A special feature of this issue is a series of articles from the Northeast Regional Project on Aging (NE-172), which, in its latest reiteration, is the USDA Multi-State Research Project on Aging (still NE-172). This project began in 1989 with researchers conducting studies that have focused on the accurate assessment of nutritional risk of elderly adults. This project combined the expertise of researchers who have been working together for more than 15 years on the biochemical, dietary, and social factors that affect the nutritional risk of older adults. Six articles in this issue provide an excellent example of the sharing of resources and data among colleagues and research teams.
Richard Cook from the University of Maine and former chair of the NE-172 Technical Committee has given an historical perspective of the project, beginning with the nutrition studies conducted after World War II in the Northeast.
Early research efforts gave rise to the need to focus on older adults in 1989 and quickly expanded the collaborations among Land Grant institutions and other public and private universities.
The article by Fey-Yensan and colleagues represents quantitative and qualitative data on fruit and vegetable intakes of older adults from 4 research sites in the Northeast: the universities of Rhode Island, Maryland, Massachusetts, and the District of Columbia. Nutrition education efforts and strategies to change food behaviors are reviewed. Practitioners are encouraged to incorporate some of their successful strategies, and to become knowledgeable about all food programs and their possibilities for clients in local communities.
The third article highlighted from the Multi-State Research Project on Aging compares the dietary patterns and weight status of 2 groups of older adults, one in rural Pennsylvania from the investigators at Penn State University, and one in urban Boston from the Tufts Center on Aging.
Body mass indexes (BMIs) and waist circumferences were measured and compared in the 2 groups. The authors found that the quality of diets was improved in both groups, particularly for participants with intakes that were rich in fruits, cereals, and milk.
Lammi-Keefe has reviewed laboratory studies on the use of selected biochemical indicators in determining the nutrition risk of elderly adults as part of the last 2 decades of NE-172. Iron status and reference ranges for vitamins A and E were studied along with the applicability of selected apolipoproteins for predicting the risk of coronary heart disease. The article has carefully outlined the linkages between research findings and dietetic practice. This information may be helpful as a foundation for determining additional biochemical predictors of disease risk in selected elderly populations.
A comparison of lipoproteins and diets of elderly adults with and without cardiovascular diseases was conducted based on 1264 free-living participants of the Framingham Heart Study by Contois and his collaborators. The differences observed in this study suggest that a more aggressive response to coronary heart disease diagnosis is necessary for men than for women.
Another interesting area of research in adult nutrition is the biochemical measurement of antioxidant status. Prior reviews what we know about the noninvasive biomarkers of radical-induced damage in biological tissues and fluids and other biomarkers of antioxidant status.
Much of his work, begun at the Tufts Center on Aging, has focused on an Oxygen Radical Absorbance Capacity (ORAC) assay for foodstuffs and plasma/urine analyses. His collaboration on NE-172 has helped to increase our knowledge base on the beneficial effects of antioxidants from consumption of fruits and vegetables.
Huhmann et al have addressed a topic of great interest to dietitians who work with stroke patients at risk for dysphagia. They assessed the level of agreement between registered dietitians and speech language pathologists on the risk predictors of dysphagia for 32 stroke patients in the hospital. They concluded that dietitians can be effective in identifying dysphagia risk using a Dysphagia Screening Tool that they devised and have published in this issue.
Sari Edelstein has provided a brief report on nutrition referrals and payment ratios in a large physician network in New England. Her results have prompted her to recommend that "dietitians should become more familiar with coding guidelines for proper insurance reimbursement".
Lipids and fatty acid intakes of overweight and obese adults are examined by Belhumeur et al, especially the short-term effects of fat reduction, weight loss, and exercise. One hundred fifty-four adults in a weight management program participated in an evaluation of physical and biological parameters. Clinically, weight management programs should measure clinical profiles and consider counseling on trans fatty acids in the diets of program participants.
My appreciation is extended to Helen Smiciklas-Wright for coordinating the submissions for this issue and to my other colleagues for providing the review articles of the NE-172 research project. I have thoroughly enjoyed their friendship and collegiality since 1993. Please send me any comments or ideas for future topics that should be addressed in TICN.