Location: Delta Obesity Prevention Research2013 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:
Over the life of the current specific cooperative agreement, the University of Southern Mississippi has contributed to the mission of the Delta Obesity Prevention Research Unit to conduct nutrition research to prevent or lower obesity in at-risk, rural populations by addressing two of its objectives: 1)extend the behavioral knowledge gained from ARS research studies and other food availability and food cost surveys in the Delta, to adapt existing Dietary Guidelines eating patterns, such as the USDA Food Guide (MyPyramid) and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan, for the Lower Mississippi Delta population. Test these new eating patterns for nutritional adequacy and likelihood of their adoption by the Delta population; and 2) evaluate whether the new eating patterns, with and without physical activity, would help to reduce weight gain and risk factors for obesity-related chronic disease in the Delta population through the use of studies that test different methods of nutrition education and theories of how people change health behaviors. In order to address the first objective, scientists from the University of Southern Mississippi worked with ARS scientists to identify specific changes to the typical Lower Mississippi Delta diet and to specific food groups in the diet that if adopted would reduce MyPyramid (now MyPlate) food group and nutrient shortcomings and improve adherence to the Dietary Guidelines. Data from the Foods of Our Delta Study (FOODS) 2000 were used to identify food group shortcomings critical to reducing weight gain and risk factors for obesity-related chronic diseases. We used a measure of diet quality known as the Healthy Eating Index to identify these food group shortcomings. We also assessed whether shortcomings differed according to factors like age, sex, education level, and Body Mass Index. As part of this research, familiar foods that were available in the Delta and cooking methods were identified that could be recommended for use to reduce the shortcomings. Next, we worked with ARS scientists to conduct computer simulation studies testing the increase in diet quality if different levels of diet revisions were to be adopted by Delta residents. We tested how much the Healthy Eating Index would improve if people in the Delta adopted single diet revisions such as drinking water instead of sugar-sweetened drinks or eating baked instead of fried chicken. We also tested how much the Health Eating Index would improve if people in the Delta adopted all of the diet revisions as a whole. We then used the findings from these two studies to begin the process of addressing the second objective. We created and pre-tested education methods and messages that would appeal to the Delta population to promote adoption of the diet revisions. We held key informant interviews and focus groups with women from communities in Mississippi to determine what methods of communication and message delivery they liked and to find out what educational activities they wanted. We chose women because previous research by the Delta Nutrition Intervention Research Initiative found that women were the primary "gatekeepers" of nutrition for families in the Delta. During FY 11, we planned and carried out a feasibility study to test the procedures, lesson plans, and data collection tools intended to be used in the main study for FY12. This study included 66 people divided into two different educational programs. One program focused on 5 key messages from the dietary guidelines (fruits, vegetables, whole grains, lean protein, and Solid Fats and Added Sugars). The second program focused only on Solid Fats and Added Sugars. Fifty-six people completed the study with complete data for both pre- and post-study. Focus groups were held with a smaller number of these people who had completed each of the programs to get feedback that was then used to make small changes to the nutrition lessons and data collection procedures so they would be better. In addition, the USDA released its new ChooseMyPlate.gov website during this time, so we made small changes to the education materials to be used in the main study so that they would be based on the latest information. To address the second objective we carried out the main study with women's social, civic, and faith-based groups in the Delta region to promote adoption of the diet revisions. Our goal was to find out if one education program worked better than the other to improve diet quality as measured by the Healthy Eating Index. A total of 320 people across 16 groups provided baseline data when they were enrolled into the study during June/July 2011. The 16 groups were assigned to one of the two education programs in such a way as to avoid clustering of groups within communities to different programs as well as to make sure there were similar education levels and group sizes across the two programs. Education sessions for the study began in November 2011 after three nutrition educators were hired and trained in study procedures and the education materials and lesson plans. Post-study data were collected in May-June 2012. We had 75% of the people stay in the study during the 6-month period. During FY 13, we completed the study described above by collecting data three months after the study ended (September-October 2012). A total of 146 people attended this final data collection phase. Research staff planned and carried out a health fair in July 2013 for former study participants and other interested community members. Ten health-related agencies from the Delta region took part in the health fair which was held in Indianola, MS.
1. The Healthy Diet Innovation scale. The Healthy Diet Innovation scale, a survey measuring the perceived attributes of a healthy diet can assist researchers to assess changes in a person’' perception of starting and staying with a healthy diet. Knowing which attributes a person thinks are the most important to adopting a healthy diet may benefit the development of science-based nutrition education programs. Researchers at the University of Southern Mississippi, supported by the Delta Obesity Prevention Research Unit in Little Rock, Arkansas, developed a survey that identified that the generational, protective, low complexity, and observability attributes of a healthy diet could be used to promote and evaluate starting and staying with a healthy diet. This survey may be an important tool used by researchers to address the obesity epidemic.