Newsflash Fall 2015 Issue

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The Yale-Griffin Prevention Research Center Newsflash Fall 2015 Issue The PRC has prepared this electronic Newsflash to keep you informed about our work and invite you to take part in our research, education
The Yale-Griffin Prevention Research Center Newsflash Fall 2015 Issue The PRC has prepared this electronic Newsflash to keep you informed about our work and invite you to take part in our research, education and outreach activities. It serves as a communication tool for our Community Committee members, and our colleagues in academia, education, clinical settings, and social service agencies. If you have ideas for working together on shared projects, please let us know. For more information about the Yale-Griffin PRC: Please visit our website at PRC Updates Celebrate Food Day on October 24 th - Food Day is an annual event to encourage people to enjoy real food and take action to solve food-related problems in their communities at the local, state, and national level. Every year, thousands of events are held across the U.S. This year s theme is putting our food system on a more humane, sustainable path. In our local area, PRC Director Dr. David Katz and his wife Catherine S. Katz, PhD will oversee a Food Day event at Yale University, which will include music videos on the theme of Unjunk Yourself, a dance team performance and group dance, a presentation on The Four Pillars of Food (taste, health, sustainability, and vitality), and a book signing/mixer. This fun and interactive event will take place on Saturday, October 24 th from 11 a.m. to 1 p.m. in front of the Sterling Library on the Yale University campus. Good to Go Gang LLC releases first edition of video library based on ABC for Fitness The Good to Go Gang (GTGG) wellness initiative has recently partnered with the National Association of Police Athletic/Activities Leagues (PAL) to help elementary school children eat well, exercise, and make good decisions. The GTGG program, loosely based on the ABC for Fitness program developed by PRC Director Dr. David Katz, uses videos with animated characters to guide the children in quick 5-minute activity bursts through the day, and encourages them to make better food choices. The videos take them to imaginary sites such as ski slopes, medieval jousting arenas, and ancient Mayan temples, making exercise and learning a fun adventure. Good to Go Gang LLC has already created an initial 30-minute exercise video, and plans to make 4 additional videos available to schools and organizations during the school year. PAL, which has more than 350 chapters across the US, is based on the conviction that young people, if reached early enough, can develop strong positive attitudes toward police officers. For more information on the Good to Go Gang videos, visit the website A portion of the proceeds of the Good to Go Gang program sales will be donated to Dr. Katz s Turn the Tide Foundation ( Goodbye and best wishes to: Yasemin Kavak, MPH, PRC Research Associate, who has accepted a position at the Yale Cancer Center, where she will coordinate Phase 1 clinical trials. Yasemin has been with the PRC since her days as an undergraduate public health intern from Southern, and while obtaining her MPH from the University of Massachusetts. She has been involved with all aspects of project coordination on many of our clinical research studies, and also initiated a set of faith-based cooking classes in Seymour for a pilot study in Seymour. We d like to thank her for her contributions to the PRC and wish her well. Current Projects PROJECT UPDATE - Valley Initiative to Advance Health & Learning in Schools (VITAHLS) This initiative, led by the PRC and Griffin Hospital in partnership with 4 school districts, involves developing, implementing, evaluating and sustaining a comprehensive Valley-wide school-based program focusing on nutrition and physical activity for PreK-12 students. Our partners are the Ansonia, Derby, Seymour, and Shelton school districts, and Emmett O Brien Regional Technical School. For more information, contact VITAHLS Coordinator Gina Smith: Staff wellness in Ansonia: This fall we will partner with the Valley YMCA to offer a Couch to 5K training program for staff at Mead Elementary School. The program s 8 weekly sessions began during the week of September 21 st and will run through the week of November 9 th. A Couch to 5K program can help people (regardless of their current fitness levels) to get ready to take part in a 5K (3.1 mile) walking or running event OR can simply help them to get up and move. Ideally, it includes 3 days of training per week for 8 weeks. Each session lasts about 30 minutes, includes a warm-up, and builds upon prior sessions by gradually increasing the alternating walk/jog intervals. As with a similar program offered in Seymour last year, our goal for the end of the 8-week program is for Mead School staff to be motivated to continue to exercise together on their own, and for other Ansonia schools to gain interest in hosting similar physical activity opportunities for their staff. Upcoming presentations: This fall, we will share highlights and insights gained from our VITAHLS project at two statewide events. First, we will present Designing a School-Based Childhood Obesity Prevention Initiative on October 23 rd at the CT Public Health Association s annual meeting at the Coco Key Convention Center in Waterbury. Then we will present Motivating Your School Community to Adopt a Healthy Lifestyle on November 4 th as part of a Physical Education & Health Education Professional Development Day at the Naugatuck High School. Community Health Opportunities Organized with Schools at the Epicenter (CHOOSE): Our PRC s primary CDC-funded research project for the next 5 years will offer and compare the impact of different levels of interventions in five communities, with school districts serving as the epicenters, and expanding within and beyond schools into other portals in their respective communities. The Valley Initiative to Advance Health and Learning in Schools (VITAHLS) is one component of the CHOOSE project. CHOOSE will use a multilevel approach to improve diet quality and physical activity in children and adults by delivering complementary programming through community portals, and will compare 4 levels of intervention. Target portals include schools, worksites, clinical settings, faith-based organizations, media, and supermarkets. For CHOOSE we will continue to develop and expand our VITAHLS school-based initiative in the Ansonia, Derby, Seymour, and Shelton school districts, and will add a new partner with similar demographics (tentatively the Naugatuck School District, pending Board of Education approval) to serve as a control/delayed intervention district. We have already been collecting aggregate data annually on students academic achievement, school attendance, discipline, physical fitness, and body mass index (BMI) in the 4 VITAHLS school districts, and will continue to do so in these and in the control school district as part of CHOOSE. Later this fall, we will also work with all 5 school districts to recruit a small subset of students from grades 4, 6, and 8, along with one parent/guardian of each student, for baseline collection of additional data to help us to analyze the impact and reach of CHOOSE. This data, which will include diet quality, waist circumference, and blood pressure, will be collected from about students (plus one parent/guardian of each student) from each school district. ONGOING STUDY - Vascular Reactivity Assessment by a Novel Diagnostic Device, AngioDefender, Compared to Using Brachial Artery Ultrasound Imaging Study details: Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels that include coronary heart disease, cerebrovascular and peripheral arterial diseases, deep vein thrombosis, and pulmonary embolism. Since symptoms often remain silent until a major health event occurs, it is important to detect and prevent CVDs at an early stage. A non-invasive way to detect CVD risk measures the function of endothelial cells that help blood vessels dilate as blood flows through them. Endothelial function is usually assessed by a non-invasive ultrasound procedure that measures the dilation of the brachial artery in the arm as blood flows through the artery. This procedure works well, but requires skilled technicians and expensive equipment. For this study, we want to compare a new automated machine (AngioDefender TM ) to brachial artery ultrasound imaging in measuring blood vessel function. We conducted 2 pilot studies in 2014, funded by Everist Health, which showed the 2 techniques to be comparable. However, since those studies involved a small number of people, we want to compare the 2 techniques again with a larger number of people to see if the results still hold true. We will partner with the Boston University School of Medicine, the Medical College of Wisconsin, and the University of Colorado to conduct this larger study, which is also funded by Everist Health. Who we re recruiting: A total of 152 adults from the 4 sites. The Yale-Griffin PRC has completed Phase 1, which involved 8 participants. We will soon recruit 30 more participants for Phase 2. Adults age 18 years or older could qualify to take part based on overall health, body mass index, arm circumference, blood pressure, blood cholesterol and glucose levels, absence of certain CVD clinical signs, absence of viral or bacterial infections, and ability to comply with the procedures. People who took part in our 2014 pilot studies will not qualify to take part in Phase 2. What will happen: Study participants will be asked to come to the PRC on 2 consecutive days, after fasting and refraining from strenuous activity, medications, and smoking a few hours before each appointment. Each day, their endothelial function will be tested by the brachial artery ultrasound imaging and by the AngioDefender. TM The order of the tests will be assigned randomly. During each test, a blood pressure cuff will be placed on the arm, inflated to reduce blood flow for 5 minutes, then deflated, then rapidly inflated and deflated for several minutes. Each test will last 30 to 45 minutes and take place about 2 hours apart from the other test. Participants will need to continue fasting, refrain from physical activity, take no medications, and not smoke until the end of the second test. Compensation: Participants will each receive $200 for taking part in this study. They will also receive information about their blood pressure, waist circumference, and body mass index (BMI). How to apply: If you or someone you know is interested in participating, contact Ms. Rockiy Ayettey ( phone ext. 300). Project Findings Dose and Response to Cocoa (DARC): A Randomized Double-Blind Controlled Trial Purpose: This study compared the effects of 2 daily doses of cocoa consumption (5 vs. 10 grams of cocoa powder provided in a combination of chocolate and cocoa beverages) over an 8-week period on risk factors for cardiovascular disease in 120 adults with stage 1 hypertension (60 adults at the PRC, and 60 at the Boston Medical Center). Cocoa-containing products have already been known to have cardio-protective effects, perhaps due to their flavonoid content. Our own prior studies have shown that a dose of 10 grams of cocoa powder could lead to improved blood vessel function in overweight adults. The DARC study was designed to learn whether the cardiovascular benefits of cocoa-containing products would vary when comparing this dose (10 grams of cocoa powder) to a smaller dose (5 grams of cocoa powder), and whether there would be a direct impact on blood pressure. Because chocolate is a popular dietary source of cocoa but is high in calories and fat and often high in added sugar, it is important to determine the minimum dose of cocoa that can provide heart-healthy benefits without affecting weight and blood sugar, if used in chocolate products. Outcome Measures: Blood pressure, endothelial function (ability of blood vessel walls to dilate as blood flow through them), serum lipids, glucose, insulin, body weight, and waist circumference. Results: When we analyzed the data for the entire group of participants, we found that daily consumption of either 5 or 10 grams of cocoa-containing products did not significantly improve their blood pressure, endothelial function, arterial stiffness, lipid profile, glucose levels, or insulin resistance. When we analyzed that data on a sub-group basis (based on the types of blood pressure prescription medications that participants happened to be taking prior to, and during, the study), we found some differences in outcome measures based on these types of medications: (1) Daily consumption of cocoa-containing products, as compared to placebo: reduced blood pressure in participants on ACE inhibitors, beta blockers, or diuretics; improved endothelial function in participants on beta blockers; lowered triglycerides in participants on ACE inhibitors; increased HDL cholesterol in participants on calcium channel blockers; and reduced insulin resistance in participants on ACE inhibitors. (2) A dose-response effect of cocoa products on blood pressure was evident in participants on ACE inhibitors, with the 10 gram dose showing more benefit than the 5 gram dose. Conclusion: For adult patients with stage 1 hypertension, the extent to which adding cocoacontaining products to their usual diets appears to reduce their cardiovascular disease risk seems to depend on which prescription medications that they are taking to control their blood pressure. Further studies are warranted to explore the potential benefits of cocoa-containing product consumption among patients with stage 1 hypertension. Funding source: The Hershey Company For more information: Contact Dr. Valentine Njike, MD, MPH, PRC Assistant Director of Research and Evaluation, phone , ext Grant Proposals and Awards RECENTLY-SUBMITTED PROPOSAL Effects of Non-Fat vs. Full-Fat Dairy Products on Cardiovascular Risk Factors in Adults with Metabolic Syndrome: A Randomized Controlled Trial In September, we submitted a proposal to Dairy Management, Inc. for a study to compare the impact of high-fat vs. non-fat dairy products on measures of cardiovascular disease (CVD) risk in adults with metabolic syndrome. People with metabolic syndrome have at least 3 conditions (such as high blood pressure, high triglycerides and fasting glucose, low HDL cholesterol, or obesity) that raise their CVD risk. If funded, we plan to recruit 33 adults with metabolic syndrome and ask them to consume 2 daily servings of dairy products during 2 different 6-week phases of the study. One phase will include fullfat dairy products, and the other will include non-fat dairy products. We will use a crossover study design, in which we will randomly assign each participant to start with either a full-fat or non-fat dairy phase, then have a 4-week washout period of consuming his/her usual foods but no dairy products, then respectively cross over to either a non-fat or full-fat dairy phase. Other than specified dairy products, study participants will have the choice of what they want to eat and in what amounts during each of 6-week phase. The primary study outcome measure will be will be endothelial function (how well blood vessels can dilate properly so blood can flow through them). We will also measure their weight, body composition, waist circumference, blood pressure, fasting blood lipids, fasting blood glucose, insulin levels, and C-reactive protein (a measure of inflammation in the body). Presentations David Katz, MD, MPH, FACPM, FACP, PRC Director, delivered several presentations: If Lifestyle is the Medicine, What s the Spoon? keynote presentation on June 22 nd to the Canadian Laboratory Medicine Congress in Montreal, Canada. Dietary Fats, Overcooked: Lots of Heat, Little Light on July 31 st at the International Conference on Nutrition in Medicine: Cardiovascular Disease at the George Washington School of Medicine in Washington, DC. Masticating the Truth and Refusing to Swallow: We Know What to Do to Reduce Chronic Illness, webinar on Sept. 10 th cosponsored by Healthways and the American College of Lifestyle Medicine. Lifestyle as Medicine: A GLiMMER of Hope? on Sept. 15 th at RGA Reinsurance in Bloomington, MN. Presentation at the Food as Medicine program held Sept. 18 th 22 nd at Canyon Ranch in Lenox, MA. Keynote presentation on Sept. 22 nd at the Worksite Wellness Council of Massachusetts Annual Conference in Gillette Stadium in Foxboro, MA. Publications Katz DL. Doctors, TV, and Truth: Evidence in the Realm of Edutainment. J Public Health Manag Pract Sep-Oct;21(5): Katz DL. Oblivobesity: Looking Over the Overweight That Parents Keep Overlooking. Child Obes Jun;11(3): In-Service / Training Opportunities You are invited to join us at our Journal Club meetings, usually held every other month. We review and critique publications on topics such as community-based research, clinical research, and public health. This helps us stay up-to-date on research findings. It also allows us to examine publications (for the research questions, study design, results and conclusions) so we can apply the knowledge gained and lessons learned to the design of our own projects. The next Journal Club meeting will be held at the PRC on the second floor of Griffin Hospital. Tuesday, October 20 th from 1:00 to 2:30 p.m. Kleber ME, Delgado GE, Lorkowski S, März W, von Schacky C. Trans fatty acids and mortality in patients referred for coronary angiography: the Ludwigshafen Risk and Cardiovascular Health Study. Eur Heart J Sep 22. [Epub ahead of print] PubMed PMID: If you have questions or want to receive a PDF version of the article by , contact Dr. Valentine Njike by at or by phone at ext Let s Stay in Touch We want to hear from you let us know what you are doing and how our research might assist you in your work. Please contact Beth Comerford, MS, Deputy Director or any of the staff listed in this Newsflash. Yale-Griffin Prevention Research Center 130 Division Street, Derby, CT Phone: (203) Fax: (203) The Yale-Griffin PRC is a member of the Prevention Research Centers Program. This Newsflash was supported by Cooperative Agreement # 1U48DP under the Health Promotion and Chronic Disease Prevention Research Centers Program, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention of the Department of Health and Human Services.
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