Progress 10/01/08 to 09/30/13
Outputs
Target Audience: Our target audience includes children and adults in Florida communities. Our goal is to develop strategies to support healthful behaviors. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? These projects have supported the training of graduate students in Nutrition, Dietetics and Psychology. One project has also employed four part time registered dietitians to work in their communities with women with breast cancer. How have the results been disseminated to communities of interest? Results of projects are currently being analyzed and will be shared directly with community partners as well as in refereed publications. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
We have completed the intervention phase of the Extension Family LIfestyle Intervention Program (EFLIP). EFLIP enrolled over 200 overweight children and their parents/caregivers from rural counties in north central Florida. We are analyzing major outcomes currently and preparing manuscripts and presentations. We are currently conducting a healthy lifestyle intervention for overweight women with breast cancer in Gainesville and Jacksonville, FL. We have also developed two public service announcements to promote fruit and vegetable consumption in elementary school cafeterias and are testing whether viewing the announcements results in greater consumption. We have used USDA's Healthy Eating Index several times to assess the impact of our interventions on diet quality.
Publications
- Type:
Journal Articles
Status:
Accepted
Year Published:
2013
Citation:
Janicke DM, Lim CS, Mathews AE, Shelnutt KP, Boggs SR, Silverstein JH, Brumback BA (2013). The community-based healthy-lifestyle intervention for rural preschools (CHIRP) study: design and methods.
Contemp Clin Trials. Mar;34(2):187-95.
- Type:
Journal Articles
Status:
Accepted
Year Published:
2013
Citation:
Vincent, HK and Mathews A (2013). Obesity and Mobility in Advancing Age: Mechanisms and Interventions to Preserve Independent Mobility. Curr Obes Rep. 2:275283.
- Type:
Journal Articles
Status:
Accepted
Year Published:
2013
Citation:
Labyak, CA, Janicke, DM, Lim, CS, Colee, J and Mathews, AE (Epub August 22, 2013). Anthropometrics to Identify Overweight Children at Most Risk for the Development of Cardiometabolic Disease. Infant Child and Adolescent Nutrition. DOI: 10.1177/1941406413501379.
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Progress 10/01/11 to 09/30/12
Outputs
OUTPUTS: 1 - Extension Family Lifestyle Program (Funded by NHLBI, PI: David Janicke, PhD; Co-I: Mathews) This study is fully recruited and is nearing completion. Primary data analysis will begin mid-2013. Several sub-analysis of baseline data were conducted and presented at various professional meetings. One doctoral student made a unique contribution to this study by adding the sagittal abdominal diameter (anthropometric measurement) to determine what measure most closely correlates with cardiometabolic disease risk factors. Manuscipt in progress. 2-The effect of fiber snack foods on dietary intake in healthy adults (Funded by General Mills, Co-Investigators: Mathews, Henken and Dahl). This randomized, prospective, placebo controlled trial recruited 97 healthy adults in the fall of 2011. Adults completed an 8 weeks randomized intervention with or without added dietary fiber. Several presentations were made at professional meetings including the impact of added fiber in gastrointestinal symptoms as well as the primary outcome of impact on dietary intake. Manuscripts in progress. 3-Rural LITE(Funding: NHLBI, PI: Perri; Co-I: Mathews). Study completion nearing with analysis to begin immediately. 4- CHIRP: Community Health Intervention for Rural Preschoolers (PI: David Janicke, PhD, Co-I: Mathews). This NIH funded family intervention received funding as was initiated this period. This project seeks to test the impact of two interventions on BMI-z score, dietary and physical activity behaviors of preschoolers, and their families, that are at risk for becoming obese. 5- MyLIFE: My Lifestyle Intervention of Food and Exercise. (Funding: UF Opportunity Fund, PI: Mathews) This two year project seeks to test the impact of a lifestyle intervention on markers of breast cancer recurrence in women who have a previous breast cancer diagnosis and are overweight. We have completed the data collection portion of phase 1 (focus groups with patients and health care providers) and are analyzing these results. Recruitment for the randomized trial to begin in March 2013. 6-Deep Water Horizons Oil Spill Risk Assessment (PI: Andrew Kane, PhD, Co-I: Mathews). Dr. Mathews joined this NIH funded project to assist with assessment of seafood intake by those living along the Gulf coast. To assist with the process we created a food frequency survey and developed photographs of various portion sizes of fish and shrimp to assist with portion size estimation of these foods. The utility of these pictures was tested in two separate research trials and were found to increase the accuracy of portion size reporting by men. Gulf seafood intake data collection to begin in 2013. Manuscript and presentation will be prepared to share this information accessible to others. Other: I was again invited to present in a grant funded seminar series regarding obesity education for medical residents at the University of Florida, College of Medicine. This seminar was attended by over 50 residents. I was an invited speaker at the University of Florida, 20th Annual Diabetes Care Symposium, January 2012. Topic: Nutritional and Behavioral Approaches for Long-term Weight Loss Maintenance. PARTICIPANTS: Anne Mathews is responsible for all objective physical activity data that was collected in all studies and its ongoing analysis. She is the primary investigator for the MyLIFE project and is leading manuscript development for several projects. TARGET AUDIENCES: The target audiences for these weight management projects include several minority and/or underserved populations including children and adults in rural areas as well as college students, women with breast cancer, and those potentially most impacted by the Deep Water Horizons Oil Spill. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The relationship between adiposity, lifestyle behaviors, genetics and chronic disease continues to be elucidated. Modifying disease risk through "improvements" in nutrition and physical activity habits is a powerful modifier. Our research evaluating the effects of various approaches to improve lifestyle health and to accurately and objectively assess behaviors and outcomes will contribute to this body of work. Our work is targeting populations that may most benefit from improvements in lifestyle by focusing on specific populations such as those with a history of breast cancer as well as prevention of obesity in preschool children. Most of the outlined projects are multi year interventions and initial analysis of baseline data has begun with several projects nearing completion.
Publications
- Horacek TM, White AA, Greene GW, Reznar MM, Quick VM, Morrell JS, Colby SM, Kattelmann KK, Herrick MS, Shelnutt KP, Mathews A, Phillips BW, Byrd-Bredbenner C. Sneakers and spokes: an assessment of the walkability and bikeability of U.S. postsecondary institutions. J Environ Health. 2012 Mar;74(7):8-15.
- Mathews AE, Mathews CE. Inherited β-cell dysfunction in lean individuals with type 2 diabetes. Diabetes. 2012 Jul;61(7):1659-60. doi: 10.2337/db12-0373.
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Progress 10/01/10 to 09/30/11
Outputs
OUTPUTS: Significant progress has been made on 7 separate projects this year plus a new evaluation of existing data from a previous project. 1- Extension Family Lifestyle Program (PI: David Janicke, PhD) Continues recruitment of families throughout rural counties in north central Florida. Several counties have completed the first year of intervention and are into the follow up phase. 2-The effect of fiber snack foods on dietary intake in healthy adults (Co-Investigators: Mathews, Henken and Dahl). This randomized, prospective, placebo controlled trial recruited 97 healthy adults in the fall of 2011. Adults are completing 8 weeks of added daily snack foods either with or without fiber. The primary outcome is impact of increased dietary fiber on food and nutrient intake. Participants are completing a number of evaluations pre and post. 3- Energy expenditure during Zumba (PI: Mathews). This study was undertaken to assess energy expenditure (calories burned) during typical Zumba exercise classes and to compare perceptions about energy expenditure with actual energy expenditure. This project was completed in response to well-known advertising that promoted the extreme energy expending benefits of this type of exercise. We recruited 50 females to participate in 3 exercise classes and we assessed their actual energy expenditure using accelerometers. 4-"Lifestyle Intervention Treatment Effectiveness" Trial to evaluate the effect of various levels of a behavioral intervention on long term weight management (PI: Perri). We have recruited and enrolled over 640 overweight adults in 10 rural FL counties into a 2 year weight management program. 5- EVALUATION OF PERCEIVED VERSUS MEASURED BODY FAT PERCENT AND PERCEIVED VERSUS MEASURED BODY MASS INDEX OF UNDERGRADUTE STUDENTS AT THE UNIVERSITY OF FLORIDA (Co-Investigators: Mathews, Shelnutt). This project recruited 92 young adults. Each participant underwent measures of height, weight, body composition and waist circumference. In addition they completed questions that asked these values and the meaning of these values prior to having them measured. 6- Motivational Interviewing in Dietetics Counseling, (Co-Investigators: Mathews, Kauwell, Kendall). Two videos demonstrating motivational interviewing techniques for use in dietetics education courses were developed in summer 2011. Each video focuses on a weight management counseling session because it is a major practice issue in dietetics and does not require extensive knowledge of the nutritional management of more complex diseases, thereby making it applicable to students in both undergraduate and graduate courses. 7-The impact of a lifestyle intervention on overall diet quality. We evaluated diet quality, using the healthy eating index, of 290 women who completed a lifestyle intervention that promoted weight loss. PARTICIPANTS: Anne Mathews is responsible for all objective physical activity data that was collected in all studies and its ongoing analysis. This includes the Rural Lite, Zumba, and Extension Family Lifestyle projects. Dr. Mathews oversaw all aspects of Zumba Energy Expenditure project. She co-authored the scripts for the Motivational Interviewing videos and oversaw their production and editing with Drs. Kauwell and Kendall. Dr. Janicke is the PI of the Extension Family Lifestyle Project. Dr. Perri is the principal investigator for the Rural Lite Study and is responsible for all aspects of this large intervention project. Drs. Mathews, Dahl and Henken all contributed to the development of the dietary fiber intervention and its execution. Dr. Shelnutt led the protocol for the body fat perception project and Dr. Mathews trained the student technicians in taking measurements. TARGET AUDIENCES: The target audiences for these weight management projects include several minority and/or underserved populations including children and adults in rural areas as well as college students. PROJECT MODIFICATIONS: No significant modifications noted.
Impacts
Our research evaluating the effects of dietary fiber on food intake by young adults has large potential impacts for all adults. With over 65% of the US adult population being overweight, finding solutions that can be adopted by food companies and individuals to curb this trend is essential. If successful, this could support the addition of dietary fiber to a number of food products and serve as a motivational reason for people to choose foods that are high in fiber, which are often also low in calories and rich in other nutrients. Both ongoing weight management intervention projects described above have very large potential impacts on the health of our society, particularly those living in rural areas where access to health care is often limited. Each of these projects are multi year interventions and initial analysis of baseline data has just begun. We have submitted several abstracts to the Society for Behavioral Medicine annual meeting as well as the American Dietetic Association annual meeting. Lastly, the Motivational Interviewing project produced two high quality educational CDs that will be used in training our own dietetics students and will be available for sale through UF's IFAS Bookstore.
Publications
- Janicke, D.M., Lim, C.S., Perri, M.G., Mathews, A., Bobroff, L., Silverstein, J.H., Brumback, B., & Dumont-Driscoll, M. (2010). Extension Family Lifestyle Intervention Project (E-FLIP for Kids): Design and Methods. Contemporary Clinical Trials, 32: 50-58.
- Janicke, D.M., Gray, W.N., Mathews, A.E., Simon, S., Lim, C.S., Dumont-Driscoll, M., & Silverstein, J.H.(2011). A Pilot Study Examining a Group-Based Behavioral Family Intervention for Obese Children Enrolled in Medicaid: Differential Outcomes by Race. Childrens Health Care, 40:3, 212-23.
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Progress 10/01/08 to 09/30/09
Outputs
OUTPUTS: Significant progress has been made on 7 separate projects this year. Each project specifically addresses physical activity and or dietary factors that may contribute to long term management of body weight and its health effects. 1 - Elder Meal Consumption and Food Quality Project. (Funded by FL Dept of Elder Affairs) Designed study protocol with FL Dept of Elder Affairs staff. Created similar but higher quality meals to be tested. Completed initial taste panel testing in UF taste panel. Completed all data collection at 6 separate congregate meal sites in 3 counties. Submitted 5 progress reports to the Dept of Elder Affairs. Have begun full data analysis with final report due in April, 2010. 2-Effects of glucomannan on glycemic response: We recruited 30 and completed 29 subjects (3 visits each) in the dietary fiber/glycemic response study. Initial results of the first 10 subjects were analyzed and presented at UF's McNair Scholars Day in April 2009. Analysis of all subjects is currently underway. 3- FLIP: Family Lifestyle Intervention Project for FL Medicaid Recipients. We have nearly completed 40 overweight children and their families that are FL Medicaid recipients through a 12-week family based weight management program. We have begun to analyze the physical activity data and its impact on body weight and other biological markers. 4-Rural LITE: A "Lifestyle Intervention Treatment Effectiveness" Trail to evaluate the effect of various levels of a behavioral intervention on long term weight management. We have recruited and enrolled over 350 overweight adults in 6 rural FL counties into a 2 year weight management program. We are recruiting subjects in 4 "waves." The first wave has completed its initial 6 month intervention and assessment. Have begun analyzing baseline physical activity and dietary data to evaluate their effects on biological markers and quality of life. Recruitment is ongoing to reach a goal of 542 subjects. Designed 5 week behavioral intervention campaign and trained group leaders on its implementation. 5-Extension FLIP - Family Lifestyle Intervention Program being conducted with 9 rural FL county extension offices. Contributed to design of study and child and parent intervention. Updated traffic light diet food book to best reflect stud goals and common food choices. We have begun recruitment/screening for this NIH funded child/family weight management program. Baseline measurements and intervention to begin in Jan 2010. 6-Geographic Information System (GIS) to target childhood obesity. Completed a 6 month planning grant to develop a GIS to target childhood obesity through the Robert Wood Johnson Foundation. Submitted and received grant to build the GIS. Work has begun on this project. 7-UF Health Behaviors Study. Recruited and completed over 30 subjects to evaluate the effect of self monitoring of body weight on food choices and other health behaviors. Recruitment is ongoing for this project. PARTICIPANTS: Anne Mathews is responsible for all objective physical activity data that was collected in all studies and its ongoing analysis. This includes the FLIP Medicaid, E-FLIP, Rural Lite, and UF Health Behaviors Study. She led a parent only group for 12 weeks in the FLIP Medicaid Study. Dr. Mathews designed the behavioral campaign for the Rural Lite Study and co-authored the 3 mentioned abstracts. Drs. Shay and Sims have contributed to the design and oversight of the Elder Meal Quality Project. Dr. Sims was integral in the design of the higher quality meal and conduction of taste panel testing. Dr House is the primary contributor to the price/quality analysis. Dr. Mathews oversaw all aspects of the glycemic response study with ongoing consultation with Dr. Shay. Dr. Janicke is the principal investigator in both the FLIP and E-FLIP study and is responsible for all aspects of the intervention. Dr. Perri is the principal investigator for the Rural Lite Study and is responsible for all aspects of this large intervention project. Dr. Perri is also the principal investigator for the UF Health Behaviors Study. Drs. Steiner and Bejleri are the principal investigators for the RWJF GIS Study. Dr. Mathews contributed to the writing of both grants for this project and the evaluation and availability of data to be used in the initial GIS. TARGET AUDIENCES: The target audiences for these weight management projects include several minority and/or underserved populations. The FLIP study targets only children and caregivers that receive Medicaid support in the state of Florida. The E-FLIP and Rural Lite projects target only those that live in counties that are considered rural, where health services are often limited and access to healthy foods and safe and/or stimulating opportunities for physical activity may be limited. These three studies provide small group nutrition and physical activity education along with group behavioral intervention designed to support individuals in making specific health behavior changes. The target audience for the glycemic response are females of Asian, African American decent with a family history of type 2 diabetes, while the UF Health Behaviors study seeks to understand behaviors of a variety of undergraduate students at the University of Florida. The Elder Meal Quality Project targets the State of FL Dept of Elder Affairs by providing objective data to assist the department in making the best decisions regarding possible cost benefits of providing higher quality meals to its Older American Act Meal recipients. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Our research evaluating the effects of food quality on food intake by elders at congregate meal sites has large potential impacts for both the meal recipients and the FL Dept of Elder Affairs. Our initial analyses reveal that food quality does impact the intake of certain, but not all foods, indicating that while quality is important, it is not the only factor that effects intake and that other factors such as energy density/volume may also need to be considered when designing meals. We are currently developing and will analyze the price/quality index and make recommendations on the benefits of providing higher quality foods to elders at congregate meal sites. The results of the dietary fiber/glycemic response study will add to a growing body of knowledge evaluating the impact of various types of fiber (not just total amount) on glucose control and satiety. This has potential impacts for both food manufacturers and individuals attempting to manage their glucose levels and body weight. All 3 weight management intervention projects described above have very large potential impacts on the health of our society, particularly those living in rural areas where access to health care is often limited. Each of these projects are multi year interventions and initial analysis of baseline data has just begun. We have submitted 3 abstracts to the Society for Behavioral Medicine annual meeting. Two compared self reported physical activity reports from 2 separate questionnaires with objective physical activity data and showed that individuals are poor reporters of their activity levels, particularly in regards to physical activity intensity which has a large impact on daily energy expenditure and thus energy equilibrium. The 3rd abstract reports on the use of a 5 week campaign implemented several months after the initial behavioral intervention. Impacting the weight and health of children has proven to be difficult in other intervention studies and few large scale projects have been reported. The FLIP and E-FLIP projects are targeting two nontraditional and underserved populations - those receiving Medicaid benefits and those living in rural areas. Lastly, the GIS project has potential national impacts as it will provide a tracking and evaluative system not only for RWJF grantees but for researchers, policy makers, and community advocates across the country. The UF Health Behaviors will contribute to our understanding of why self-monitoring is so important for long term weight management and also contribute to a body of collected information on the behaviors of undergraduate students. Weight and weight change in this age group is largely indicative weight patterns later in life. This information will also help us in designing the most appropriate interventions for this age group. Published manuscript on effects of the first year of a 12 year intervention on physical activity and fitness from the Look AHEAD Study.
Publications
- Jakicic JM, Jaramillo SA, Balasubramanyam A, Bancroft B, Curtis JM, Mathews A, Pereira M, Regensteiner JG, Ribisl PM; Look AHEAD Study Group. Effect of a lifestyle intervention on change in cardiorespiratory fitness in adults with type 2 diabetes: results from the Look AHEAD Study. Int J Obes (Lond). 2009 Mar;33(3):305-16. Epub 2009 Jan 20.
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