In this pilot study, we evaluated the feasibility of nutrition education, cooking instruction and produce vouchers for pregnant low income mothers to increase fruit and vegetable consumption. Participants were first trimester pregnant mothers receiving prenatal care at a local Federally Qualified Health Clinic (FQHC) in San Antonio. They attended a grocery shopping tour and cooking class conducted by a registered dietitian, focusing incorporating fruit and vegetables into meals, and a monthly $40 voucher, redeemable for fruit and vegetables. Mothers with high menu planning and grocery shopping skills and more fruit at home reported higher fruit intakes. Mothers with high grocery shopping skills reported higher vegetable intakes. Compared to baseline, the reported home availability of fruit, and fruit and vegetable intakes were significantly improved at post 1; fruit and vegetable home availability, menu planning and grocery shopping skills, and fruit and vegetable intakes were significantly higher at post 2.

Key Take Away Points

  • The younger the moms and the lower the food security, the less likely they were to complete the study requirements (shopping tour, cooking class, nutrition education at appointments, and 3 surveys). Age (p=0.062: those <21 less likely to complete) and food security (p=0.54: low food secure moms less likely to complete.)
  • Home vegetable availability is significantly correlated with menu planning skills (p<0.45; p<0.05), and grocery shopping skills (0.652; p<0.01).
  • Fruit Intake significantly correlated with home fruit availability (0.538; p<0.01), menu planning skills (p<0.40; p<0.05), and grocery shopping skills (0.540; p<0.01).
  • Vegetable intake is significantly correlated with grocery shopping skills (0.542; p<0.01).
  • From baseline to post survey 1, only home availability of fruit (p=0.012) significantly improved for the normally distributed variables.

Author Biography

Julie La Barba, MD, FAAP is the founding Medical Director of CHEF (Culinary Health Education for Families) and Assistant Professor, Department of Pediatrics, Baylor College of Medicine at The Children’s Hospital of San Antonio. Dr. La Barba is a graduate of Vanderbilt University (B.S. Human & Organizational Development), UT Health Science Center in San Antonio (MD) and completed her Pediatric Residency at University Hospital/The Children’s Hospital of San Antonio. After practicing medicine in the UT Department of Pediatric Gastroenterology, she focused on childhood nutrition and public health advocacy for the underserved. Honors include Les Dames D'Escoffier International 2015 Inaugural "Plate Changer" Award and the 2016 Bexar County Medical Society's Extraordinary Women in Medicine Leadership Award. Rooted in the belief that food is medicine, CHEF’s mission is to drive healthy eating among families by promoting nutritious food and home cooking as key ingredients in the recipe for life-long health and wellness. Karen Weber Cullen, PH, R.D. is a retired professor of Pediatrics-Nutrition with the Children’s Nutrition Research Center, Baylor College of Medicine. Dr. Cullen is a wealth of information who provided expertise in research design and common measures.


This study was made possible by: CHEF (Culinary Health Education for Families) at The Children’s Hospital of San Antonio powered by The Goldsbury Foundation, Marisol Garcia-Hodge, MD, Associate Professor, Department of OB/GYN, Baylor College of Medicine at The Children's Hospital of San Antonio, Rachel Mendoza, RN, Centromed OB/GYN Clinic, Rosario G. Ocampo, RN, BSN at the Max and Minnie Tomerlin Voelcker Clinical Research Center, H-E-B and The San Antonio Food Bank. Generous funding for this study was primarily provided by the Goldsbury Foundation as well as by H-E-B and CHEF at the Children’s Hospital of San Antonio. This project was also funded in part by federal funds from the USDA/ARS under Cooperative Agreement 58-3092-5-001. The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement from the U.S. Government.