Locher J.L.,University of Alabama at Birmingham |
Locher J.L.,Center for Aging |
Locher J.L.,Lister Hill Center for Health Policy |
Locher J.L.,Nutrition Obesity Research Center |
And 15 more authors.
Journal of Nutrition in Gerontology and Geriatrics | Year: 2011
We conducted a study designed to evaluate the efficacy and feasibility of a multilevel self-management intervention to improve nutritional intake in a group of older adults receiving Medicare home health services who were at especially high risk for experiencing undernutrition. The Behavioral Nutrition Intervention for Community Elders (B-NICE) trial used a prospective randomized controlled design to determine whether individually tailored counseling focused on social and behavioral aspects of eating resulted in increased caloric intake and improved nutrition-related health outcomes in a high-risk population of older adults. The study was guided by the theoretical approaches of the Ecological Model and Social Cognitive Theory. The development and implementation of the B-NICE protocol, including the theoretical framework, methodology, specific elements of the behavioral intervention, and assurances of the treatment fidelity, as well as the health policy implications of the trial results, are presented in this article. © 2011 Copyright Taylor and Francis Group, LLC.
Robertson H.T.,University of Alabama at Birmingham |
Smith D.L.,Nutrition Obesity Research Center |
Smith D.L.,University of Alabama at Birmingham |
Pajewski N.M.,University of Alabama at Birmingham |
And 6 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2011
Many rodent experiments have assessed effects of diets, drugs, genes, and other factors on life span. A challenge with such experiments is their long duration, typically over 3.5 years given rodent life spans, thus requiring significant time costs until answers are obtained. We collected longevity data from 15 rodent studies and artificially truncated them at 2 years to assess the extent to which one will obtain the same answer regarding mortality effects. When truncated, the point estimates were not significantly different in any study, implying that in most cases, truncated studies yield similar estimates. The median ratio of variances of coefficients for truncated to full-length studies was 3.4, implying that truncated studies with roughly 3.4 times as many rodents will often have equivalent or greater power. Cost calculations suggest that shorter studies will be more expensive but perhaps not so much to not be worth the reduced time. © The Author 2010. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
News Article | February 27, 2017
BOSTON (Feb. 27, 2017)--Heart disease is the leading cause of death for Black/African American women in the US and more Black/African American women die every year from heart disease compared to their white and Hispanic counterparts, according to the Centers for Disease Control. A pilot study, led by researchers at the Friedman School of Nutrition Science and Policy at Tufts University, aimed to address this disparity by investigating the impact of engaging Black/African American women in "Change Clubs" on measures of heart health. The results of the pilot study were published in BMC Public Health on Jan. 24. Using the African American Collaborative Obesity Research Network (AACORN) model focused on engaging community members in the planning and implementation of interventions, the researchers collaborated with four local churches in predominately Black/African American Boston neighborhoods, and worked with participants to identify and address health concerns in their respective communities. Working with the researchers from Tufts, a group of 28 self-identified Black/African American women aged 30 to 70 who were clinically overweight and led a mostly sedentary life formed Change Clubs in the four churches. The Change Clubs met weekly for six months. During the first three months, each Change Club identified a nutrition or physical activity concern in their community and planned a group project to address the concern. For example, one club wanted to increase access to heart-healthy food, while another club decided to educate the community about healthy eating and fitness choices. The final three months were dedicated to implementing the action steps and benchmarks established by the Change Clubs during the first half of the intervention. During the weekly meetings, a nutrition or physical activity topic was covered. The researchers anticipated that this curriculum would provoke individual behavior changes surrounding nutrition and exercise and that the women would reinforce these behavior changes among each other. By empowering one another, the group was able to effect change in their communities. Surveys at the end of the intervention indicated that participants believed they had been effective in positively motivating their communities. The Change Clubs met their self-identified action steps and outcomes. For example, one Club decided upon heart-healthy recipes and conducted monthly cooking demonstrations for the community, while another Club engaged children and parents at a local school to develop a heart-healthy cookbook for families. Additionally, in individual outcomes, the intervention had an effect on specific physical measures of the women's heart health. Overall, the women were able to finish a walk test of cardiorespiratory fitness more quickly and their systolic blood pressure had decreased slightly from pre-intervention measures. Considering the prevalence of heart disease among Black/African American women, this clinically significant decrease in systolic blood pressure is promising and a possible result of the exercise curriculum in the Clubs. "The nutrition and exercise curriculum during each meeting was adapted to the individual communities from the Strong-Women - Healthy Hearts program developed by Tufts researchers. By interweaving this curriculum into the Change Clubs, we hoped that the individual members would make behavioral changes in regards to nutrition and exercise and reinforce those changes within the group, resulting in improved measures of heart health among the women. Overall, civic engagement and empowerment had a positive effect on the communities as well as the women individually," said senior author Sara Folta, Ph.D., associate professor at the Friedman School who also holds a secondary faculty appointment at the Jonathan M. Tisch College of Civic Life. "The Change Clubs place the focus on the collective health of the community and champion the strengths of the Black/African American community. Through this pilot, we hoped to determine how feasible and effective the Change Clubs would be in changing the heart health-related behaviors among Black/African American women in order to expand this type of work in the future," said lead author Alison G. M. Brown, M.S., doctoral candidate at the Friedman School. "Overall, the study results indicate that this civic engagement approach is a promising intervention tool to stimulate positive behavior change among Black/African American women." The researchers note that this was a pilot study and suggest a larger, randomized, control trial to explore Change Clubs and civic engagement as a way to improve the heart health of Black/African American women. Additional authors are Linda B. Hudson, Sc.D., and Kenneth Chui, Ph.D., M.P.H., M.S., both assistant professors in the Department of Public Health and Community Medicine at Tufts University School of Medicine, Nesly Metayer, Ph.D., senior fellow at the Moakley Center for Public Management at Suffolk University, Namibia Lebron-Torres, M.S., research coordinator at the Friedman School of Nutrition Science and Policy at Tufts University, and Rebecca A. Seguin, Ph.D., M.S., assistant professor at Cornell University College of Human Ecology. This study was supported the Boston Nutrition Obesity Research Center, Tisch College of Civic Life and Tufts, and Aviva Must, Ph.D., Morton A. Madoff Professor and Chair of Public Health and Community Medicine and dean of Public Health and Professional Degree Programs at Tufts University School of Medicine. The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight degree programs - which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics - are renowned for the application of scientific research to national and international policy.
Dhurandhar E.J.,University of Alabama at Birmingham |
Dawson J.,Nutrition Obesity Research Center |
Alcorn A.,Nutrition Obesity Research Center |
Larsen L.H.,Copenhagen University |
And 9 more authors.
American Journal of Clinical Nutrition | Year: 2014
Background: Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown. Objective: We tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. Design: We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m2) between 25 and 40] aged 20-65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants were randomly assigned. Results: A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.71± 1.16, -0.76 ± 1.26, and -0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.53 ± 1.16, -0.59 ± 1.06, and -0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group. Conclusions: A recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but contrary to widely espoused views this had no discernable effect on weight loss in free-living adults who were attempting to lose weight. This trial was registered at clinicaltrails.gov as NCT01781780. © 2014 American Society for Nutrition.
Hsiao P.Y.,Pennsylvania State University |
Mitchell D.C.,Pennsylvania State University |
Coffman D.L.,Pennsylvania State University |
Allman R.M.,Birmingham Atlanta VA Geriatric Research |
And 9 more authors.
Journal of Nutrition, Health and Aging | Year: 2013
Objectives: To characterize dietary patterns among a diverse sample of older adults (≥ 65 years). Design: Cross-sectional. Setting: Five counties in west central Alabama. Participants: Community-dwelling Medicare beneficiaries (N=416; 76.8 ±5.2 years, 56% female, 39% African American) in the University of Alabama at Birmingham (UAB) Study of Aging. Measurements: Dietary data collected via three, unannounced 24-hour dietary recalls was used to identify dietary patterns. Foods were aggregated into 13 groups. Finite mixture modeling (FMM) was used to classify individuals into three dietary patterns. Differences across dietary patterns for nutrient intakes, sociodemographic, and anthropometric measurements were examined using chi-square and general linear models. Results: Three dietary patterns were derived. A "More healthful" dietary pattern, with relatively higher intakes of fruit, vegetables, whole grains, eggs, nuts, legumes and dairy, was associated with lower energy density, higher quality diets as determined by Healthy Eating Index (HEI)-2005 scores and higher intakes of fiber, folate, vitamins C and B6, calcium, iron, magnesium, and zinc. The "Westernlike" pattern was defined by an intake of starchy vegetables, refined grains, meats, fried poultry and fish, oils and fats and was associated with lower HEI-2005 scores. The "Low produce, high sweets" pattern was characterized by high saturated fat, and low dietary fiber and vitamin C intakes. The strongest predictors of better diet quality were female gender and non-Hispanic white race. Conclusion: The dietary patterns identified may provide a useful basis on which to base dietary interventions targeted at older adults. Examination of nutrient intakes regardless of the dietary pattern suggests that older adults are not meeting nutrient recommendations and should continue to be encouraged to choose high quality diets. © 2013 Serdi and Springer Verlag France.
News Article | January 11, 2016
Why all scientific diet research turns out to be bullshit The gold standard for researching the effects of diet on health is the self-reported food-diary, which is prone to lots of error, underreporting of "bad" food, and changes in diet that result from simply keeping track of what you're eating. The standard tool for correcting these errors comparisons with more self-reported tests. As if that wasn't bad enough, eating correlates with everything, so if you go "p-hacking" through the data, looking for correlations after the fact. My take on all this is that if there was a gross, easily observable effect from eating food that humans have been eating for hundreds or thousands of years, we'd already know about it. That's why the amazing study showing that kiwi fruit promote good sleep turns out to have only 24 subjects, only two of them men, to rely on self-reporting, and to be funded by the kiwi industry. That's why the incredible news that tomatoes improve memory turns out to be a preliminary result of a small study on very old Japanese people. If you're not very old and of Japanese descent, that finding means something between nothing and so little as to be indistinguishable from nothing. So a good rule of thumb, as far as I'm concerned, is that any nutrition study that finds any genuinely surprising, large-scale effect, is bullshit. Tiny, difficult-to-disentangle effects? Sure, there's probably a lot of those. But "Eating peanuts makes you grow extra nipples on your ass-cheeks?" If that were the case, we'd have noticed by now. Although concerns about self-reported dietary intakes have been around for decades, the debate has come to a head in recent years, said David Allison, director of the University of Alabama’s Nutrition Obesity Research Center in Birmingham. Allison was an author of a 2014 expert report from the Energy Balance Measurement Working Group that called it “unacceptable” to use “decidedly inaccurate” methods of measurement to set health care policies, research and clinical practice. “In this case,” the researchers wrote, “the adage ‘something is better than nothing’ must be changed to ‘something is worse than nothing.’” The problems with food questionnaires go even deeper. They aren’t just unreliable, they also produce huge data sets with many, many variables. The resulting cornucopia of possible variable combinations makes it easy to p-hack your way to sexy (and false) results, as we learned when we invited readers to take an FFQ and answer a few other questions about themselves. We ended up with 54 complete responses and then looked for associations — much as researchers look for links between foods and dreaded diseases. It was silly easy to find them. You Can’t Trust What You Read About Nutrition [Christie Aschwanden/538]
Qin Y.,Nutrition Obesity Research Center |
Hamilton J.L.,Nutrition Obesity Research Center |
Bird M.D.,Loyola University Chicago |
Chen M.M.,Loyola University Chicago |
And 4 more authors.
Alcoholism: Clinical and Experimental Research | Year: 2014
Background: Ethanol (EtOH) exposure prior to traumatic injury, such as a burn, elevates systemic and local inflammatory responses and increases morbidity and mortality. Adipose is a large tissue mass that is often inflamed during obesity or other stresses, which disturbs metabolic homeostasis. To date, there has been little investigation into the inflammatory response of adipose tissue after combined EtOH exposure and burn injury. Methods: Two EtOH exposure regimens were utilized to examine the role of inflammation in adipose tissue after EtOH and burn injury. Mice were either given a single or episodic binge exposure to EtOH or saline followed by scald (burn) or sham injury 30 minutes later. Twenty-four hours post injury, serum and adipose tissue were collected for assessment of inflammatory mediators. Results: Single binge EtOH alone induced no inflammation in adipose when compared with sham vehicle-treated mice. However, single binge EtOH followed by burn injury induced significant elevations in mRNA and protein concentrations of pro-inflammatory mediators interleukin-6 (IL-6), KC, and monocyte chemoattractant protein 1 compared with either insult alone or sham vehicle group. Additionally, EtOH exposure and burn injury significantly blunted inducible nitric oxide synthase (iNOS), indicating a complex inflammatory response. Episodic binge EtOH exposure followed by burn injury exacerbated the postburn adipose inflammatory response. The magnitude of the episodic binge-induced inflammatory parameters postburn were 2- to 5-fold greater than the response detected after a single exposure of EtOH, indicating EtOH-induced potentiation of burn-induced inflammatory response. Finally, inflammatory loci and crown-like structures in adipose were significantly increased by episodic binge EtOH and burn injury. Conclusions: This is the first report of binge and burn-induced crown-like structure formation. Evidence presented herein suggests an important role for alcohol and burn as an additional mediator of adipose inflammation in postburn injury, a common complication in burn patients. © 2013 by the Research Society on Alcoholism.