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Article Excerpt
Adequate nutrition and physical activity are essential for health maintenance, functional independence, and quality of life. Messages designed to prevent disease and improve the health and quality of life for all Americans have been promoted by national public policies such as Healthy People 2010 (U.S. Department of Health and Human Services [DHHS], 2000), the Food Guide Pyramid (U.S. Department of Agriculture [USDA], 1996), the Dietary Guidelines for Americans (USDA & DHHS, 2000), and the Surgeon General's Report on Physical Activity and Health (DHHS, 1996). Despite the surge in social marketing campaigns, many Americans--particularly older adults--are not meeting these recommendations. Data from the Behavioral Risk Factor Surveillance System, for example, showed that in 1998 only 21.2 percent of adults age 65 and older in Georgia consumed 5 or more daily servings of fruits and vegetables (Behavioral Risk Factor Surveillance System, 1998). In an additional report in 1999, data from this Surveillance System indicated that in the past 30 days, 41.5 percent of Georgians age 65 or older were not involved in any leisure-time activity, that is, nonoccupational physical activity (1999).
The Administration on Aging's Older Americans Nutrition Program, formerly known as the Elderly Nutrition Program, was established in 1972 to fund nutrition and social service programs for adults age 60 and older. Also known as the Title III Nutrition Program, this service, based on factors such as low income, physical disability, and social isolation, is intended to improve the dietary intakes of older adults, with emphasis given to those at greatest risk of developing nutrition problems. The Older Americans Nutrition Program also provides numerous services that emphasize preventive intervention programs through the use of nutrition screenings and education, as well as other health-related and social support services (Millen, Ohls, Ponza, & McCool, 2002). It is also the largest U.S. community nutrition program for older adults, serving over 3 million meals daily across the Nation, including meals to almost 32,000 Georgians in 2000 (Georgia Department of Human Resources, 2002).
An Executive Summary of Title III programs reported significant health problems within the U.S. population of older adults (Millen et al., 2002, Ponza, Ohls, & Millen, 1996). Many of these health problems--such as cardiovascular disease, hypertension, diabetes mellitus, and obesity--are related to poor nutrition and physical activity and therefore could be lessened by interventions related to nutrition and physical activity. Data from other national sources (Millen et al., 2002; Ponza et al., 1996) and from within Georgia (Accettura, 2000; Aspinwall, 2001; Brackett, 1999) indicate that participants in the Title III Nutrition Program are at high nutritional risk and have physical impairments included within the list of activities of daily living.
Prior research by the University of Georgia's Department of Foods and Nutrition has exposed the high-risk status of many older adults in northeast Georgia who participate in the Older Americans Nutrition Program and has provided a snapshot of the probable characteristics of the program's participants across the State. These studies found that more than 50 percent of participants were at high nutritional risk and that more than 30 percent were obese, had self-reported diabetes or poor glucose control, and were hypertensive (Accettura, 2000; Brackett, 1999). These results indicate that this population is at increased nutritional risk, are at increased risk for poor health overall, and could benefit greatly from nutrition intervention programs. Thus, a great need exists to develop, implement, and evaluate nutrition and health education programs to determine gains in knowledge and behavior changes. Hence, the goals of this study were to evaluate the effect of a nutrition education curriculum and an intervention program (leg exercises) designed to enhance older adults' knowledge about nutrition and fitness and to improve their behaviors related to diet, physical activity, and overall health and well-being.
National recommendations indicate that facilities with Older Americans Nutrition Programs are ideal settings for nutrition and health promotion programs in older adult populations (Millen et al., 2002). Most research with these program participants focused on documenting poor nutritional status and nutritional risk factors (Millen et al., 2002). The evaluation of combined nutrition and physical activity interventions targeted to older adults in this program in the Southeast is lacking. Therefore, this evaluation is of great value for both the well-being of the older adults served and for the State in its quest to provide nutrition and health promotion activities and services for this population.
Methods
The first phase of the study consisted of training the staff, followed by recruiting the participants, obtaining approvals from institutional review boards and informed consent from participants, and administrating the pre-test, which consisted of a questionnaire and two fitness batteries. The second phase consisted of the intervention: nutrition education and leg-exercise programs. The last phase was the post-test.
Participant Recruitment and Criteria
The directors of centers for senior citizens, county Extension agents, health educators, and staffs of Area Agencies on Aging...
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