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As increasing numbers of baby boomers enter retirement age, Georgia senior centers will be inundated with more computer-savvy seniors than ever before. Web-based nutrition education is a pragmatic option to complement the traditional classroom nutrition education sometimes hindered by the centers’ limited monetary and personnel resources. This exploratory observational study sought to pilot test a companion to classroom nutrition education, a prototype Dietary Approaches to Stopping Hypertension (DASH) diet website, for future implementation in Georgia senior centers. Classroom DASH diet lessons were designed and pilot tested on a convenience sample of community dwelling older adults in 6 metropolitan area centers (n=109). Next, the same lessons were incorporated into a senior-friendly DASH diet website specially designed to meet the needs of older adults and pilot tested on a second convenience sample in one center (n=5). Descriptive and analytical statistics were used to compare baseline and post-website blood pressures, body weights, and DASH-related nutrition knowledge. There was a significant difference in the scores for systolic blood pressure at baseline (M=145.60, SD=8.385) and post-website (M=136.40, SD=9.607) conditions; t(4)=3.74, p =.020. Diastolic blood pressure and weight showed no significant change. A survey of DASH-related knowledge, behaviors, and beliefs showed movement towards desired responses on 44% of survey questions after the intervention. An opinion survey collected seniors’ perspectives on their website experience. 100% of participants reported satisfaction with the website and willingness to continue using it. Refinements to the alpha-prototype website are recommended before further testing with a larger pilot study group. Although expanded research is necessary, results from this limited pilot test suggest that web-based nutrition education is a promising method to reinforce classroom lessons teaching dietary and lifestyle management of hypertension in Georgia senior centers. Multi-component nutrition education holds potential to address diversity in cultures, learning preferences, and functional limitations of Georgia seniors.

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The primary goal of this project was to develop, implement, and evaluate a lifestyle modification intervention that did not require extensive, ongoing personal contact to improve lifestyle behaviors shown to lower blood pressure (BP) in adults with prehypertension (N=23, mean age=54, mean BP=126.7/75.1). Incorporating clinical practices and psychological approaches to behavior change, this intervention used primarily the DASH Eating Plan, coupled with a low-sodium diet and a walking program; it applied social cognitive theory to health behavior change, specifically self-regulation for self-monitoring and management of BP, diet, exericse, and weight. The study compared two conditions, the DASH 2 Wellness Only standard of care condition to the DASH 2 Wellness Plus treatment condition on the primary outcome measures of fruit and vegetable (servings/day), sodium consumption (milligrams/day), physical activity (steps/day), weight (kgs), and blood pressure (primarily systolic BP). Consistent with hypotheses, MANOVAs detected significant differences between the conditions with D2W Plus evidencing a larger increase in change of total daily steps (M= 2900.14, SD= 1903.83) than D2W Only, (M= 636.39, SD= 1653.26), a larger decrease in systolic BP change (MMHG) (M= 15.14, SD= 4.33) than D2W Only, (M= 4.61, SD= 8.28), and a larger decrease in weight change (kg) (M= 4.78, SD= 3.81) than D2W Only, (M= 1.47, SD= 2.57). While conditions did not significantly differ on daily sodium reduction or fruit and vegetable increase, D2W Plus evidenced a larger decrease in sodium (mg) (M= 932.22, SD= 1019.22) than D2W Only, (M= 423.64, SD= 749.15) and larger increase in fruit and vegetable increase, (M= 2.10, SD= 1.73) than D2W Only, (M= 1.02, SD= 2.24). It was also hypothesized that the D2W Plus condition would show greater improvements in nutrition-specific and PA-specific health beliefs of self-regulation, social support, self-efficacy, social support, and outcome-expectancy compared to those in the D2W Only condition. A MANOVA revealed significant group differences in PA-specific health beliefs primarily attributable to increased PA self-regulation in D2W Plus compared to D2W Only, (M= 1.78, SD= 0.75) and (M= 0.55, SD= 0.57), respectively. While no overall significant group differences were found for nutrition-specific health beliefs, analyses showed meaningful differences in nutrition-specific health beliefs attributable to increased nutrition self-regulation strategies in D2W Plus compared to D2W Only. Results provide preliminary support for the efficacy of an electronic delivery of an intervention aimed at improving lifestyle behaviors and lowering BP in middle-aged individuals with prehypertension. / Ph. D.

This paper reviewed the mechanisms of systemic inflammation and the nutritional status of the individuals who suffer from chronic diseases including rheumatoid arthritis, systemic lupus erythematous, chronic obstructive pulmonary disease, irritable bowel diseases include ulcerative colitis and Crohn’s disease, asthma, and atherosclerosis. Treatment modalities such as diet regimens will also be discussed. The Anti-Inflammatory diet, Mediterranean Diet, and the Dash diet will be discussed. Nutritional status and inflammation go hand in hand according to the findings available today. There is still more research required to completely understand the mechanisms that occur in inflammation.