Progress 10/01/04 to 09/30/09
Outputs
OUTPUTS: The nature of the relationship between Body Mass Index and DETERMINE Checklist data was explored from a sample of 4121 Maine seniors. Also, NIH classifications for BMI were compared with a modified literature based scheme for older adults. A trend analysis of the Maine DETERMINE Checklist data from 2000 to 2005 was carried out. Age, BMI, county, food delivery method and gender were examined in relation to how they affected risk of malnutrition. A longitudinal analysis of the risk of malnutrition was performed with DETERMINE Checklist data from 2003 to 2005. Fresh fruit and vegetable patterns of 103 Maine senior FarmShare participants were examined. In response to an end of the year survey sent out to Maine senior FarmShare participants, 4087 additional comments returned with the surveys were examined for commonalities. PARTICIPANTS: Not relevant to this project. TARGET AUDIENCES: Not relevant to this project. PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
BMI data supported the notion of a more reliable indicator of potential nutritional risk in seniors than the DETERMINE Checklist cumulative score. The literature based cut off of underweight for BMI appeared to be more useful at identifying risk than the conventional NIH based cut off. DETERMINE Checklist data showed individuals less than 75 years of age had a consistently higher nutritional risk than those age 75 and over. Congregate meal consumers had significantly less risk of malnutrition than home delivered meal consumers. Those with a BMI in the overweight range were at the lowest nutritional risk, while those in the underweight range were at the highest nutritional risk. No difference in nutritional risk was found between males and females. In the longitudinal analysis, those 75 years or older had less risk of malnutrition than the seniors of lesser age. Females had consistently higher risk than males. Those eating at congregate meal sites had roughly half the nutritional risk as those eating home delivered meals. Overweight individuals had less risk than the obese or underweight individuals. Risk remained relatively stable over the 3 year period. FarmShare participants over 12 weeks received greater than 3 servings of fruits and vegetables per day. While receiving fresh produce, participants had fewer difficulties in paying for necessities such as prescription medications, electricity, phones and heat. Home bound individuals were fortunate to have deliveries from farmers and positive health aspects were reported from availability of fresh fruits and vegetables. Feedback from the FarmShare experience showed 6 major domains on how the program affected individuals. Many with health issues felt a beneficial affect to their health concerns. Those with budget problems ate a greater variety and quantity of fresh fruits and vegetables than would normally be possible. Often, seasonality was extended through canning and freezing of the produce.
Publications
- No publications reported this period
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Progress 10/01/07 to 09/30/08
Outputs
OUTPUTS: Experiment 2, Diet Patterns and Biomarkers. A whole grain screener developed by the University of Rhode Island was modified and administered to 122 DETERMINE YOUR NUTRITIONAL HEALTH CHECKLIST participants of Area Agencies on Aging in Maine. The screener was designed to look at overall grain consumption (whole grain items as well as refined carbohydrates). Screener results (frequency of consumption of items) were compared to the level of nutritional risk of individuals as assessed by DETERMINE Checklists to see if consumption of whole grain items decreased risk scores. Experiment 3, Farmer's Markets. Following the Maine FarmShare programs carried out from 2002-2005, end of program year surveys were sent out to each of the 18,412 participants. Of those seniors receiving the survey, 10,481 were returned and 4,087 included comments about the program following the survey proper. These extra comments were examined for commonalities. PARTICIPANTS: Not relevant to this project. TARGET AUDIENCES: Workers at Area Agencies on Aging. Workers and participants of the Summer Farm Share Programs. Those interested in whole gain consumption. PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
Experiment 2, Diet Patterns and Biomarkers. Only one item in the whole grain screener (white pasta, p=0.04) predicted a significant increase in the level of nutritional risk. Other items approaching significance were bagels (p=0.07), white bread (p=0.07) multigrain bread (p= 0.09) and whole wheat pasta (p=0.07), which might have achieved significance if the sample size of individuals tested had been higher. Experiment 3, Farmer's Market. Based on individual comments from a survey of the Maine FarmShare Program, six domains surfaced. Participants suffering from disease of health-related problems found the program to be very beneficial. Budgeting, income and pricing were of high concern to these low income seniors, and were often mentioned in the comment area. Convenience and location also raised many concerns among this group. Transportation was a big issue. Quality/variety of the produce was usually satisfactory but occasionally a problem. Many chose to freeze or can some of the produce to eat off season. These low income seniors appreciated what the program had to offer but were frustrated with its limitations. For three years those covered by the survey received $100 allotments per person per summer. However, that changed to $50 allotments by Federal decree in the fourth year to severely limit what seniors could obtain for summer produce.
Publications
- No publications reported this period
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Progress 10/01/06 to 09/30/07
Outputs
A trend analysis of the Maine DETERMINE Checklist data from 2000-2005 was carried out. Age, BMI, county, food delivery method, and gender were examined in relation to how they affected the risk of malnutrition. All participants were at least 60 years old and all Maine counties were represented. A longitudinal analysis of the risk of malnutrition was performed as well with DETERMINE Checklist data from 2003-2005. Participants included those who were in the program for the entire three-year period.
Impacts
In the trend analysis the Young Old group (74 years or less)had a consistently higher nutritional risk than the Old Old group (75 years or older). Participants who consumed their meals at a congregate site had a significantly lower risk for malnutrition than those who received home delivered meals. Participants who were in the overweight group (BMI 25.0 to 29.0) were at the lowest risk for malnutrition while participants who were in the under weight group (BMI less than 18.5) were at the highest nutritional risk. Genetics and lifestyle most likely contributed to the lower level of risk in the Old Old group. The difference in risk between males and females was not statistically significant. Participants who consumed their meals at congregate sites had lower nutritional risk because they most likely had better mobility and were less socially isolated than the home delivered participants. Those in the county in Maine with the highest population (Cumberland) showed the
lowest level of risk across the six year period. In the longitudinal analysis, the Young Old group had consistently higher levels of risk than the Old Old group. Females had consistently higher risk than males. Participants who ate at the congregate meal sites had roughly half of the nutritional risk as the home delivered participants. Those who were overweight had less risk than those who were underweight or obese. Risk remained relatively stable over the years.
Publications
- Prior RL, Gu L, Wu X, Jacob, RA, Sotoudeh G, Kader AA, Cook RA. Plasma antioxidant capacity changes following a meal as a measure of the ability of a food to alter in vivo antioxidant status. J. Am. Col. Nutr. 2007;26:170-181.
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Progress 10/01/05 to 09/30/06
Outputs
Obj. 2, Expt. 3: Data were obtained from 103 low income Maine seniors participating in the Maine Senior FarmShare Program during the 2004 growing season. Types of fruits and vegetables received during the twelve week season varied according to the maturation characteristics of the fruits and vegetables. During this time, seniors received greater than three servings of fruits & vegetables per day. During the growing season, those receiving fresh produce had fewer difficulties in paying for necessities such as prescription medications, electricity, phones and heat. Home bound individuals were especially grateful for convenient deliveries from the farmers. Evidence was obtained for positive health aspects from receiving $100 shares for fresh fruits and vegetables throughout the summer. These relationships will be further explored during the coming year. BMI/DETERMINE Checklist Classification Comparisons and Longitudinal Analyses: The nature of the relationship between
Body Mass Index and the DETERMINE Checklist was explored from a sample of 4121 Maine Seniors. Also NIH classifications for BMI were compared with a modified literature based scheme for older adults. Literature based scores included a higher level of risk for underweight and a more restrictive level of assessment for normal weight. Obese classifications were the same. BMI data supported the notion of a more reliable indicator of potential nutritional risk in seniors than the DETERMINE Checklist cumulative score. Literature based cutoffs for the elderly appeared to be useful in determining nutritional risk of underweight and should be explored in additional studies. A more refined longitudinal analysis of DETERMINE Checklist data than used in previous years was initiated for the years 2003 to 2005. Phase I involved a trend analysis of all participants submitting data during those years, and Phase II involved an analysis of only participants involved for all years.
Impacts
Participation in the Maine Senior FarmShare Program resulted in positive health aspects and helped reduce nutritional risk among the eldely. Body Mass Index was a more reliable indicator of potential nutritional risk for elders than the DETERMINE Checklist. Literature based BMI cutoffs for underweight among the elderly appeared to be more useful than the usual NIH based cutoffs for underweight.
Publications
- Rozario, S. Evaluation of Nutrition Risk and Body Mass Index in Maine, May 2006, Thesis, University of Maine, 71pp.
- Connor, K. Fresh Fruit and Vegetable Purchasing Patterns of Maine Senior FarmShare Participants, May 2006, Thesis, University of Maine, 78pp.
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Progress 10/01/04 to 09/30/05
Outputs
Fresh fruit and vegetable purchasing patterns of 97 Maine Senior Farm Share participants were examined. Detailed records were kept of all fruits and vegetables being received during the harvest season from five major farms. Each participant was awarded a $100 share for the purchase of fruits and vegetables during the growing season. Total diet intake data were not recorded. Amounts of different types of fruits and vegetables provided for consumption each week were calculated for the whole group and then a daily average per person determined. Nutrient contributions of the fruits and vegetables are being determined and recommended number of servings eaten per day as compared to 5 to 9 a day as well as comparisons to the food guide pyrimid recommendations are being determined. Survey data are available on the age, gender, health and marital status of the subject population as well as information on barriers that the seniors may have in obtaining fruits and vegetables.
Data are being analyzed. A study is being planned which will focus on the nature of the relationship between the DETERMINE CHECKLIST Total Risk Score and Body Mass Index. A curvilinear relationship is hypothesized. Individuals with a BMI less than 18.5 or greater than 30.0 would be expected to have a high Total Risk Score, whereas individuals with a BMI of 25.0-29.9 would be expected to have a lower Total Risk Score. In addition, the researchers wish to discover if the validity of the relationship between Total Risk Score and BMI changes when age, gender and delivery of meals (Congregate or Home Delivered) are taken into consideration. The Maine 2004 Fiscal year Elderly Screening Intitiative data are expected to be used for the study. The sample size is 4527 elderly and includes participants from all 16 counties in Maine.
Impacts
The nutritional impact of additional fresh fruits and vegetables in the diets of low income elderly will be determined as well as barriers to such increases. The study of a relationship between DETERMINE CHECKLIST Total Risk Score and BMI will be examined in light of several variables as a possible new nutritinal risk assessment tool for low income elderly.
Publications
- No publications reported this period
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