Introduction
The coexistence of food insecurity and excess body weight has been well documented
in women. Both food insecurity and excess body weight have multiple consequences for
physical and mental health. Concerns have been raised about interventions aimed to
reduce food insecurity because these interventions might contribute to excess body
weight, particularly in adult women. The purpose of this study was to develop, implement,
and evaluate an intervention to simultaneously reduce food insecurity and body weight
through alleviating discouragement—which women described as feeling sad, depressed,
hopeless, and lacking drive to do important activities, such as finding a job or studying
more—by increasing women's empowerment.
Study design
This 2-armed cluster RCT was conducted from February to December 2017. Data were analyzed
from January to July 2018.
Setting/participants
Participants were food-insecure women with excess body weight in the Central Canton
of the province of Alajuela, Costa Rica.
Intervention
The intensive intervention arm consisted of activities at the individual (12 sessions
lasting 2 hours each, 3 follow-up monthly sessions, and 1 closing session), household
(1 workshop with the participants’ household and community members and homework with
family participation), and community (2 brochures and 1 workshop) levels. The nonintensive
control arm consisted of 3 sessions about healthy lifestyles lasting 1 hour each.
Main outcome measures
Outcome measures included BMI, waist circumference, and food insecurity.
Results
A total of 171 participants were enrolled (83 in intensive and 88 in nonintensive
control arms). At 6 months, the intensive arm had greater decreases from baseline
in BMI (−0.648, p=0.019), waist circumference (−2.21, p=0.002), and food insecurity (−1.35, p=0.009) compared with the nonintensive control arm.
Conclusions
The intensive intervention was effective in simultaneously reducing food insecurity
and excess body weight. Educational components should be added to interventions aimed
to reduce food insecurity.
Trial registration
This study is registered at www.clinicaltrials.gov NCT03492619.
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Article Info
Publication History
Published online: February 06, 2020
Identification
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
