Chronic disease prevention: Nutrition and behavioral neuroscience approaches

Wolf, Tovah
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Chronic disease in middle-aged and aged adults in the United States continues to be on the rise. It is estimated that 60% of adults in the USA have one chronic disease and that 40% have at least two chronic diseases. The leading causes of death and disability include heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes and chronic kidney disease. The economic burden of these diseases is estimated to be $3.3 trillion dollars in annual health care costs (CDC). It has been suggested that the key lifestyle risks for the development of chronic disease include poor nutrition, tobacco use, lack of physical activity and excessive alcohol consumption. Other risk factors include high blood pressure, diets low in fruit and vegetables and high in saturated fat and sodium.

The purpose of this dissertation is to explore nutrition and behavioral approaches to chronic disease prevention and treatment in middle-aged and aged adults by: 1) examining the relationship between insulin resistance (IR) and during a stress reactivity task, during a resting electromyography (EEG task), during a cognition task, as well as examining the differences in baseline urine cortisol levels. 2) examining the relationship between IR and functional magnetic resonance imaging (fMRI) during a stress reactivity task. 3) comparing DASH diet compliance by sex, age, race and ethnic groups among participants receiving a DASH education session at baseline and three follow-up one-on-one Dietary Approaches to Stop Hypertension (DASH) dietary counseling sessions by a Registered Dietitian Nutritionist (RDN).

The first study revealed that dysmetabolism is associated with increased emotional reactivity, predisposition toward negative affect, and specific cognitive deficits. The second study suggests that the dysmetabolism seen with insulin resistance may impact how one reacts.

in stressful situations, cognition during tasks, fluid intelligence and potentially increase depressed mood and anxiety as well. The third study identified that one’s ethnicity, age and gender my effect their adherence to DASH eating. Findings of this dissertation support the need for additional research on IR mechanism of action to be further explored at a psychological, behavioral and molecular level. In addition, findings of this dissertation may provide insight that health professionals like RDN’s who provide DASH diet counseling with a motivational interviewing component may be a useful intervention to increase DASH diet eating compliance.

DASH Diet, Diabetes, Heart Disease, Insulin Resistance