Location: Delta Obesity Prevention Research2010 Annual Report
1a. Objectives (from AD-416)
The mission of the Delta Obesity Prevention Research Unit is to conduct nutrition research to prevent obesity in at-risk, rural populations in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. The Agricultural Research Service (ARS) is coordinating a major research endeavor that brings together the talents of ARS and other research cooperators in a tri-state region to accomplish the following: 1) Identify barriers and facilitators to adherence to the Dietary Guidelines for Americans (DG) and examine how differential profiles of adherence relate to obesity in children and adults of the Delta region (ARS HEALTH study); 2) extend the behavioral knowledge gained from ARS research studies and other food availability and food cost surveys in the Delta, to adapt existing DG eating patterns, such as the USDA Food Guide (MyPyramid) and the DASH Eating Plan, for the Lower Mississippi Delta population. Test the developed eating patterns for nutritional adequacy and feasibility of adoption by the Delta population. Concurrently, adapt DG physical activity recommendations for the Delta population and examine feasibility of adoption; and 3) evaluate the effectiveness of the adapted DG eating patterns, with and without physical activity, in reducing weight gain and risk factors for obesity-related chronic disease in the Lower Mississippi Delta population through the use of interventional studies. Determine if diet-gene relationships underlie the effectiveness of the adapted eating patterns.
1b. Approach (from AD-416)
The Delta Obesity Prevention Research Unit, in partnership with other ARS laboratories and research cooperators, has developed a strategic plan to improve the health of at-risk, rural populations of the Lower Mississippi Delta through obesity prevention research. Utilizing multi-faceted research approaches, this endeavor will provide a greater understanding of this population’s adherence to national dietary guidance for prevention of obesity and reduced risk for obesity-related chronic disease through the use of dietary and physical activity interventions using established scientific study designs and methods meeting the requirements for evidence based reviews. This cooperative research seeks solutions to these complex challenges through multidisciplinary team research and through cooperation with the general public, local government, policy makers, other institutions and agencies. Research internships addressing the objectives above may be created for university students in the tri-state area.
3. Progress Report
During FY2010, University of Southern Mississippi (USM) scientists completed an analysis of the FOODS 2000 dietary data to assess Healthy Eating Index (HEI-2005) diet quality scores for the Lower Mississippi Delta population (LMD) based on the 2005 USDA/HHS Dietary Guidelines for Americans. HEI-2005 scores were computed for various demographic groups and compared to national HEI-2005 scores from the National Health and Nutrition Examination Survey (NHANES). The HEI-2005 scores for the LMD were evaluated for differences between race, sex, age groups, education, and income groups. A manuscript of the analysis and results was prepared and is under review with the Journal of the American Dietetic Association. USM scientists developed the intervention topic areas based on the food group inadequacies identified in the FOODS 2000 analysis above. Intervention learning outcomes and learning activities targeting the food group inadequacies were developed for the two intervention experimental groups. Focus groups were held with women representative of the target population to refine the topics, learning outcomes, and activities. The protocol for the formative research phase was developed and included: developing a database of potential women's social and civic organizations; identifying key informants from those organizations; developing interview questions for key informants targeting organizational structure, interest, and mechanisms of supporting an intervention; and developing focus group questions for organization members targeting their perceptions of a successful nutrition intervention, barriers to participation and interest in participation. Key informant interviews and focus groups were initiated after IRB approval was received from the USM. Due to limited numbers of potential participants from majority white organizations as well as participation by women in multiple social/civic organizations, which might impact plans for randomization to treatment by group membership, the geographic area for recruitment was expanded and organization names and contact information continue to be added to the database. The need for a field coordinator based in the LMD region to coordinate recruitment, retention, intervention, and data collection efforts was identified during the initiation of formative research procedures. As part of the formative research, a survey for assessing change in social support, self-efficacy, and decisional balance (psychosocial constructs associated with health behavior changes) for consumption of targeted food groups was developed and administered to women in two non-intervention communities to assess internal consistency and reliability of the survey instrument. The instrument was modified based on the findings and administered to young women attending USM. The resulting analysis indicated the instrument had good internal consistency and reliability. The Nutrition Data System group at the University of Minnesota was contacted for conducting the necessary 24-hour dietary recalls. The ADODR monitors activities for the project by routine site visits, quarterly project review teleconferences, and annual research workshops.
1. Designing dietary modifications to increase Dietary Guidelines for Americans adherence in the Lower Mississippi Delta Region. To inform the design of culturally appropriate dietary modifications to increase adherence to the Dietary Guidelines for Americans (DGA) in the Delta population, a descriptive analysis of the FOODS 2000 dietary data was conducted. University of Southern Mississippi researchers as part of the Delta Obesity Prevention Research Unit, Little Rock, Arkansas, determined the adherence to 2005 DGA in the LMD, and demographic differences in adherence using the 2005 Healthy Eating Index (HEI-2005). Our analysis revealed the total HEI-2005 score for the Delta, excluding the sodium component score, was lower than the national population with lower scores for whole fruit, total vegetables, dark green and orange vegetables and legumes, and milk, indicating that adherence to the Dietary Guidelines was poorer in the Delta compared to the US as a whole. Younger age was the largest determinant of poor dietary quality in the Delta, with the total HEI score and eight component scores decreasing with decreasing age; 20 of 35 food sources also differed by age. This objective approach for determining food group and nutrient inadequacies can be used for other target populations when designing dietary modifications to improve adherence to dietary recommendations.