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Reduction in Modifiable Osteoporosis-Related Risk Factors Among Adults in the Older Americans Nutrition Program J.M.K. Cheong, MS M.A. Johnson, PhD R.D. Lewis, PhD J.G. Fischer, PhD J.T. Johnson, PharmD The University of Georgia The purpose of this study was to determine the prevalence of low bone mineral density, the prevalence of modifiable osteoporosis-related risk factors, and the effectiveness of a nutrition and bone health education intervention that is tailored for a multiethnic (Caucasian and African American), low-income, low-literacy elderly population. The six risk factors were low intake of eight calcium-rich foods (less than 3 servings/day), nonuse of calcium supplements, nonuse of vitamin D-containing supplements, low physical activity (less than 5 times/week and less than 150 minutes/week), one or more of four risks for falling in the home, and current tobacco use. The 71 participants were a convenience sample from the Northeast Georgia Older Americans Nutrition Program who received Title III-C or Title III-D services. Fifty-nine completed heel bone mineral density tests at baseline and osteoporosis risk assessment questionnaires both at baseline and post-intervention. At baseline, 60 percent of the adults had either osteoporosis or osteopenia, and African-American women had more osteoporosis-related risk factors than did Caucasian women. After the intervention, the number of risk factors decreased significantly by 0.8, and over half of the participants decreased at least one risk factor. Additionally, the number of participants who consumed 3 or more servings of calcium-rich foods daily or used a calcium supplement more than doubled. O steoporosis is a major public health threat that is largely preventable (National Institutes of Health [NIH], 2001). In the United States, 10 million people have osteoporosis, and another 18 million have osteopenia—low bone mass that increases the risk for osteoporosis (NIH, 2001). Consequences of osteoporosis include chronic pain, bone fractures, need for placement into long-term care facilities, and death (NIH, 2001). Because of the high prevalence and debilitating consequences of osteoporosis and bone fractures, we developed an educational intervention related to nutrition and bone health that was targeted to participants in the Older Americans Nutrition Program (OANP). Formerly known as the Elderly Nutrition Program, OANP is the largest community nutrition program for older adults in the Nation, serving about 7 percent of the older population overall and about 20 percent of the poor elders (Administration on Aging, 2002; Millen, Ohls, Ponza, & McCool, 2002). This program provides nutrition education, as well as congregate and homedelivered meal services. The educational messages in this intervention were developed from recommendations of the 2000 NIH 2003 Vol. 15 No. 1 83
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Research Articles Special Issue Eld
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CENTER FOR NUTRITION POLICY AND PRO
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Research Articles Improving Calcium
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fiber, niacin, and vitamin C than d
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Researchers completed and compiled
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greens were a good source of dietar
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Marketing and education strategies
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Jackson, K.A., & Savaiano, D.A. (20
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The Influence of the Healthy Eating
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Box 1 - Basic definitions of the St
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Treatment and Analysis The HELP was
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Table 2. Pre-test and post-test com
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References American Dietetic Associ
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Using a Concurrent Events Approach
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her daughter and husband, who died
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money started to become depleted be
Page 33 and 34: References Administration on Aging,
Page 35 and 36: Measuring the Food Security of Elde
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Page 41 and 42: food sufficiency question (3.9 perc
Page 43 and 44: Figure 1. Comparison of item severi
Page 45 and 46: Table 3. Other food problems report
Page 47 and 48: References Andrews, M., Nord, M., B
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Page 53 and 54: Table 2. Fruit and vegetable intake
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Page 57 and 58: Table 4. Physical activity, knowled
Page 59 and 60: Hackman, R.M., & Wagner, E.L. (1990
Page 61 and 62: these cognitive demands (Buzzard &
Page 63 and 64: Phase II In this phase, 90 differen
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Page 73 and 74: Table 3. Diet rating of the Healthy
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Page 77 and 78: increasing portion of the budget mu
Page 79 and 80: women often continue working past a
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Page 87 and 88: Baseline At baseline, heel BMD, wei
Page 89 and 90: Table 2. Baseline and post-interven
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Page 95 and 96: More older men than older women lik
Page 97 and 98: Schools offer a mix of foods in add
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