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<p>The project described herein builds on earlier work by this team of scientists. This proposal includes interventions to increase physical activity in combination with interventions to increase consumption of fruits, vegetables and whole grains and a determination of lifestyle choices (including number of pregnancies and breast feeding earlier in life) as factors related to the incidence of chronic conditions, including macular degeneration or blindness in later years. 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. Objectives:</p>
<p>1. To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults. </p>
<p>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. </p>
<p>Outputs Development and pre-testing of an educational curriculum designed to increase whole grain food consumption in older adults. Analyzed results of dietary change in conjunction with three different exercise regimes to determine which has a greater impact on physical functioning and reduced coronary heart disease risk. A Food and Physical Activity Environment tool will be developed for communities to use to assess local environments supportive of increasing fruits, vegetables, whole grains, and physical activities in older adults. A culturally sensitive recipe book with traditional recipes collected from participants to motivate participants to use familiar recipes with healthier modifications. Data indicating how dietary intake of folic acid affects plasma levels of homocysteine, cholesterol (total, LDL, and HDL), triglycerides, glucose, and CRP, and cognitive indicators of memory. Assessment of macular pigment density data as it relates to dietary and plasma lutein; plasma or RBC DHA levels; and the ratio of plasma lutein to plasma/RBC DHA levels. Analyzed data on the association of number of births and/or the length of breastfeeding early in life (during the childbearing years) with the incidence of age related macular degeneration or blindness later in life (postmenopausal years). Analyzed results of the FDA Food Safety Survey focusing on trends related to food handling and food safety practices among older adults greater than 60 years of age.</p>
<p>APPROACH:<br/> 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. Overweight men and women 60 years or older will be randomized to a different exercise training or control group for 24 weeks. Subjects will attend weekly nutrition sessions (modified DASH)diet decreasing total caloric intake for 5-10% weight loss. Exercise interventions will follow standardized formats individualized for each subject. Trained exercise physiologists and graduate students will administer the exercise portion of the study, while a registered dietitian will oversee the
nutrition education intervention component, which will include providing calcium and vitamin D supplements. The control group will consist of a usual care, dietary weight loss only encouragement to increase physical activity. Outcome measures will include changes in leg extensor muscle strength and power, physical function (400 meter walk, short physical performance battery), fasting lipids and glucose, body and muscle composition (DXA, computed tomography/MRI of mid-thigh and mid-abdomen), bone density (DXA), BMI, and food frequency and physical activity questionnaires. Additional demographic information will also be collected for descriptive purposes for each group. Sobjust will be tested for macular pigment in Objective 2, Experiment 2b. 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. 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 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; in ophthalmology and pediatrics at LSU Medical School. Additionally we will examine how both pregnancy and breast feeding impact macular pigment density in women. 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) The
methodology for evaluating carotenoid status and MPOD will be coordinated with the exercise study. 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 heterochromatic flicker photometry. 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.
<p>PROGRESS:<br/> 2012/10 TO 2013/09Target Audience: This year our group pariticpated in Objective (1)To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults. The whole grain curriculum developed by the team was used for 75 adults, over 65 years of age, throughout the state of NH (and Iowa) who participated in a 3 part education program with the intended goal of increasing awareness and consumption of whole grains assessed using a pre-test/post-test format. Changes/Problems: I was on medical leave for a portion of the project. The time away and transition back has influenced the ability to maximize accomplishment. What opportunities for training and professional development has the project provided? UNH Graduate student Kristin Davis will complete her MS thesis on this project. Several undergraduate
students have received training on disseminating the whole grain curriculum and working with an older adult population. How have the results been disseminated to communities of interest? Participation in the whole grain curriculum project provides engagement with the research for older adult participants. What do you plan to do during the next reporting period to accomplish the goals? Two graduate students will complete their MS thesis based on the research on the project and plan on disseminating information at professional meetings in spring and fall 2014.
PROGRESS: 2011/10/01 TO 2012/09/30<br/>OUTPUTS: Objectives 1. To examine novel interventions to increase fruit, vegetable and whole grain intake and physical activity in older adults. Students are trained to deliver a curriculum developed from results of NE 1023 (2004-9) for improving the intake of whole grains, delivered through various community settings in NH, IA and MA and evaluated. Alternative delivery methods such as web-based programming that might extend the reach of the program to older adults is planned. 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. Twenty normal and overweight adult are being assessed for macular pigment density as a marker of carotenoid status following supplementation and related to diet, body
mass index BMI and markers of inflammation. PARTICIPANTS: Karen Semo, Senior Lab Technician was responsible for HPLC analysis of carotenoids Bianca Ciufreddo, BS is a graduate student working on the project Adam Wenzel, PhD. St Anselm College was a collaborator who recruited subjects, collected dietary data, measured macular pigment density and evaluated lipid profiles. Catherine Violette, PhD RD is Extension Professor responsible for the whole grain education program TARGET AUDIENCES: The target audience is the older population in community settings. PROJECT MODIFICATIONS: Not relevant to this project.
<p>PROGRESS: 2010/10/01 TO 2011/09/30<br/>OUTPUTS: Normal, mild and overweight college students are recruited for macular pigment optical density (MPOD) measurement using heterochromatic flicker photometry. In this study the retinal carotenoid density is being assessed relative to body weight, BMI, lifestyle questionnaire and dietary intake evaluation using the LZQ questionnaire for lutein and zeaxanthin. Information on the significance of the research has been presented to a research team from the IdEA Network for Biomedical Research Excellence (INBRE) A second output is participation in a priority-setting project to determine key environmental supports for promoting healthy eating among older adults. While there has been attention paid to the role of the environment (grocery stores, schools, parks, farmers' markets, etc.) in facilitating access and affordability of
healthful diets, most of these studies focus on reducing obesity or increasing fruits and vegetables in general or in children. There are very few studies addressing this topic in older adults, and very little guidance available for communities who are planning initiatives to improve healthful eating for all of their residents, including older adults. Analytic Hierarchy Process are working to identify key behavioral settings and strategies for enabling healthful eating in older adults at the environmental level. PARTICIPANTS: The project was enhanced with a partnership with Adam Wenzel, PhD, St Anselm College in Manchester NH and two graduate students. Participants in the study have been recruiting from the St Anselm faculty, staff and students. The multistate team engaged a group of community nutrition experts for the Analytic Hierarchy Assessment lead by Nancy Cohen, PhD, University of
Massachusetts TARGET AUDIENCES: Target audience for this research are older adults who will benefit from understanding the role of diet on age related eye disease and the role of the environment on healthful eating. The environment scan results will help target effective environmental modification to enhance access to healtful diet for older adults. PROJECT MODIFICATIONS: Not relevant to this project.
<p>PROGRESS: 2009/10/01 TO 2010/09/30<br/>OUTPUTS: The research is focused on determining if and how changes in diet and exercise patterns will influence disease risk as we age. This is the first year of the project so outputs for this reporting period are limited to one research discussions at The American Dietetic Association meeting, incorporating the MPOD methodology into graduate training in nutrition and incorporating the objective and methodology into a collaborative project through the IDeA Network of Biomedical Research Excellence (INBRE-NH). PARTICIPANTS: The work is in collaboration with researchers at experiment stations in NH, RI and LA and involves graduate students in research training. TARGET AUDIENCES: The target audience includes elderly, especially low income and minority adults at risk for diet related disease and older women with risk factors for AMD.
PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.