Implications of Prenatal Exposure to the Spring 2011 Alabama and Missouri Tornadoes on Birth Outcomes.

OBJECTIVE: Despite emerging evidence of the detrimental effects of natural disasters on maternal and child health, little is known about exposure to tornadoes during the prenatal period and its impact on birth outcomes. We examined the relationship between prenatal exposure to the spring 2011 tornado outbreak in Alabama and Joplin (Missouri) and adverse birth outcomes. METHODS: We conducted a retrospective, cross-sectional cohort study using the 2010-2012 linked infant births and deaths data set from the National Center for Health Statistics for tornado-affected counties in Alabama (n=126,453) and Missouri (Joplin, n=6,897). Chi-square and logistic regression analyses were performed to estimate associations between prenatal exposure to tornadoes and birth outcomes. RESULTS: Prenatal exposure to the tornado incidents did not influence birth weight outcomes. Women exposed to Alabama tornadoes were less likely to have a preterm birth compared to unexposed mothers (OR: 0.93, 95% CI: 0.91, 0.96). Preterm births among Joplin-tornado exposed mothers were slightly higher (13%) compared with unexposed mothers (11.2%). Exposed mothers from Joplin were also more likely to have a cesarean section compared to their counterparts (OR: 1.14, 95% CI: 1.02, 1.26). CONCLUSIONS: We found no association between tornado exposure and adverse birth weight and infant mortality rates. Our findings suggest that prenatal exposure can amplify the odds for a cesarean section. (Disaster Med Public Health Preparedness. 2019;13:279-286).

Patterns and Correlates of Grip Strength in Older Americans.

BACKGROUND: Muscle strength is a sensitive indicator of morbidity and mortality in older adults. Loss of muscle strength contributes to a decline in physical functioning. Hand grip strength is a simple measurement but correlated with total body muscle strength. This study evaluated the patterns and correlates of grip strength among older adults in the United States. METHOD: The grip strength data were analyzed from the National Health and Nutrition Examination Survey. RESULT: Individuals (n=1009) aged ≥65 years old who had a grip strength measure were included in this analysis. Age distribution was 31.5%, 27.2%, 16.2%, and 25.0% for 65-69, 70-74, 75-79, and 80+ respectively. Race distribution was 81.1%, 8.3%, 7.1%, and 3.5% for Whites, Blacks, Hispanics, and Asians respectively. The mean grip strength was 71.7kg in males and 44.6kg in females, and declined as age increased (p<.0001). Blacks had the highest grip strength, followed by Whites and Hispanics, and Asians had the lowest measure (p<.0001). Although several variables were found to be correlated with grip strength univariately, after adjusting for gender, age, and race, the factors that remained significantly and independently associated with weak grip strength were lower body weight, not being in good health status, and physical limitations. CONCLUSION: Grip strength reduced as age increased. Blacks and Whites displayed higher grip strength than Asians and Hispanics. General health status, weight status and physical functioning were independently associated with grip strength. These findings suggest that grip strength could be a useful indicator for overall health assessment in older adults.

The "10 keys" to healthy aging: 24-month follow-up results from an innovative community-based prevention program.

The purpose of this report was to evaluate a prevention program to reduce risk factors for common diseases among older individuals in a lower income community. This randomized community-based study enrolled older adults into a Brief Education and Counseling Intervention or a Brief Education and Counseling Intervention plus a physical activity and (for those with hypertension) a dietary sodium intervention. Outcomes were collected on 389 adults with a mean age of 73.9 years over 24 months. Adherence to the "10 Keys" improved significantly in the proportion meeting goals for low-density lipoprotein cholesterol (+14%), bone mineral density testing (+11%), pneumonia vaccination (+11%), colonoscopy (+14%), and adherence to antihypertensive medication (+9%). This program resulted in significant reductions in key risk factors, increases in immunizations, and adherence to established prevention guidelines over 2 years. Further research is needed to refine the use of community health counselors for translating prevention knowledge into community settings. A major limitation of these studies is the low participation percentage.

The 10 keys to healthy aging: findings from an innovative prevention program in the community.

OBJECTIVE: To develop and evaluate a novel, comprehensive prevention program for older adults designed to assess and improve adherence to preventive health care goals. METHOD: In McKeesport, Pennsylvania, 389 men and women aged 65 and older were enrolled. We assessed adherence to 10 preventive health goals, provided education and counseling, and reevaluated after 12 months. RESULTS: At baseline, adherence varied. After 12 months, proportions of participants meeting goals were improved for several areas. Overall, improvements were seen for the proportion of participants meeting goals for low-density lipoprotein (LDL) cholesterol (+43%), blood pressure control in hypertensives (+17%), blood glucose control in diabetics (+50%), and colon cancer screening (+13%). Among those without prior vaccination, influenza vaccine increased by 25% and pneumonia vaccine by 20%. DISCUSSION: This comprehensive prevention program had short-term benefits for improving adherence to established prevention guidelines in older adults. This low-cost effective program could be disseminated nationwide.

The key to life nutrition program: results from a community-based dietary sodium reduction trial.

OBJECTIVE: Evaluation of a dietary Na reduction trial in a community setting. DESIGN: Community-based randomized trial. Ten-week nutrition intervention activities focused on lifestyle modification to decrease dietary Na intake, under the supervision of a registered dietitian. Twenty-four hour urine specimens were collected at baseline and follow-up visits to determine 24 h urinary Na excretion. SETTING: The University of Pittsburgh Center for Healthy Aging, Key to Life Nutrition Program. SUBJECTS: Hypertensive adults at least 65 years of age. RESULTS: Mean age of participants was 75 years. Twenty-four hour mean urinary Na excretion at baseline was 3174 mg/d. This reduced to 2944 mg/d (P = 0.30) and 2875 mg/d (P or=1000 ml, baseline to 12 months), mean urinary Na excretion decreased from 3220 mg/d to 2875 mg/d (P

Perceptions and beliefs about the role of physical activity and nutrition on brain health in older adults.

PURPOSE: To examine older adults' perceptions of the link between physical activity (PA) and nutrition to the maintenance of cognitive health. DESIGN AND METHODS: Forty-two focus groups (FGs) were conducted with 396 ethnically diverse (White, African American, American Indian, Chinese, Vietnamese, and Hispanic) community-dwelling older adults. FGs were audio recorded, transcribed verbatim, and coded using a constant comparison method. Responses pertaining to PA and nutrition were analyzed. RESULTS: Participants noted a positive link between both PA and dietary practices and brain health, although some participants voiced skepticism regarding diet. Walking was most frequently cited as a recommended PA, but participants did not know the recommended frequency, duration, and intensity. Limiting portion sizes; preparing foods in healthier ways; eating more fish, fruits, vegetables, low-fat foods, and chicken; and eating less red meat and chicken with the skin were associated with brain health. Multiple dietary supplements were also discussed. More racial/ethnic differences were noted for PA than for diet. IMPLICATIONS: Interventions and media campaigns may benefit from explicitly linking PA and dietary habits with brain health and helping older adults understand that cardiovascular risk factors are also dementia risk factors. Emphasizing the total diet (vs. specific nutrients) and providing clear messages regarding the frequency, duration, and intensity of recommended PA would also be useful.