{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:06:54Z","timestamp":1784124414549,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Morningcrest Foundation"},{"name":"Ardmore Institute of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of \u201cfood is medicine\u201d interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed \u201cfood is medicine\u201d guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time.<\/jats:p>","DOI":"10.3390\/nu15204417","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T09:56:57Z","timestamp":1697623017000},"page":"4417","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-4686","authenticated-orcid":false,"given":"Marianna S.","family":"Wetherill","sequence":"first","affiliation":[{"name":"Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK 74135, USA"},{"name":"Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA"},{"name":"OU Culinary Medicine Program, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacey T.","family":"Caywood","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK 74135, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hollman","sequence":"additional","affiliation":[{"name":"Office of Research Development and Scholarly Activity, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valarie P.","family":"Carter","sequence":"additional","affiliation":[{"name":"OU Culinary Medicine Program, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1984-7298","authenticated-orcid":false,"given":"Joshua","family":"Gentges","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashli","family":"Sims","sequence":"additional","affiliation":[{"name":"Iron Gate, Tulsa, OK 74103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie Vesely","family":"Henderson","sequence":"additional","affiliation":[{"name":"Iron Gate, Tulsa, OK 74103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s11606-011-1638-4","article-title":"Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults","volume":"26","author":"Baggett","year":"2011","journal-title":"J. Gen. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/jhn.12130","article-title":"Food choice and nutrient intake amongst homeless people","volume":"27","author":"Sprake","year":"2014","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"778","DOI":"10.2105\/AJPH.92.5.778","article-title":"Emergency Department Use Among the Homeless and Marginally Housed: Results From a Community-Based Study","volume":"92","author":"Kushel","year":"2002","journal-title":"Am. J. Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E90","DOI":"10.5888\/pcd10.120301","article-title":"Nutritional Assessment of Free Meal Programs in San Francisco","volume":"10","author":"Lyles","year":"2013","journal-title":"Prev. Chronic Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1080\/19320248.2011.597832","article-title":"Do Soup Kitchen Meals Contribute to Suboptimal Nutrient Intake & Obesity in the Homeless Population?","volume":"6","author":"Sisson","year":"2011","journal-title":"J. Hunger Environ. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1017\/S1368980015002682","article-title":"Nutrition for homeless populations: Shelters and soup kitchens as opportunities for intervention","volume":"19","author":"Koh","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/0002-8223(93)91752-C","article-title":"Nutritional and economic advantages for homeless families in shelters providing kitchen facilities and food","volume":"93","author":"Wiecha","year":"1993","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.2105\/AJPH.2018.304528","article-title":"Comprehensive Diabetes Self-Management Support From Food Banks: A Randomized Controlled Trial","volume":"108","author":"Seligman","year":"2018","journal-title":"Am. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1079\/PHN2003589","article-title":"Diet, nutrition and the prevention of dental diseases","volume":"7","author":"Moynihan","year":"2004","journal-title":"Public Health Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"429","DOI":"10.2190\/986L-LHQ6-2VTE-YRRN","article-title":"The Concepts and Principles of Equity and Health","volume":"22","author":"Whitehead","year":"1992","journal-title":"Int. J. Health Serv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106723","DOI":"10.1016\/j.ypmed.2021.106723","article-title":"Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating","volume":"153","author":"Wetherill","year":"2021","journal-title":"Prev. Med."},{"key":"ref_12","unstructured":"Housing Solutions (2022, October 29). A Way Home for Tulsa: Interactive Data Dashboard 2022. Available online: https:\/\/www.housingsolutionstulsa.org\/reports-data\/."},{"key":"ref_13","unstructured":"Iron Gate (2022, November 09). Mission Impact. Available online: https:\/\/www.irongatetulsa.org\/mission-index-impact."},{"key":"ref_14","unstructured":"Centers for Disease Control and Prevention (2019). Behavioral Risk Factor Surveillance System Survey Questionnaire."},{"key":"ref_15","unstructured":"Housing Solutions (2020). 2020 Point-in-Time Count Data, Housing Solutions."},{"key":"ref_16","first-page":"446","article-title":"A modified short version of the oral health impact profile for assessing health-related quality of life in edentulous adults","volume":"15","author":"Allen","year":"2002","journal-title":"Int. J. Prosthodont."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e472","DOI":"10.1161\/CIR.0000000000001031","article-title":"2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement from the American Heart Association","volume":"144","author":"Lichtenstein","year":"2021","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/phn.12180","article-title":"Assessment of Food Intake, Obesity, and Health Risk among the Homeless in Rhode Island","volume":"32","author":"Martins","year":"2015","journal-title":"Public Health Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1017\/S0007114517002495","article-title":"Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK","volume":"118","author":"Fallaize","year":"2017","journal-title":"Br. J. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"l1451","DOI":"10.1136\/bmj.l1451","article-title":"Ultra-processed food intake and risk of cardiovascular disease: Prospective cohort study (NutriNet-Sant\u00e9)","volume":"365","author":"Srour","year":"2019","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1093\/advances\/nmab049","article-title":"Ultra-processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action","volume":"12","author":"Juul","year":"2021","journal-title":"Adv. Nutr. Int. Rev. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jacka, F.N., O\u2019neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., and Chatterton, M.L. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the \u2018SMILES\u2019 trial). BMC Med., 15.","DOI":"10.1186\/s12916-017-0791-y"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"E3384","DOI":"10.1111\/hsc.13939","article-title":"The experience of food insecurity during and following homelessness in high-income countries: A systematic review and meta-aggregation","volume":"30","author":"Easton","year":"2022","journal-title":"Health Soc. Care Community"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"373","DOI":"10.5993\/AJHB.43.2.13","article-title":"Modifiable Risk Factors and Readiness to Change among Homeless Adults","volume":"43","author":"Maness","year":"2019","journal-title":"Am. J. Health Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"455","DOI":"10.5993\/AJHB.40.4.7","article-title":"Health Risk Factors and Desire to Change among Homeless Adults","volume":"40","author":"Taylor","year":"2016","journal-title":"Am. J. Health Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1017\/jns.2021.104","article-title":"Potassium intake is associated with nutritional quality and actual diet cost: A study at formulating a low sodium high potassium (LSHP) healthy diet","volume":"11","author":"Farapti","year":"2022","journal-title":"J. Nutr. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1017\/S0954422416000068","article-title":"Nutrition and the homeless: The underestimated challenge","volume":"29","author":"Seale","year":"2016","journal-title":"Nutr. Res. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1353\/hpu.2018.0090","article-title":"Dietary Inadequacies Among US Homeless Families: An Enduring Problem","volume":"29","author":"Brown","year":"2018","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/19320248.2018.1484315","article-title":"Challenges and opportunities to increasing fruit and vegetable distribution through the US charitable feeding network: Increasing food systems recovery of edible fresh produce to build healthy food access","volume":"14","author":"Wetherill","year":"2018","journal-title":"J. Hunger Environ. Nutr."},{"key":"ref_31","unstructured":"Epidemiology and Genomics Research Program (2020, February 21). Recommendations on Potential Approaches to Dietary Assessment for Different Research Objectives Requiring Group-level Estimates. The Dietary Assessment Primer Website, Available online: https:\/\/dietassessmentprimer.cancer.gov\/approach\/table.html."},{"key":"ref_32","unstructured":"Feeding America (2022). 2021 Annual Report, Feeding America."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/20\/4417\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:08:52Z","timestamp":1760130532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/20\/4417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":32,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["nu15204417"],"URL":"https:\/\/doi.org\/10.3390\/nu15204417","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]}}}