Food and Nutrition Education in Primary Health Care for Individuals with Chronic Diseases: A Clinical Trial

Abstract

Objective: To evaluate the effectiveness of Food and Nutrition Education (FNE) workshops based on the principles of the Dietary Guidelines for the Brazilian Population and community gardening activities as health promotion strategies for individuals with Noncommunicable Diseases (NCDs). Method: This parallel quasi-experimental clinical trial was conducted in São Paulo, Brazil. The intervention group participated in three in-person workshops integrating FNE, community gardening, and food tasting sessions. In addition, participants received vegetable seedlings, printed educational materials, and weekly mobile phone reinforcement for three months. The control group received a book on healthy eating. The assessed outcomes included food consumption frequency, adherence to the dietary guidelines, whole-food utilization, food security, quality of life, and physical activity. Shapiro–Wilk, Student’s t, Mann–Whitney, and χ² tests, as well as intention-to-treat analyses, were performed using a 5% significance level. Results: 3-month study retention was 71/90 (79%) in the intervention group and 50/90 (56%) in the control group. Most participants self-identified as having non-White skin color (57%), with a median age (IQR) of 59 (50–66) years, and 47% had completed high school. No significant differences were observed between groups except for a higher proportion of women in the intervention group (93%) than in the control group (74%) (p = 0.004). Following the intervention, participants in the intervention group were less likely to consume soft drinks (p = 0.009) and maintained their adherence score to the Dietary Guidelines for the Brazilian Population, whereas the control group showed a decline (p = 0.004). No between-group differences were observed in food access, whole-food utilization, quality of life, or physical activity. Conclusion: Food and Nutrition Education, combined with weekly reinforcement of educational content delivered via mobile phone over three months, was effective in maintaining healthy eating practices.