Director's Cut
Dear Friends,

As we celebrate National Nutrition Month, I am reminded of the many issues that impact nutrition for older adults. Food has such an important influence on healthy aging, and too often, poor food choices or food insecurity affects people's ability to age well. Healthy food choices can impact health and overall feeling of wellness, and help to prevent or manage chronic diseases such as obesity, diabetes, arthritis, and heart disease. Culturally sensitive community education can help people make better decisions about the food they choose to eat.

5.5 million older adults in the United States face food insecurity. Food insecurity includes inadequate financial resources to buy healthy food, poor mobility restricting one's ability to get to a market, and living in "food deserts" - geographical areas with limited supplies of healthy foods. Healthcare providers and legislators need to work together to both educate the public and raise awareness to issues impacting nutrition in older adults. Programs such as Meals on Wheels and Senior Center Breakfast/Lunch programs need to be supported and widely available. Good nutrition not only leads to healthier aging; it also reduces the burden frail and malnourished older adults place on the healthcare system. 

We are delighted to have researchers from Rockefeller University as this month's guest contributors to talk about nutrition and aging with a focus on the DASH diet. Rockefeller University is well known for its Nobel Prize winners and its cutting edge science. 

We also take this opportunity to remind all our readers to wash their hands and stay safe as we deal with the challenges of the coronavirus. 

Best Wishes,
Tara A. Cortes, PhD, RN, FAAN

Dietary Approaches to Stopping Hypertension

Andrea Ronning, RDN, MA
Director of Bionutrition
Rockefeller University Hospital

Calla Tse, MS
Dietitian Intern
Lehman College, CUNY

Julie Wilcox, MS
The Julie Wilcox Method

Diet fads come and go, but the evidenced-based plan known as Dietary Approaches to Stopping Hypertension or the DASH eating plan is still prescribed to lower or control high blood pressure. The Administration on Community Living (ACL) of the United States Department of Health and Human Services (HHS) supports a grant studying the outcome on blood pressure after incorporating the DASH eating plan into the congregate meal program at two sites of a New York City Senior Center network. 

The DASH eating plan was implemented at two of the senior centers after a pilot study found that up to 84% demonstrated uncontrolled hypertension. This study also found that many older adults had two or more comorbidities (diabetes, cardiovascular diseases, renal disease), rarely consumed more than five servings of fruits and vegetables, and have concerns about food insecurity. Eating plans are modifiable by behavioral changes. These behavioral changes in eating plans influence many health outcomes. The research investigators believed that implementing the DASH eating plan at the senior centers would have a positive effect on the findings from the pilot study.

What is the DASH eating plan all about? It is a plant-based eating plan that is rich in fruits, vegetables, whole grains, nuts, legumes, and seeds while being lower in sugar and fat, especially in animal protein, dairy products, and visible fats.

The DASH diet consists of:

Grains: 6 or more daily servings
Fruits and Vegetables: 8 daily servings 
Low-fat or fat-free products: 2-3 daily servings
Protein Foods: 2 daily servings 
Nuts, legumes, and seeds: 4-5 weekly servings  
Limits sugar and fat

While at first glance, it might appear overwhelming to structure a daily eating pattern because of the volume and cost of the recommended foods, meeting with a Registered Dietitian-Nutritionist will show how this is achievable. An example of a modifiable behavior for breakfast is to eliminate simple sugary foods like syrup with pancakes and include whole-wheat pancakes topped with a medley of berries that have a sprinkle of cinnamon and dash of vanilla extract added. 

Two major NIH studies found that eating the DASH plan for 14 days lowered systolic blood pressure in those who were hypertensive and normotensive. Other studies have shown that a decrease in 1-5 mm Hg in blood pressure has a positive impact on cardiovascular disease. The exact mechanism of why the DASH eating plan works to lower blood pressure is not yet conclusive. A thought is that the increased potassium intake and lower sodium intake causes an increase in the excretion of sodium and water. Although the mechanism is not clear, it is a no-brainer that adopting the DASH eating plan will have a positive impact on the overall health of older adults.  
Spotlight on HIGN

Tina Sadarangani, PhD, RN, ANP-BC, GNP-BC
Assistant Professor
New York University Rory Meyers College of Nursing

Tina Sadarangani is an Assistant Professor, adult/gerontologic primary care nurse practitioner, and a leading researcher focused on outcomes associated with adult day services use among ethnically diverse older adults. Her research brought to light the disproportionately high prevalence of malnutrition among adult day services users, including high rates of  food insecurity among racial minorities . Dr. Sadarangani's work has also focused on research, policy, and advocacy related to the Child and Adult Care Food Program. This program, which sets requirements around food served in adult day centers, is not adequately meeting the  nutritional needs of frail older adults , particularly those living with dementia. Dr. Sadarangani's work with organizations such as  Defeat Malnutrition Today , a coalition of over 100 organizations, has informed recent reports by the  Government Accountability Office  highlighting the need to reevaluate and strengthen nutrition programs serving older adults, like the Child and Adult Care Food program. Additionally, she has led an interdisciplinary call by dietitians and physicians to enrich meal programs, including the Older Americans Act congregate meal program and home-delivered meals programs, to better meet the needs of an increasingly  ethnically diverse aging population .  


Deadline for Applications: April 15th

The Health and Aging Policy Fellows Program aims to create a cadre of leaders who will serve as change agents in health and aging policy to ultimately improve the health care of older adults. The year-long fellowship offers a rich and unique training and enrichment program that is focused on current policy issues, communication skills development, and professional networking opportunities to provide Fellows with the experience and skills necessary to help affect policy.

The program has a broad interdisciplinary focus, and Fellowship cohorts have included physicians, nurses, social workers, psychologists, food scientists, city planners, healthcare administrators, epidemiologists, economists, and lawyers from academic and practice settings, spanning career stages from newly minted PhDs to senior professors and community leaders.

For more information visit Health and Aging Policy Fellows