A Diet Intervention Study To Mitigate Fatigue Symptoms And To Improve Muscle And Physical Function In Older Adults With Post-Acute COVID-19 Syndrome

一项饮食干预研究，旨在减轻患有急性后 COVID-19 综合症的老年人的疲劳症状并改善肌肉和身体功能

• 批准号: 10734981
• 负责人: Galya Bigman
• 金额: $ 12.42万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734981
• 关键词: 2019-nCoV; Abate; Academia; Adherence; Adult; Aging; American; Anti-Inflammatory Agents; Attenuated; Baltimore; Biological Markers; Black Populations; COVID-19; Clinical Trials; Complex; Control Groups; Coupled; Deterioration; Diet; Dietary Fiber; Dietary Intervention; Dietitian; Disease; Dual-Energy X-Ray Absorptiometry; Education; Elderly; Equilibrium; Equipment and supply inventories; Exhibits; Fatigue; Feasibility Studies; Food; Fruit; Future; Geriatrics; Hand Strength; Health; Healthy Eating; Hispanic Populations; Hour; Individual; Infection; Inflammation; Inflammatory; Intake; Interleukin-6; Intervention; Intervention Studies; Leadership; Life; Long COVID; Maryland; Measures; Mentored Research Scientist Development Award; Mentors; Mentorship; Muscle; Muscle Weakness; Muscle function; Not Hispanic or Latino; Nutrient; Nutritional; Nutritional Study; Omega-3 Fatty Acids; Participant; Pathology; Physical Function; Physical Performance; Plants; Proteins; Public Health; Randomized; Randomized, Controlled Trials; Recommendation; Recovery; Research Personnel; Sampling; Seafood; Structure; Symptoms; Systemic disease; Testing; Thinness; Training; Translating; Underrepresented Minority; Universities; Vegetables; Vitamin D; Walking; Whey Protein; Woman; aged; attentional control; bean; career; common symptom; comparison control; coronavirus disease; dietary; dietary guidelines; eligible participant; ethnic minority; experience; group intervention; improved; indexing; men; multidisciplinary; muscle form; nutrition; pandemic disease; preservation; prevent; racial minority; skills; statistics

Nearly one in five American adults who survived the coronavirus disease (COVID-19) are still suffering from post-acute COVID-19 syndrome (PACS),42 a complex systemic disease manifests in fatigue and muscle weakness that substantially limits one or more major life activities.35-41,92 For older adults, having PACS coupled with an inadequate diet may compound their health deterioration and hasten their physical function decline. 43- 44 Nutritional studies demonstrate that a whole diet comprises foods high in anti-inflammatory activities, e.g., whole grains, fruits, vegetables, and omega-3 fatty acid-rich foods substantially reduce disease-related fatigue, likely by reducing inflammation.49-50 U.S. adults who followed the Dietary Guidelines for Americans (DGA) were more likely to preserve muscle grip strength than those who did not.17 Since fatigue and physical function are interrelated, a ‘Whole-Diet Approach’56,61,62 aligned with the DGA60 with a focus on nutrients high anti- inflammatory activities may be an effective strategy to ameliorate recovery from PACS in older adults. This project proposes to examine, in a 16-week randomized-controlled dietary intervention, the effect of the ‘Whole- Diet Approach’ on mitigating symptoms of PACS related to nutrition, e.g., fatigue and muscle weakness and will explore the underlying mechanisms via biomarkers. The sample will comprise men and women aged 50 years or older with PACS, including underrepresented minorities (50% Non-Hispanic-Blacks). At baseline, N=56 eligible participants will be randomized to either: 1) a dietary intervention following the new DGA with a focus on nutrients high in anti-inflammatory activities via foods and or supplements (e.g., vitamin D, omega-3, and whey); or 2) attention control. Aim 1. In a 16-week, randomized-controlled trial, we will examine the effect of the Whole-Diet Approach (WDA) on the Healthy Eating Index (HEI) and fatigue compared to attention control in adults with PACS. Aim 2. To assess the impact of the dietary intervention following the WDA on muscle mass, strength, and physical function compared to attention control in adults with PACS. Aim 3. To explore the mechanism of decreased fatigue and improved muscle and physical function by examining changes in nutritional and inflammatory biomarkers from baseline to 16 weeks. The proposed dietary intervention to attenuate PACS in older adults is a feasible study relevant to public health. The University of Maryland Baltimore provides a unique opportunity to be trained by a multidisciplinary team of mentors who are experts in clinical trials, muscle, physical function, nutrition, geriatrics, statistics, and COVID-19 to conduct this study successfully. The findings can be translated into a new strategy to counteract fatigue and physical function decline following PACS. The K01 Award will provide me with the training I need to become an independent investigator in dietary trials to advance the field of nutrition and aging while gaining the skills and experience in leadership and mentorship to launch my career in academia.

近五分之一的冠状病毒病 (COVID-19) 幸存者仍然患有 急性 COVID-19 综合征 (PACS)，42 一种复杂的全身性疾病，表现为疲劳和肌肉 严重限制一项或多项主要生活活动的弱点。35-41,92 对于老年人，结合 PACS 饮食不足可能会加剧他们的健康恶化并加速他们的身体机能下降43-。 44 营养研究表明，整体饮食包含抗炎活性高的食物，例如， 全谷物、水果、蔬菜和富含 omega-3 脂肪酸的食物可显着减少与疾病相关的疲劳， 可能是通过减少炎症来实现的。49-50 名遵循美国人膳食指南 (DGA) 的美国成年人 比那些没有保持肌肉握力的人更有可能保持肌肉握力。 17 由于疲劳和身体机能 相互关联的，“全饮食方法”56,61,62 与 DGA60 一致，重点关注营养物质高抗 炎症活动可能是改善老年人 PACS 恢复的有效策略。 项目建议在为期 16 周的随机对照饮食干预中检查“整体饮食”的效果 “饮食方法”可减轻与营养相关的 PACS 症状，例如疲劳和肌肉无力，以及 将通过生物标志物探索潜在机制。样本将包括 50 岁的男性和女性。 岁或以上的 PACS 患者，包括代表性不足的少数群体（基线时 50% 的非西班牙裔黑人）。 N=56 名符合资格的参与者将被随机分配到以下任一组：1) 新 DGA 后的饮食干预 通过食物和/或补充剂关注具有高抗炎活性的营养素（例如维生素 D、omega-3、 和乳清）；或2）注意力控制。 目标 1. 在一项为期 16 周的随机对照试验中，我们将检验全饮食方法的效果 (WDA) 对健康饮食指数 (HEI) 和疲劳与 PACS 成人注意力控制的比较。 目标 2. 评估 WDA 后的饮食干预对肌肉质量、力量和肌肉质量的影响 患有 PACS 的成人的身体功能与注意力控制的比较。 目标 3. 探索通过以下方法减轻疲劳并改善肌肉和身体功能的机制 检查从基线到 16 周营养和炎症生物标志物的变化。 拟议的减轻老年人 PACS 的饮食干预是一项与公众相关的可行研究 马里兰大学巴尔的摩分校提供了接受多学科培训的独特机会。 导师团队是临床试验、肌肉、身体机能、营养、老年病学、统计学和 成功开展这项研究的 COVID-19 研究结果可以转化为应对新策略。 PACS 后的疲劳和身体功能下降 K01 奖将为我提供所需的培训。 成为饮食试验的独立研究者，以推进营养和衰老领域的发展，同时获得 在领导和指导方面的技能和经验，以开启我在学术界的职业生涯。