Assessment of Whole Grain Intake and Health Correlates in an Aging Population Alexis Howard, Undergraduate Research Fellow Karen Colannino, RD, LDN, NFS Graduate Student Nancy Fey-Yensan, PhD, RD Professor in the Department of Nutrition and Food Sciences

Why Whole Grains? Why Older Adults? Current research suggests that older adults will benefit from increasing their whole grain consumption. Whole grains contain many essential nutrients that are lost if the grain is refined. WG intake may decrease the risk of heart disease, type II diabetes, hypertension, obesity, and many types of cancer. Older Adults experience higher incidence of chronic disease, poor health, and specific nutrient deficiencies. The 2005 Dietary Guidelines recommend 3 servings of WG daily, but research shows that older adults usually consume less than 1 serving daily. The sample included 58 low income older adults living in Rhode Island. Why Older Adults?

-Impact of Nutrition Education -Benefits of Whole Grains We looked at: -Grain Food Intake -Impact of Nutrition Education In other words, the research GOALS: -To determine quantity & type of grain food intake -To determine effectiveness of 2 nutrition education intervention models in affecting dietary change related to whole grain intake, as well as change in attitude and knowledge relating to whole grains -Examine selected biochemical, behavioral, and weight-related benefits to increasing whole grain consumption over a 4-6 month period -Benefits of Whole Grains

Baseline Data Collection: -Nutrition Assessment -Finger Stick Blood Sampling -58 older adults (age 59+; mean age 77) recruited from Rhode Island’s low-income housing sites -Nutrition assessment : whole diet food frequency questionnaire, and a pre-intervention survey concerning current knowledge, attitude, and intake of whole grain foods -Anthropometry : height, weight, and waist circumference & blood pressure levels -Finger stick blood sampling performed onsite to analyze total cholesterol, HDL cholesterol, and fasting blood glucose. -Anthropometrics

4 Month Intervention -Newsletter Group -Workshop Group -Control Group -4 month intervention : 2 treatment groups -Newsletter Treatment Group: received 4 monthly whole grain newsletters by mail; modeled after Nutrition to Go, developed by USDA/URI SNAP targeted at low income, low literate older adults: large font, colorful pictures, use of white space, appropriate reading level -Workshop Treatment Group: attended monthly nutrition education workshops that accompanied newsletters: reinforced newsletter concepts, recipe demonstration, tasting, raffle for WG foods, time for questions -Control group received no intervention.

My Piece: Designed: 4 Monthly Newsletters 2 Handouts Assisted With: -Baseline Data Collection -Intervention Programs -Data Organization -Data Analysis -Presentation of Results My Piece: -Developing 4 Newsletters and 2 Hand-Outs -Purpose: remove barriers: lack of awareness of health benefits of WG, difficulty finding WG in the grocery store, higher price of WG, perception of inferior taste and texture, and lack of familiarity with preparation methods -Information, Pictures, Recipes 1: The Whole Story on Whole Grains: General 2: Bread and Cereal 3: Pasta and Rice 4: Less Known Whole Grains

Multiple Disease States Results: Anthropometrics and Blood Analysis Weight Categories Mean BMI = 29 47% Overweight 35% Obese -58 older adults; majority were Caucasian widowed overweight females; mean age of 77 -Mean BMI of 29, higher end of overweight category; 47% overweight, 35% obese (no significant changes from baseline to post) -70% had waist circumference measure associated with significant health risk (significant decrease in waist circumference from baseline to post intervention occurred in the Workshop Treatment Group) -Majority on 3+ prescription medications: health benefits difficult to assess: medication-controlled blood pressure and blood levels of cholesterol and glucose Multiple Disease States Polypharmacy

The Whole Story on Whole Grains! Results: The Whole Story on Whole Grains! Attitude? Knowledge? -Attitude: # Reported liking WG increased in all groups: 5% control, 6% treatments -Knowledge: identify foods as whole grains or refined grains, Control and Newsletter Groups improved in 4/9 WG categories, Workshop Group improved in all 9- 40% correctly identified all 9 whole grain foods. -Workshop group lowest respondents unsure of WG benefits at post, news and workshop both had less unsure about difference b/w whole and refined grains -Workshop gained knowledge in locating whole grains and confidence in preparation compared to control -Change in actual intake: hard to assess significant difference across groups Behavior?

What I Learned: The steps of the research process... -How to take blood pressure, conduct a finger stick blood analysis, and facilitate diet history recall -How to develop effective nutrition education materials -The rewards of community nutrition Future studies: -subjects’ overall limited awareness, knowledge, and intake of whole grain foods shows need for focus in this area -more time needed to change behavior -increased diversity and size of sample -use of medical charts in addition to self-reported data -assessment of exercise ... and its rewards.