UTSW-led study sheds light on nutritional interventions for patients with diabetes

Published on: September 08, 2026 By: Christen Brownlee

Apron-clad people preparing food in a large kitchen. — A UTSW study showed culinary medicine as a therapy for patients with Type 2 diabetes slightly improved their average blood sugar levels over a 6-month period. Above, UTSW’s Culinary Medicine team provides education in teaching kitchens for medical students, residents, fellows, and other health professionals.

A UT Southwestern-led randomized clinical trial evaluating culinary medicine (CM) and medical nutrition therapy (MNT) for adults with Type 2 diabetes found significant improvement in the medical nutrition therapy group. However, investigators say extensive COVID-related disruptions substantially limited the statistical power of the study, published in Diabetes, Obesity, and CardioMetabolic CARE, and underscore the need for larger trials to fully evaluate culinary medicine.

Michael Bowen, M.D., M.P.H

“While MNT has been proven to improve diabetes outcomes, our study shows that CM holds promise. But we don’t have the data to show that it truly improves health outcomes yet,” said Michael Bowen, M.D., M.P.H., Associate Professor of Internal Medicine, Pediatrics, and Health Economics, Systems, and Policy in the Peter O’Donnell Jr. School of Public Health. Dr. Bowen co-led the study with first author Carolyn Smith-Morris, Ph.D., M.S., Professor and Interim Chair of Social and Behavioral Sciences.

MNT is a cornerstone of Type 2 diabetes treatment, Dr. Smith-Morris explained. In this intervention, patients receive personalized instruction from registered dietitians on how they can improve their blood sugar levels by making changes to their diet. Through a series of individual and group sessions, educators help patients set healthy eating goals and learn to prepare balanced meals, read food labels, and understand the effects of carbohydrates on their disease. Classes are typically held where patients receive their medical care.

In contrast, CM is a relatively new intervention for Type 2 diabetes and other conditions affected by diet. A collaborative therapy combining the expertise of physicians, registered dietitians, and chefs, it educates patients on nutrition through group cooking classes often taught in community or health system commercial kitchens. Patients learn through facilitated discussions, hands-on meal preparation, shared meals, and practical skill-building designed to translate nutrition recommendations into everyday life.

Carolyn Smith-Morris, Ph.D., M.S.

Although CM began gaining ground about 15 years ago, Dr. Bowen said, few randomized controlled clinical trials – a gold-standard evaluation of an intervention’s effectiveness – have compared how well it performs against other interventions.

To put CM to the test, Dr. Bowen, Dr. Smith-Morris, and their colleagues – including Jaclyn Albin, M.D., Director of the UTSW Culinary Medicine Program – compared its effectiveness with MNT in a group of patients from Parkland Health.

Seventy-nine patients with uncontrolled Type 2 diabetes were

enrolled in the study between November 2021 and February 2023 and randomly assigned to receive either MNT or CM. Although the original design called for participants to receive six monthly classes in person, trial organizers had to pivot and develop ways to hold classes virtually after the pandemic began. That meant MNT classes often took place over the phone or on a virtual platform called Webex, and CM classes were held via Zoom. Because patients attended most sessions remotely, the researchers couldn’t test their hemoglobin A1c (HbA1c) – a measure of blood sugar over time – at the beginning and end of the study. Consequently, they extracted this information from each patient’s electronic health records.

Because of incomplete data and attrition due to COVID-related issues – such as patients being unable to attend in-person doctor visits or having difficulty navigating unfamiliar video platforms – the final analysis included data from only 30 MNT and 17 CM participants. Results showed that those in the MNT group reduced their HbA1c by 1.15%, a statistically significant finding. Those in the CM group reduced their HbA1c by 0.55%, a value that shows promise but isn’t statistically significant, Dr. Bowen said.

“Although the study was too small to draw definitive conclusions about culinary medicine’s effectiveness, the improvement we observed is encouraging.” Jaclyn Albin, M.D.

These results may not reflect the true potential of CM because the study was “underpowered,” meaning it had too few participants to draw an accurate conclusion, explained Dr. Albin, who is also Associate Professor of Pediatrics, Internal Medicine, and Social and Behavioral Sciences.

“Although the study was too small to draw definitive conclusions about culinary medicine’s effectiveness, the improvement we observed is encouraging,” Dr. Albin said. “Larger trials will help us better understand whether combining evidence-based nutrition education with practical culinary skills and expert support can translate into meaningful improvements in clinical outcomes.”

Jaclyn Albin, M.D.

Other UTSW researchers who contributed to this study are Song Zhang, Ph.D., and Sandi L. Pruitt, Ph.D., Professors of Social and Behavioral Sciences; Vincent Merrill, Ph.D., Biostatistical Consultant; Molly McGuire, M.P.H., Lead Clinical Research Coordinator; Guadalupe Perez, M.P.H., Clinical Research Coordinator; Milette Siler, M.B.A., RDN, LDN, Senior Program Coordinator; and Marisel Ponton, M.S., Population Research Project Associate.

The study was funded by a grant from the W.W. Caruth Jr. Foundation (74-6000203), the UT Southwestern Funds to Retain Clinical Scientists (UT FOCUS), the American Heart Association (923721), the Doris Duke Charitable Foundation COVID-19 Funds to Retain Clinical Scientists, the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) (UL1 TR003163), and the Clinical and Translational Science NIH grant (UL1-RR024982).

Endowed Titles

Dr. Bowen is a Dedman Family Scholar in Clinical Care.

Dr. Pruitt holds the Barrett Family Professorship in Cancer Research.