NE1439: 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:

[03/09/2016] [11/10/2016] [11/07/2017] [11/09/2018] [10/31/2019]

Date of Annual Report: 03/09/2016

Report Information

Annual Meeting Dates: 06/07/2015 - 06/09/2015
Period the Report Covers: 10/01/2014 - 09/30/2015

Participants

Participants Attachment:

NE1439.AnnualMeeting.Minutes-Notes.2015-6.docx

Brief Summary of Minutes

Minutes Attachment:

NE1439.AnnualMeeting.Minutes-Notes.2015-6.docx

Accomplishments

Overview Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modifications (NE1439) is a transdisciplinary research project that has actively engaged with each other and with external stakeholders and peer groups.  Two examples of our outputs that clearly illustrate the transdisciplinary work of NE1439 to improve the lives of older adults are two research presentations that were given in the past year.  Four universities (WVU, ISU, URI, UMass) collaborated on “Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modification a Multistate Collaboration” presentation at the annual Society for Nutrition Education and Behavior in 2015.  This presentation was an important milestone for the project in order to inform external peer groups of the multistate project and goals and to highlight the research.  The presentation generate interest and questions and new members who attended the NE1439 annual meeting in June 2015.  Additionally, four universities (UMass, WVU, NYU, ISU) collaborated on “Environmental supports of healthy eating in older adults in diverse communities”, a presentation at the annual Experimental Biology conference in 2015.  This transdisciplinary research highlighted one of NE1439’s research goals and the collaborative work within NE1439.   There are three major research areas in NE1439: 1) Molecular and mechanistic understanding of how nutrients and activity can influence age-related diseases; 2) Environmental factors influencing the adoption of health-promoting lifestyle; and 3) Lifestyle needs assessment and evaluation of lifestyle interventions that lead to measurable outcomes.  These three research areas together address “Understanding Individual Health”, one of the major challenges identified by the National Research Council in A New Biology for the 21st Century.  The NE1439 goals also address two USDA-NIFA priority areas: 1) food security and hunger and 2) obesity.  Having the NE1439 goals address these priorities also ensures that the transdisciplinary work will impact major public health challenges through impacting lifestyle (diet and physical activity) choices at the individual and community level.   Research Area #1.  Molecular and mechanistic understanding of how nutrients and activity can influence age-related diseases. Though Rutgers is leading the work in this research area, both URI and WVU hope to incorporate these assays into future research grant proposals in order to have a better understanding of the aging process. Rutgers is developing an assays to measure telomere length in individuals with diets high in fruits, vegetables, and whole grains and compare to individuals with a poorer, high-fat diet in order to be able to have data on how to interpret  Telomere health and how that is associated with the health trajectory of older adults.  Our role is to understand how diet, aging, and the circadian clock serve as protective factors to change the health trajectory of older adults. Our work is focused on understanding how a healthy diet rich in antioxidants (like fruits, vegetables and whole grains) can influence the circadian clock factors that serve to protect the genome from DNA damage as people age. In this capacity, we are developing biomarkers to ascertain how a healthy diet can prevent premature aging at the cellular level and working in collaboration to develop a non-invasive test for human subjects. Our target audience is people in the biomedical and nutrition professions as well as the general public.  The impact of our work is social, heath, and economic. We hope to understand how diets rich in antioxidants (fruits, vegetables, and whole grains) function at the molecular level to protect the genome and prevent aging and age-related diseases.  Better knowledge in this area will help the health and social well-being of older adults by allowing them to obtain a more healthy and independent life-style and this will serve to reduce health care costs. The major goal of my individual project is to understand how the circadian clock components help protect the genome and prevent telomere erosion.  We also want to develop a biomarker to measure telomere length that can serve as an indicator of healthy aging.  Specifically, we want to determine how diets rich in antioxidants and the circadian clock work in concert to help protect the genome and prevent age related diseases. We have accomplished a number of tasks related to our goals and the work is progressing very well.  We have confirmed that the circadian clock transcription factor BMAL1 (Brain, Muscle, ARNT-like 1) binds to telomeres in a rhythmic manner and the peak in binding occurs in late afternoon early evening (6 - 10 pm).  The peak in binding is followed by a rhythm in TERRA (Telomeric repeat-containing RNAs) expression that peaks early morning (2 - 6 am).  TERRA is needed to establish heterochromatin at the telomeres and the heterochromatin serves to protect the telomere from oxidative damage that shortens telomeres.  With that in mind, we tested and then confirmed a rhythm in heterochromatin formation at the telomeres. Specifically, we found a rhythm in heterochromatin formation at the telomere that followed the rhythm in TERRA expression and peaked in late morning early afternoon (10 am - 4 pm). This rhythm in heterochromatin that occurs during the day helps protect the telomeres from oxidative damage.  Based on this data our working hypothesis is as follows. As individuals age, there is a corresponding decline in circadian physiology.  A compromised circadian clock affects heterochromatin formation at the telomere and diets rich in antioxidants can partially compensate and provided a protective measure against oxidative damage.  In contrast, high-fat diets that cause and increase in oxidative stress will have a greater deleterious effect (when combined with a compromised circadian clock) and accelerate telomere erosion leading to advanced aging and higher incidence of age-related disease.  Research Area #2.  Environmental factors influencing the adoption of health-promoting lifestyle. The University of Massachusetts has taken the lead in this research area and a number of universities are collaborating on these projects including ISU, NYU, WVU and URI.  Currently the research is focusing on community organization professionals involved with older adults and/or provide services to older adults.  The UMass researchers collaborated with NE1439 members to examine important environmental supports of healthy eating in older adults via online group discussions with community organization professionals working with older adults in food and nutrition-related settings. Overall, accessibility and cost were ranked the most important, followed by transportation and social support. All communities considered congregate mealsites (CMS) one of the most important settings with some differences among sites. Researchers at UMass collaborated with researchers from Iowa, New York and West Virginia and examined important environmental supports of healthy eating in older adults. In 2014, online small group discussions were conducted to explore key informant perceptions of important enablers (factors that facilitate behavioral change) and behavioral settings (places where older adults access food) in diverse communities. Community organization professionals working for senior centers, regional departments/agencies on aging and health, extension offices, community centers and food banks discussed recommendations for changes to the community food environment to increase consumption of healthy foods in older adults and completed an online survey to further prioritize the enablers and behavioral settings. The key informants represented a medium MA city, a large NY city, two central IA counties and two southern WV counties. Data collected in Springfield, MA in 2013 was included in data analysis. Overall, accessibility and cost were ranked the most important enablers, followed by transportation and social support. All communities considered congregate mealsites (CMS) one of the most important behavioral settings with some differences among sites. MA participants ranked food stores and CMS the most important settings overall and for cost and transportation. CMS was also one of the most essential settings for accessibility and social support. IA participants regarded food stores and CMS important for accessibility and cost, and CMS the most important for social support. In WV, senior centers were most critical to provide accessible, affordable healthy foods with social support and transportation. Home delivered meals were the most notable to address accessibility in NY and CMS for cost and transportation. These results can be used by communities to increase access, affordability, social support, and transportation to healthy foods for older adults. This research resulted in a number of research presentations to professional and community stakeholders: <ul> <li>Cohen, N.L. and Chao, S. “RD/DTRs and Local Communities Together: Partnering to Improve the Health and Wellbeing of Older Adults,” to the Massachusetts Dietetic Association, Norwood, MA, April 2015</li> <li>Jiang, Q., Cohen, N., Marra, M., Woolf, K., Gilbride, J., Francis, S. Environmental supports of healthy eating in older adults in diverse communities at the 18th Annual SPHHS Research Day at UMass Amherst on April 6, 2015</li> <li>A summary report for the community of the findings from the New York cohort was presented to the local office for health and human services as part of the collaborative study conducted in 2014</li> </ul>    Research Area #3.  Lifestyle needs assessment and evaluation of lifestyle interventions that lead to measurable outcomes. The University of Minnesota NE1439 investigators are focusing on Experiments 1 (Determine older adults’ perceptions and recommendations for community environmental supports for health eating) and 2 (Determine, examine and understand cultural, personal and accessibility barriers in regards to foods consumed by individuals in the low-income populations) from Research Area #3.  Older adults 60 years and older are the primary population of interest, with some comparisons with younger women to better understand how behaviors change and impact nutritional risk through the aging process. This past year we investigated  food choice and food access among seniors living in two similar urban counties with different SNAP usage rates using focus group methodology.  We found  that seniors’ food choice was impacted by many factors including: a) past food experiences; b) financial and food security; c) strategies to access food; d) physical and cognitive changes associated with the aging process; and e) social influences Although influences from their past experiences framed the development of food choice, comments showed that food cost and accessibility appeared to have a more substantial impact on the dietary patterns of seniors, with barriers to food access potentially causing further dietary changes. This work has been analyzed, written up and is under review.  Also during this year, using data previously collected, we observed associations between dietary intake, supplement intake, and hypertension among post-menopausal, African American women.  Working with 105 pre-menopausal and 87 post-menopausal, African American women, our study found significant differences in dietary and supplement intake, BMI, and BP between the two groups. The women consumed above the RDA for most nutrients, consuming twice the required sodium. Further, pre-menopausal women were below the RDA for iron and both groups consumed below the RDA for fiber, calcium, magnesium, and vitamin E. Nutrition education may be a key intervention strategy to encourage balanced dietary intakes among this population and reduce the risk of chronic disease. These data have also been analyzed and written up and the manuscript is currently under review. Researchers at Iowa State University (ISU) and the University of Rhode Island have been working individually and collaboratively on Experiment 3 in this research area: to determine to what extent client-centered, community-based nutrition education impacts dietary practices, knowledge and nutritional risk of congregate meal site participants.  The researchers at ISU are also working on Experiment #4 of this research area: to promote healthful aging through the community-based implementation of a refined LIFE Program through county Extension offices in rural Iowa counties.  ISU targets older adults ages 50 years and older and URI targets older adults 60 years and older. During the past reporting period, 2,098 older Iowans participated in nutrition programs that led to increased awareness of community resources available to lower food security, identified food safety education topic areas for future nutrition education interventions. The Wellness and Independence through Nutrition (WIN) Program for older adults promoted the benefits of SNAP to 774 older adults; 54 were referred for SNAP application assistance. 83% answered at least one nutrition-related question correctly and 98% answered a SNAP question correctly after attending a WIN session. The Nutrition Education With Seniors (NEWS) newsletter program for older adults participating in the supplemental and commodity food program provides nutrition education and reaches about 2,200 older adults annually; 79% use the nutrition information provided. A statewide evaluation of a SNAP-Ed program for older adults began Spring 2015.  Currently, 790 older adults are enrolled; 438 are receiving the intervention. Another small pilot project assess food safety knowledge needs areas of 80 community-residing older adults was conducted. Three Extension online modules were created to address these needs areas and are currently being evaluated. The SNAP outreach program resulted in the referral of 54 older adults.  If each older adult who was referred met the eligibility criteria and received SNAP benefits, the potential annual economic impact for this group would be $51,840 (54 adults x $80 average SNAP [in Iowa] to adults age 50+ x 12 months). Additionally, every $1.00 provided in SNAP benefits generates $1.73 in local economic activity (NCOA, 2015). Thus, the potential overall economic impact of the WIN Program to the 54 adults who were referred is estimated to be $89,683. A number of outputs and activities were developed at ISU from this research: <ul> <li>Publications (listed in the Publications section)</li> <li>Online mini-modules (Extension; Educational Aids or curricula)</li> <li>Developed seven online mini modules for use by the Midlife and Beyond Extension group based on needs assessment data generated as part of this multistate project.</li> <li>3 Nutrition Modules: 3 Meals a Day Leaves You with Energy to Play!, Feasting on Fruits and Vegetables, Power Up with Protein</li> <li>1 Physical Activity Module: Exercise Your Independence</li> <li>3 Food Safety Modules: It’s All About the Temperature! Freeze Smart, Thaw Safely!</li> </ul> As stated before, the investigators at URI were working with ISU on developing successful programs to enhance successful aging and reduce chronic disease risk via improved dietary intake and physical activity and functioning in older adults. The primary population of study at URI is older adults who are 60 years of age and older. The primary outcomes and outputs include a number of research abstracts (4 – listed in the Publication section) and papers (3 – also listed in the Publication section).  We have also started the next phase of our research which is a clinical trial that is examining impacts of a resistance training protocol on measures of sarcopenia in older women.  We recruited 25 older women with sarcopenia or pre-sarcopenia.  This study will be completed in the winter of 2016.  These pilot data will serve as preliminary data for an R21 that URI, ISU and Mississippi State University (Dr David Buys who attended his first NE1439 in June 2015) in 2016. The investigators from New York University (NYU) have also worked collaboratively with other members of the multistate (Univ Mass Amherst, West Virginia University, Iowa State University) in a project examining environmental determinants of eating behaviors in older adults.  Results were presented at the Experimental Biology 2015 professional meeting. We have also continued with data analysis from our study examining the relationship between physical inactivity and cardiometabolic risk in adults with rheumatoid arthritis.  Results from this study were also presented at Experimental Biology 2015 and research papers are in development.  We have also used this year to identify external funding sources.  NYU has produced a number of research abstracts and papers (listed in the Publications section) as well as reached out to community stakeholders via two presentations: <ul> <li>Arthritis Foundation Osteoarthritis Symposium. NYU Langone Medical Center. “Nutrition.” September 2015.</li> <li>Psoriasis and Psoriatic Arthritis Patient Seminar. NYU Langone Medical Center. “Nutrition – Practical Approach to a Healthy Diet.” September 2015.</li> </ul> The investigators at the University of the District of Columbia (UDC) are also working within Research Area #3 and are targeting low-income older adults and mid-life populations in the District of Columbia.  Original recipes and memoires were collected from the seniors.  The recipes were analyzed, created a healthier version of the recipes and compiled into recipes book with original and modified recipes, nutrient facts and historical perspective for each.  Additionally, Survey instrument was designed to gather data on identifying the barriers for good nutrition.  The investigators at UDC have established working partnerships with community congregate meals sites, churches and recreational centers as the UDC Gerontology Institute. A number of outcomes have been generated: <ul> <li>A recipe book was distributed</li> <li>Two student presentations were made at a regional research meeting in June 2015. One was a demographic analysis of the target audiences; the other provided a detailed nutritional analysis of selected African vegetables as an alternative food choice for members of the target population.</li> <li>A survey instrument has been developed that will collect quantitative and qualitative data that will identify and explain personal (family and cultural) characteristics, attitudes, and beliefs, that influence the purchase, preparation, and consumption of fruits, vegetables, and whole grains among the target population; and will determine if any of these characteristics are barriers to healthy food choices. This instrument has been sent to the University IRB for approval.</li> </ul> Plans for the coming year This multistate, NE1439, has encouraged all the participating universities to look at health in aging form the molecular through the community level.  Because there is representation at all levels, we continue to learn from each other.  For example, investigators report using validated tools (like the Dietary Screening Tool) or specific questions in focus groups to better assess the impact of various variables on older adults and their diets and physical activity.   We plan to continue our ongoing projects and determine additional ways to collaborate on larger projects together.  For example, a number of universities are collaborating with UMass on taking the results from the focus groups with the community partners and seeing how their recommendations will address enablers and behavioral setting that can support increased consumption of nutrient-dense foods in older adults.  In addition, we will be able to compare and contrast among different regions in the country.  Important areas that we have identified through our own research as well as through our partnerships with stakeholders include examining the following in older adults, including minority populations of older adults: socioeconomic factors, eating patterns, safety and efficacy of dietary supplements, food access and food assistance programs, and behavioral lifestyle choices on body composition.  We also plan to continue to apply for external funding together and to publish our research.

Publications

Marra MV, Violette C, Xu F, Cohen NL. Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modification a Multistate Collaboration. Society for Nutrition Education and Behavior (SNEB) Annual Conference, Pittsburgh, PA, July 27, 2015. Francis, S.L., Oates, K., & Heuer, A. (in press). Promoting Awareness of SNAP Among Iowans Age 50+ with The Wellness and Independence through Nutrition (WIN) Program.  Journal of Extension. Francis, S.L., Margrett, J.A., Hoerr, K., Heinz, M., Peterson, M., & Franke, W. Community-based Exergaming Program Improves Rural-Residing Older Adults’ Functional Fitness and Well-being. Journal of Extension. Roy, A., Francis, S.L., & Shelley, M. Nutritional risk of community-residing older adults: What behaviors should nutrition interventions target? Journal of Nutrition in Gerontology and Geriatrics. Hoerr, K., Francis, S.L., Margrett, J., Peterson, M., & Franke, W. Promoting the Congregate Meal Program to the Next Generation of Rural-Residing Older Adults.  Journal of Nutrition in Gerontology and Geriatrics. Woolf K, Bushman B, Gabriel K, Carter S. Promoting healthy lifestyles during the menopausal transition: benefits of physical activity and nutrition. ACSM’s Health & Fitness Journal, 20(1):20-28, 2015. Woolf K, Miller S, Reese C, Beaird L, Mason M. Accuracy and applicability of resting metabolic rate prediction equations differ for women across the Lifespan. Journal of Nutritional Therapeutics, 4(2):50-63, 2015. Woolf K, Kiely M, Yazici Y.  The relationship between physical inactivity, body composition, and cardiometabolic risk in adults with rheumatoid arthritis.  FASEB Journal 29(1):588.5, 2015. Jiang Q, Cohen N, Marra M, Woolf K, Gilbride J, Francis S.  Environmental supports of healthy eating in older adults in diverse communities. FASEB Journal 29(1):741.14, 2015. Thomas L, Ward B, Tsai M, Fazio T, Lam N, Burris J, Kiely M, Yazici Y, Woolf K. Assessment of individuals with rheumatoid arthritis using the Healthy Eating Index 2010. FASEB Journal 29(1):589.10, 2015. Ward B, Thomas L, Kiely M, Yazici Y, Woolf K. Use of dietary supplements in individuals with rheumatoid arthritis. FASEB Journal 29(1):589.6, 2015. Maris S, Quintanilla D, Letendre J, Taetzsch A, Mahler L, Xu F, Lofgren IE, Delmonico MJ.  The Combined Effects of Tai Chi, Resistance Training, and Diet on Physical Function and Body Composition in Obese Older Women.  Journal of Aging Research.  2014.  Accepted. Taetzsch A, Quintanilla D, Maris S, Letendre J, Mahler L, Xu F, Delmonico MJ, Lofgren IE.  Impact on Diet Quality and Resilience in Urban Community Dwelling Obese Women with a Nutrition and Physical Activity Intervention.  Journal of Nutrition, Health and Aging.  Accepted. Xu F, Delmonico MJ, Lofgren IE, Mahler LA, Beebe N, Letendre J, Bakke J. Effects of Tai Chi Plus Behaviorally-Based Dietary Weight Loss on Physical Functioning and Coronary Heart Disease Risk Factors in Obese Older Women”. Journal of Nutrition in Gerontology and Geriatrics.  Accepted Uy, K. M., Maris, S., Quintanilla, D., Taetzsch, A., Picard, A., Letendre, J., Xu, F., Lofgren, I.E., Mahler, L., Delmonico, M.J. (2015, April) Effect of an Exercise and Dietary Intervention on Cognitive Function in Obese Older Women. Medicine& Science in Sports& Exercise, Supplement, 47(5S), 247. Paulin, C., Benson, M., Beebe, N., Katkowski, L., Xu, F., Delmonico, M.J., & Lofgren, I.E. (2015, April). Effect of Adding Tai Chi to a Dietary Weight Loss Program on Bone Mineral Density in Obese Older Women. The Journal of the Federation of American Societies Experimental Biology, 29, 738.10. Cohen, N.L. “RD/DTRs and Local Farming Communities Together: Partnering to Improve the Health and Wellbeing of Older Adults,” to the Food and Nutrition Conference and Expo, Academy of Nutrition and Dietetics, Atlanta, GA, October 2014 Cohen, N.L. and Jiang, Q.  Using a socioecological framework to identify community priorities for healthy eating among older adults.  Society for Nutrition Education and Behavior, Pittsburgh, PA, July 2015. Oemichen M, Smith C. Investigation of the food choice, promoters and barriers to food access issues, and food insecurity among low-income, free living Minnesotan seniors. Journal of Nutrition Education and Behavior, Under review Oemichen M, Smith C. Dietary and supplement intakes among pre- and post-menopausal African American women and their impact on risk of hypertension. The Journal of Nutrition in Gerontology and Geriatrics, Under review.

Impact Statements

The research at the individual level will help to better tailor interventions that can be tested and for the successful aspect to be "scaled up" for other site to use.

Date of Annual Report: 11/10/2016

Report Information

Annual Meeting Dates: 06/05/2016 - 06/07/2016
Period the Report Covers: 10/01/2015 - 09/30/2016

Participants

Brief Summary of Minutes

Minutes Attachment:

NE1439 - 2016 Meeting minutes_6.8mm.docx

Accomplishments

<h2>Short-term Outcomes</h2> Objective 1: Previously, we confirmed that the circadian clock transcription factor BMAL1 (Brain, Muscle, ARNT-like 1) binds to telomeres in a rhythmic manner and the peak in binding occurs in late afternoon early evening (6 - 10 pm). The peak in binding is followed by a rhythm in TERRA (Telomeric repeat-containing RNAs) expression that peaks early morning (2 - 6 am). TERRA is needed to establish heterochromatin at the telomeres and the heterochromatin serves to protect the telomere from oxidative damage that shortens telomeres. With that in mind, we tested and then confirmed a rhythm in heterochromatin formation at the telomeres. Specifically, we found a rhythm in heterochromatin formation at the telomere that followed the rhythm in TERRA expression and peaked in late morning early afternoon (10 am - 4 pm). This rhythm in heterochromatin that occurs during the day helps protect the telomeres from oxidative damage. Our current progress has expanded these on these findings and we have begun looking at how there is a redistribution of heterochromatin with age and how genome-wide expression of RNA changes with age. The age-related changes in gene expression are complete and the redistribution of heterochromatin is in progress. We have also begun to examine how oxidative stress influences normal expression of TERRA at the telomeres and we have determined that this cause a phase-shift in TERRA expression. We are now looking at whether this causes altered timing of heterochromatin at the telomeres.   Objective 2: In Minnesota, we selected participants living in 2 counties based on SNAP high and low participation rates, to investigate how seniors in each of those counties accessed food and made food choices, and to investigate whether or not SNAP was viewed as a valuable program to increase food security. This was accomplished by conducting eight focus groups (4 in each of the 2 types of counties). We found seniors used both SNAP and the congregate dining programs assisted seniors in one county, whereas, in the other county, SNAP usage was considered unacceptable by some because of negative stigma attached to the program or because they lacked knowledge of the program. Also, data collection related to the food environment for OA survey tool was completed in two study sites and is currently underway at two other study sites. Furthermore, in DC progress was made in better understanding the barriers to food consumption among OAs with limited incomes including the assessment of the target audience, survey draft completion, training of researchers and the development of a focus group discussion guide.   Objective 3: We examined "Socio-Demographic Predictors of Nutritional Risk: Cross Sectional Analyses from the UAB Study of Aging II" and found in a cohort of 276 older adults from urban and rural Alabama social factors affecting nutritional risk differently by race and gender; we have a manuscript in development. Also, an internal grant was received to conduct a pilot randomized controlled trial of an intervention to mitigate nutritional risk after hospital discharge. During the past reporting period 5,400 older Iowans participated in nutrition programs that led to increased awareness of community resources available to lower food security, identified food safety education topic areas for future nutrition education interventions. The Wellness and Independence through Nutrition (WIN) Program for OAs promoted the benefits of SNAP to 2,105 OAs; 55 were referred for SNAP application assistance. Most (91.4%) of participants were better informed about SNAP after a WIN program session. The Nutrition Education With Seniors (NEWS) newsletter program for OAs participating in the supplemental and commodity food program provides nutrition education and reaches about 2,200 OA annually; 83% use the nutrition information provided. A statewide evaluation of a SNAP-Ed program for OAs ended December 2015. The total sample size was 1,303; however, 354 completed a survey at all three time points (PRE, MID, POST). No significant changes were detected in self-efficacy, nutritional risk or dietary intake frequencies. Those who attended 4+ sessions had significantly higher nutritional status than the control group. Participants in the treatment group reported making dietary and lifestyle changes throughout the intervention timeframe, thought the program was excellent and would recommend it to a friend. The sarcopenia work conducted at URI entailed developing and implementing a 12-week community-based intervention to investigate the efficacy of a periodized RT intervention strategy to treat older women with sarcopenia or presarcopenia (EXD, n=13, age = 71.8 ± 4.8 years) compared to an active control group (CON, n=12, age 72.9 ± 4.6 years). Participants were recruited from the community in July -August, 2015. Outcomes included body composition from dual energy X-ray absorptiometry and bioelectrical impedance, physical function tests, standing balance and mobility tests, lipid profile, muscle strength and power, cognitive function, general health, diet composition, sleep quality, resiliency and flexibility. Data analysis is still in progress. Our preliminary results shown that the EXD and CON group both had significant improvement in chest press [EXD: absolute change, 5.13 (95% CI, 3.45 to 6.80), p < 0.001; CON: absolute change,2.68 (95% CI, 1.41 to 3.94), p = 0.001], leg press [EXD: absolute change, 20.85 (95% CI, 11.81 to 29.88), p < 0.001; CON: absolute change, 17.94 (95% CI, 12.20 to 23.68), p < 0.001] and gait speed [EXD: absolute change, -0.55 (95% CI, -0.86 to -0.24), p = 0.003; CON: absolute change, -0.65 (95% CI, -1.07 to -0.22), p = 0.007]. There were significant between-group differences in chest press (p = 0.035). Adherence to interventions was 89%. All participants received exercise packets and informational sheet to continue exercise regularly afterwards. Participants also received their data and an explanation of the results at the end of the intervention.   <h2>Outputs</h2> <ul> <li>Collectively, the projects provided training opportunities for 13 Extension staff, 27 volunteers, 22 undergraduate students, and 17 graduate students. The skills acquired by students include quantitative (e.g., data entry, analysis, dissemination) and/or qualitative research (e.g., conducting focus groups, analyzing focus group data for themes, etc.), professional writing (e.g., manuscripts, abstracts, theses), and lab work (e.g., telomere length assays, chromatin immunoprecitations, Northern blots, molecular cloning, etc.).</li> <li>Numerous grants (~$240,000) were received to fund work related to this multistate project including Federal, State, Community and University. </li> <li>15 Journal articles published, in press, under review, or in preparation</li> <li>9 Presentations (oral and poster)</li> <li>3 Abstracts</li> <li>1 Thesis</li> <li>1 Education Aid</li> </ul>   <h2>Activities</h2> The work accomplished through this multistate effort would not be possible without collaboration.  Below is a list of the collaborative efforts included with this report: <ul> <li>Nutritional risk assessment (carry over from NE1039 project): Rhode Island, New Hampshire, Iowa </li> <li>Whole Grain program evaluation (carry over from NE1039 project): New Hampshire, Iowa </li> <li>Sarcopenia Prevention program preliminary grant work: Rhode Island, Iowa, Mississippi, West Virginia, Minnesota </li> <li>Consumer’s Perception of the Food Environment: Massachusetts, Rhode Island, West Virginia, New York, Iowa, Illinois </li> <li>USDA AFRI Undergraduate Research and Extension Experiential Learning Fellowship application (unfunded): Rhode Island, New York</li> </ul>

Publications

Impact Statements

Funding Period: July 1, 2016 – June 30, 2019 Title of Grant: Nutrition Education with Seniors (NEWS) education program Funder: Department of Community, Family and Youth Services’ Senior Services and Commodity Supplemental Foods Programs in Polk County Grant Amount: $47,990 Role: Sarah L. Francis, PI

Date of Annual Report: 11/07/2017

Report Information

Annual Meeting Dates: 06/11/2017 - 06/13/2017
Period the Report Covers: 10/01/2016 - 09/30/2017

Participants

Prema Ganganna (UDC), Sabine O’Hara (UDC), Sarah L. Francis (ISU), Nancy Cohen (UMass), Chery F. Smith (UMN), Matthew Delmonico(URI), Ingrid Lofgren(URI), Furong Xu(URI), William J. Belden (Rutgers), Melissa Marra (WVU), David Buys (MSU), Kathleen Woolf (NYU), Judith Gilbride (NYU), Nadine Sahyoun (UMD)

Participants Attachment:

NE1439 2017 Meeting Minutes corrected 12.27.18.doc

Brief Summary of Minutes

The meeting minutes were provided under "Participants." Attached here is a summary of our meeting outcomes.

Minutes Attachment:

NE 1439 Annual 2017 Meeting Outcomes.pdf

Accomplishments

Short-term Outcomes: <ul> <li>For Objective 1, a breakthrough was made in adapting the Leukocyte Telomere Length (LTL). Telomere length was used as an outcome measure of a telehealth intervention for men that was conducted in West Virginia.</li> <li>The projects conducted under Objective 2 added to the body of knowledge on the importance of the community food environment and how it can be enhanced so that older adults can improve their dietary intake.</li> <li>For Objective 3 projects we noted an improved understanding of nutrition related concerns for older adults with chronic disease. For example, Iowa-based projects resulted in maintained the nutritional status, increased familiarity with recommended lifestyle practices concerning eating three meals daily, being physically active, eating produce daily, and increasing protein intake. Needs assessments also identified the food safety needs of older adults taking part in the congregate meal program. Additionally, in Rhode Island pilot work on sarcopenia interventions helped to improve the health of older women through addressing sarcopenia classification of Rhode Island women, which may have future impacts on sarcopenia interventions or prevention.</li> </ul>  Outputs: <ul> <li>Collectively we trained 21 undergraduate students, 15 graduate students, and 12 Extension personnel. The skills acquired by these trainees include:</li> <ul> <li>Quantitative research (e.g., data collection, data entry, analysis)</li> <li>Qualitative research (e.g., conducting focus groups, analyzing focus group data, etc.)</li> <li>Professional writing (e.g., manuscripts, abstracts, theses)</li> <li>Laboratory skills (e.g., telomere length assays, northern blots, etc.)</li> <li>Anthropometric measures (e.g., height, weight, skin folds, etc.)</li> <li>Nutritional Status assessment (e.g., DST, MNA)</li> <li>Dietary Intake Assessment (e.g., 24-hour food recalls, food records, etc.)</li> </ul> <li>Collectively we received 8 grants ($212,097 Total): 3 state, 6 university, and 2 research station grants. (see list below)</li> <li>The team had 3 joint journal articles and 3 joint abstracts</li> <li>The team facilitated 1 symposium at the 2017 International Association of Gerontology and Geriatrics Conference: â€&oelig;Successes in Older Adult Nutrition and Physical Activity Studies: a USDA Multistate Research Project."</li> </ul>  Activities: <ul> <li>Three states (Massachusetts, Iowa, and Illinois) collaborated on the Consumer's perception of the food environment study (Objective 2). During this study, 142 surveys were collected in older consumers from MA, IL and IA this year. Data analysis will continue next year, along with manuscript submissions.</li> <li>Two states (West Virginia and New Jersey) worked together on a Telomere study (Objective 1) that used blood from participants in a telemedicine study (Objective 3). For this study, Telomere length was assayed (in NJ) from 96 men who were taking part in a telehealth study (in WV).</li> <li>Based on the assessments conducted under Objectives 2 and 3, team members from Rhode Island, Mississippi, Minnesota, West Virginia and Iowa wrote and submitted two grant applications (NIH R21 [October 2016] and NIFA Rural Health and Safety Education [June 2017]) to support a community-based sarcopenia prevention program that included both nutrition and physical activity. Neither were funded; however, the NIFA application was ranked high. The team is exploring other funding opportunities.</li> </ul> Milestones: We achieved two major milestones related to Objective 1, Experiment 1. First, we have fully adapted the Leukocyte Telomere Length (LTL) Assay. This was first developed in zebrafish and then confirmed in mice. The second milestone came when we assayed Telomere length from 96 individuals as part of an NE1439 collaboration with West Virginia University (WVU). Blood samples were collected from 96 individuals and sent to Rutgers University.Â  We extracted DNA and performed the TLT assay. Data was then sent back to WVU.  We also did some pilot experiment to measure markers of inflammation. Using the sera from the remaining blood samples we perform an enzyme-linked immunosorbent assay (ELISA) looking at tumor narcosis factor alpha (TNF alpha).Â  Results from the ELISA were also sent to WVU and correlation between diet, carotenoids, telomere length and TNF alpha are currently underway.   NE:1439 Grant Awards from October 1, 2016 to September 30, 2017 Funding Period: October 2013 - Present Title of Grant: Fresh Conversations Evaluation Funder: Iowa Department of Public Health Grant Amount: $56,471 (2016-17)  Role: Sarah Francis, Consultant   Funding Period:October 2012 - Present Title of Grant: Promoting Wellness and Independence for Midlife and Older Iowans through the Iowa Food Assistance Program (2012-2013: Reaching Out to Mid-Life and Older Iowans and to Promote Wellness and Independence through the Iowa Food Assistance Program) Funder: Iowa Department of Human Services Grant amount: $43,858 (2016-17)   Role: Sarah Francis, PI   Funding Period:July 1, 2016 - June 30, 2019 Title of Grant: Nutrition Education with Seniors (NEWS) education program Funder: Department of Community, Family and Youth Servicesâ€™ Senior Services and Commodity Supplemental Foods Programs in Polk CountyÂ  Grant Amount: $15,996 (2016-17) Role: Sarah Francis, PI   Funding Period: October 1, 2016 - September 30, 2017 Title of Grant:A technology-based assessment of sedentary behaviors and physical activity patterns in adults with psoriasis and psoriatic arthritis compared to healthy controls. Funder: New York University, University Research Challenge Fund Grant Amount: $12,000 Role: Kathleen Woolf, PI   Funding Period: 10/01/2016 - 07/01/2017 Title of Grant: Meals Enhancing Nutrition after Discharge (MEND) for Older Adults in Rural Settings Funder: Mississippi Agricultural and Forestry Experiment Station Grant Amount: $22,570 Role: David Buys, PI    Funding Period: 05/01/17 - 04/31/2018 Title of Grant: Expanding Community Nutrition to a Service-learning Course Funder: Mississippi State University, Center for Teaching and Learning Grant Amount: $2,953 Role: David Buys, Co-PI   Funding Period: 03/15/17 - 06/30/18 Title of Grant: Experiential Learning in Community Nutrition Funder: Mississippi State University, Division of Agriculture, Forestry, and Veterinary Medicine Grant Amount: $2,050  Role: David Buys, Co-PI   Funding period: May 1, 2017 through September 30, 2018 Title: Food access, specialty diet adherence, diet perception, and cultural appropriateness of meal programs for older African American women with hypertension and diabetes who qualify for food assistance Funder: University of Minnesota, RAP Grant: $1,500 Authors Co-PIs: Eva Knezic, Chery Smith   Funding Period: July 1 - September 1, 2017 Title of Grant: The Impact of Periodized Resistance Training on Sarcopenia in Older Women Funder: The University of Rhode Island Grant Amount: $2,200 Role: Furong Xu, PI; Matthew Delmonico & Ingrid Lofgren, Co-PIs   Funding Period: January 1, 2017 - December 31, 2017 Title of Grant:Â  Targeting diabetes-promoting gut microbiota in adult pigsÂ  Funder: Special Research Initiative, Mississippi Agricultural & Forestry Experiment Station Grant Amount: $50,000 Role: Wen-Hsing Cheng, PI

Publications

As a group we 10 published journal articles, 19 presentations (both oral and poster), 10 research abstract, 5 theses/dissertations and 1 Extension curriculum. Of these 3 journal articles, 3 reserach abstracts and 3 presentations were NE-1439 joint products.

Impact Statements

This multistate project targets nutrition scientists, dietitians, as well as community-residing adults ages 45+ living in rural, urban and suburban areas of the country. First, the activities under Objective 1, Experiment 1 targeted scientists and nutritionists with the long-term goal that it will be of benefit to the public. Understanding how diet can affect the circadian clock, which in turn protect one’s genome from DNA damage that causes disease, will promote healthier and more independent lifestyles in an aging population. This in turn will provide ancillary benefits to the economy and society. We have recently fully adopted the Leukocyte Telomere Length Assay. We have also conducted the Telomere length assessment of older men in a telehealth study. Secondly, Objective 2 projects included the development of a food environment assessment tool, conducting needs and preference assessments, promoting SNAP outreach, and pilot testing sarcopenia prevention programs. The work on the food environment assessment tool has expanded the knowledge of the importance of the community food environment and how it can be improved for better older adult nutrition. This food environment work adds to the body of knowledge on the importance of the community food environment and how it can be enhanced so that older adults can improve their dietary intake. It may also inform local communities and encourage discussions of potential policy changes and ideas for community planning to facilitate fruit and vegetable consumption in their older adult residents. Next, the SNAP outreach program resulted in the referral of 29 older adults. If each older adult who was referred met the eligibility criteria and received SNAP benefits, the potential annual economic impact for this group would be $27,840 (29 older adults x $80 average SNAP [in Iowa] to adults age 50+ x 12 months]). Additionally, every $1.00 provided in SNAP benefits generates $1.73 in local economic activity. Furthermore, several of the lifestyle intervention projects under Objective 3 have resulted in improved nutrition and health status for older adults with chronic disease. For example, based on our peer-reviewed published research, our project helps to improve the health of older women through addressing sarcopenia classification of Rhode Island women, which may have future impacts on sarcopenia interventions or prevention.

Date of Annual Report: 11/09/2018

Report Information

Annual Meeting Dates: 06/06/2018 - 06/08/2018
Period the Report Covers: 10/01/2017 - 09/30/2017

Participants

Brief Summary of Minutes

Minutes Attachment:

2018 Meeting Minutes 11.9.18.doc

Accomplishments

Short-term Outcomes: <ul> <li>Objective 1 projects: <ul> <li>Trained scientists in telomere length assay to use in their research.  In particular, collaborators are using this assay to study the adverse health effects of alcohol and how it affects Fetal Alcohol spectrum disorders.</li> <li>We have begun utilizing targeted lipidomics (emerging field of biomedical research which includes complex lipidome [set of lipid species in an organism] analysis) to identify alterations of fatty acid oxylipins in conditions affecting muscle health such as cachexia, obesity and type 2 diabetes.</li> </ul> </li> <li>Objective 2 projects: <ul> <li>Conducted four focus groups in Iowa that helped identify areas for improvement of the congregate meal program that are being applied as part of a meal program innovations project.</li> <li>Conducted four focus groups in Iowa that helped identify barriers toward Meals on Wheels program participation and provided strategies to help local provider increase program awareness among community-residing older adults.</li> </ul> </li> <li>Objective 3 projects: <ul> <li>Promoted awareness of the SNAP among 2,976 older Iowans; 8 % of participants were better informed about SNAP after attending these outreach sessions.</li> <li>Conducted four-week program to 151 older Iowans that significantly increase familiarity about consuming three meals, protein, and produce daily and being physically active. The majority also reported being very likely to make the recommended lifestyle behavior after each lesson: Meals (50.3%), Produce (53.7%), Protein (78.5%), and physical activity (53.7%).</li> <li>Increased the knowledge of students to nutrition assessment techniques in older adults</li> <li>Improved prioritization of need for meals and nutrition services among vulnerable older adult populations</li> </ul> </li> <li>Created jobs: 1 previous doctoral student is now postdoc at Mississippi State University and another is an Assistant Research Professor at Mississippi State University</li> </ul>   Outputs: <ul> <li>Collectively we trained 23 undergraduate students, 19 graduate students, and 2 Post-Doctoral Associates. The skills acquired by these trainees include:</li> <ul> <li>Quantitative research (e.g., data collection, data entry, analysis)</li> <li>Qualitative research (e.g., conducting focus groups, analyzing focus group data, etc.)</li> <li>Professional writing (e.g., manuscripts, abstracts, theses)</li> <li>Laboratory skills (e.g., telomere length assays, northern blots, etc.)</li> <li>Anthropometric measures (e.g., height, weight, skin folds, etc.)</li> <li>Nutritional Status assessment (e.g., DST, MNA)</li> <li>Dietary Intake Assessment (e.g., 24-hour food recalls, food records, etc.)</li> </ul> <li>Collectively we received 12 grants ($538,361.67Total); listed at end of this section</li> <li>The team published 13 journal articles including 1 joint journal article (Massachusetts, Illinois, and Iowa) and 3 published abstracts (1 joint abstract [West Virginia and Rhode Island]).</li> <li>The team provided 17 research presentations; 1 of which was a joint presentation</li> <li>The team supervised the publication of 4 theses and/or dissertations.</li> <li>1 informational handout and 2 Extension lessons with supplemental materials were produced</li> </ul>   Activities: <ul> <li>Four states (ISU, UMass, NYU, and WVU) published an article related to a study conducted 2015-2017 (Objective 2).</li> </ul> <ul> <li>Preparation has been started for six articles that will be submitted for a consideration in a special issue in Topics in Clinical Nutrition about the work that has been completed through the NE1439 multistate project. (All objectives)</li> </ul>   Milestones: <ul> <li>Incorporated the prioritization tool in the screening of needs in all nutrition programs in the state of Maryland</li> <li>This year, we evaluated consumer perceptions of environmental supports for healthy eating among older adults.</li> <li>We have identified and begun collaboration with two experts in targeted lipidomics.</li> </ul>   Funding Received (12 total; $538,361.67) <ol> <li>Funding Period: September 2018 to Present Title of Grant: Linn County Innovations in Nutrition Program Funder: Iowa Department on Aging Grant Amount: $25,360 Role: Sarah L. Francis, Evaluator</li> <li>Funding Period: October 1, 2017 to September 30, 2018 Title of Grant: Fresh Conversations Evaluation Funder: Iowa Department of Public Health Grant Amount:  $33,747 Role: Sarah L. Francis, Consultant</li> <li>Funding Period: October 1, 2017 to September 30, 2018 Title of Grant: Promoting Wellness and Independence for Midlife and Older Iowans through the Iowa Food Assistance ProgramFunder: Iowa Department of Human Services Grant Amount:  $36,558 Role: Sarah L. Francis, Principal Investigator</li> <li>Funding Period: July 1, 2018 to Present Title of Grant: Nutrition Education with Seniors (NEWS) education program Funder: Department of Community, Family and Youth Services Senior Services and Commodity Supplemental Foods Programs in Polk County  Grant Amount: $15,996.67</li> <li>Funding Period: November 1, 2017 through July 15, 2019 Title of Grant: Innovation in Nutrition Service Project: Home Delivered Meals Screening Funder: Maryland Department of Aging Grant Amount: $9000 Role: Nadine Sahyoun, PI</li> <li>Funding Period: March 1, 2018 through August 31, 2018 Title of Grant:  Methods for making synthetic antibodies Funder: Rutgers University Office of Research and Economic Development. Grant Amount: $10,000 Role: William Belden, PI</li> <li>Funding Period: 2017-2018. Title of Grant: Focus Groups Funder: University of Minnesota Grant Amount: $1700</li> <li>Funding Period: September 1, 2018 through August 31, 2021  Title of Grant: Optimized selenium intake, gut microbiota and diabetes  Funder: National Institutes of Health  Grant Amount: $300,000 + F&A ($100,000/year)  Role:  Wen-Hsing Cheng, PI</li> <li>Funding Period: October 1, 2017-September 30, 2018 Title of Grant: Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modifications.  Funder: USDA NIFA NE- 1439 Regional Research Project, Mass Ag Experiment StationÂ Â  Grant Amount: Approximately $6000 Role: N. Cohen, PI of Massachusetts project</li> <li>Funding Period: Period: Sep 2018- Aug 2023 National Needs Fellowship: Multidisciplinary Training of Fellows in Food & Nutrition for Obesity & Cancer Prevention     $ 75,000 /year USDA 2017-09503   Role: Project Director.  Co-Directors: S. Clinton, K. Lee, Y. Vodovotz </li> <li>Funding Period: Jan 2018-Jan 2020  Dietary fats, mitochondrial function and muscle health in cancer patients  Martha Belury and Subha Raman, Dual PI  Funding NIH/NCI R21206566  $125,000/year Role:  PI, 10%     Co-Is: R. Andridge, M. Lustberg</li> <li>Funding Period: Aug 2017 to Jul 2018 Beef intake and muscle strength, cardiometabolic health and fatigue in women with breast cancer  Martha Belury, PI National Cattlemen Beef Association  Period $100,000 / year. Co-I: R. Andridge</li> </ol>

Publications

Impact Statements

Aging adults face numerous barriers towards achieving optimal health and wellness including chronic disease, nutritional risk, food insecurity and functional impairments. The United States (U.S.) population is experiencing a shift in demographics, as adults aged 60 to 65 years and older, have become the largest growing age group. The USDA NE-1439 Multistate Project “Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modifications” is an interdisciplinary team of researchers who are examining diet and activity factors that influence healthy aging through translational research approaches. Our work addresses the numerous factors impacting the health and well-being of older adults including poverty, food security, nutritional risk, dietary intakes, and physical activity. We examine these issues at a cellular, individual and societal level. In 2017 to 2018, we trained 23 undergraduate and 18 graduate students and two post-doctoral associates. Our team members were awarded 12 grants totaling $538,361.67 for projects conducted as part of this multi-state research project. We published 14 journal articles including one joint article (Iowa, Massachusetts, New York, and West Virginia) and three research abstracts, including a joint one by West Virginia University and University of Rhode Island. We gave 17 research presentations, including one joint (Iowa, Massachusetts, and Illinois) presentation at the American Society for Nutrition conference. First, we have developed the Telomere Length assay (an assay to measure DNA integrity that is commonly used as a marker for cellular aging) and have begun looking at markers of inflammation (Objective 1). Our produce food environment work (Objective 2) has identified need areas that will enable communities to plan for priority services and programs that assist older adults to achieve the recommended intakes for produce. We also identified the motivators and barriers toward participation in the congregate meal program and meals on wheels program. Reports were provided to these programs locally with strategies for increasing program awareness and potentially enrollment. We also identified motivators for older adults to participate in the congregate meal program and Meals on Wheels and provided strategies for these programs to use to increase program utilization. Furthermore, our food security focused interventions have resulted in older adults making healthier food choices, applying food budget tips, and being better informed about SNAP. Additionally, our nutritional risk and physical activity work (Objective 3) identified the need for community-based programs focused on lowering age-related muscle loss (sarcopenia). In response, we have developed a potential physical activity intervention that can prevent further sarcopenia severity as well as a healthy aging series that has increased familiarity with lifestyle behaviors linked to health and wellness.

Date of Annual Report: 10/31/2019

Report Information

Annual Meeting Dates: 06/05/2019 - 06/07/2019
Period the Report Covers: 10/01/2018 - 09/30/2019

Participants

Members who attended: Sarah Francis (ISU), David Buys (MSU), Matthew Delmonico (URI), Ingrid Lofgren (URI), Furong Xu (URI), Elgloria Harrison (UDC), Judith Gilbride (NYU), Nancy Cohen (UMASS), William Belden (RUTGERS), Sabine O’Hara (UDC)

Guests who attended: Elmira Asongwed (UDC), Pier Broadnax (UDC), Michelle Harris (UDC), Diane Hyman (UDC), Phronie Jackson (UDC), Anne Marie Jean-Baptiste (UDC), Tia Jeffery (UDC), Lillie Monroe-Lord (UDC), Kelly Thomas (UDC)

Brief Summary of Minutes

Minutes Attachment:

NE1439 Annual Meeting Minutes_June 2019 Meeting.docx

Accomplishments

Short-term Outcomes: <ul> <li>Objective 1 projects: <ul> <li>We adopted and applied leukocyte telomere length assay resulting in one joint publication (Rutgers and West Virginia University).</li> <li>We performed age-related studies using model organisms to understand how the circadian transcriptome and facultative heterochromatin changes with age.</li> <li>Conducted experiments designed to better understand how the circadian clock (a major factor in metabolism) and epigenetics change with age. This entailed examining how the liver transcriptome changes under amino-acid stress and how non-coding RNAs guide facultative heterochromatin.</li> <li>Conducted research studies that contributed to understanding the need for folic acid fortification.</li> <li>Created jobs: 1 previous doctoral student involved with the dietary lipids in aging work is now serving as a scientific officer</li> </ul> </li> </ul>   <ul> <li>Objective 2 projects: <ul> <li>We anticipate a change in knowledge among nutrition and gerontology professionals and community providers regarding steps communities can take to improve older adult nutrition.</li> </ul> </li> </ul>   <ul> <li>Objective 3 projects: <ul> <li>Promoted awareness of the SNAP among 958 older Iowans; 0% of participants were better informed about SNAP after attending these outreach sessions.</li> <li>Conducted four-week program to 196 older Iowans that significantly increased familiarity about consuming three meals, protein, and produce daily and being physically active. The majority also reported being “very likely” to make the recommended lifestyle behavior after each lesson.</li> <li>A commodity and supplemental food nutrition education program (NEWS) reached about 4,000 older Iowans. Of those surveyed, 80.7% used the information provided to make food choices, 89.1% stated the food assistance information or budget-friendly shopping tips have been useful, 60.8% have made at least one of the recipes at home.</li> <li>Increased the knowledge of students to nutrition assessment techniques in older adults</li> <li>Improved assessment of health and nutrition status among older adults at a Y in New York City.</li> <li>Increased nutrition knowledge and behaviors of older adults at Y in New York City.</li> <li>Conducted food demonstrations using a cookbook developed as part of the NE1439 project amongst urban-residing older adults in low-income areas</li> <li>Provided research participants with the information they need to better monitor their health status changes in terms of diet, physical activity and physical function.</li> </ul> </li> </ul>   Outputs: <ul> <li>Collectively we trained 39 undergraduate students, 34 graduate students, 1 Post-Doctoral Associate and 12 Extension personnel. The skills acquired by these trainees include:</li> <ul> <li>Quantitative research (e.g., data collection, data entry, analysis)</li> <li>Qualitative research (e.g., conducting focus groups, analyzing focus group data, etc.)</li> <li>Professional writing (e.g., manuscripts, abstracts, theses)</li> <li>Laboratory skills (e.g., telomere length assays, northern blots, etc.)</li> <li>Anthropometric measures (e.g., height, weight, skin folds, etc.)</li> <li>Nutritional Status assessment (e.g., DST, MNA)</li> <li>Dietary Intake Assessment (e.g., 24-hour food recalls, food records, etc.)</li> <li>Program implementation</li> </ul> <li>Collectively we received 8 grants ($1,427,075 Total): 2 Federal, 4 state, and 2 research station grants.</li> <li>The team published 25 journal articles including 4 joint journal articles (Iowa, Maryland, New Jersey, Rhode Island, and West Virginia) and 10 published abstracts.</li> <li>The team provided 28 research presentations.</li> <li>The team supervised the publication of 4 theses and/or dissertations.</li> <li>2 Extension lessons with supplemental materials and one cookbook were produced</li> </ul>   Activities: <ul> <li>Four states (ISU, UMass, NYU, and WVU) published an article related to a study conducted 2015-2017 (Objective 2).</li> </ul> <ul> <li>Four articles were submitted and accepted for a special issue in Topics in Clinical Nutrition about the work that has been completed through the NE1439 multistate project. (All objectives)</li> </ul>   Milestones: <ul> <li>Incorporated the prioritization tool in the screening of needs in all nutrition programs in the state of Maryland</li> <li>This year, we evaluated consumer perceptions of environmental supports for healthy eating among older adults.</li> <li>We have identified and begun collaboration with two experts in targeted lipidomics.</li> </ul>

Publications

Impact Statements

FUNDING RECEIVED ($1,472,075) FOR NE1439 RELATED PROJECTS 1. Funding Period: October 2018 – September 2019 Title of Grant: Linn County Innovations in Nutrition Program Funder: Iowa Department on Aging Grant Amount: $25,360 Role: S. Francis PI for evaluation 2. Funding Period: October 2018 – September 2019 Title of Grant: Fresh Conversations Evaluation Funder: Iowa Department of Public Health Grant Amount: $41,332 Role: S. Francis PI for evaluation 3. Funding Period: October 2018 – September 2019 Title of Grant: Promoting Wellness and Independence for Midlife and Older Iowans through the Iowa Food Assistance Program Funder: Iowa Department of Human Services Grant Amount: $36,887 Role: S. Francis PI 4. Funding Period: October 2018 – September 2019 Title of Grant: Nutrition Education with Seniors (NEWS) education program Funder: Department of Community, Family and Youth Services’ Senior Services and Commodity Supplemental Foods Programs in Polk County Grant Amount: $15,996 Role: S. Francis PI 5. Funding Period: September 29, 2018 through September 28, 2019 Title of Grant: “Advancing, Inspiring, and Motivating for Community Health through Extension: AIM for CHangE” Funder: Centers for Disease Control and Prevention Grant Amount: $1,100,000 Role: David Buys, PI 6. Funding Period: October 1, 2018- September 30, 2019 Title of Grant: Changing the Health Trajectory for Older Adults through Effective Diet and Activity Modifications Funder: USDA NIFA, MA Experiment Station Grant Amount: $2500 Role: Nancy Cohen, PI 7. Funding Period: Nov 2018- Oct 2023 Title: National Needs Fellowship: Multidisciplinary Training of Fellows in Food & Nutrition for Obesity & Cancer Prevention Funder: USDA 2017-09503 Amount: $300,000 Role: Martha Belury Project Director 8. Period: Jan 2018-Jan 2021 Title: Dietary fats, mitochondrial function and muscle health in cancer patients Funder: NIH/NCI R21206566 Grant Amount: $400,000 Role: Martha Belury, Dual-PI