Location:2011 Annual Report
1a. Objectives (from AD-416)
Develop and evaluate culturally appropriate dietary and physical activity interventional strategies, based upon the Dietary Guidelines for Americans (DGA), for obesity prevention and health promotion in this population.
1b. Approach (from AD-416)
This objective will be accomplished in two stages. We will first develop and evaluate relevant and culturally appropriate dietary modifications aimed at effecting significant improvement in adherence to the 2005 Dietary Guidelines for Americans (DGA) in Delta populations. This will be accomplished by performing analysis of existing data from the FOODS 2000 study and food supply adequacy study to develop specific culturally acceptable dietary modification that can improve scores for specific Health Eating Index (HEI)-2005 dietary components using familiar and available foods. The potential population impact of these modifications will be evaluated using data simulations methods. Finally we will utilize these dietary modifications to develop a culturally apporpriate church-based intervention aimed at improving dietary quality and physical activity frequency among Delta African Americans.
3. Progress Report
We determined changes in the Healthy Eating Index-2005 total, component scores, and total energy intake resulting from substitution of more culturally accepted healthful foods and beverages for less healthful ones using statistical simulation procedures. As part of this analysis, we conducted a sub-analysis specifically looking at the impact of the replacement of sugar sweetened beverages with water on dietary quality of Lower Mississippi Delta adults included in the Foods of Our Delta (FOODS) dataset. We are currently implementing a church-based dietary and physical activity intervention program among African American churches in the Lower Mississippi Delta region in a cooperative project with the Delta Health Alliance and Mississippi Valley State University. We have successfully recruited and implemented the program with 8 intervention and 5 control churches. A database was developed in collaboration with the Mid-South Area Information Technology (IT) team and all non-dietary survey data have been cleaned, double-entered, and systematically checked for accuracy through a multi-level quality assurance process. All food-frequency questionnaires have been cleaned and church cohort 1 (completed during FY 2010) have been sent for processing to Northeastern University. Six focus groups have been completed and transcribed for three intervention churches. We were awarded funding by the Delta Health Alliance to conduct a prenatal/postnatal mother and child-centered obesity prevention program adapted both culturally and for home-dissemination from the Australian Infant Feeding Activity and Nutrition Trail (INFANT) trial. Mississippi State University, Cary Christian Center, and Mississippi Valley State University through cooperative agreements, assisted in the implementation of the StartSmart program by serving as an intervention or control site. Louisiana State University served as an advisor through a cooperative agreement for breastfeeding intervention materials and surveys. We trained 11 community outreach workers to implement the intervention program and/or collect study-related data. Ninety moms from five Lower Mississippi Delta counties were recruited and consented to participate in the StartSmart program and served either as an intervention or control mom. Seventy-seven home-based lessons were provided by the outreach staff at intervention sites (47 moms received the breastfeeding lesson; 28 moms received the 3 month lesson titled Baby’s First Spoonful: Introduction to Solid Foods; and 2 moms received the 6 month lesson, Beverage Basics, Reading the Food Label, and Physical Activity). Data was collected on 96 occasions from the expectant and/or new moms residing in the Lower Mississippi Delta region. We are currently entering and cleaning all the data collected before termination of the project into a database developed in collaboration with Mid-South Area IT staff.
1. Identification of the top dietary sources contributing to the Healthy Eating Index 2005 (HEI-2005) and differences by demographic group in Lower Mississippi Delta (LMD) adults. The HEI-2005 assesses diet quality in terms of adherence to the 2005 Dietary Guidelines for Americans (DGA 2005); lower scores are associated with poorer adherence. Designing dietary interventions to increase adherence to the DGAs requires knowledge of the top food sources corresponding to specific DGA inadequacies within a given population and also inadequacies by demographic group. ARS scientists from Baton Rouge, LA, in collaboration with the ARS Delta Obesity Prevention Research Unit and University of Southern Mississippi (USM) conducted an analysis to evaluate diet quality among LMD adults to determine the top five dietary sources contributing to HEI-2005 component scores and differences by demographic group. Results showed that younger age was the largest determinant of a low diet quality score. The top five dietary sources contributing to HEI-2005 component scores for LMD adults differed by sex, race, age, income, and education level particularly for total vegetables and calories from solid fats, alcoholic beverages, and added sugars (SoFAAs). Soft drinks were the leading source of calories for the SoFAAs component score for all demographic groups. The scientists concluded that demographic differences exist in top food sources contributing to HEI-2005 component scores in LMD adults suggesting that interventions in this region should not be “one-size fits all” but should be tailored specifically to the target demographic group. The information generated from this research is being used as part of an ARS specific cooperative agreement with the USM to develop targeted nutrition interventions to increase DGA adherence in LMD women.
2. Determination of change in diet quality and total calorie intake resulting from substitution of culturally acceptable healthful food and beverages for less healthful ones in Lower Mississippi Delta (LMD) adults using statistical simulations. Among 2005 Dietary Guidelines for Americans, key recommendations are food groups (fruits, vegetables, whole grains, and fat free or low-fat dairy) to encourage reduction in fat consumption, and decreased consumption of added sugars and other caloric sweeteners. Little is known about which of these recommendations can have the greatest potential for improving the diet quality of a population. ARS scientists from Baton Rouge, LA, in collaboration with ARS Delta Obesity Prevention Research Unit and the University of Southern Mississippi (USM) conducted an analysis simulating the impact of replacing less healthy foods and beverages with culturally-acceptable more healthful alternatives on dietary quality, assessed by the Healthy Eating Index- 2005 (HEI-2005), and calorie intake in LMD adults. Results showed for single food and beverage replacements, 100% replacement of grain desserts with juice-packed fruit cocktail and sugar-sweetened beverages with water resulted in the largest improvement in diet quality and greatest decrease in total calories. The 100% combined substitution of all the targeted foods and beverages resulted in a 12.0-point increase in HEI-2005 total score and decrease of 785 calories in this LMD adult population. The researchers concluded that nutrition interventions based on simultaneous changes within several food and beverage groups may be more effective at improving diet quality and decreasing caloric intake than an approach focusing exclusively on a single food or beverage for the LMD adult population. The information generated from this research is being used as part of an ARS specific cooperative agreement with USM to develop targeted nutrition interventions to increase DGA adherence in LMD women.
Thomson, J.L., Onufrak, S.J., Connell, C., Zoellner, J., Tussing Humphreys, L.M., Bogle, M.L., Yadrick, K. 2011. Food and beverage choices contributing to dietary guidelines adherence in the Lower Mississippi Delta. Public Health Nutrition. pp.1-11.