NE1039: Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modifications

(Multistate Research Project)

Status: Inactive/Terminating

Project Menu

SAES-422 Reports

Annual/Termination Reports:

[02/18/2011] [09/06/2011] [09/24/2012] [09/18/2013] [04/16/2015]

Date of Annual Report: 02/18/2011

Report Information

Annual Meeting Dates: 06/07/2010 - 06/08/2010
Period the Report Covers: 10/01/2009 - 09/01/2010

Participants

Nancy Cohen, University of Massachusetts
Matthew Delmonico, University of Rhode Island
Sarah L. Francis, Iowa State University
Prema Ganganna, University District of Columbia
Judith A. Gilbride, New York University
Mark A. Kantor, University of Maryland
Ingrid Lofgren, University of Rhode Island
William S. Rice III, University District of Columbia
Catherine Violette, University of New Hampshire
Susan Welsh, USDA/NIFA
Gloria Wyche-Moore, University of District of Columbia
Furong Xu, University of Rhode Island

Participants Attachment:

Attachment

Brief Summary of Minutes

NE 1039
Annual Meeting Minutes

Technical Committee Workshop
June 7-8, 2010
Whispering Pines Conference Center, W. Alton Jones Campus,
University of Rhode Island

Presiding: Mark Kantor, Chair
Mark welcomed the group. Each participant introduced him/herself. We welcomed the new attendees, Sarah Francis from Iowa State University and Furong Xu from the University of Rhode Island.

Dr. Gloria Wyche-Moore welcomed us to the meeting as our Administrative Advisor. She updated us on her busy year as Dean of Community Outreach, AES and Extension at UDC.

Dr. Susan Welsh, our USDA/NIFA Representative, also welcomed us and provided an update of activities and changes at the National Institute of Food and Agriculture (NIFA). Here are brief highlights:
- On October 1 CSREES became NIFA. Mission areas include research, education and economics (NIFA, ERS, ARS, National Agricultural Statistics).
- New leadership includes Roger Beachy, Director of NIFA and Roger Shaw, MD, Chief Scientist.
- Susan recommended a new book A New Biology for the 21st Century.
- NIFA grant funding has not increased in years so the goal now is to show impact. Susan described the grants available in nutrition.
- The Dietary Guidelines Advisory Committee report will be out at the end of June. Once published in the Federal Register, the comment period will begin.

We discussed the need for our multistate project group to recruit more members. We are the only USDA multistate project addressing older adults, especially biomarker methodology. We also need to discuss the amount of time needed for our annual meeting.

Station Reports:
The following stations reported:
Rhode Island. Matthew Delmonico, Ingrid Holmes, plus 3 graduate students: Kate Cottell, Chad Straight, and Leah Dorfman
New Hampshire. Catherine Violette
Maryland. Mark Kantor
Massachusetts. Nancy Cohen
Iowa. Sarah Francis. Intergenerational nutrition and physical activity study
District of Columbia. Prema Ganganna and William Rice
New York. Judy Gilbride

June 8, 2011

Recruiting New Members:
The group discussed the need to expand our membership and recruit new members to the NE 1039 project. Here are some of the suggestions generated:
- Julie Jones (MN), whole grain expert, retired
- Penny Ralston, FL
- Members of SNEs Healthy Aging Division, eg. Karla Shelnutt, Linda Bobroff, Jackie McClellan)
- The NE 1039 proposal is available on the NIMMS site.
- Mark will send us a pdf of the proposal to send to interested people
- Susan has a list of Extension people interested in nutrition and physical activity
- Sarah will talk with her colleague in Kinesiology

We agreed that it is important to target people by expertise so we don't get too large.

NE 1039 Leadership:
Mark Kantor will continue as Chair of the NE 1039 project group. The Vice Chair position remains vacant. Prema is now Secretary and Matt is Member-at-Large.

SNE Presentation and Summary of NE 1023:
Mark Kantor and Catherine Violette are presenting a summary of our work on the NE 1023 project in a symposium sponsored by the Healthy Aging Division at SNEs annual meeting in Reno during July. The group brainstormed ideas and suggestions for the presentation:
-Include a description of how regional projects work
-Provide a brief history or our group
-List of NE 1023 names
-Include the objectives and outcomes on NE 1023
-Mark will summarize the work on biomarkers and Catherine will summarize the educational interventions
-Provide a handout of our publications and use as a recruiting tool
-Describe the advantages and disadvantages of working in multistate groups
-Describe the future direction of NE 1039

2011 Annual Meeting:
The dates for the 2011 annual meeting were set as June 6-7, 2011. Location was discussed and decided as Portland, ME. We decided to convene at noon on Monday and adjourn at 3 pm on Tuesday.

The 2010 meeting adjourned at 11:50 am on June 8, 2010.

Accomplishments

Catherine Violette, University of New Hampshire I presented selected results of Objective 2, Experiment 2 (NE 1023) on July 12, 2009 during the annual meeting of the Society for Nutrition Education in New Orleans, LA. Approximately 25 conference attendees participated in the session. While attending the annual SNE meeting I talked with a member of the Healthy Aging Division and explored with her how our NE 1023 research group could best disseminate a summary of our 5 year project to their membership. The leadership of the Healthy Aging Division asked us to prepare a proposal for a symposium sponsored by the Healthy Aging Division to be presented during the 2010 SNE annual meeting in Reno NV. Mark Kantor prepared the proposal which was accepted by SNE. Mark Kantor and Catherine Violette will represent the NE 1023 project members and present the symposium entitled Whole Grains, Leafy Greens, Biomarkers, and Eating Behavior: A Multistate Collaboration on Healthy Aging Success Story on Monday, July 26, 2010. The draft whole grain curriculum for older adults which is based on the results of the NE 1023 project was disseminated to three UNH Cooperative Extension Educators and collaborators for review. Their input and suggestions were reviewed and the curriculum revised. One session of the three-session program was formatted as a one-session program to be piloted by NH Family and Consumer Resources Educators with groups of older adults in New Hampshire. Nine Extension Educators were trained on the curriculum and provided an update on whole grain foods during a two-hour inservice delivered via GoToMeeting® technology. A central database is being developed to summarize evaluation results for the one-session program. Anecdotal feedback indicates that the Extension Educators enjoy implementing the program and feedback from participants is very positive. A three panel display detailing the 3-step whole grain identification process used in the curriculum was developed. A copy of the display was distributed to all 10 NH counties. The displays have been used during health fairs and displayed in Cooperative Extension offices. The three-session education program will be completed for pilot testing during the fall of 2010. The testing protocol will be finalized. Extension Educators will be contacted and trained to deliver the program in 2011. Sarah L. Francis, Iowa State Univ OUTPUTS: We (an interdisciplinary team: exercise physiologist, psychologist, dietitian, youth development specialist) applied for and received NIFA funding for an intergenerational physical activity program designed to be implemented in rural residing congregate mealsites. The overall objective is to pilot test a community-based, intergenerational exergaming program for older and young adults (Living well through Intergenerational Fitness and Exercise [LIFE] Program). The central hypothesis for the proposed research is that the LIFE Program will increase functional fitness, subjective well-being and physical activity readiness to change among older adults while improving aging perceptions among young adults. Since receiving the grant (September 2010) the main focus has been program planning and material development. During this time, we applied for and received Institutional Review Board permission; developed a "phase-in" site schedule; met with previously identified collaborators; drafted accompanying materials (recruitment information, questionnaires, program logo, wellness newsletters); developed the Trainer workshop curriculum handouts, PowerPoint slides, accompanying user manual); purchased materials; and conducted site visits. Specific accomplishments achieved during this period: 1. Scheduled seven meal sites to host program (five Spring 2011, two Summer 2011); 2. worked with graphic designer to create a LIFE program logo for use on all accompanying material; 3. Began intensive trainer recruitment at Iowa State University (16 confirmed trainers); 4. Created eight wellness newsletters. We pilot-tested these with a small sample of 28 older adults to gather input regarding content, design, name, and relevance to their lives. This input was included during the revision process; 5. Developed a training manual/user guide draft (10 chapters, plus appendices). This will be used during the training workshops. Final edits will be done during Fall 2011 prior to making the manual/user guide available on CDs; 6. designed training workshop PowerPoint presentations (5 total) and agenda; 7. Ordered required supplies and materials (Wii kits, training workshop supplies, etc.) through our university purchasing department. PARTICIPANTS: INDIVIDUALS: Sarah L. Francis, Ph.D., MHS, RD (PI), Assistant Professor/State Nutrition Extension Specialist, Dept. of Food Science and Human Nutrition; Warren D. Franke, Ph.D., FACSM (Co-investigator), Professor/Director, The Exercise Clinic at Dept. of Kinesiology; Jennifer A. Margrett, Ph.D. (Co-investigator), Assistant Professor, Department of Human Development and Family Studies; Marc Peterson (collaborator), Program Specialist, 4-H Youth Development, Iowa State University Extension, Polk County; Kara Strand, Graduate Student, Dept. of Food Science and Human Nutrition. ORGANIZATIONS: Aging Resources of Central Iowa (congregate mealsites in Story County Iowa). TARGET AUDIENCES: The LIFE program utilizes an intergenerational design towards health promotion of older adults. We are recruiting a convenience and snowball sample of rural older adults age 60+ (n=100) and young adults ages 16-22 years (n=30). Young adults will serve as the on-site program trainers and older adults will be program participants. To ensure success, a key component is the training workshop for the trainers during which training materials will be provided. A one-day trainer workshop for young adult volunteers will be completed prior to the on-site program implementation. The trainer workshop will discuss the various program assessment tools, using Wii as an intervention tool, physical activity safety issues for older adults, working with older adults, and group activities. Accompanying printed materials will be provided. Older adult participants will attend the on-site program twice weekly for eight weeks for a total of 90 minutes of activity (Day 1: 30 minutes Wii, Day 2: 30 minutes Wii and 30 minutes interactive group games). Wii is the primary avenue for physical activity promotion; however, once weekly 30-minute group activity will be incorporated to promote dialogue between participants and trainers. The second part of the intervention for older adults is the newsletter intervention which uses eight bi-monthly wellness newsletters distributed over a four month period following the on-site program. IMPACT: 2010/01 TO 2010/12 The drafts of the newsletters, user manual and training workshop curriculum will be used during the pilot project time period (Jan 2011-Dec 2011). Throughout the study period evaluation data (focus group and survey) will be collected on each of the above items. The feedback will be used to revise the aforementioned products prior to final production. The newsletter will be made available through ISU-Extension in print or pdf; the user manual and workshop curriculum will be available in a CD format. University of Rhode Island, Matt Delmonico, Ingrid Lofgren, Furong Xu: Review of Research Completed During our recent USDA-funded quasi-experimental community outreach study (UR-IDEAL II, fall 2009), 109 overweight and obese older adults aged 60-74 years underwent 8 weeks of dietary education and low to moderate intensity resistant training at four Rhode Island senior centers. Subjects in the DEPT group significantly increased their muscle strength (15%, p < 0.001) and lost weight, decreased percent body fat and body mass index decreased (p <0.05). They also improved their dietary quality as measure by the Dietary Screening Tool (p < 0.01) and decreased their triacylglycerols (p < 0.05). Adherence to the dietary intervention sessions was 85% for the DE group and 98% for the DEPT group. In the DEPT group, compliance was high in regards to the PT, as subjects attended 96% of the PT exercise sessions. This suggests that dietary education with resistance training can be completed in senior centers and can reduce the risk of coronary heart disease and improve physical functioning. In the spring of 2010, we completed a pilot study (UR-IDEAL III), with 11 obese older women (60-79 years of age) who participated in 12 weeks of dietary education and structured Tai Chi sessions. Though not significant, positive changes in waist circumference, body mass, and body mass index were close to significance and there were significant improvements in hamstring and lower back flexibility (p<0.05). Improvements in flexibility can impact physical functioning. Future Grant Proposals Drs. Delmonico and Xu are co-principal investigators and Dr. Lofgren is co-investigator on "Effects of Tai Chi during weight loss in obese older women," a USDA-funded three year study. In phase I, 32 obese women will be recruited to be randomized to diet education only or Tai Chi training with dietary education. Phase two will be a quasi-experimental study in which diet education with Tai Chi is done in four Rhode Island senior centers to test the impact on physical functioning and risk of coronary heart disease. In addition, Drs. Delmonico, Lofgren, and Xu submitted an NIH R15 AREA grant proposal to the National Center for Complementary and Alternative Medicine entitled "Effect of Tai Chi during Weight Loss in Obese Older Women". We originally submitted in February 2010 and the proposal was scored but not funded. We will resubmit in October of 2010. UDC, Prema Ganganna, William Rice: The current UDC NE-1039 project seeks to design and implement intervention strategies that will increase fruit, vegetable, and whole grain consumption in the multicultural elderly population in the District of Columbia. A motivational educational curriculum will be developed that will include recreational games and activities. This curriculum will be tested on a sample or individuals who have been identified as low consumers of fruits, vegetables, and whole grains. An ancillary question will be to determine the extent to which elderly citizens provide significant nutritional care to children. A recent city ordinance, The District of Columbia Healthy Schools Act of 2010, requires that District of Columbia Public Schools and the community at large attend to the health needs of children, particularly regarding nutrition. Anecdotal evidence suggests that a significant number of school age children are cared for by elderly relatives. If this is the case, nutritional habits of the elderly will affect children; and interventions with the elderly should address this possibility. Specific objectives of the UDC project are to: " compare knowledge, priorities, and attitudes of high fruit, vegetable, and whole grain consumers with low fruit, vegetable, and whole grain consumers; and assess the effect of these cognitive and affective characteristics on food choices and consumption. " design new, innovative, and fun filled games and activities that provide effective nutrition education. " collect traditional recipes from the elderly, modify the ingredients and cooking methods to improve nutrition density by increasing variety and content of fruits, vegetables, and whole grains. " publish a recipe book with original and modified recipes that incorporates memories,stories, and cultural traditions from the elderly, providing a record of their significant life experiences. " determine the extent to which elderly citizens provide nutritional care to children. " network with community leaders and organizations to schedule ongoing nutrition awareness programs and food demonstrations. Methodology The population for this study is the group of citizens of the District of Columbia aged 60 and above. A sample will be selected from the District of Columbia congregate sites. Approximately 150 free-living volunteers, aged 60 and above will be randomly selected from the registered participants at the 59 available congregate sites. The congregate sites provide direct services from the District of Columbia's Office on Aging for through a senior service network. These services include nutritious and tasty meals, social and recreational activities as well as information on staying well. Advice and guidance on dietary intake are provided to individuals for improving their nutritional status. Noon meals are served at all 59 centers in wards 1through 9 in the District of Columbia. Volunteers will be required to sign a consent form and will be oriented about the objectives and purpose of research. A survey instrument that will distinguish between high and low consumers of fruits, vegetables,and whole grains, will be field tested and validated. The survey will require each subject to complete a four day food dairy. Moreover, the survey will identify cognitive and affective determinants of food choices. Data from the diary will assess the number of portions of fruits, vegetables, and whole grains consumed by each subject. A camera will be given to each participant as an incentive to participate in the study and also to take pictures of each meal consumed to provide an accurate data of fruits and vegetables. Participants will be trained in the simple use of cameras and given specific instructions for taking pictures of meals and meal preparation. Using the 4-day dietary data the numbers and portion of fruits and vegetables consumed per person will be calculated and averaged over the four day period. Results of the survey and the four day food diary will be used to partition subjects into 2 group: high consumers and low consumers. Nutrition analysis software and the Statistical Package for the Social Sciences (SPSS) will be used to analyze data from each group. Independent variables including knowledge, attitudes, perceptions, non nutritional life styles, etc. will be identified. Regression and factor analysis will be used to determine which of these independent variables are the strongest predictors of the dependent variable consumption of fruits, vegetables, and whole grains. The low consumer group will serve as a treatment group and will receive intervention intended to increase fruit, vegetable and whole grain consumption. Interventions will be non invasive. Intervention strategies will be validated on subsequent samples of low consumers of fruits, vegetables, and whole grains. University of Massachusetts, Nancy Cohen Objective 1: To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults. Objective 1, Experiment 1 Environmental changes to increase fruits, vegetables, and whole grain intakes and physical activity in older adults. (UMass, lead; RI, MD participating stations) Researchers at UMass Amherst have been working with the Food Sank of Western Massachusetts to develop and implement a survey of residents in a Springfield, MA neighborhood to determine perceptions of local access to quality, affordable fresh fruits and vegetables. Purchase of fruits and vegetables at corner stores (bodegas) and self-reported consumption will also be assessed. Thus far, the survey has been developed and translated into Spanish, IRB approval was obtained from the University of Massachusetts, and data have been collected from approximately 50 residents. Data collection is ongoing. Once complete, data from older and younger adults will be compared with respect to perceived availability of and access to fresh fruits and vegetables locally. UMass researchers have also been preparing to develop a survey to identify perceived and desired environments that would promote fruit, vegetable and whole grain consumption in diverse older adults in collaboration with participating stations and a local western Massachusetts community. The survey will be administered to regional elder service agency staff, nutrition professionals and community members of a city food policy council in western Massachusetts.

Publications

Two manuscripts summarizing the results of the Objective 2, Experiment 2 research project were prepared. One manuscript, entitled Package Information Used by Older Adults to Identify Whole Grain Foods, has been submitted to the Journal of Nutrition for the Elderly. The second will soon be completed and submitted to the Journal for Nutrition Education and Behavior. Abstracts Presented 1. Straight C, Dorfman L, Cottell K, Lofgren IE, Delmonico MJ. 2010. Can Isometric Knee Extensor Torque from Hand-held Dynamometry Predict Physical Function in Overweight Older Adults? Medicine & Science in Sports & Exercise. 42;5. 2. Dorfman LR, Straight CR, Cottell KE, Riebe DA, Lofgren IE, Delmonico M]..2010. Body Composition Indices and their Association with Physical Functioning in Community-Dwelling Older Adults. Medicine & Science in Sports & Exercise. 42;5. 3. Cottell KE, Dorfman LR, Straight CR, Delmonico M], Lofgren IE. 2010. Assessment of Overweight and Obese Older Adults using a Dietary Questionnaire and Biochemical Values. FASEB J. 24:738.1. Papers Submitted or In Progress 1. Cottell KE, Dorfman LR, Straight CR, Delmonico MJ, Lofgren IE. 2010. The Effects of Diet Education Plus Light Resistance Training on Coronary Heart Disease Risk Factors in Community-Dwelling Older Adults. Journal of Nutrition, Health, and Aging. Accepted. 2. Straight C, Dorfman L, Cottell K, Krol J, Lofgren IE, Delmonico MJ. Effects of Resistance Training and Dietary Changes on Physical Function and Body Composition in Overweight and Obese Older Adults. Journal of Physical Activity and Health, In Review, 2011. 3. KroIJ, PayneJ, Cottell K, Dorfman L, Straight C, Xu F, Lofgren IE, Delmonico MJ. Effects of Tai Chi and Diet on Physical Function in Obese Older Women. Being prepared for submission to the European Journal of Applied Physiology, 201l. 4. Straight C, Lofgren IE, Delmonico MJ. Resistance Training in Older Adults: Are Community"Based Interventions Effective for Improving Health Outcomes? Being prepared for submission to the American Journal of Lifestyle Medicine, 2011.

Impact Statements

Date of Annual Report: 09/06/2011

Report Information

Annual Meeting Dates: 06/06/2011 - 06/07/2011
Period the Report Covers: 10/01/2010 - 09/01/2011

Participants

Cohen,Nancy (cohen@nutrition.umass.edu)- University of Massachusetts; Delmonico, Matthew (delmonico@uri.edu)- University of Rhode Island; Francis, Sarah L. (slfranci@iastate.edu) - Iowa State University; Ganganna, Prema (pganganna@udc.edu) - University District of Columbia; Lofgren, Ingrid (ingridlofgren@uri.edu) - University of Rhode Island; Rice, William S. III (wrice@udc.edu) - University District of Columbia: Violette, Catherine (catherine.violette@unh.edu) - University of New Hampshire; Welsh, Susan (swelsh@nifa.usda.gov) - USDA/NIFA; Wyche-Moore, Gloria (gwychemo@udc.edu) - University of District of Columbia; Xu, Furong (fxu2007@mail.uri.edu) - University of Rhode Island; Celentano-Curran, Joanne (joanne.celentano@unh.edu) - University of New Hampshire

Brief Summary of Minutes

Minutes Attachment:

Attachment

Accomplishments

Accomplishments University of Massachusetts, Nancy Cohen; Objective 1, Experiment 1 Environmental changes to increase fruit, vegetable and whole grain intakes in older adults Researchers in MA are examining perceptions of the community environment as supportive of increased consumption of fresh fruits and vegetables in older adults. Working in collaboration with the Food Bank of Western Massachusetts, UMass investigators developed a survey to assess perceived availability of fresh fruits and vegetables among residents of a limited income neighborhood in Springfield, Massachusetts. Interviews were conducted in English or Spanish with 78 men and women who were on the street in the vicinity of a neighborhood store or bodega, including 30 subjects over age 50 (n=16 over age 60). Preliminary data indicate that the majority of respondents drive themselves to go food shopping, with 10-14 individuals citing taking the bus, walking, or riding with someone else to shop for food. Two-thirds of respondents shopped for fresh fruits and vegetables at a large supermarket, but many purchased fresh produce at small grocery stores (26%), farmers' market (22%), and fruit stands (17%). Few subjects (<8%) shopped for fresh fruits and vegetables at a bodega or corner store, warehouse store or food pantry. When asked where they preferred to get their fruits and vegetables, fewer respondents cited a supermarket or small grocery store, and more cited farmers' market or fruit stand (28% and 29%, respectively). The majority of subjects were not able to walk from home to a place where they can buy affordable, good quality fruits and vegetables, Nevertheless, over half of respondents did consider that it was easy to find good quality and affordable fresh fruits and vegetables in their neighborhood, but over one-third considered it to be difficult to find. Using a brief two-item fruit and vegetable screener, 63% of subjects reporting consuming two or fewer servings of fruit and 61% consumed two or fewer servings of vegetables per day. Most interviewees were interested in consuming more fruits and vegetables, and over 20% indicated that lower prices, better quality and larger selection of produce, and more stores selling fruits and vegetables would facilitate their increased consumption. Few subjects cited recipe ideas or having more stores accept SNAP or WIC as community facilitators for increasing their produce consumption. There were few differences in survey responses among subjects over age 50 compared to younger subjects. Older subjects tended to get cite the food pantry as a source of their fresh produce more than younger respondents. Fewer older subjects than younger respondents considered that it was somewhat easy to find good quality and affordable fruits and vegetables. Eleven percent of younger subjects responded that stores offering more prepared ready-to-eat fruits and vegetables would help them to eat more produce, but no older subjects rated this item as important. Analysis of these data and further studies are planned to determine perceptions of community availability of fresh produce in older adults. UMass researchers also collaborated with investigators from Florida State University to examine the role of social support on dietary quality among older adults. Through this study, we investigated the effect of demographics, social network size, frequency of contact, and proximity on dietary quality based on 3 24-hr recalls in 80 public housing residents age 55+. Data were analyzed using Pearson correlation coefficients, multiple regression analyses, and structural equation modeling (SEM). Number of meals consumed, frequency of social network contact, and proximity of network significantly influenced dietary quality. These studies indicate that the dietary intake of older adults may be influenced by both social and physical environments. Further research on perceptions related to the environment and the intake of fruits and vegetables in older adults is ongoing. Iowa State University, Sarah Francis Life program of researchers is theory based- for rural residing inactive older adults. 8 week on-site program and 16 week news letter intervention. The program is conducted in 7 different sites. Goal was to evaluate the efficacy of the LIFE program for older adults and increase older adults functional fitness, subjective well-being. Wii EA active: The first part was Conducted for 30 minutes twice a week for 8 weeks- 12 different workouts with exercises appropriate for older adults. Strength training and aerobic activities, walking and running, dancing, boxing. Second part was interactive games to promote team building, problem solving and communication skills, intergenerational activity, alternative activity and contribute to the cognitive component of the program. Methodology used were, identifying rural communities, recruitment, training interested trainers, trainers workshop and lead on-site LIFE program. Recruited interested participants, 43 participants, filled out questionnaire, consent form, physicians approval, trainer led on site LIFE program, Measurement: pre, post and follow up measurements, looked at characteristics, number and percent of gender, marital status and living arrangement., general health, contact with youth in a day. Measured quality of life including depression, satisfaction with life and positive and negative life schedule. The best liked features were, feeling of doing something good for my body, exercising in a group, enabled to do exercise. Progress: 2010/01 TO 2011/08 OUTPUTS: We (an interdisciplinary team: exercise physiologist, psychologist, dietitian, youth development specialist) applied for and received NIFA funding for an intergenerational physical activity program designed to be implemented in rural residing congregate meal sites. The overall objective is to pilot test a community-based, intergenerational exergaming program for older and young adults (Living well through Intergenerational Fitness and Exercise [LIFE] Program). The central hypothesis for the proposed research is that the LIFE Program will increase functional fitness, subjective well-being and physical activity readiness to change among older adults while improving aging perceptions among young adults. Quarter 1 (September 1, 2010 - December 31, 2010) involved program planning and material development. During this time, we applied for and received Institutional Review Board permission; developed a phase-in site schedule; met with previously identified collaborators; drafted accompanying materials (recruitment information, questionnaires, program logo, wellness newsletters); developed the Trainer workshop curriculum (handouts, PowerPoint slides, accompanying user manual); purchased materials; and conducted site visits. A detailed description of accomplishments is shown below. Scheduled seven meal sites to host program (five Spring 2011, two Summer 2011). These sites are located in the study area (35 miles round-trip from Ames, IA). All are located in Story County Iowa with five identified as rural. Worked with graphic designer to create a LIFE program logo for use on all accompanying material. Began intensive trainer recruitment at the University. To date, we have 15 confirmed trainers (out of 30+ inquiries). A training workshop is scheduled for January 17th. [Objective 2] Created eight wellness newsletters. We pilot-tested these with a small sample of 28 older adults. They completed a brief questionnaire developed to gather input regarding newsletter content, layout (font size, color scheme), name, and relevance to their lives. This input was included during the revision process. The newsletters are being finalized by the editor and graphic designer for our review. Developed a training manual/user guide draft (10 Chapters, plus appendices). This will be used during the training workshops. Final edits will be done during Fall 2011 prior to making the manual/user guide available on CDs. Members of the research team will keep track of questions asked during the workshop so that we can revise the materials to ensure the resources provided are informative. We will also use the data collected through focus to identify any program areas that may need modified. The input gathered will be included with the final manual/user guide. Designed training workshop PowerPoint presentations (5 total) and agenda. These presentations include: LIFE Program Overview (Purpose, Program Design, Expectations of Trainers) -Interactive Games (Background, training on team building games) -Introduction to Older Adults (demographics, myths, characteristics of older adult learners, strategies to building successful relationships with older adults, simulated aging activity) -Older Adults and Physical Activity (benefits, safety concerns, strategies to ensure safety, senior fit test training and practicum) -Wii Active as a Research tool (background information, steps to ensuring safety, how to use Wii, practicum) -Ordered required supplies and materials (Wii kits, training workshop supplies, etc.) through our University purchasing department. Quarter 2 (January 1, 2011-April 29, 2011) involved participant and trainer recruitment; compilation of Wii Kits; training workshop implementation; launching of five research sites; and data collection -Started five research sites. -Conducted an eight-hour training workshop for 13 trainers. The second training workshop for the summer session of the LIFE program is scheduled for June 2011 -Finalized and printed the eight wellness newsletters (LIFE Lessons) in February 2011. The newsletter intervention for the first site began April 25, 2011. -Designed training agenda for on-site leaders. The on-the-job training includes 4½ hours of training under the guidance of the Trainer. Quarter 3 (April 30, 2011 July 29, 2011) involved participant and trainer recruitment; training workshop implementation; closing of five research sites; launching of two research sites; focus group discussions and data collection -Closed five research sites and launched two new sites. Currently 52 participants and 18 trainers have completed and/or are enrolled (Tables 1-2). To date, five sites have pre- and post-data available (28 participants, 13 trainers). -Conducted an eight-hour training workshop for five trainers. This training workshop invited previous participants to come and discuss their experiences -The newsletter intervention has been active since April 25, 2011. -Conducted trainer focus group session May 2011 -Scheduled participant/trainer focus group discussion (August 3, 2011) -Identified four (2 urban, 2 rural) needs assessment focus group sites -Conducted one statewide needs assessment focus group (July 27th; N=6 participants) -Scheduled two additional focus groups (August 11th and Sept 7th). A fourth focus group is still being scheduled. PARTICIPANTS: Individuals: Sarah L. Francis, Ph.D., MHS, RD (PI), Assistant Professor/State Nutrition Extension Specialist, Dept. of Food Science and Human Nutrition; Warren D. Franke, Ph.D., FACSM (Co-investigator), Professor/Director, The Exercise Clinic at Dept. of Kinesiology; Jennifer A. Margrett, Ph.D. (Co-investigator), Assistant Professor, Department of Human Development and Family Studies; Marc Peterson (collaborator), Program Specialist, 4-H Youth Development, Iowa State University Extension, Polk County; Kara Strand, Graduate Student, Dept. of Food Science and Human Nutrition. Organizations: Aging Resources of Central Iowa (congregate mealsites in Story County Iowa). Target Audiences: The LIFE program utilizes an intergenerational design towards health promotion of older adults. We recruited a convenience and snowball sample of rural older adults age 60+ (n=52) and young adults ages 16-22 years (n=18) (Tables 1 and 2). Young adults served as the on-site program trainers and older adults were the program participants. To ensure success, a key component is the training workshop for the trainers during which training materials will be provided. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period. IMPACT: 2010/01 TO 2010/12 The drafts of the newsletters, user manual and training workshop curriculum will be used during the pilot project time period (Jan 2011-Dec 2011). Throughout the study period evaluation data (focus group and survey) will be collected on each of the above items. The feedback will be used to revise the aforementioned products prior to final production. The newsletter will be made available through ISU-Extension in print or pdf; the user manual and workshop curriculum will be available in a CD format. Tables 1-3 provide the most recent data analysis available for the LIFE Program research project. University of New Hampshire, Joanne Curran-Celentano 2011 Modifications Proposed for Objective 2: Objective 2, Experiment 1 The effect of combined physical activity and dietary interventions on body composition, physical performance, and CHD risk factors in overweight and obese older adults. (URI lead; UNH participating) Purpose. To develop effective intervention strategies to improve physical performance and reduce CHD risk factors in overweight and obese older adults. All data will be collected at the URI station for analysis. In addition, subjects will be tested for macular pigment in Objective 2, Experiment 3b (below). Remove this for modification below. Objective 2, Experiment 2 Investigating determinants of macular pigment density as a biomarker of carotenoid status and eye disease risk in the elderly. 2a. Purpose. To determine the impact of pregnancy and lactation on lutein status, retinal health and MPOD; Does number of pregnancies impact lutein/n-3 FA status and health risk with aging. (UNH lead; LSU participating) We will build on our previous work on age-related macular degeneration (AMD), macular pigment density, dietary lutein and dietary DHA. As women, compared to men, are at higher risk for AMD we propose to explore if life events and choices that are specific to women (number of pregnancies and breast feeding versus formula feeding) diagnosed with AMD are related to incidence for AMD. This will be done by retrospective examination of medical records; this will be carried out in partnership with clinicians in ophthalmology and pediatrics at LSU Medical School. Additionally we will examine how both pregnancy and breast feeding impact macular pigment density in women. These data will help establish if pregnancy and breast feeding women should be consuming more lutein and DHA compared to non-pregnant and non-breast feeding women to protect their retina with aging. Status Report Objective 2 Experiment 2 a: Data are currently being collected on 300 women over 50 years of age seen at the ophthalmology unit at LSU Medical Center and diagnosed with age-related eye disease (macular degeneration and cataract). Information related to number of pregnancies and infant feeding practices will be related to diagnosis to test the hypothesis that changes in hormone status and transfer of carotenoid from mother to infant during pregnancy and breastfeeding influence long term macular pigment density and function. 2b. Purpose. To assess the impact of exercise and weight loss on carotenoid status and macular pigment optical density (MPOD); to characterize the transport of lutein and MPOD as impacted by exercise and/or weight loss. (UNH lead and RI participating). This study is an expansion of our current research looking at transport of lutein following supplementation for 120 days. The methodology for evaluating carotenoid status and MPOD will be coordinated with the exercise study of URI (Objective 2, experiment 2). RI will identify and screen subjects for inclusion in Objective 2, Experiment 2 and collect relevant dietary, anthropometric and biochemical data. MPOD will be measured using a Macular Metrics heterochromatic flicker photometry unit set-up at the laboratory at URI. Subject MPOD will be established at baseline and measured every 4 weeks for the duration of the 16 week intervention. At the time of each retinal measurement, blood samples will be collected for carotenoid analysis by HPLC at NH. Changes in MPOD and carotenoids will be assessed along with changes in serum cholesterol, lipid profiles, dietary and anthropometric measures. Modification: Since the presence of macular pigment through the lifecycle is hypothesized to influence risk of aging eye disease and obesity is a known risk factor for AMD, we are assessing MPOD on normal, overweight and obese young adults in two studies. Data collection is ongoing in both a. Normal, mild and overweight college students are recruited for MPOD measurement using heterochromatic flicker photometry. In this study the retinal carotenoid density will be assessed relative to body weight, BMI, lifestyle questionnaire and dietary intake evaluation using the LZQ©" questionnaire (HNRCA and Tufts University) for lutein and zeaxanthin. b. Normal and overweight adults aged 18-50 are being actively recruited to participate in a 12 week lutein intervention to determine the impact of body weight, body composition and dietary pattern on absorption, transport and deposition of supplemented lutein (10 mg lutein, 2 mg zeaxanthin). The effect of supplementation on serum, macular density and markers of inflammation will be evaluated. Five measurements of MPOD are being assessed over 3 month intervention. MPOD will be measured using a Macular Metrics heterochromatic flicker photometry unit set-up at the laboratory at St Anslem College. At the time of each retinal measurement, blood samples will be collected for carotenoid analysis by HPLC at UNH. Changes in MPOD and carotenoids will be assessed along with changes in serum cholesterol, lipid profiles, dietary and anthropometric measures. Dietary intake and lifestyle questionnaire (LZQ") is included in the assessment. This study is supported in part by the NH INBRE grant with St Anslem College investigator Adam Wenzel, PhD. University of the District of Columbia, Prema Ganganna & William Rice The major goal of the UDC NE-1039 project is to design and implement intervention strategies that will increase fruit, vegetable, and whole grain consumption in multicultural elderly individuals in the District of Columbia who have been identified as low consumers of these foods. These interventions will be designed as a result of data collected using a survey instrument that has been constructed to: -Compare knowledge, priorities, and attitudes of high fruit, vegetable, and whole grain consumers with low fruit, vegetable, and whole grain consumers. -Compare the cognitive and affective characteristics of these two groups in order to assess their effect on food choices and consumption. -Determine the extent to which elderly citizens provide nutritional care to children. (The assumption is that interventions with child caregivers will positively affect the children in their care.) The survey instrument was completed and pilot tested on 16 elderly adults who are registered participants in congregate sites provided by the District of Columbia Office on Aging through a senior service network. Research assistants were trained in cognitive interview techniques. However there were logistical limitations at the pilot sites that prevented individual interviews. Surveys were completed by subjects working in small groups. Some items were skipped, misunderstood, or misinterpreted, and it is likely that group dynamics compromised some of the responses. Interviewer prompts and probes did not occur. As a result, valuable data especially affective data was sacrificed. Unclear items have been rewritten, and steps will be taken to insure that interviews of subjects will occur individually and privately. Attitudes about foods and eating will be sought in addition to consumption data. Pilot data suggest: -The survey is able to partition subjects into fruit and vegetable consumption groups. -Whole grain numbers rely on clarity of definitions that interviewers will be able to explain. -Subjects seemed generally aware of the benefits of fruits, vegetables, and whole grains, even when they were not consumed in adequate quantities. -Diagnosis of mobidity changes eating behavior. -It is not unusual for elderly individuals to prepare regular meals for children under 13 years of age. Five student research assistants have begun interviews and will complete a total of 100 subjects. In addition to the survey completion, each subject will provide photographs of all meals for 4 days as an accurate record of consumption. Data analysis will provide guidance for the development of interventions for low consumers of fruits, vegetables, and whole grains. Subjects will participate in intervention development. One cooperative project will be a recipe book that will include family recipes with healthy nutritional modifications, as well as personal, cultural, and historical entries. Special consideration will be given to interventions for child caregivers. University of Rhode Island, Matthew Delmonico, Ingrid Lofgren, and Furong Xu During our recent USDA-funded randomized clinical trial (UR-IDEAL IV, spring 2011), 32 obese older women aged 55-79 years underwent 16 weeks of either 1) dietary education alone for weight loss (WL) (one session a week for 45 minutes) or 2) dietary education for weight loss and Tai Chi (TC) (3 sessions a week for 60 minutes) at the University of Rhode Island. Subjects were assessed at baseline and post-intervention by the following tests; height, weight, BMI, physical functioning, dietary intake (FFQ and DST), flexibility, blood lipids, body composition (iDXA), and muscle mass (CT scan of the thigh). Weight loss for the TC group was ~2.3% and weight loss for the WL groups was ~3.4%. Attendance for the TC group was ~ 70% for TC and 80% for WL sessions. Attendance for the WL group was ~80% for WL sessions.

Publications

1. Cottell KE, Dorfman LR, Straight CR, Delmonico MJ, Lofgren IE. 2010. The Effects of Diet Education Plus Light Resistance Training on Coronary Heart Disease Risk Factors in Community-Dwelling Older Adults. Journal of Nutrition, Health, and Aging, In Press, 2011. 2. Straight C, Dorfman L, Cottell K, Krol J, Lofgren IE, Delmonico MJ. Effects of Resistance Training and Dietary Changes on Physical Function and Body Composition in Overweight and Obese Older Adults. Journal of Physical Activity and Health, In Press, 2011. 3. Straight C, Lofgren IE, Delmonico MJ. Resistance Training in Older Adults: Are Community"Based Interventions Effective for Improving Health Outcomes? American Journal of Lifestyle Medicine, In Press, 2011. 4. Valente EA, Sheehy ME, Avila JJ, Gutierres JA, Delmonico MJ, Lofgren IE. The Effect of the Addition of Resistance Training to a Dietary Education Intervention on Apolipoproteins and Dietary Quality in Overweight and Obese Older Adults. Clinical Interventions in Aging, In Press, 2011. 5. Ralston, PA., Cohen, N.L., Wickrama, K.A.S., and Kwag, K. Social support and dietary quality in older African American public housing residents. Research on Aging, In Press, 2011.

Impact Statements

Date of Annual Report: 09/24/2012

Report Information

Annual Meeting Dates: 06/18/2012 - 06/20/2012
Period the Report Covers: 10/01/2011 - 09/01/2012

Participants

Brief Summary of Minutes

Minutes Attachment:

Attachment

Accomplishments

Accomplishments/Station Reports University of Massachusetts, Nancy Cohen Nancy Cohen (with graduate students Amanda Sylvie and Qianzhi Jiang) Objective 1, Experiment 1: Environmental changes to increase fruit, vegetable, and whole grain intakes in older adults Researchers in MA are examining recommendations for changes to the community environment to support increased consumption of fresh fruits, vegetables, and other high-nutrient foods in older adults. In 2011-12, we used a qualitative ranking tool to identify the most important and most changeable environmental determinants to improve nutritional status among older adults. Two online brainstorming sessions were held among 12 national experts in community nutrition and geriatric nutrition, including Northeast Regional Project collaborators from NH, IA, and NY. Based on social-ecological theory, the expert panel reviewed factors that enable healthy eating and community settings where nutrition behaviors are practiced. A hierarchy model was used to identify the most important and modifiable enablers to improve older adults eating behaviors. In this model, enablers were considered as determinants that could influence senior nutrition at the environmental level. Open-ended questions were used to stimulate ideas of possible changes in different behavioral settings at community levels. Audio recordings of the discussions were reviewed, and major themes were summarized. As a result, accessibility, affordability, social support, and living accommodations were identified as the factors that can enable improvement in nutritional status. Among enablers, accessibility had the highest percent of importance related to the goal of healthy eating in older adults, followed by social support. Based on the results of the hierarchy model, food stores had the highest priority score when considering accessibility and affordability. Congregate nutrition sites ranked high when considering social support and living accommodations. Senior housing was also important as related to living accommodations. Congregate nutrition sites and food stores were most important in contributing overall to the goal of healthy eating in older adults, followed by senior housing, health care settings, religious settings, and restaurants. Possible changes in each of these behavioral settings include: providing cooking demonstrations, nutrition screening and education, and cultural and ethnic foods at congregate nutrition sites, as well as more funding; providing easier-to-reach items and easier-to-read nutrition information in food stores with advertising of healthy foods and smaller packaging; building community gardens, holding health fairs, and offering nutrition education programs and healthy cooking demonstrations at senior housing through peer training; offering healthy vending and cafeteria food and nutrition information at health care sites; offering congregate meals, health screenings and nutrition education at religious settings; and offering smaller portions, healthier choices, discounts for healthy choices, and nutrition labels in restaurants. Further research on recommended environmental changes to improve the nutritional intake of older adults is ongoing. Iowa State University, Sarah Francis Life & Chef Charles OUTPUTS: The Living well through Intergenerational Fitness and Exercise [LIFE] Program pilot tested a community-based, intergenerational exergaming program for older and young adults. The central hypothesis was that the LIFE Program would increase functional fitness, subjective well-being and physical activity readiness to change among older adults while improving aging perceptions among young adults. We tested this hypothesis by pursuing the following research objectives: 1. Determine the effects of the LIFE program on older adult health and subjective well-being; 2. Determine the influence that a reversed intergenerational approach utilizing service learning has on young adults perceptions on aging and older adults; and 3. Determine the current and future health promotion needs and preferences of Iowans (age 45 and older) currently not eligible for or participating in congregate meal site health promotion programs. For this project we developed: recruitment information, questionnaires, program logo, wellness newsletters (8), a Trainer workshop curriculum (handouts, PowerPoint slides) and program user guide (10 Chapters, plus appendices). We provided two Trainer workshops, tested the program at seven locations (5 senior centers, 2 senior apartment complexes), and conducted three program focus groups. Four statewide needs assessment focus groups were conducted. The LIFE project has been presented at the 2011 Urban 4-H Conference and the 2011 Gerontological Society of America meeting. In fall 2011, funding was also received for the Chef Charles revision project through the Wellmark Foundation. The Chef Charles program a newsletter-based nutrition education program for congregate meal site participants that is led on-site by a nutrition educator or volunteer. Chef Charles encourages: fruit, vegetable and calcium-rich food consumption; physical activity; food safety practices; and promotes food security. The Chef Charles Revision Project will integrate information attained through qualitative program evaluation, professional independent program review, and future needs and preference assessment to create an evidence-base nutrition education program for older adults. The research objectives for this project include: 1. Determine the effects of the revised Chef Charles program on older adult nutritional risk, self-efficacy of healthful eating, and fruit and vegetable consumption. The working hypothesis for this research objective is that in incorporating components of the HBM and the target audiences needs and preferences in the Chef Charles program design, we will evoke changes in older adult nutritional risk, self-efficacy and fruit and vegetable intakes; and 2. Determine the effects of the revised Chef Charles program on participant satisfaction. The working hypothesis for this research objective is that the proposed modifications in the revised program will lead to higher participant program satisfaction. To date we have identified four congregate meal sites to participate in the study (2 treatment, 2 control), designed a new Chef Charles newsletter template for the treatment groups, and started participant recruitment. OUTCOMES/IMPACTS: The LIFE Program has a 67.6% (46 out of 68 participants) completion rate for older adult participants and 100% completion rate for Trainers. Pre- (Week 1), post- (Week 8), and follow-up (Week 25) data were collected for all participants and trainers. For participants who were classified as inactive at Week 1 (21 total), five became active by Week 8 (p-value equal to 0.021), and six additional from Week 8 to Week 25 (p-value equal to 0.010). This was a 51 percent increase. Significant (p-value equal to or less than 0.005) improvement was seen in the number of chair stands participants were able to complete in 30 seconds from Week 1 to Weeks 8 and 25. Additionally, right handgrip strength improved (p-value equal to or less than 0.005) from Week 1 to Week 25. Furthermore, flexibility, as measured by the back scratch test, for the left arm significantly improved from Week 1 to Weeks 8 (p-value equal to or less than 0.038) and 25 (p-value equal to or less than 0.005). All other fitness and subjective well-being variables indicated improvement, however none were significant. Almost all participants (40 out of 46) stated they would recommend the LIFE Program to friends or family. Trainers demonstrated significant improvement in aging knowledge (p-value equal to 0.027), expectations regarding aging and mental health (p-value equal to 0.017), expectations regarding aging and cognitive function (p-value equal to 0.043), total expectations regarding aging score (p-value equal to 0.046), and a reduction in the number of aging stereotypes believed (p-value equal to 0.016) from Week 1 to Week 8. Trainer follow-up data are currently being analyzed. No changes were detected with anxiety about aging. Finally, focus groups transcripts are currently being analyzed to identify key themes. There are no outcomes to report for the Chef Charles revision project at this time. PARTICIPANTS: Individuals: Sarah L. Francis, Ph.D., MHS, RD (PI), Assistant Professor/State Nutrition Extension Specialist, Dept. of Food Science and Human Nutrition; Warren D. Franke, Ph.D., FACSM (Co-investigator), Professor/Director, The Exercise Clinic at Dept. of Kinesiology; Jennifer A. Margrett, Ph.D. (Co-investigator), Assistant Professor, Department of Human Development and Family Studies; Marc Peterson (collaborator), Grant Coordinator Dept. of Food Science and Human Nutrition (at the time of the study Peterson was a Program Specialist, 4-H Youth Development, Iowa State University Extension); Kara Strand and Rebecca Brotzman, Graduate Students, Dept. of Food Science and Human Nutrition. Organizations: Aging Resources of Central Iowa (congregate mealsites in Story and Polk Counties Iowa), Iowa Department on Aging, and Iowa Department of Public Health. TARGET AUDIENCES: The LIFE program utilized an intergenerational design towards health promotion of older adults. We recruited a convenience and snowball sample of 100 rural older adults age 60 years and older (68 started the program; 46 completed) and 48 young adults ages 16 years and older (18 started the program; all completed). Young adults served as the on-site program trainers and older adults were the program participants. Trainers were female (17 out of 18 total) between ages 21 and 25 years (13 out of 18 total) in their junior and senior year of college (14 out of 18 total) with occasional daily contact with older adults (11 out of 18 total) who had not lived with an older adult in the last five years (13 out of 18). Participants were independently-living (37 out of 46 total) widowed (27 out of 46 total) females (40 out of 46 total) with a mean age of 75.3 years in somewhat to very good health (28 out of 46 total) who had occasional daily contact with youth (32 out of 46 total). Needs assessment focus group participants (27 total) were married (17 out of 27 total), white (26 out of 27 total), educated (23 out of 27 total) females (21 out of 27 total) with a mean age of 62.5 years who lived in rural areas (19 out of 27 total) and worked at least 31 hours weekly (15 out of 27 total). For the Chef Charles revision project, 64 individuals have expressed interest in participating. PROJECT MODIFICATIONS: Reported modifications refer to the LIFE project. On-Site Leader Recruitment: A proposed sustainable LIFE Program component is the use of on-site leaders; however recruitment of on-site leaders has proven extremely difficult. Most participants state they would like the program to continue but are not interested in leading it. The most common reason is Im retired and dont want to commit to anything long term. In an attempt to aid the recruitment process the research team opted for on-the-job training rather than a two-hour workshop. The on-the-job trainer agenda includes a six week training agenda totaling four and one-half hours of training. It occurs 15 to 20 minutes before and after each session. These sessions are provided by the Trainers. Number of participants: The original grant application listed a goal of 100 participants (based on 10 participants per site; 10 sites total). Since the number of sites was reduced to seven the revised target participation numbers were 70 participants (10 per site; 7 sites total) and 21 trainers (3 per site; 7 sites total). Recruitment efforts were successful in garnering interest (100 participants and 48 trainers); however about two-thirds (68 out of 100) of participants and one-third (18 out of 48) of trainers chose to begin the program. University of New Hampshire, Joanne Curran-Celentano Objective 2, Experiment 2 Investigating determinants of macular pigment density as a biomarker of carotenoid status and eye disease risk in the elderly. 2a. Purpose. To determine the impact of pregnancy and lactation on lutein status, retinal health and MPOD; Does number of pregnancies impact lutein/n-3 FA status and health risk with aging. (LSU with UNH participating) Update - Women, compared to men, are at higher risk for developing age-related macular degeneration (AMD), one of the leading causes of blindness in the elderly. We explored if pregnancy, which is known to deplete women of docosahexaenoic acid (DHA, 22:6n-3), a long chain n-3 fatty acid that is essential to the structure and function of the eye, is a risk factor for development of AMD. Our data have shown that DHA is preferentially transferred across the placenta during a pregnancy that is not complicated by gestational diabetes, whereas lutein-zeaxanthin are not preferentially transferred. Our hypothesis was that women who had had more pregnancies would be at greater risk for developing AMD. In this case controlled study, women (n=501, 50+ years of age) diagnosed with and without AMD at three private eye care facilities in Louisiana were recruited to participate. Participants were asked questions about their physical and retinal health, past pregnancies, family histories, and vitamin and fish oil supplementation. The evaluation of each subjects macular health was assessed by their ophthalmologist or optometrist. Significant predictors of being diagnosed with AMD were: age, parity, and BMI by parity. As age, BMI and the number of pregnancies increase the probability of being diagnosed with AMD also increases. Thus, it is possible that supplementation with DHA during pregnancy may be protective against future AMD. 2b. (Modified 2011) Since the presence of macular pigment through the lifecycle is hypothesized to influence risk of aging eye disease and obesity is a known risk factor for AMD, we are assessing MPOD on normal, overweight and obese young adults in two studies. Data collection is ongoing in both a. Normal, mild and overweight college students are recruited for MPOD measurement using heterochromatic flicker photometry. In this study the retinal carotenoid density will be assessed relative to body weight, BMI, lifestyle questionnaire and dietary intake evaluation using the LZQ©" questionnaire (HNRCA and Tufts University) for lutein and zeaxanthin. b. Normal and overweight adults aged 18-50 are being actively recruited to participate in a 12 week lutein intervention to determine the impact of body weight, body composition and dietary pattern on absorption, transport and deposition of supplemented lutein (10 mg lutein, 2 mg zeaxanthin). The effect of supplementation on serum, macular density and markers of inflammation will be evaluated. Five measurements of MPOD are being assessed over 3 month intervention. MPOD will be measured using a Macular Metrics heterochromatic flicker photometry unit set-up at the laboratory at St Anslem College. At the time of each retinal measurement, blood samples will be collected for carotenoid analysis by HPLC at UNH. Changes in MPOD and carotenoids will be assessed along with changes in serum cholesterol, lipid profiles, dietary and anthropometric measures. Update on CRP data: In a sample of 54 individuals, macular pigment was inversely related to c-reaction protein (CRP), a biomarker for inflammation, and was significantly higher among individuals in the lowest quartile of CRP concentration. Perhaps the macular pigment or factors affecting the macular pigment, such as diet, directly or indirectly influence inflammatory status, and consequently, retinal health. Carotenoid data is currently being analyzed NH work on Objective 1: Supporting student participation in the NH effort in pretesting whole grain education diet assessment and tool evaluation program. University of Rhode Island Matthew Delmonico, Ingrid Lofgren, and Furong Xu Objective 2, Experiment 1 During our recent USDA-funded randomized clinical trial (UR-IDEAL V, spring 2012), 54 obese older women aged 55-80 years underwent 16 weeks of dietary education (1 session a week for 30 minutes) for weight loss and Tai Chi (TC) (2 sessions a week for 45 minutes) at two different Rhode Island senior centers (North Kingstown and South Kingstown). All orientations, testing, and intervention delivery were done at the senior centers. Participants were community-dwelling older women who are obese (body mass index (BMI) between 30.0-50.0 kg/m2) and who were in need of weight loss based on national guidelines. Subjects were assigned to an intervention group (n=41) or to a waitlist control group (n=13). Those in the intervention group participated in a Tai Chi exercise program (two times per week for 16 weeks. Additionally, the dietary intervention (once per week) was based on the Dietary Approaches to Stop Hypertension (DASH) program, which focused on increasing whole grain, unsaturated fats, and fiber intake while reducing sodium, saturated/trans fat, and sugar intake. The DASH program has been successfully implemented in older adult populations, resulting in decreased body weight and CHD risk and increased weekly physical activity. Participants assigned to the waitlist control group were asked to maintain their normal lifestyle during the intervention but had the opportunity to participate in a two week Tai Chi program after post testing. Outcomes included changes in physical and muscle function, diet quality, blood lipids, blood pressure, physical activity, quality of life, body weight and composition, body girths, sleep quality, cognitive function, and BMI. We are now in the development stage of completing a similar intervention next year in a senior center in Providence, Rhode Island that has a high percent of minority women who attend. The TC exercise intervention will occur three times a week and will incorporate resistance training twice a week. The dietary intervention will focus on maintaining a healthy weight rather than weight loss. Future Grant Proposals We plan on submitting an R15 in conjunction with Iowa State University in February 2013. Iowa State University is also a member of the NE1039 multistate. University of the District of Columbia Prema Ganganna, Ph.D., R.D., Principal Investigator William Rice, M.A., Research Associate Objective 1, Experiment 3 The goals of the UDC NE-1039 project are to design and implement intervention strategies that will increase fruit, vegetable, and whole grain consumption in multicultural elderly individuals in the District of Columbia who have been identified as low consumers of these foods. These interventions will be designed using data collected using a nutritional knowledge and behavior survey instrument, and a four day written and photographic food diary. (Each subject is provided with a digital camera both as participation incentive and as a means of validating of food consumption.) The objectives of the data analysis will be to: "Compare knowledge, priorities, and attitudes of high fruit, vegetable, and whole grain consumers with low fruit, vegetable, and whole grain consumers. "Compare the cognitive and affective characteristics of these two groups in order to assess their effect on food choices and consumption. "Determine the extent to which elderly citizens provide nutritional care to children. The assumption is that the nutritional knowledge and behavior of these care givers will have direct impact on the nutritional behavior of the children they care for. Subjects are randomly selected from elderly (over 65) adults who are registered participants in congregate sites provided by the District of Columbia Office on Aging through a senior service network. Five research assistants trained in cognitive interview techniques, have completed individual survey interviews of 45 subjects. These subjects have completed the written and photographic food diary. Interviews and food diaries of at least 55 additional subjects will be completed by September 2012. The table below summarizes results of 45 completed surveys. High FV Low FV High WG Low WG Cares for Children Diet Change Obese Male 3 9 2 10 4 3 4 Female 9 24 4 29 14 10 13 Descriptive analysis of the data provided by 45 subjects suggests: "Subjects can be partitioned into high and low fruit and vegetable and whole grain consumption groups. (Subjects were given a definition of whole grains.) "Subjects seemed generally aware of the benefits of fruits, vegetables, and whole grains, even when they were not consumed in adequate quantities. "Diagnosis of illness changes eating choices and behavior. "It is not unusual for elderly individuals to prepare regular meals for children under 13 years of age. "Nutritional knowledge is a byproduct of the individual interview process. Data analysis will provide guidance for the development of interventions for low consumers of fruits, vegetables, and whole grains. Subjects will participate in intervention development. Cooperative projects that will occur concurrently with data collection and analysis will be compilation of a recipe book that will include family recipes with healthy nutritional modifications, together with personal, cultural, and historical entries; and creation of innovative instructional games and activities. Special consideration will be given to interventions for child care givers.

Publications

Publications Attachment:

Attachment

Impact Statements

Date of Annual Report: 09/18/2013

Report Information

Annual Meeting Dates: 06/02/2013 - 06/04/2013
Period the Report Covers: 10/01/2012 - 09/01/2013

Participants

Gilbride, Judith - NYU (judith.gilbride@nyu.edu);
Woolf, Kathleen - NYU (kathleen.woolf@nyu.edu);
Delmonico, Matthew - URI (delmonico@uri.edu);
Lofgren, Ingrid - URI (ingridlofgren@uri.edu);
Xu, Furong - URI (fxu2007@mail.uri.edu);
Violette, Catherine - UNH (catherine.violette@unh.edu);
Lammi-Keefe, Carol -LSU (CLammi-Keefe@agcenter.lsu.edu);
Cohen, Nancy - UMASS (cohen@nutrition.umass.edu);
Curran-Celentano, Joanne - UNH (joanne.celentano@unh.edu);
Marra, Melissa - WVU (Melissa.Marra@mail.wvu.edu);
Ganganna, Prema - UDC (pganganna@udc.edu);
Rice, William - UDC (wrice@udc.edu);
Jiang, Qianghi - UMASS (qjiang@schoolph.umass.edu);
O'Hara, Sabine - UDC (sabine.ohara@udc.edu);
Sayhoun, Nadine - UMD (nsahyoun@umd.edu);
Francis, Sarah - ISU (slfranci@iastate.edu)

Brief Summary of Minutes

Members Present: Sarah L. Francis; Judith Gilbride; Kathleen Woolf; Joanne Curran Cilantano; Catherine Violette; Kristin Davis; Ingrid Lofgren; Qianghi Jiang; Sabine OHara; Nadine Sahyoun; Melissa Ventura Marra; Nancy Cohen; Furong Xu; Carol Lammi-Keefe; Matt Delmonico; William Rice; Prema Ganganna

Brief Summary of Minutes of Annual Meeting

NE 1039 Annual Meeting Minutes Technical Committee Workshop June 2-4, 2013, Residence Inn, Portsmouth, NH

6/2/13

5:30 pm

Group gathering - Portwalk Meeting Room

Organize and plan for the meeting - Matt

Review request for continuation

Discussion of goals and objectives

Review NE1039 Info/Recruitment sheet what changes do we want to make? Add grant titles and/or funding agencies?

Dinner

6/3/13

Presiding: Dr. Matthew Delmonico, Chair.

Dr. Delmonico welcomed the Technical committee group and requested members to introduce themselves. Dr. Sabine OHara, Dean of College of Agriculture, Urban Sustainability and Environmental Sciences (CAUSES) and also the leader of the Technical Committee updated on the organization of the University of the District of Columbia, gave a brief overview of her background, her role as the dean of CAUSES and leader of the research project. Dr. OHara stressed as to how we have to meet the stated objectives of the NE-1039 project and recommended that the next project should emphasize: obesity as related to socio-economic factors; research regional distinctions, identify targeted populations; study the differences in settings and establishing a grant writing committee for the next five year grant submission. Dr. Delmonico suggested summarizing the station reports and having a brain storming session to discuss how the results of the present four year research could be used to strengthen the future research project. Dr. Lofgren discussed about electing the future Chair, Co-Chair and Secretary for the Research Committee. Ingrid was chosen unanimously as the next president, Dr. Sarah Francis as the Chair elect, Dr. Melissa Marra as the secretary and Dr. Kathleen Woolf as member-at-large. Pursuant to the election of new members the station reports were presented by Dr. Ganganna and Mr. Rice.

Drs. Delmonico and Lofgren connected with Dr. Dierdra Chester from NIFA and she stated that she is waiting for funding approval for submission of the next project and agreed to provide any assistance in the submission of the new project for the next five years from 2014-2019. She also suggested that there would be no changes in the established five priorities in the new Farm Bill except inclusion of water quality and increased funding for this new addition. She also stated that they are looking at the new Dietary Guidelines that change every five years. Dr. Jane Clary, who is the present director is handing over charge to Dr. Chester as the new research project director. Dr. OHara also emphasized on adding food, water, health and wellness. Pursuant to the discussion with Dr. Chester from NIFA, Dr. Delmonico opened the discussion to brainstorm for ideas to improve the projects for the projected next five years. Dr. Ganganna suggested to investigate and identify barriers to changing dietary habits inclusive of accessibility, availability, physical function, lack of knowledge, social support, cost, dependence on small corner stores, use of farmers market, motivations, community partnership, trust and intergenerational factors. Dr. Francis suggested looking into consumption of fruits and vegetables based on health belief theory. She also stated her research group is not diverse as it is difficult to recruit African Americans in Iowa. She mentioned the need to conduct needs Assessment with appropriate medical nutrition assessment. Dr. Nadine Sayhoun from University of Maryland, suggested assessment to prioritize the eligibility to meals on wheels program.

Dr. OHara stated that she hosted a conference sponsored by the American Psychological Society at the University of the District of Columbia. The conference focused on: obesity among African Americans; barriers of motivation to change dietary habits including socioeconomic and educational level; behavioral issues and regional characteristics.

Dr. Delmonico presented his station report Went to several identified sites, set up booths, distributed fliers and approached housing facilities and recruited 25 participants. The research at URI focused on the effect of combined physical activity and dietary interventions on body composition, physical performance and CHD factors in overweight and obese adults. Tai Chi (TC) and resistance training were combined and the goals were to enable participants to lose weight, increase mono- and poly unsaturated fat consumption and decrease trans fat intake. The group met once a week, discussed various aspects of diet and PA, maintained diet records, and assesses their ability to stand on one foot to assess their functional capability, measured cholesterol, glucose, HDL, LDL at all sites. Researchers trained 4 graduate and 13 undergraduate students. Participants enjoyed activities with all other optional competitive activities. The session was followed by a talk by the guest speaker.

Dr. Lofgren continued and stated that research focused on measuring the LDL particle size and found changes in particle size among participants between the control and the intervention groups. They did a 16-week behaviorally-based dietary program using modified DASH diet. No fat free mass change between Tai Chi plus weight loss group and the weight group was observed. However, significant differences were observed between Tai Chi plus weight loss group and the weight loss group for leg strength, grip strength timed up and go test and fat free mass. The research concluded that Tai Chi during dietary weight loss did not appear to have a significant additive effect on global measures of physical function and most measures of body composition but may increase muscle strength. Dr. Lofgren discussed the challenges of their research and stated that participants felt the 16 weeks was too long and looked for a quick magic bullet in lieu of diet and exercise. URIs next stage and step would be to concentrate on cognitive component.

Dr. Marra from West Virginia stated that they are also doing a project with approximately 240 participants to improve their physical performance and health.

Dr. Nancy Cohen and Qianzhi Jiang from Massachusetts presented on their research Environmental Changes to Increase Fruit, Vegetables and Whole Grain Intakes in Older Adults. They are examining recommendations for changes to the community environment to support increased consumption of fresh fruits, vegetables and other nutrient dense foods in older adults. In 2011-12 a sample national scholars in the area of community nutrition and geriatric nutrition identified their priorities for the most important and most changeable factors within the community environment to improve nutritional status in older adults. As a result accessibility, affordability, social support and living accommodations were identified as important enabling factors to improve nutritional status, with food stores, congregate nutrition sites, senior housing, health care settings, religious settings, and restaurants as priority behavioral settings. In 2012-2013 MA is utilizing similar mixed methods approach to examine priority local environments to improve nutritional status in a city in western Massachusetts. A purposive sample of representatives of social senior centers and senior service agencies, community health coalitions, food planning councils, health agriculture and aging agencies, food banks, and local food coalitions have been invited to participate in focus groups to identify the enablers of healthy eating among older adults in the community and, to generate ideas for possible changes in community behavioral settings. They will then participate in an online ranking procedure using the analytic hierarchy process to calculate specific contributions of each important behavioral setting toward each important enabling factor for the identified community. The future steps identified by the researchers are to: 1) Duplicate in multiple states/areas; 2) Compare among states/areas; 3) identify similarities and differences. They are expecting approximately recruiting 12 participants through contact sites.

Dr. Cohens presentation was followed by Dr. Catherine Violette, UNH Cooperative Extension, University of New Hampshire on Pre-testing a whole grain foods education program. The is it whole grain curriculum for older adults was based on the results of NE-1023project which was developed into a one-session and three session format. Program was pre-tested in 2009-2011 and was revised in 2012 and was finalized as a one-hour, three session education program. Two versions of the program were developed by UNH and Iowa State; one using power point slides to communicate basic information on whole grains and second using handouts. Assessment was done to evaluate participants knowledge and practice changes in identifying whole grain foods using product packages.

In NH Nutrition Connections Program Associates and six volunteer UNH Nutrition Program students were trained to implement the program in September 2012. Response to the program from participants has been very positive. is it Whole Grain program was also implemented during the fall of 2012 reaching 54 older adults, but only 34 sets of usable data were obtained. The reasons for incomplete data base were, incomplete forms, participants attending only1 or 2 of three sessions and could not complete post session questionnaire, or were less than 60 years of age. Delivery of the program will continue until 60=90 data sets are completed.

Dr. Sayhoun from University of Maryland gave a brief account of their research on Behavior and Knowledge on Food Safety. A curriculum was developed on food safety. Six modules were developed and train one or two interns/year. They also offer Webinar on food safety and the trainees get certified. They conduct food safety training as train the trainee program so the trainees after getting certified can train others. They are also working on educating community on increasing folate consumption

Dr. Woolf from NYU briefly presented her research on Inactivity that Influences Cardiovascular Activity. Their research focused on state level obesity and its relationship to cardiovascular disease, common measurement tools, gathering statistics on local obesity and compare to regional statistics.

Dr. Curran-Celentano from UNH presented their research on the important role of lutein and zeaxanthin in reducing risk of advanced macular degeneration disease. The research focused on the density of eye pigment based on the intake and sources of carotenoids. The team was not sure whether density is a marker of pigments. She stressed that eye disease is a chronic phase but can be prevented by dietary factors. Interestingly Dr. Curran-Celentano stated that obesity is associated with eye disease. Mention was also made of a grant in coordination with the University of Georgia to conduct research on luteins association with cognition and the transport across the blood brain barrier. She emphasized that lutein deficiency can be a biomarker of risk and can be supplemented/added to foods. Dr. Carol Lammi Keefe from Louisiana added that she is working on a project on the effect of earlier eating habits to later macular degeneration. She conducts interviews participants through coordinating with optometrist, gather information on BMI and number of pregnancies to study the effect of early eating habits to macular degeneration. Females consuming less DHA and lutein related to low optical pigment density and also stressed that Higher BMI is related to retinal degeneration.

Dr. Delmonico recommended that the group be divided into small sessions to work on the objectives for the next five year grant period. Dr. Francis recommended a group brainstorming prior to breaking into smaller groups.

The discussion progressed as follows:

Previous objectives

- To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults

- Food, environment, nutrition- barriers for males and females for changing dietary habits

- To identify effective biomarkers and other indicators that reflect improvement in diet (fruit, vegetables and whole grains) and physical activity and chronic disease risk in older adults

Suggestions for new project for the next research period

- Dr. Sayhoun suggested looking into the motivators for maintaining and improving lifestyle habits for better health and apply that knowledge for designing strategies for non compliant population.

- Assess older adults (48 + years) compliance with dietary guidelines and physical activity

- Longitudinal measures of compliance- observation and compare between urban, suburban and rural population. Examine environmental setting and how it helps/hinders compliance with dietary guidelines

- Improve older adults compliance with dietary guidelines, diet and physical activity

- Interventions with more follow up measures

- Examine how changes in environmental setting can help enhance compliance with dietary guidelines.

- Dr. Sayhoun suggested addressing two or three questions on assessment to Department of Public Health to address the overarching problem of impact.

- Members suggested to address, obesity, New dietary guidelines, DGA, HEI, PA, physical fitness/functioning, wellness and food security

The discussion was followed by guest speaker, Dr. Dain LaRoche, from the Department of Kinesiology, UNH. The speaker was introduced by Dr. Curran-Celentano and the topic was Excess fat mass and strength asymmetry impairs walking performance in older women. The study was done on the age group between 65-80 and n=25. Body composition was done using bodpod and measured maximal torque, and rate of torque, knee extension, knee flexion, plantar- and dorsiflexion. The participants walked at standard 0.8 m/s-1 at a self selected maximum speed. Recorded spatial temporal measures and gait variables using instrumented treadmill. Stride time, limb support time from force data were calculated. He stresses that strength, knee extension and torque a declines with aging. The decline seems more in women than men and lower extremity weakness increases the risk for falls by X 4, two times for hospitalization, times X 2 risk for nursing home admission and risk X 2 for death. Studenski et al. conducted a meta analysis on gait speed and survival. People who were expected to walk 1.6 m/s live up to 100 years and 0.8 m/s up to 80 years. Old adults with sedentary habits loose muscle mass and gain adipose tissue and asymmetric knees had lower threshold than symmetric knees. Dr. La Roche summarized his presentation as follows:

- Excess fat mass is a marker of lower strength and power relative to lean body muscle mass

- Strength relative to mass is strongly related to walking ability

- Strength asymmetry associated with reduced walking ability, increased gait asymmetry and increased gait variability.

Currently he is conducting research on blood flow restricted exercise efficiency (BFREE) and body weight unloading study, which is an artificially adjusting ratio of strength-weight by unloading.

6/4/13

The session started by Dr. Delmonico stating that all annual reports should be posted on SAKAI. Matt addressed the executive committee meetings and proposed to hold the next 2014 Technical Committee meeting in New Hampshire on June 8th 2014. He also suggested that all attendees should attend he complete two day sessions and the second day session would end at 4:30 PM on Tuesday June 9th, 2014. He addressed the committee to decide on the new objectives and specific plans to incorporate into the new proposal for the next five year research period from 2015-2019.

Dr. OHara proposed to work on a timeline including what and how we have met the objectives as proposed in 2009 for NE-1039 and specify the how this research results would be used to proceed win the next five years. She also addressed the committee to specify the grant amount received by individual researcher to fulfill their chosen objectives for NE-1039.

Dr. Delmonico addressed the committee to add the following to the annual report when it is downloaded to SAKAI.

- no. of graduate students trained

- no. of undergraduate students trained

- Community presentations

- Research presentations

- Grants and the amount awarded

- Publications

- Objective for which the research was done

- Experiment for which the research was done

- Plan to finish and what we are going to do during the next year

Members had a long discussion on grants awarded for the same objectives through various grants. Dr. Delmonico reviewed all the information required for annual reports to be posted by June 25th and minutes to be posted on SAKAI by July 4th. Members were encouraged to bring students to present their research during 2014 Technical Committee meeting.

Dr. Delmonico reviewed objectives for the next 5 years.

1. Diet quality, nutritional assessment, food security and food safety and bioactive/biomarkers

New objective: 1). To examine a trans disciplinary approach and the food environment including diet quality, nutritional assessment, food security, bioactive compounds and biomarkers across the adult lifespan.

- Food environment

- Regional differences

The morning session was followed by the presentation by guest speaker from NEMS, Dr. Adam Wentzel PhD, St Anselm College on Macular Pigment Lutein and Zeaxanthin.

The full proposal is due by early December 2013. The group will need to identify peer reviewers for the proposal.

Dr. Violette suggested the proposal be drafted Summer 2013. Drs. Francis and Lofgren recommended a due date of August 15, 2013.

Everyone should include background information along with objective, experiment and some methodology (about 1 paragraph in length)what is the project, describe general methodology. There is usually about 2-3 experiments under each objective. The lead station will write the experiment. Ingrid stressed there is flexibility with the objectives and experiments in case the program changes

Proposed timeline:

Aug 15: first draft due (Drs. Delmonico and Lofgren)

Sept 27: Drs. Delmonico and Lofgren will post draft of Sakai for group to review

Oct 18: Comments and list of peer reviewers (include someone from Ag experiment station) to Matt and Ingrid (through Sakai or email)

Nov 9: Drs. Delmonico and Lofgren will post the revised proposal on Sakai for group to review

Nov 27: Comments due to Drs. Delmonico and Lofgren

Dec 6: Final Draft due (Drs. Delmonico and Lofgren)
Sarah will assist with logic model

Discussion regarding proposal:

It was encouraged we keep the following in mind:

Priority areas: food security, food safety, sustainability, water, climate change, childhood obesity

NERA: Guidelines for multistate, advisory tools etc.
http://www.nera.umd.edu/advisorTools/neSupGuidelines.cfm#VI This was included in Sabines email on May 27th.

Dr. Cohen suggested we submit a revised proposal and its rejected then we appeal for an extension. Nancy stressed that for the continuation we need to show impacts (publications, joint projects). Presentations are not counted, just what's been published (manuscripts, theses, dissertations).

The first conference call will be early October.

There was a lot of discussion about midlife and older adults

- Dr. Violette asked what definition is being used for midlifewe decided not to quantify it. Our target will be midlife and older Americans.

- Dr. Sayhoun opted for older adults only

The possibility to have only one general objective with various experiments was discussed

Proposed Objective options discussed included:

- To assess needs and develop novel interventions to improve the dietary quality and physical activity that impacts quality of life in midlife and older adults. (Quality of Life, helps tie in biomarker research)

- To assess needs and develop novel interventions to improve aspects of physical wellness in midlife and older adults

Nutritional Assessment was discussed as being an overarching theme that encompasses diet quality and biomarkers. Katherine also suggests assessment and interventions be included with nutritional quality.

Nancy reminded group that we need to conduct a CRIS review to ensure that there is not overlap between our proposed project and another multistate.

A lot of discussion was had surrounding our target audience:

Nadine encouraged the group to stay focused on older adults and asked that midlife be removed.

Ingrid cautioned that we stay distinct form young adult multistate efforts

Katherine suggested that we tease out midlife from older adults in the objectives

Proposed Tools: Dietary Physical Activity QOL, DST, POMS, PANAS, SWL, LAS, MNA

Proposed/Discussed Experiments:

Environment: (UMass lead) look at food environment scale for older adults based on 2008-13 project; Need partners to help collect data for identifying factors and eventual testing

Nutritional Assessment:

General Nutrition/Wellness (URI, ISU, UNH): for 2014 no one is sure about funding so look at low cost experiments. 1) Conduct systematic review of where NHANES, HEALTHY ABC, etc.where are the reductions in QOL, PA, nutrition based on ages to help identify when to start interventions, holistic attributes toward older adult health/wellness programs (similar to 2004 Sahyoun article looking at effective nutrition programming but looking at a variety of interventions to propose best practices for transdisciplinary programming)

Biomarkers (UNH, LSU, St. Ambrose): include cognitive testing, sleep quality, active pal vs. active graft. Adam would look at cognitive; systematic review

Bioactive compounds and cognition (UMD): epidemiological study using NHANES data (in discussions)

Physical Activity

RA (NYU): adults 50+ wear accelerometers, complete 7d food records and supplement use (Pilot program has 100 people). Actipal/actigraft; look at osteoarthritis vs. RA and sitting time

Tai Chi (URI, WVU): continue with Tai Chi studies

Other proposed ideas:

BRFSS: each state find out about adding a question to the survey. If this is a possibility, then we could collect national data regarding a particular research question. Nadine will look into this option.

Other information:

Dr. Wentzel will be added to Sakai

Next meeting is June 8-11, 2014 Portsmouth, NH (UDC, UMD, WVU, ISU will likely need to stay Tues night too)

Accomplishments

University of Massachusetts, Dr. Nancy Cohen (with graduate student Qianzhi Jiang) Objective 1, Experiment 1 Objective 1, Experiment 1: Environmental changes to increase fruit, vegetable, and whole grain intakes in older adults Researchers in MA are examining recommendations for changes to the community environment to support increased consumption of fresh fruits, vegetables, and other nutrient-dense foods in older adults. In 2011-12, a sample of national scholars in the area of community nutrition and geriatric nutrition identified their priorities for the most important and most changeable factors within the community environment to improve nutritional status in older adults. As a result, accessibility, affordability, social support, and living accommodations were identified as important enabling factors to improve nutritional status, with food stores, congregate nutrition sites, senior housing, health care settings, religious settings, and restaurants as priority behavioral settings. In 2012-2013, we are utilizing a similar mixed methods approach to examine priority local environments to improve nutritional status in a city in Western Massachusetts. A purposive sample of representatives of local senior centers and senior service agencies, community health coalitions, food planning councils, health, agriculture, and aging agencies, food banks, and local food coalitions have been invited to participate in focus groups to identify enablers of healthy eating among older adults in the community and to generate ideas for possible changes in community behavioral settings. They will then participate in an online ranking procedure using the analytic hierarchy process to calculate specific contributions of each important behavioral setting toward each important enabling factor for this community. Data collection is currently in progress. This model will be replicated in diverse communities in the Northeast region over the next year to examine common themes for community-based actions and recommendations for environmental changes that focus on improving the nutritional intake of older adults. - no. of graduate students trained 1 - no. of undergraduate students trained 0 - Community presentations 1 - Research presentations 0 Iowa State University, Sarah Francis Objective 1, Experiment 2 Pre-testing a whole grain foods education program (UNH lead; MA, MD participating stations) The Is it Whole Grains? evaluation project is sponsored through an Iowa State University (ISU) Extension Grant and is evaluating the impact of this curriculum on older adult whole grain knowledge and intended behavior change. The curriculum, Is it Whole Grain? 3 Steps to 3 Servings of Whole Grains, is based on the results of the NE1032 that examined how older adults identify whole grain foods using product packages. The resulting curriculum is a three session program (1 hour each) and is being evaluated in New Hampshire and Iowa. In Iowa, the program has been taught at seven locations (1 senior center, 4 retirement communities [higher income older adults], 2 senior apartment complexes [older adults with limited resources]). Other than demographic data, no data analysis has been conducted at this time. In Iowa, the Whole Grains program, to date, has reached 60 predominately white (56 white, 2 Asian, 1 other, 1 no answer) women (51 females, 8 males, 1 no answer). Most participants (32 out of 60) are between age 81 and 90 years and have post-high school education (52 out of 60). Efforts are underway to reach a more diverse audience. Objective 2, Experiment 1 The effect of combined physical activity and dietary interventions on body composition, physical performance, and CHD risk factors in overweight and obese older adults. ISU project 1 (Evaluation of newsletter nutrition education program): The Chef Charles (CC) Revision project was funded by the Wellmark Foundation. The CC program is a newsletter-based nutrition education program for congregate mealsite participants led on-site by a nutrition educator. CC encourages: fruit, vegetable and calcium-rich food consumption; physical activity; food safety practices; and promotes food security. The CC Revision Project revised the traditional newsletter based on needs and preferences of the clientele and used the Health Belief Model (HBM). The research objectives were 1. determine the effects of the revised CC program on older adult nutritional risk, self-efficacy of healthful eating, and fruit and vegetable consumption, and 2. determine the effects of the revised CC program on participant satisfaction. The majority of initially enrolled CC Program participants (60 out of 73, 82.2 percent) completed the program. There were 31 participants in the control group and 29 in the treatment group. Statistical analyses determined previous participation in the Chef Charles program did not influence the outcomes. Slightly over a third (24 participants, 38.3 percent) of participants were classified as at nutritional risk at the beginning; this number decreased slightly at post (20 participants, 33.3 percent), but not significantly. The change in dietary practices (nutritional risk) for the treatment group (mean change score equaled 5.25) was significantly higher (p-value equal to 0.042) than the control group. The treatment group also had a significantly higher increase in reported frequency of vegetable (p-value equal to.019) and dairy (p-value equal to 0.023) intakes. No other differences between groups were noted for the other measures (food security and self-efficacy). Over half of all participants (46 participants, 76.7 percent) reported making dietary changes as a result of participating in the Chef Charles program. The Chef Charles revision project provided education to 60 seniors (25 males, 34 females) with a mean age of 72.6 years with most (42 out of 60) having higher than a high school education. Long-term impact of project: The Iowa Department on Aging is in the process of reorganizing the Area Agencies on Aging (AAA) which entails reducing from 13 to 6 starting July 2013. Currently, public health uses SNAP-Ed funds to support the CC Program in approximately one-third of eligible meal sites. The reorganization of the AAA opens up new opportunities to expand program reach. The current plan is to double the SNAP-Ed investment in the CC Program and implement a new delivery model that will increase efficiency and reach to potentially all of the eligible meal sites. There is one publication in preparation related to the CC Program. A poster was presented at the 2013 Experimental Biology conference as well. ISU Project 2 (Evaluation of community-based exergaming program): The Living well through Intergenerational Fitness and Exercise [LIFE] Program (LIFE 2), is using evidence-based programming criteria to refine a community-based intergenerational exergaming program for rural America. This is a continuation of the LIFE 1 Program (NIFA funded) and is using a community-based implementation strategy as opposed to the original research-style delivery. The LIFE 2 Program, also funded through NIFA, is being implemented in 15 rural Iowa Counties through Extension. The program has entailed the training of 11 Extension employees, creation of a comprehensive program manual, and younger adult trainer training modules. The LIFE 2 program is actively being implemented in 7 rural counties with 61 older adults and 28 younger adults. It is being planned in the remaining 8 counties. The LIFE 2 program is expected to reach up to 80 younger adults (age 16+) and 400 older adults (age 60+) by the end of the research period. For LIFE 1 there is one publication in press and four in preparation. LIFE 1 results have also been presented as two oral and three posters at national conferences. The overall all objective of the Viva Gauge validation study (ISU funded study) is to develop and test mid-arm and calf circumference bracelet-like measurement tools (Viva Gauge) that are the diameter ranges specified on the Mini Nutritional Assessment (MNA) so that they are fast and easy to use by untrained personnel while providing valid and reliable results when compared with that of the traditional MNA administered by trained staff. To date, the Viva project entailed developing two arm bands and one leg band, training of 12 students (3 graduate, 9 undergraduate), and screened 130 adults age 65+. The goal is to screen 300 older adults. The Viva Gauge study has conducted nine screenings (2 health fairs, 3 retirement communities, 1 foster grandparent program, 2 grocery stores, 3 in-home via meals-on-wheels, 1 senior center). These screenings reached 130 older adults and identify 26 (20%) as at risk and/or malnourished. RESEARCH PRESENTATIONS: Francis, S.L, Shelley, M., MacNab L. A theory-based newsletter nutrition education program reduces nutritional risk in community-residing older adults. FASEB J. (27):839.2. Poster session at the 2013 Experimental Biology Conference, Boston, MA. Heinz, M.S., Margrett, J.A., Francis, S.L., Strand, K.A., & Franke, W.D. Intergenerational Wii© Physical Activity Program: Mixed Methods Findings of Socialization Benefits. Poster session at the Gerontological Society of America November 2012 meeting. San Diego, CA. Margrett, J.A., Heinz, M.S., Francis, S.L., Strand, K.A., & Franke, W.D. Benefits beyond the Physical: Intergenerational Wii© Activity Program and Affective Well-being. Poster session at the Gerontological Society of America November 2012 meeting. San Diego, CA Francis, S.L., Brotzman, R., Strand, K.A., Margrett, J.A., Franke, W.D., Peterson, M.J. Wellness programming needs and preferences for adults age 45+. Journal of the Academy of Nutrition and Dietetics, 112(9), suppl 3: A-12. Oral presentation given by Francis at the 2012 Food and Nutrition Conference and Expo (FNCE), Academy of Nutrition and Dietetics, Philadelphia, PA. Francis, S.L., Brotzman, R., Strand, K.A., Margrett, J.A., Franke, W.D., Peterson, M.J. Congregate Meal Program Perceptions Among Iowans Aged 45+. Journal of the Academy of Nutrition and Dietetics, 112(9), suppl 3: A-26. Poster session at the 2012 Food and Nutrition Conference and Expo (FNCE), Academy of Nutrition and Dietetics, Philadelphia, PA. Strand, K.A., Francis, S.L., Margrett, J.A., Franke, W.D., & Peterson, M.J. (2012). Intergenerational exergaming physical activity program increases flexibility and strength in older adults. FASEB J. (26):367.5 Oral presentation given by Strand at Experimental Biology Conference, San Diego, CA 2012. PARTICIPANTS: Faculty: 3 (Nutrition/Extension, Kinesiology, Human Development and Family Studies) Extension Personnel: 11 Students: 7 (1 MS Nutritional sciences, graduated; 2 BS/MS Diet and Exercise [in progress], 1 MS Gerontology [in progress], 3 dietetic undergraduates (if VIVA counts9) Community Organizations: Aging Resources of Central Iowa, Iowa Department on Aging, and Iowa Department of Public Health. FUNDING: October 2012-Present ($170,349 total or $195,195if VIVA project is applicable) NIFA (External funding; LIFE 2 program implementation): $168,329 Excellence in Extension (Internal funding; Whole grains project): $2,020 College of Human Sciences Collaborative Seed Grant (Internal funding; nutritional assessment): $24,846 October 2011-September 2012: Wellmark Foundation (External funding; Chef Charles project): $21,580 October 2010-September 2011: NIFA (External funding; LIFE 1 program creation and implementation): $141,317 2013-2014 Plans - Apply for NIH R01 for continued funding of the LIFE Program - Complete nutrition assessment study. If results indicate that the VIVA tools are valid, will apply for NIH SBIR or R21 grant funding to expand validation in more diverse communities. - The Whole Grains program will be revised based on study participants feedback and developed into a statewide Extension-delivered nutrition program in Iowa. - Prepare for publication a cross-sectional report of the DST findings in New Hampshire, Rhode Island and Iowa - Using information obtained through the nutritional assessments collected thus far (Mini Nutritional Assessment and DST), develop holistic wellness programming that addresses the identified nutritional and wellness needs for Extension. University of New Hampshire, Joanne Curran-Celentano 2011 Modifications Proposed for Objective 2: Objective 2, Experiment 1 The effect of combined physical activity and dietary interventions on body composition, physical performance, and CHD risk factors in overweight and obese older adults. (URI lead; UNH participating) Year 2012-13 2 Graduate Students 3 - 6 Undergraduate Students Community Presentations 6 Research Presentations 4 (+collaborative 6) Related Grants INBRE - $40,000; UGA $35,000 Publication none related one in preparation Outcomes/Impacts: Objective 2: To identify effective biomarkers and other indicators that reflect improvement in diet (fruit, vegetables, and whole grains) and physical activity and chronic disease risk in older adults. Completing the study this month testing twenty normal and overweight adult for changes in macular pigment density as a marker of carotenoid status and CRP as a marker of inflammation following supplementation and as related to diet, BMI and markers of inflammation. Outcome expected is the relationship between body weight and changes in macular pigment, relationship to inflammatory markers and risk of age-related eye disease. Objective 1 Experiment 2 Catherine Violette, PhD RD is Extension Professor responsible for the whole grain education program and my new graduate student, Kristin Davis, will be working on the whole grain project exploring the impact of changes in knowledge on whole grain selection, changes in nutrient intake when whole grains are consumed and a systematic review of whole grain fiber v phytonutrient. Going forward: Collaboration with UGA Center on Aging for lutein and cognition should add this to the project. Publications: No Publications Reported University of Rhode Island, Drs. Delmonico, Lofgren, and Xu Objective 2, Experiment 1 The effect of combined physical activity and dietary interventions on body composition, physical performance, and CHD risk factors in overweight and obese older adults. (URI lead; UNH participating) Purpose. To develop effective intervention strategies to improve physical performance and reduce CHD risk factors in overweight and obese older adults. Review of Research Completed During our recent USDA-funded randomized clinical trial (UR-IDEAL VI, spring 2013), twenty-five obese older women aged 50-80 years underwent 12 weeks of dietary education (1 session a week for 45 minutes) for weight loss and exercise training (3 sessions a week for 205 minutes) for physical function improvement at one urban Rhode Island senior center. Exercise portion includes three 55-minute Tai Chi (TC) sessions on non-consecutive days of the week and two 20-minute additional resistance exercises on two of those three TC sessions. Subjects were assessed at baseline and post-intervention by the following tests; height, weight, BMI, physical functioning, dietary intake (Dietary Screening Tool), flexibility, blood lipids (Cholestech), body composition (Tanita BF-556), blood pressure (sphygmomanometer), and cognitive function (the repeatable battery for the assessment of neurological status). Fifty-three percent of the experimental group lost an average of ~2.2% or more of their initial body weight as compared with 33% of the control group with ~1.9% weight loss. Attendance for the experimental group was ~ 67% for exercise sessions. We are now in the development stage of updating present intervention strategies in an effort to carry on larger scale project next year in two senior centers in Providence, Rhode Island that has a high percent of minority women who attend. The TC exercise intervention will occur three times a week and will incorporate resistance training twice a week. The dietary intervention will focus on maintaining a healthy weight rather than weight loss. Student Training 1. Four graduate students trained in community based research. 2. Thirteen undergraduate students trained and expected to gain a better understanding of research and its role in community health promotion for older adults. Future Grant Proposals We have submitted a grant application to AstraZeneca HealthCare Foundation in February 2013. We plan on submitting an R15 in conjunction with Iowa State University in summer 2013. Iowa State University is also a member of the NE1039 multistate. Research Presentations 1. Delmonico MJ, Bekke J, Letendre J, Beebe N, Quintanilla D, Lofgren IE, Xu F. 2013. Effect of Tai Chi plus dietary weight loss on blood pressure in obese older women. American College of Sports Medicine annual meeting, May 2013. 2. Bekke J, Letendre J, Beebe N, Lofgren IE, Xu F, Delmonico MJ. 2013. Effects of a Dietary and Tai Chi Intervention on Body Composition in Obese Older Women. Experimental Biology conference, April 2013. 3. Letendre J, Bekke J, Beebe N, Lofgren IE, Xu F, Delmonico MJ. 2013. The Effects of Tai Chi plus behaviorally-based dietary weight loss on physical functioning in community-dwelling obese older women. Experimental Biology conference, April 2013. 4. Taetzsch A, Lobuono D, Letendre J, Bekke J, Beebe N, Delmonico MJ, Xu F, Lofgren IE. 2013. The effects of nutrition education and Tai-Chi on dietary intake and resiliency in community dwelling older adults. Experimental Biology conference, April 2013. Community Presentations Dr. Delmonico 2/2013 Guest Speaker, Rumford Grange: Exercise for seniors 2/2013 Guest Speaker, Kickemuit Grange: Exercise for seniors

Publications

Beebe N, Magnanti S, Katkowski L, Benson M, Xu F, Delmonico MJ, Lofgren IE. Effects of the Addition of Tai Chi to a Dietary Weight Loss Program on Lipoprotein Atherogenicity in Obese Older Women. Journal of Alternative and Complementary Medicine, In Press, 2013. Katkowski LA, Benson MC, Magnanti S, Lofgren IE, Xu F, Delmonico MJ. Additive effect of Tai Chi during weight loss on physical function and body composition in obese older women. Alternative Therapies in Health and Medicine, In Press, 2013. Strand, K.A., Francis, S.L., Margrett, J.A., Franke, W.D., & Peterson, M.J. (in press) Community-based exergaming and wellness program increases physical activity and subjective health among rural older adults. Journal of Aging and Physical Activity. Macnab, L., Francis, S.L, Litchfield, R (November 2012). Whole Grains. 4 pages, FAM12. Sylvie, A.K., Jiang, Q., and Cohen, N. Identification of Environmental Supports for Healthy Eating in Older Adults. J Nutrition Gerontol Geriatrics 32(2): 161-174, 2013.

Impact Statements

Date of Annual Report: 04/16/2015

Report Information

Annual Meeting Dates: 06/09/2014 - 06/10/2014
Period the Report Covers: 10/01/2013 - 09/01/2014

Participants

Judith Gilbride - NYU;
Kristin Davis – UNH;
Catherine Violette – UNH;
Joanne Curran-Celentano – UNH;
William Rice – UDC;
Prema Ganganna – UDC;
Nancy Cohen – UMass;
Qianghi Jiang – UMass;
Matthew Delmonico – URI;
Ingrid Lofgren – URI;
Furong Xu – URI;
Elgloria Harrison - UDC;
Chery Smith – UMN;
William J. Belden - Rutgers

Brief Summary of Minutes

Minutes Attachment:

Attachment

Accomplishments

Non-Technical Summary Older Americans are the fastest growing segment of the U.S. population; the U.S. Census Bureau projects that the older adult population will comprise 20% of the population by 2030, up from 12.4% in 2006 [1]. Older adult wellness is a growing public health concern as Baby Boomers approach retirement age. The National Institute on Aging (2011 – ref needed) estimates that by the year 2040, there will be a doubling of adults age 65 to 84 and a quadrupling of those age 85+ by 2050. However, there is limited research with respect to dietary and other lifestyle factors involved in achieving or optimizing their health status. Fruit, vegetables and whole grains contain numerous bioactive compounds that are involved in reducing oxidative damage in tissues, improving gastrointestinal function, and other physiological processes. There is a growing body of evidence from human and animal studies that fruit and vegetable consumption reduces risk for various age-related diseases [2] including heart and vascular disease [3-6], some cancers [7, 8] and eye diseases [9]. Approximately 35% of adults over the age of 75 have 3 or more chronic conditions, including, hypertension, heart disease, diabetes, arthritis, and macular degeneration/blindness (citation). Poor physical health and negative health outcomes exacts an economic toll, as older adults who are disabled by or hospitalized for largely preventable, diet-related diseases represent a disproportionate amount of national health care costs [10]. Currently, modifiable lifestyle practices are placing older adults at risk of chronic disease and disability. Over half (58.2%) of older adults are not meeting the intakes of fruit while over two-thirds (70.4%) are not consuming the recommended vegetable intakes intakes (http://www.cdc.gov/aging/pdf/state-aging-health-in-america-2013.pdf). Additionally, only 4% of older women and 11% of older men consumed at least six daily servings of grain products (with at least three being whole grain) (citation). Physical activity participation declines prior to age 64 (Schoenborn & Adams, 2010) such that, by age 65, 87% of adults are physically inactive (CDC, 2007). Currently, only 10% of adults 64-74 years, and 7% of those 75+ years engage in physical activities that enhance and maintain strength and endurance 2+ days per week. Similar statistics describe those who engage in physical activities promoting development and maintenance of cardiorespiratory fitness. This physical inactivity is an important contributor to many of the age-associated declines that affect quality of life and severity of chronic diseases (Romack, 2004). Evidence is mounting to demonstrate that changes in diet and exercise that are implemented in the later years can be effective in both extending life and improving quality of life. The NE 1039: Changing the Health Trajectory for Older Adults through Effective diet and Activity Modifications multistate project takes an interdisciplinary approach toward older adult wellness through nutrition and physical activity interventions. The key objectives of this multistate initiative are: (1) Explore environmental changes to increase fruit, vegetable, and whole grain intakes in older adults; (2) Examine the effect of combined physical activity and dietary interventions on body composition, physical performance, and coronary heart disease (CHD) risk factors in overweight and obese older adults; and (3) Investigate determinants of macular pigment density as a biomarker of carotenoid status and eye disease risk in older adults. There is clearly a need for additional research that will lead to improvements in both diet and exercise behaviors in older Americans, and that will address health disparities that exist among the elderly, particularly those from minority groups and of lower socioeconomic status. Some of the projects objectives and related experiments are listed below. <ol><li>Environmental changes to increase fruits, vegetables, and whole grain intakes and physical activity in older adults. <li>Evaluation of education programs on whole grain, fruit and vegetable consumption and/or physical activity in older adults. <li>Design and evaluation of a motivational curriculum and modified recipes to increase fruits and vegetables in a multicultural population of older adults. <li>Maximizing the benefits of fruits, vegetables, and whole grains by keeping foods safe among recipients of home delivered meals. <li>To develop effective intervention strategies to improve physical performance and reduce CHD risk factors in overweight and obese older adults. <li>Investigating determinants of macular pigment density as a biomarker of carotenoid status and eye disease risk in older adults.</ol> Outputs: <ul><li>“Is it Whole Grain? Three Steps to Three Servings of Whole Grains” curriculum developed and tested <li>Culturally sensitive recipe book with traditional recipes was created <li>Intergenerational exergaming physical activity program with accompanying curriculum and website was developed and pilot-tested <li>URIDEAL CURRICULUM <li>Anthropometric tools to use with the Mini Nutritional Assessment were created and validated <li>Socioecological model for environmental factors affection older adult nutrition and food selected developed <li>Generated an antibody for the clock protein BMAL1, which will help with future biomedical research pertaining to telomere length assays.</ul> Accomplishments Major goals of the project Objectives 1. To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults. a. Objective 1, Experiment 1: Environmental changes to increase fruits, vegetables, and whole grain intakes and physical activity in older adults. b. Objective 1, Experiment 2: Pre-testing a whole grain foods education program c. Objective 1, Experiment 3: Design and evaluation of a motivational curriculum and modified recipes to increase fruits and vegetables in a multicultural population of older adults d. Objective 1, Experiment 4: Maximizing the benefits of fruits, vegetables, and whole grains by keeping foods safe among recipients of home delivered meals. 2. To identify effective biomarkers and other indicators that reflect improvement in diet (fruit, vegetables, and whole grains) and physical activity and chronic disease risk in older adults. a. Objective 2, Experiment 1: The effect of combined physical activity and dietary interventions on body composition, physical performance, and CHD risk factors in overweight and obese older adults. b. Objective 2, Experiment 2: Investigating determinants of macular pigment density as a biomarker of carotenoid status and eye disease risk in older adults. c. Objective 2, Experiment 2a: To determine the impact of pregnancy and lactation on lutein status, retinal health and MPOD; Does number of pregnancies impact lutein/n-3 FA status and health risk with aging? d. Objective 2, Experiment 2b: To assess the impact of exercise and weight loss on carotenoid status and macular pigment optical density (MPOD); to characterize the transport of lutein and MPOD as impacted by exercise and/or weight loss. What was accomplished under these goals? Collectively, this project provided approximately 5,135 older adults access to nutrition and/or physical activity interventions that lead to improved lifestyle practices (e.g., increased physical activity, increase produce intake, increased whole grain knowledge, etc). Over 900 older adults were screened for nutritional risk. Early identification of nutritional risk could potentially save about $1,500 annually in health care cost for these individuals if they made lifestyle changes to lower their nutritional risk as the interventions recommended. Numerous curriculums and educational materials were developed. How have the results been disseminated to communities of interest? The results from the various research projects have been disseminated in the communities of interest via press releases, professional poster and oral presentations (e.g., Experimental Biology, Food and Nutrition Conference and Expo, Society of Nutrition Education and Behavior, Gerontological Society of America, etc.), professional journals (e.g., Journal of Nutrition in Gerontology and Geriatrics, Journal of Aging and Physical Activity, Medicine & Science in Sports & Exercise, etc), websites (e.g., www.extension.iastate.edu/life), news shows (e.g., http://whotv.com/2014/02/25/weekly-workout-breathing-life-into-exercise/), and community interest groups (e.g., food policy council). Target Audience The target audience for the whole project was older adults. The different institutions targeted various sub-populations within that group. Iowa State University targeted older adults 50+ years of age. Louisiana State University looked at young adults to see how early life habits, including nutrition, may be determinants of health and wellness later in life. New York University . . . . The target population for Rutgers at this point is other researchers looking at the biology of aging. The targeted population at UDC was those 60+ years of age, who were primarily African-American men and women in senior congregate sited. The Office of Aging and urban communities were the targeted populations for outreach and extension work. The University of Massachusetts targeted community leaders that work directly with older adults (in a broad sense); senior center directors, researchers, etc. University of New Hampshire targeted older adults, 65+ years of age. The researchers at URI targeted older, obese women in the state of Rhode Island. The WVU site also targeted the same community leaders in older adult health as UMass. Changes/Problems (if appropriate, Nothing to Report) The following sites had no changes or problems to report: ISU, LSU, Rutgers, UDC, UMass, URI, and WVU. A member of the UNH group, Dr. Joanne Curran-Celentano was on medical leave for a portion of the project. The time away and transition back has influenced the ability to maximize involvement. How the collaboration on NE1039 has benefitted the group members. Participation in the multistate offers a number of benefits to all of the research team. In addition to share ideas on aging and health, networking with other faculty and students, learning from each other, and receiving constructive feedback. This project has been an excellent vehicle for training undergraduate students in research. Students have received awards from the universities for travel to national meetings to present findings. This has been an opportunity on the management and direction side to establish guidelines for the students working on the project so that there is continuity in laboratory coverage for subjects and communication amongst the students regarding recruitment and scheduling of subjects for assessments and interviews. Three sites utilized the Dietary Screening Tool from Pennsylvania State University (previous multistate member) and are currently working on a joint publication. The URI research team coordinated and actively maintain the multistate Sakai site to help communicate during the year with all the multistate members. The multistate has also provided the opportunity to increase sample size and generalizability by increasing diversity. Two sites took part in the evaluation of the Is it Whole Grains? Curriculum which has become an Extension-delivered program in Iowa. Additionally, four sites took part in the community assessment project coordinated by UMass. Multistate members also have taken advantage of other members expertise – UNH researchers trained two sites on cognitive interview protocols. Two sites provided a clear way to identify whole grains which improved research at the different sites. 1. LA W, S C, D G, W H: 65+ in the United States. In Current Population Reports (Bureau USC ed. Washington DC: US Department of Health and Human Services; 2014. 2. Facchini FS, Humphreys MH, DoNascimento CA, Abbasi F, Reaven GM: Relation between insulin resistance and plasma concentrations of lipid hydroperoxides, carotenoids, and tocopherols. Am J Clin Nutr 2000, 72:776-779. 3. Davy BM, Melby CL: The effect of fiber-rich carbohydrates on features of Syndrome X. J Am Diet Assoc 2003, 103:86-96. 4. Fitzpatrick DF, Bing B, Maggi DA, Fleming RC, O'Malley RM: Vasodilating procyanidins derived from grape seeds. Ann N Y Acad Sci 2002, 957:78-89. 5. Antoch MP, Song EJ, Chang AM, Vitaterna MH, Zhao Y, Wilsbacher LD, Sangoram AM, King DP, Pinto LH, Takahashi JS: Functional identification of the mouse circadian Clock gene by transgenic BAC rescue. Cell 1997, 89:655-667. 6. Steinmetz KA, Potter JD: Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc 1996, 96:1027-1039. 7. El-Sohemy A, Baylin A, Kabagambe E, Ascherio A, Spiegelman D, Campos H: Individual carotenoid concentrations in adipose tissue and plasma as biomarkers of dietary intake. Am J Clin Nutr 2002, 76:172-179. 8. Keevil JG, Osman HE, Reed JD, Folts JD: Grape juice, but not orange juice or grapefruit juice, inhibits human platelet aggregation. J Nutr 2000, 130:53-56. 9. Fitzpatrick DF, Fleming RC, Bing B, Maggi DA, O'Malley RM: Isolation and characterization of endothelium-dependent vasorelaxing compounds from grape seeds. Journal of Agricultural and Food Chemistry 2000, 48:6384-6390. 10. Position of the American Dietetic Association: nutrition, aging, and the continuum of care. J Am Diet Assoc 2000, 100:580-595.

Publications

Please refer to publication attachment that contains the full report for products/publications resulting from this multistate project.

Publications Attachment:

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Impact Statements

The physical activity interventions resulted in: <ul><li>Improved functional fitness and physical activity participation for those who participated in an exergaming physical activity program <li>URIDEAL SUMMARY OF PHYSICAL ACTIVITY OUTCOMES</ul>
The nutrition education interventions resulted in: <ul><li>Improved their whole grain knowledge and increased intention to consume whole grains following a three-week whole grain program <li>Lowered nutritional risk six months following a monthly nutrition program through the congregate meal program <li>Improved fruit and vegetable intakes</ul>
Found that as a woman?s age, body mass index (fatness), and number of pregnancies increased, the probability of being diagnosed with adult macular degeneration increased.
Although not a project objective several needs and preference assessments were conducted to assist with the completion of Objectives, 2, 3 and 5. <ul><li>Nutritional risk was assess in 992 community-residing older adults to identify needs for future nutrition education interventions <li>The environmental factors affecting older adult nutrition that can help direct communities to promote healthy foods in older adults were assessed in four states. </ul>