American Heart Association Clinical Research Grant:Wellness in the Rutgers Workplace: Lifestyle Management Program$74,000.00 over two years: July 2006 – June 2008, R Touger-Decker, PI.
This study investigated the effect of a worksite wellness program using two different media on weight loss and cardiovascular risk (Framingham Score) in overweight and obese employees of the University of Medicine & Dentistry of New Jersey. This study had 2 primary aims, to determine the effectiveness of a 12 week Lifestyle Management Program (LMP) using two methods of delivery on diet, weight, physical activity and CVD risk outcomes at 12 and 26 weeks and to determine the effectiveness of the method of delivery (in-person vs. Internet) at 12 and 26 weeks. The program included three arms, a control group which of employees on the Stratford NJ campus, an Internet arm on the Piscataway campus and an in-person arm on the Newark campus. Each arm was done on a separate campus to reduce the potential for contamination of subjects in the respective arms. The LMP in the two experimental arms included anthropometric (weight, body mass index, waist circumference, waist hip ratio) and laboratory (total and HDL cholesterol, glucose) measurements as well as completion of food frequency, quality of life and physical activity questionnaires at baseline and program completion (week 12) as well as at 26 weeks. Control group participants were recruited through a health fair and have these same measurements at baseline. A subgroup of the control subjects had measurements repeated at 26 and 52 weeks. Subjects in the experimental arms will have individual appointments with the team at baseline and weeks 6, 12 and 26 as well as group sessions and weigh-ins weekly. Group sessions focused on diet, lifestyle, CVD risk reduction and physical activity for 12 weeks delivered either in-person or via the Internet using the platform for distance learning. A sub-group of each experimental arm and the control group had measurements repeated at 52 weeks. Changes in CVD risk, anthropometric measures, physical activity, diet and quality of life were measured.
2007 Foundation of Rutgers. The relationship of metabolic syndrome and periodontal disease in U.S. adults. $20,000 over 1 year, Diane Rigassio Radler, PhD, RD (PI)
Periodontal disease (PD) is a chronic oral infectious disease that progresses to subsequent infection of the ligaments and bone supporting the teeth. It is one of the primary causes of tooth loss in adults. Metabolic syndrome is characterized by the presence of interrelated clinical components of metabolic origin contributing to the formation of cardiovascular disease (CVD). Clinical characteristics of chronic diseases, for example dyslipidemia in CVD, impaired fasting glucose in diabetes, and abdominal adiposity in obesity are several of the criteria that comprise metabolic syndrome. CVD, diabetes, and obesity have been associated with PD, but no such relationships with metabolic syndrome have been reported in the U.S. population. Once associations between metabolic syndrome and PD are established, interventions to target the most related modifiable risk factors may be implemented.
The purpose of this study was to determine the relationship between metabolic syndrome and periodontal disease among adult participants in the most recent National Health and Nutrition Examination Survey (NHANES 2003-2004). The hypothesis to be tested was that adults with metabolic syndrome will be more likely to have PD than adults without metabolic syndrome. NHANES data are collected from the U.S. population in a multistage, stratified sampling design to be representative of all groups of people.
The outcomes and implications of this research are important. Establishing associations between metabolic syndrome and PD is the first step toward developing interventions. In addition this research fits with the SHP research objectives and strategic plan.
Pre-diabetes is defined as the presence of impaired fasting glucose or
impaired glucose tolerance. There is good experimental evidence showing
that type 2 diabetes mellitus (T2DM) can be prevented or delayed with diet
and lifestyle modification. Moreover, high levels of the inflammatory
biomarkers C-reactive protein and interleukin-6 identify patients at
increased risk for developing cardiovascular disease and progressing from
pre-diabetes to overt T2DM. Almond-enriched meal patterns have potent
natural anti-inflammatory properties that might decrease C-reactive protein
levels, improve cardiovascular risk, and delay the onset of T2DM in adults
with pre-diabetes. This study will evaluate the effects of an
almond-enriched diet on glycemic control, specific inflammatory biomarkers,
and cardiovascular risk factors in adults with pre-diabetes over a 16-week
period at the Rutgers of New Jersey (Rutgers).
This study's primary clinical outcome variable will be HbA1c. Secondary
outcome variables will include insulin resistance utilizing homeostasis
model analysis, C-reactive protein, interleukin-6, body weight, body
composition, waist circumference, blood pressure, and serum lipids. This
study will provide vital information about the role of almonds in delaying
progression from pre-diabetes to T2DM in adults.
National Kidney Foundation—Council on Renal Nutrition Research Grant. Effect of Aggressive Osteodystrophy Management on Clinical Outcomes in Stage 5 Chronic Kidney Disease, July 2006-June 2007, $16, 450.00 over 1 year. L. Byham-Gray (PI).
Bone disease in patients diagnosed with kidney failure has serious health implications. Researchers are starting to identify that aggressive management of bone disease and the consequent vascular calcification may lower patients' risk for morbidity (e.g., cardiovascular events) as well as mortality. This project plans to determine how the type of medical management (aggressive or conventional) for bone disease affects clinical outcomes. Using a retrospective design, this project will examine key bone health measures or markers of bone disease, such as parathyroid hormone, serum calcium and phosphorus levels as well as calcium-phosphorus products that are routinely collected in the five participating dialysis clinics and to determine whether having an bone disease manager designated in the clinic resulted in better clinical outcomes in comparison to those clinics who employed conventional management of renal osteodystrophy.
University of Medicine and Dentistry of New Jersey Foundation Research Grant. Effect of Medical Nutrition Therapy on Clinical Patient-Oriented Outcomes Among Overweight/Obese Older Adults Treated by the New Jersey Institute for Successful Aging, July 1, 2007-June 30, 2008, $20,000.00 over 1 year. L. Byham-Gray (PI).
The worldwide obesity problem is of global proportions with more than one billion adults overweight, inclusive of 300,000 million being clinically defined as obese. Overweight and obesity cause severe effects on the body including rises in blood pressure, and abnormalities in blood glucose and lipids (e.g., cholesterol, triglycerides) thereby contributing to long-term chronic disease and disability. The globesity epidemic transcends all generations, independent of age. According to recent trends in aging, the weight status of older adults has risen considerably since 1994. The majority of deaths among older adults is cardiovascular-related, and is largely attributed to the long-term effects of excess body weight/fat. Therefore, studying the role of lifestyle interventions in preventive health and successful aging is paramount.
The purpose of this proposed study is to measure the impact of providing medical nutrition therapy (MNT) interventions on weight, blood pressure, percent body fat, and eating and exercise habits among obese/overweight older adults treated at the New Jersey Institute for Successful Aging (NJISA) over short-term (12 weeks) and long-term (26 weeks) time periods. MNT refers to the services provided by a registered dietitian who covers nutrition assessment, diagnosis of nutrition-related health problems, intervention to treat identified problems, and continued follow-up and evaluation to achieve established behavioral goals.
The outcomes of the proposed study are expected to show an overall improvement in health status among participants that receive MNT. Future studies will further investigate the role of MNT and lifestyle interventions using various techniques over longer time periods among obese/overweight older adults.
Dietitians in Nutrition Support Annual Research Grant $5,000 over 1 year. The Impact of Medical Nutrition Therapy by a Registered Dietitian on Outcome in Cancer Patients, 8/2006-Present. M. Huhmann, PI.