinal

BMI

body mass index

WHO

World Health Organization

Ca

calcium

Mg

magnesium

P

phosphorus

Fe

iron

Zn

zinco

Authors’ contributions

T.K. and M.S. were involved in the conceptualization of the study, M.S. was involved in the investigation and data collection, T.K. aided in data collection and data analysis, and T.K., M.S. were involved in writing and editing the paper. All authors have approved the final version of the manuscript for publication.

Funding

This article has no funding.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The study was approved by the Gülhane Scientific Research Ethics Committe. All procedures were performed in compliance with the Helsinki Declaration. The participants provided their written informed consent to participate in this study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.