Food Insecurity and Weight Loss in an Underserved Primary Care Population: A Post Hoc Analysis of a Cluster Randomized Trial
Authors: Candice A. Myers, Corby K. Martin, John W. Apolzan, Connie L. Arnold, Terry C. Davis, William D. Johnson, Peter T. Katzmarzyk
Journal: Annals of Internal Medicine (2021)

LettersJuly 2021Food Insecurity and Weight Loss in an Underserved Primary Care Population: A Post Hoc Analysis of a Cluster Randomized TrialCandice A. Myers, PhD, Corby K. Martin, PhD, John W. Apolzan, PhD, Connie L. Arnold, PhD, Terry C. Davis, PhD, for the William D. Johnson, PhD, for the Peter T. Katzmarzyk, PhD, for the for the PROPEL Research GroupCandice A. Myers, PhDPennington Biomedical Research Center, Baton Rouge, Louisiana, Corby K. Martin, PhDPennington Biomedical Research Center, Baton Rouge, Louisiana, John W. Apolzan, PhDPennington Biomedical Research Center, Baton Rouge, LouisianaPennington Biomedical Research Center, Baton Rouge, Louisiana, Connie L. Arnold, PhDLouisiana State University Health Sciences Center, Shreveport, Louisiana, Terry C. Davis, PhD, for the William D. Johnson, PhD, for the Peter T. Katzmarzyk, PhDPennington Biomedical Research Center, Baton Rouge, Louisiana, for the for the PROPEL Research GroupAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-6326 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Food insecurity, or the lack of sufficient healthy food to sustain an active, healthy lifestyle, is associated with greater body weight in adults (1), especially in underserved populations (2). However, the influence of food insecurity on the effectiveness of behavioral weight loss interventions is unknown.Objective: To examine via post hoc analysis whether food security status modified patient responses to a high-intensity, lifestyle-based intervention for weight loss.Methods and Findings: The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial was a 2-year, cluster randomized, 2-group pragmatic trial done in 18 primary care clinics across Louisiana to ...References1. Myers CA, Mire EF, Katzmarzyk PT. Trends in adiposity and food insecurity among US adults. JAMA Netw Open. 2020;3:e2012767. [PMID: 32766803] doi:10.1001/jamanetworkopen.2020.12767 CrossrefMedlineGoogle Scholar2. Myers CA, Martin CK, Newton RL Jr, et al. Cardiovascular health, adiposity, and food insecurity in an underserved population. Nutrients. 2019;11. [PMID: 31248113] doi:10.3390/nu11061376 Google Scholar3. Katzmarzyk PT, Martin CK, Newton RL Jr, et al. Weight loss in underserved patients—a cluster-randomized trial. N Engl J Med. 2020;383:909-918. [PMID: 32877581] doi:10.1056/NEJMoa2007448 CrossrefMedlineGoogle Scholar4. Katzmarzyk PT, Martin CK, Newton RL Jr, et al. Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL): rationale, design and baseline characteristics. Contemp Clin Trials. 2018;67:1-10. [PMID: 29408562] doi:10.1016/j.cct.2018.02.002 CrossrefMedlineGoogle Scholar5. Ward ZJ, Bleich SN, Cradock AL, et al. Projected U.S. state-level prevalence of adult obesity and severe obesity. N Engl J Med. 2019;381:2440-2450. [PMID: 31851800] doi:10.1056/NEJMsa1909301 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Pennington Biomedical Research Center, Baton Rouge, LouisianaLouisiana State University Health Sciences Center, Shreveport, LouisianaPennington Biomedical Research Center, Baton Rouge, Louisiana* For members of the PROPEL Research Group, see the Appendix.Note: Study data were collected and managed using electronic data capture tools from Research Electronic Data Capture (REDCap) hosted at Pennington Biomedical Research Center. REDCap is a secure, web-based application designed to support data capture for research studies. It provides an intuitive interface for validated data entry, audit trails for tracking data manipulation and export procedures, automated export procedures for seamless data downloads to common statistical packages, and procedures for importing data from external sources.Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the Patient-Centered Outcomes Research Institute, its Board of Governors or Methodology Committee, or the National Institutes of Health.Acknowledgment: The authors thank the patients and stakeholders who are members of the PROPEL Patient Advisory Boards, Community Monitoring Board, and Project Management Committee (Chris Lodge and Ava Zebrick, MSHCM), who significantly affected the trial's design and conduct. The authors also thank the PROPEL patients, assessment technicians, and health coaches, without whom this study would not have been possible. The authors acknowledge the contributions of Willie C. White III, MPH, and the David Raines Community Health Centers; Dr. Gary Wiltz and the Teche Action Clinic sites; Michael G. Griffin, Dr. Robert Post, and the Daughters of Charity Services of New Orleans; and the Ochsner Health System and Access Health Louisiana clinic sites. The authors also thank our Data and Safety Monitoring Board for monitoring patient safety and the overall conduct of the trial: Robert Ross, PhD (Chair); John Lefante, PhD; Michael Rolfsen, MD; and Chris Lodge.Financial Support: By a Patient-Centered Outcomes Research Institute award (OB–1402–10977). Additional support was provided by grant 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center, and by grant P30DK072476 entitled "Nutrition and Metabolic Health Through the Lifespan" sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-6326.Data Sharing Statement: The following data and supporting documents will be made available beginning 1 January 2022: deidentified participant data and informed consent form (contact Peter T. Katzmarzyk; e-mail, peter.[email protected]edu). These data will be made available to researchers whose proposed use of the data has been approved by the PROPEL Publications Committee, for scientific publication, with a signed data use agreement with the Pennington Biomedical Research Center.Corresponding Author: Candice A. Myers, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808; e-mail, candice.[email protected]edu.This article was published at Annals.org on 9 March 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTreatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic ReviewsHome Food Environment Changes and Dietary Intake during an Adolescent Behavioral Weight Loss Intervention Differ by Food Security StatusFood insecurity moderates the relationship between momentary affect and adherence in a dietary intervention studyEvaluating the Full Plate Living lifestyle intervention in low-income monolingual Latinas with and without food insecurity July 2021Volume 174, Issue 7Page: 1032-1034KeywordsBody weightData managementDisclosureFoodInformation storage and retrievalNutritionObesityStatistical dataTechniciansWeight loss ePublished: 9 March 2021 Issue Published: July 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...