Recipient Organization
UNIV OF IDAHO
875 PERIMETER DRIVE
MOSCOW,ID 83844-9803
Performing Department
School of Family and Consumer Science
Non Technical Summary
Approximately two thirds of U.S. adults and one fifth of U.S. children are obese or overweight. The most recent Centers for Disease Control and Prevention statistics estimate that approximately 29 million Americans or 9.3% of the population have diabetes (CDC, 2014). In Idaho, diabetes prevalence is similar to the national average, at 9.4% of the population. If the trend continues, 1 in 3 Americans will have diabetes by the year 2050 (Boyle et. al, 2010). Educational interventions can help address the rising costs of diabetes and pre-diabetes. It is estimated that $0.78 of every U.S. healthcare dollar is spent on the treatment of chronic disease (National Governors Association, Policy Position, February 22, 2010). The total cost for Diabetes is $23.6 Million and 24% are undiagnosed. The cost is even higher for pre-diabetes is $57 million and over 50% of the cases are undiagnosed.The American Diabetes Association recommends that further research is needed on the best tools and strategies for educating individuals with diabetes (e.g. the Plate Method) (Evert et al., 2014). This project will pilot a four lesson diabetes meal planning curriculum of excellence called the Healthy Diabetes Plate, which targets individuals with type 2 diabetes. As a diabetes self-management program, it encourages personal responsibility and accountability. This project meets the mission to improve the health of people in Idaho by helping those with type 2 diabetes better manage their disease.This curriculum will contain several unique components: (1) it teaches participants to plan meals in a variety of settings (home, work, eating out, etc.), using a visual method, "the plate."; (2) it uses social media (Facebook and Pinterest) to reinforce principals covered in the classes as well as engage them and provide them with additional support; (3) it is tied to an interactive diabetes meal planning site (www.extension.uidaho.edu/diabetesplate) which teaches portion sizes and provides cooking and shopping tips, and (4) will be translated in Spanish to help the Hispanic population which are disproportionately affected by the disease. Will include Data will be collected on the effectiveness of the curriculum in teaching participants meal planning skills, changes in eating behaviors and biometric measures (e.g. A1c), and the role social media can play in implementing diabetes meal planning principals.The Probiotics and Cognition study will provide valuable information as a pilot test to then seek additional funding for larger studies looking at strains of probiotics and their effects on cognition in older adulst.
Animal Health Component
60%
Research Effort Categories
Basic
20%
Applied
60%
Developmental
20%
Goals / Objectives
Listed below are the short, medium, and long-term objectives of the Healthy Diabetes Plate project and how they will be measured:Short-term objectivesObjective 1: Participants attending the classes will correctly plan breakfast, lunch, and dinner meals, using the Plate method. This will be measured by having participants complete breakfast, lunch, and dinner meals based on food that they have at home, at the supermarket, and when eating out and what percentage of participants planned the meals correctly.Objective 2: Participants attending the classes will learn to modify recipes so they are heart-healthy. This will be measured by having participants complete a recipe activity that has them make a recipe so it is low-sodium, low-fat, low-sugar, and high fiber.Objective 3: Participants receiving the social media intervention (Facebook and Pinterest) will plan more HDP meals correctly then those who did not receive the social media intervention. This will be determined by comparing the number of meals these individuals complete correctly to individuals who did not receive the social media intervention.Medium-term and long-term objectivesObjective 4: Participants attending the classes will increase their intake of fruits, non-starchy vegetables, whole grains, lean protein, and low-fat milk/yogurt products. This will be measured by having participants complete a food frequency questionnaire at baseline, 3 months, and 6 months.Objective 4: Participants attending the classes will make changes to their diabetes self-care measures. Data that will be collected include participants' perceived ability to assess readiness to changes, set/reach goals, overcome barriers, cope with emotions, manage stress, obtain support, motivation, and make cost/benefit analysis. This will be determined by using a validated Diabetes Empowerment Scale-Short Form (DES-SF) that assesses diabetes psychosocial self-efficacy.Objective 5: Participants attending the classes will improve their diabetes self-management measures. This will be determined by measuring changes in the following biometric measures -Hemoglobin A1c, Blood pressure, and Body Mass Index- at three intervals, baseline, 3 months and 6 months.Listed below are the objectives of the Probiotics and Cognition project and how they will be measured:Overall Goal: To measure the effect of yogurt consumption and probiotics on the cognitive function of participants over the age of 50.Objectives:Objective 1 - Participants will consume yogurt daily for 3 months. One group will have yogurt that includes probiotics and a control group will consume nothing..Objective 2 - Participants will complete pre and post cognitive testing using the NIH Toolkit.Objective 3 -Participants will complete pre and post food frequency/health habits questionnaire.NIFA's Strategic Plan Sub Goals:Develop the research base for guidance on diet and physical activity and develops and implements effective educational and environmental strategies to improve the Nation's health by providing leadership for strong research, education and extension.Provide leadership and administrative guidance to education grant and formula programs that serve secondary and post-secondary institutions that invest in students and institutions which promote national and global well-being in the food and agriculture science systems
Project Methods
MethodsHealthy Diabetes Plate ProgramThe Healthy Diabetes Plate (HDP), a four-lesson peer-reviewed, evidence based curriculum, which targets individuals with type 2 diabetes. It teaches diabetes meal planning skills and was originally published in 2003. Participants attending these classes learned about the diabetes "plate" method, i.e. how five diabetes food groups - vegetables, starches, protein, fruit, and dairy-fit on a plate (Figure 1). When tested, between 85-99% of participants correctly used this "plate" method to plan their meals in a variety of settings -home, grocery store, and eating out.The new HDP program and social media supplemental activities will be taught over an eight week period. Participants will attend face-to-face classes during weeks 1, 3, 5, and 7 and completed Facebook or Pinterest activities during weeks 2, 4, 6, 8. During the face-to-face classes, participants learned about the signs and symptoms of diabetes, the Healthy Diabetes Plate (Figure 2) which consisted of five food groups -non starchy vegetables, starches, lean protein, fruit, milk/yogurt, how to select foods in the supermarket, cooking tips, and eating out. At each face-to-face class, participants completed meal planning activities. During the social media sessions (weeks 2, 4, 6 and 8) participants will complete Facebook and Pinterest activities that reinforce the concepts covered in lessons 1, 3, 5, 7, and posted pictures of meals they consumed. Seniors in the UI Coordinated Program in Dietetics will be teaching these classes with oversight from their instructors.Figure 1: The Healthy Diabetes PlateParticipantsA total of 100 adults will be targeted to enroll in this study. They will be recruited through the University of Idaho extension offices, Indian health services, diabetes support groups, and health care agencies using flyers, radio advertisements and Facebook. Eligibility criteria included being 18 years of age or older, being diagnosed with type 2 diabetes, having a caregiver or friend with diabetes or interest in diabetes meal planning. Classes will be offered for free of cost. All subjects will sign a Subject Consent Form at the first class.Data CollectionThe HDP will be evaluated using pre- and post- surveys, questionnaires, in-class meal-planning activities, and social media (Facebook and Pinterest) postings. The following types of data will be collected:Demographic and diabetes characteristics: At week 1, participants provide information on age, gender, race and ethnicity, and their diabetes characteristics.Ability to plan meals: In the four face-to-face classes, participants completed breakfast, lunch, and dinner meal planning "plate" sheets using the five diabetes food groups (Figure 2).Figure 2: Example of the Healthy Diabetes Plate Meal Planning Sheet at BreakfastChanges in behaviors: Participants will complete a pre-survey in week 1 and post-survey in week 7 that measures changes in eating behaviors, self-efficacy, and social media use.Changes in diabetes signs, symptoms: Participants will complete a diabetes signs and symptoms questionnaire pre- and post-study which will measure changes in their diabetes signs and symptoms.Probiotics and Cognition:This study will assess daily dairy-based probiotic consumption and its effect on cognitive performance in older adults (≥60 years of age) over a twelve-week period. This will be a quasi-experimental study, including one treatment group and one control group. Participants in the treatment group will consume one six-ounce yogurt each day for the duration of the twelve-week intervention. The control group will receive no yogurt and will be instructed to continue their normal dietary patterns.Laboratory VisitsParticipants will attend two testing meetings in a comfortable, private environment at each testing site. Test visit one will be scheduled before the study begins, and test visit two upon completion of the twelve-week study.Tests The NIH Toolbox tests have been developed and validated for use in research. The NIH Toolbox contains four domains, including cognition, motor, sensation, and emotion. For the purposes of this study, only the cognition portion will be administered.The food frequency questionnaire was developed and validated for use of research by researchers at the University of Idaho. This food frequency questionnaire is used to assess normal dietary consumption of probiotics in participants.Baseline/Post TestingThe cognitive performance test from the NIH Toolbox will be administered at week 0 (pre) and at the end of week 12 (post). The same procedures will be enforced at the end of the study.Supplement AdministrationDuring the intervention, participants in the treatment group will be given seven 6-oz. containers of yogurt each week, which will contain live probiotics. Participants will be instructed to consume one 6-oz. container per day.At week's end, the researcher will collect all seven of the participant's weekly yogurt containers to confirm that all supplements were consumed during the previous week. The researcher will also collect a weekly yogurt log to be filled out by each participant, indicating the time and day on yogurt consumption. Participants will receive the next seven containers for the following week at this time. This will continue for the duration of the 12-week study.ParticipantsSixty healthy adults, both male and female, age ≥ 60, will be selected.Statistical AnalysesCognition will be analyzed separately based on scores from the NIH toolbox test, to be completed at the preliminary and end-of-study testing meetings. Statistical Package for the Social Sciences (SPSS) will be used for data analysis. An independent t-test will be used to compare the scores from the first and second attempts for each participant. An alpha value of 0.05 will be set to determine the significance of the treatment across all subjects.Expected Results Based on previous research, it is expected that baseline cognitive function test scores will improve in older adults with 12-week yogurt-based probiotics supplementation.NIFA's Strategic Plan Sub Goals:Develop the research base for guidance on diet and physical activity and develops and implements effective educational and environmental strategies to improve the Nation's health by providing leadership for strong research, education and extension.Provide leadership and administrative guidance to education grant and formula programs that serve secondary and post-secondary institutions that invest in students and institutions which promote national and global well-being in the food and agriculture science systems