Brief Summary of Minutes of Annual Meeting

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)

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

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.