Inaugural HOPE Foundation Small Research Grant 2021

Posted by on 8 March 2022

The HOPE Foundation funds a wide range of research areas including biomedical, clinical, public health and wider psycho-social aspects of ageing. This grant has been awarded to Karen Mumme for a research project, Assessing diet quality in older New Zealand adults and its association with metabolic syndrome and cognitive health.

This small grant is designed to encourage researchers and/or clinicians to undertake small projects in gerontology or older adult health and well-being research, in keeping with the above objectives. The aim of this grant is to encourage research that may lead on to larger projects on aspects of ageing in New Zealand (NZ).

Assessing diet quality in older New Zealand adults and its association with metabolic syndrome and cognitive health.

Principal Investigator: Karen Mumme

Key co-investigators: Associate Professor Kathryn Beck, Dr Jamie de Seymour

College of Health, Massey University, Auckland

Background

The New Zealand population is ageing, lifespans are increasing but an increasing lifespan does not always correspond with good health (World Health Organization, 2015, Statistics New Zealand, 2016). Metabolic syndrome is characterised by a cluster of symptoms which are associated with the development of diabetes and poor cardiovascular disease outcomes (Mottillo et al., 2010, Ford et al., 2008). Both cognitive decline and mild cognitive impairment are progressive, increase with age and are inversely associated with independent living – a highly valued attribute in later years (Blazer et al., 2015).

Diet is a modifiable risk factor for many health outcomes affecting older adults e.g., cardiovascular disease and diabetes (Jayedi et al., 2020), metabolic syndrome (Rodriguez-Monforte et al., 2017), cognitive health (Chen et al., 2018), bone health and fracture risk (Fabiani et al., 2019), and sarcopenia (Bloom et al., 2018). Diet choice may be a possible consequence of older adults’ living (Wham and Bowden, 2011) and socio-economic status (Poggiogalle et al., 2021). Nevertheless, there is no up-to-date tool available to measure diet quality or adherence to optimal eating behaviours as recommended by dietary guidelines in older adults in New Zealand.

Dietary pattern analysis utilises the whole diet to examine relationships between dietary intake and the risk of chronic disease thus complementing the traditional single nutrient or food groups approach (Hu, 2002). There are two types of dietary patterns. The a priori approach uses a pre­defined scoring system, often based on dietary guidelines to measure diet quality e.g., the Healthy Eating Index (Krebs-Smith et al., 2018). The a posteriori approach is data driven and reduces the dimensionality of many food groups, in a study population, to a few dietary patterns (Hu, 2002).

Recently the Ministry of Health released new dietary guidelines for the older New Zealand population (Ministry of Health, 2020). Work is currently being conducted by our research group to develop and validate an Eating Index for New Zealand Older Adults (EINZOA) to measure diet quality and adherence to the new Ministry of Health dietary guidelines. The EINZOA index will be a free and easy tool to measure diet quality in both a clinical and research setting. The proposed project will be the first study to use the EINZOA tool to explore associations between diet quality of older New Zealand adults and health outcomes.

The objectives of this project are to:

1) apply, in a research setting, the newly developed tool (EINZOA) to measure diet quality in older adults.
2) examine the association between the diet quality and metabolic syndrome and cognitive function in older adults.
3) share the results with the public, health professionals, and other researchers of ageing.
We hypothesise good adherence to the New Zealand dietary guidelines, represented by higher scores on EINZOA will be inversely associated with the risk of metabolic syndrome and positively associated with cognitive health.

Method

The REACH (Researching Eating, Activity, and Cognitive Health, n 366, aged 65-74 years, 36% male) study, led by Associate Professor Kathryn Beck with Karen Mumme as PhD candidate, was the first study in New Zealand to explore the relationship between a posteriori dietary patterns in older adults and metabolic syndrome and cognitive health (Mumme et al., under review-b, Mumme et al., under review-a, Mumme et al., 2020, Mumme et al., 2019). The REACH study has a wealth of data and is a valuable resource for further analyses of dietary intake and health outcomes.

Using the EINZOA tool and the REACH data (Massey University Human Ethics Committee has granted ethical approval: Southern A, application 17/69 and all participants have granted informed written consent), the diet quality of the REACH population will be assessed and relationships between the diet quality and health outcomes (metabolic syndrome and cognitive health) will be explored using multiple linear regression. While this project has all necessary data (dietary and confounding factors e.g., age, sex, physical activity, energy intake, index of multiple deprivation, apolipoprotein -e4 status) it requires funding to support a salary for a researcher to compute the EINZOA diet quality scores, explore associations with health outcomes, write and publish the manuscript and disseminate the results.

Anticipated outcomes and dissemination

This project will provide evidence to support and guide the way towards healthier eating for those at risk of metabolic syndrome or to support cognitive health. The results of this project and the development and validation of the EINZOA index will be disseminated through journal publications. Results will be shared with other researchers through national conferences and seminars e.g., New Zealand Association of Gerontology, Nutrition Society of New Zealand, HOPE Foundation Exchange Day; older adults through local groups e.g., Sixties Up; the REACH participants through newsletters; and health professionals (e.g., dietitians, general practitioners) through local journals or networks.