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Sanchez-Flack JC, Tussing-Humphreys L, Lamar M, Fantuzzi G, Schiffer L, Blumstein L, McLeod A, Dakers R, Strahan D, Restrepo L, Hemphill NON, Siegel L, Antonic M, Fitzgibbon M. Building research in diet and cognition (BRIDGE): Baseline characteristics of older obese African American adults in a randomized controlled trial to examine the effect of the Mediterranean diet with and without weight loss on cognitive functioning. Prev Med Rep 2020; 22:101302. [PMID: 33665063 PMCID: PMC7902520 DOI: 10.1016/j.pmedr.2020.101302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 12/29/2022] Open
Abstract
The MedDiet is correlated with slower cognitive decline in longitudinal studies. Self-reported MedDiet adherence positively associated with select cognitive domains. Women outperformed men across verbal tasks, including learning and memory. Younger participants outperformed older participants on cognitive assessments.
In the United States, >5.4 million people age 65 and older are affected by cognitive impairment and dementia, including Alzheimer’s disease. African Americans are more likely than non-Hispanic whites to suffer from these disorders. Obesity is linked to accelerated age-related cognitive decline, and weight loss through caloric restriction is a potential strategy to prevent this cognitive impairment. Adherence to a healthful dietary pattern, such as the Mediterranean Diet (MedDiet), has also shown positive effects on reducing risk for dementia. African Americans are disproportionately affected by obesity and have less healthful diets than non-Hispanic whites. We present baseline characteristics from a three-arm randomized controlled trial that randomized 185 obese (BMI ≥ 30 kg/m2 and ≤ 50 kg/m2) healthy older adults (55–85 years of age) to: 1) Typical Diet Control (TDC); 2) MedDiet alone (MedDiet-A) intervention; or 3) MedDiet caloric restricted intervention to promote weight loss (MedDiet-WL). The majority of the sample was African American (91.4%) and female (85.9%). The two active interventions (MedDiet-A and MedDiet-WL) met once weekly for 8 months, and the TDC received weekly general health newsletters. Baseline data were collected between January 2017 and July 2019 in Chicago, IL. In our sample, closer adherence to a MedDiet pattern was associated with higher attention and information processing (AIP) and higher executive functioning (EF). Consistent with the literature, we saw that older participants performed more poorly on the cognitive assessments than younger participants, and women outperformed men across verbally mediated tasks, especially ones related to learning and memory.
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Affiliation(s)
- Jennifer C Sanchez-Flack
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.,Department of Pediatrics, University of Illinois at Chicago, 1200 West Harrison Street, Chicago, IL 60607, United States
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.,Department of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, United States.,University of Illinois Cancer Center, University of Illinois at Chicago, 818 South Wolcott Avenue, Chicago, IL 60612, United States
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University, 1750 West Harrison Street, Chicago, IL 60612, United States
| | - Giamilla Fantuzzi
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor Street, Chicago, IL 60612, United States
| | - Linda Schiffer
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Lara Blumstein
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Andrew McLeod
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.,Department of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, United States
| | - Roxanne Dakers
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Desmona Strahan
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Leo Restrepo
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Nefertiti Oji Njideka Hemphill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor Street, Chicago, IL 60612, United States
| | - Leilah Siegel
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.,University of Illinois Cancer Center, University of Illinois at Chicago, 818 South Wolcott Avenue, Chicago, IL 60612, United States
| | - Mirjana Antonic
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States.,Department of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, United States.,University of Illinois Cancer Center, University of Illinois at Chicago, 818 South Wolcott Avenue, Chicago, IL 60612, United States.,Department of Pediatrics, University of Illinois at Chicago, 1200 West Harrison Street, Chicago, IL 60607, United States
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Fitzgibbon ML, Tussing-Humphreys L, Schiffer L, Smith-Ray R, Marquez DX, DeMott AD, Berbaum ML, Hughes SL. Fit and Strong! Plus: Twelve and eighteen month follow-up results for a comparative effectiveness trial among overweight/obese older adults with osteoarthritis. Prev Med 2020; 141:106267. [PMID: 33022324 PMCID: PMC7704684 DOI: 10.1016/j.ypmed.2020.106267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/29/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Abstract
This comparative effectiveness trial compared the longer-term effectiveness (12 and 18 months) of the standard Fit & Strong! physical activity program to Fit & Strong! Plus, which combined physical activity and dietary weight loss. Outcomes were weight, diet quality, physical activity, osteoarthritis symptoms, performance measures, and anxiety/depression. In this study, 413 overweight/obese participants with OA, ≥60 years old and primarily African American, were randomly assigned to Fit & Strong! (F&S!) or Fit & Strong! Plus (F&S! Plus), with outcomes assessed at 2, 6, 12, and 18 months. 356 (86%) participants completed the 18-month visit. Compared with participants randomized to standard F&S!, F&S! Plus participants maintained longer-term benefits at 12 months in weight (mean change ± SE: -1.7 ± 0.3 kg for F&S! Plus vs -0.9 ± 0.3 kg for F&S!, p = 0.049), BMI (-0.6 ± 0.1 vs -0.3 ± 0.1 kg/m2, p = 0.04), waist circumference (-2.7 ± 0.6 vs -0.4 ± 0.6 cm, p = 0.004), and lower extremity strength (1.6 ± 0.2 vs 1.0 ± 0.2 chair stands, p = 0.046). At 18 months, F&S! Plus participants showed improved lower extremity strength (1.4 ± 0.2 vs. 0.7 ± 0.2 chair stands, p = 0.045. African American older adults in the F&S! Plus arm showed sustained modest improvements in weight, waist circumference, and lower extremity strength at 12 months and in lower extremity strength at 18 months compared to F&S!. Implications for the translation of evidence-based programs into community settings to support healthy behaviors in older adults are discussed.
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Affiliation(s)
- Marian L Fitzgibbon
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; University of Illinois Cancer Center, 818 South Wolcott Avenue, Chicago, IL 60612, United States of America; Department of Pediatrics, University of Illinois at Chicago, 840 South Wood Street, Chicago, IL 60612, United States of America.
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; University of Illinois Cancer Center, 818 South Wolcott Avenue, Chicago, IL 60612, United States of America; Department of Medicine, University of Illinois at Chicago, 808 South Wood Street, Chicago, IL 60612, United States of America
| | - Linda Schiffer
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America
| | - Renae Smith-Ray
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Health Analytics, Research and Reporting, Walgreen Co., 102 Wilmot Road, Deerfield, IL 60015, United States of America
| | - David X Marquez
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Center for Research on Health and Aging, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL 60612, United States of America
| | - Andrew D DeMott
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Center for Research on Health and Aging, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America
| | - Michael L Berbaum
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America
| | - Susan L Hughes
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Center for Research on Health and Aging, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, United States of America; Division of Community Health Sciences, University of Illinois at Chicago, 1603 West Taylor Street, IL 60612, United States of America
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Hughes SL, Tussing-Humphreys L, Schiffer L, Smith-Ray R, Marquez DX, DeMott AD, Berbaum ML, Fitzgibbon ML. Fit & Strong! Plus Trial Outcomes for Obese Older Adults with Osteoarthritis. THE GERONTOLOGIST 2020; 60:558-570. [PMID: 30476065 PMCID: PMC7350412 DOI: 10.1093/geront/gny146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We compared the effectiveness of standard Fit & Strong! (F&S!; targets physical activity [PA]) to Fit & Strong! Plus (F&S! Plus; targets PA and dietary weight loss) on weight, diet quality, and PA outcomes. RESEARCH DESIGN AND METHODS We randomly assigned 413 overweight older adults with OA to the F&S! or F&S! Plus programs and assessed outcomes at 2 and 6 months. RESULTS The F&S! Plus group lost -2.0 ± 0.2 kg (mean ± SE, 2% of starting weight) at 2 months that was maintained at 6 months. Two- and 6-month BMI and waist circumference improved significantly in the F&S! Plus group (p < .001). Diet quality at 2 months showed greater improvement in the F&S! Plus group: 4.6 ± 0.7 versus 2.0 ± 0.7, p = .006, with no significant difference between groups at 6 months. The F&S! Plus group differentially improved on PA engagement at 2 months and at 2 and 6 months in joint pain (6-month mean ± SE: -1.5 ± 0.3 vs -0.6 ± 0.3, p = .02), function (-4.7 ± 0.9 vs -1.5 ± 0.9, p = .01), and 6-min walk test (29.5 ± 5.1 m vs 14.1 ± 5.2 m, p = .04). DISCUSSION AND IMPLICATIONS Adding a dietary weight loss component to F&S! achieved weight and waist circumference benefits that were maintained at 6 months. Importantly, the weight loss was accompanied by clinically meaningful improvements in OA symptoms and mobility. Future work should investigate minimum thresholds for weight reduction that improve long-term function in this population.
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Affiliation(s)
- Susan L Hughes
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Division of Community Health Sciences, University of Illinois at Chicago
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Medicine, University of Illinois at Chicago
| | - Linda Schiffer
- Institute for Health Research and Policy, School of Public Health
| | - Renae Smith-Ray
- Institute for Health Research and Policy, School of Public Health
- Health Analytics, Research and Reporting, Walgreen Co., Deerfield, Illinois
| | - David X Marquez
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Department of Kinesiology and Nutrition
| | - Andrew D DeMott
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
| | - Michael L Berbaum
- Institute for Health Research and Policy, School of Public Health
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago
| | - Marian L Fitzgibbon
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Pediatrics, University of Illinois at Chicago
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