Does a community-based practical
food skills intervention (CookWell)
assist weight reduction
W.L. Wrieden1, A.S. Anderson2, E. Dowler3, K.
Valentine2 and P.J. Longbottom2
1School
of Pharmacy and Life Sciences, Robert Gordon
University, Aberdeen, AB25 1HG, 2Centre for Public
Health Nutrition Research, University of Dundee,
Dundee DD1 9SY and 3Department of Sociology,
University of Warwick, Coventry CV4 7AL
Background
For many socially disadvantaged families,
practical issues limit access to a healthy
varied diet.
• low disposable income
• limited access to good quality food at
affordable prices
• minimal cooking facilities and skills
• poor neighbourhoods have fewer
opportunities for health promoting activities
than more affluent communities
Background
• For women being overweight or obese was
associated with SIMD quintile.
(Scottish Health Survey 2008)
Background
• NICE (2006) recommend that weight management
programmes should use a balanced, healthy-eating
approach.
• Lower socioeconomic groups more likely to believe that
losing weight required a lot of cooking skills and involved
eating differently from others in the household (Siu,
Giskes and Turrell 2011)
• Lack of cooking skills likely to a barrier to fruit and
vegetable consumption or healthy eating (Larson et al.
2006; Winkler and Turrell 2010)
• Possible link between poor cooking skills, being
overweight and ready meal consumption (van der Horst et
al. 2011).
Background
• In 2001 there were over
170 food and health
projects in low-income
communities in Scotland
(HEBS 2001).
• One third of these had a
cookery skills
component.
• …funding allowed limited
evaluation in some
cases.
• CookWell project allowed
full evaluation of food
skills programme
The ‘CookWell’ programme – a
food skills programme to promote
healthy eating
Overall aim:
To develop and assess the impact of a
community-based practical food skills
intervention (CookWell) in low-income
communities on food intake, food preparation
methods and cooking confidence.
Cookwell
• A 10-week programme of cooking skills
classes
• 8 communities across Scotland:
Addiewell, Alloa, Ardler, Edinburgh,
Ferguslie, Greenock, Hawick, Kirkcaldy
• Community development approach
• Informed by consumer needs
Evaluation
• Quasi-experimental design:
– Intervention group
– Delayed intervention group (control)
– Pre- and post-measures:
• Budgetary (shopping diary)
• Dietary (food diary and food frequency
questionnaire)
• Height (at baseline), weight
• Cooking skills (questionnaire)
The Research
Piloting of
measures
Identification
of sites
Recruitment
Design of
intervention
and measures
Exploratory
Research
(FGs)
Immediate
follow-up
Measures
T2
Baseline
Measures
T1
6-month
follow-up
Measures
T3
Intervention
Control
Qualitative
research
(Interviews)
Evaluation
• Height at baseline T1 and weight
recorded at T1,T2 &T3
• Only those giving consent for these
measurements included
• Changes in BMI and weight compared
for intervention and delayed intervention
groups (T2 –T1) and (T3 – T1)
Results
• 93 participants,
• 50 completed 7-day food diaries at T1 and
T2.
• 40 completed diaries at T3.
• The mean age of all groups was similar
with an overall mean age of 32.3 (SD,
10.2) years and an age range of 16 to 65
years at T1
• 36 (Intervention n=24, Control n=12)
weighed at T1,T2 &T3
• 41 (Intervention n=27, Control n=14)
weighed at T1 & T3
Mean Portions per week (intervention
group)
Results
• Mean BMI was between 26 and 28,
similar to the mean for the Scottish
population.
• Slight decrease in mean weight (-0.6
kg) for intervention subjects from T1 to
T3 compared with an increase (mean
1.8 kg) seen in control subjects
(P=0.052).
• Significant difference in BMI change
(P<0.05)
Mean weight at baseline (T1), after
intervention (T2) and 6 months later (T3)
Mean BMI at baseline (T1),
after intervention (T2) and 6
months later (T3)
Intervention
SD
Control
SD
T1
28.19
6.54
26.10
4.51
T2
27.79
6.55
26.22
4.77
T3
27.95
6.90
26.74
5.08
Mean change in BMI
(P values for difference between intervention and control)
P= 0.049
P = 0.186
Results
o No significant differences in change in weight or
BMI between T1 and T2
o However 6 months after intervention mean BMI
reduced (-0.2) in intervention group but
increased (+0.6) in controls (P=0.049) for those
weighed at T1,T2 and T3
o Inclusion of those who were weighed at T1 and
T3 but not T2 gave mean BMI reduction (-0.4) in
the intervention group but increase (+0.8) in the
control group (P=0.014).
Discussion
• Both groups recorded their food intake –
difference unlikely to be due to the effect of
keeping a food diary.
• Increase seen in control subjects is not
surprising given the general tendency to
increase in weight with age.
• Larger than would be expected from the
Scottish Health Survey data (
• The true significance of these results is
difficult to gauge.
• Should we give more emphasis on cooking
skills in weight management programme
Funded by the Food Standards
Agency