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

在冠状病毒病(新冠肺炎)中幸存下来的美国成年人中，近五分之一仍在遭受 急性新冠肺炎综合征是一种以疲劳和肌肉为主要表现的复杂的全身性疾病 在很大程度上限制了一项或多项主要生活活动的弱点。35-41，92老年人，有PAC 饮食不足可能会加剧他们的健康恶化，加速他们的身体机能下降。43- 44营养学研究表明，完整的饮食包含高抗炎活性的食物，例如， 全谷物、水果、蔬菜和富含omega-3脂肪酸的食物大大减少了与疾病相关的疲劳， 可能通过减少炎症。49-50名遵循美国人饮食指南(DGA)的美国成年人是 比不保持肌肉握力的人更有可能保持肌肉握力。17因为疲劳和身体机能 相互关联的，与DGA60保持一致的完整饮食方法56，61，62，重点放在营养成分高抗- 炎症活动可能是改善老年人PACS康复的有效策略。这 该项目建议，在为期16周的随机对照饮食干预中，检查‘整体- 饮食方法“缓解PACS与营养有关的症状，如疲劳和肌肉无力 将通过生物标记物探索潜在的机制。样本将包括50岁的男性和女性 年或以上的PACS患者，包括代表不足的少数族裔(50%非西班牙裔黑人)。在基线上， N=56名符合条件的参与者将被随机分为：1)在新的DGA之后进行饮食干预 通过食物和/或补充剂(例如，维生素D、omega-3、 和乳清)；或2)注意力控制。 目的1.在一项为期16周的随机对照试验中，我们将检验全食法的效果 (WDA)对健康饮食指数(HEI)和疲劳与注意力控制的比较。 目的2.评估WDA后饮食干预对肌肉质量、力量和 成人PACS患者的身体功能与注意力控制的比较。 目的3.探讨补肾益气汤减轻疲劳、改善肌肉和身体功能的机制。 检查从基线到16周的营养和炎症生物标志物的变化。 建议的饮食干预以减轻老年人的PACS是一项与公众相关的可行研究 健康。马里兰大学巴尔的摩分校提供了一个独特的机会，接受多学科的培训 由临床试验、肌肉、身体机能、营养学、老年病学、统计学和 新冠肺炎成功地进行了这项研究。这些发现可以转化为一种新的战略来抵消 PACS后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员，推动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让我在学术界开始了我的职业生涯。

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.