Issue Brief: Indiana’s Health Professions Workforce Shortages and Mal-distribution

Workforce shortages have been documented across a broad spectrum of health profession disciplines in Indiana. Currently, federal, state and local programs exist to recruit and retain health professionals in our state; however, these programs have had minimal impact on the underlying factors that contribute to the problem. Additional steps must be taken to expand the supply of health professionals to adequately meet the growing need for health care services among Indiana residents. While many health professional shortages exist, this brief will focus on the primary care physicians and nurses needed to provide medical homes for residents of our state

Rationale and design of feeding America's bravest: Mediterranean diet-based intervention to change firefighters' eating habits and improve cardiovascular risk profiles

Among US firefighters, cardiovascular disease is the leading cause of on-duty death. Poor diet contributes to this burden, but effective strategies to encourage healthy eating in the fire service are not established. “Feeding America's Bravest” motivates firefighters and their families to modify their food culture and reduce cardiometabolic risk profiles by adopting Mediterranean diet principles. Feeding America's Bravest is a cluster-randomized, controlled trial within the 44 stations of the Indianapolis Fire Department, including about 1000 firefighters. It compares a Mediterranean Diet Nutritional Intervention (group 1) vs. usual care (group 2) for 12 months; followed by 12 months of self-sustained continuation phase in the group 1 and cross-over to Mediterranean Diet Nutritional Intervention in group 2. Group 2 will receive the MDNI for 6 months to test the efficacy of a shorter intervention followed by 6 months of self-sustained phase. The intervention includes behavioral and environmental components. The primary outcome is 12-month change in Mediterranean diet score comparing group 1 vs. group 2; we will also assess 12- and 24-month change in group 1, and 6- and 12-month change in group 2, from baseline. Secondary outcomes are changes in body weight, body composition and other cardiometabolic risk markers; and correlations between self-reported dietary habits and biomarkers of dietary adherence. This innovative trial tests a novel worksite approach to introduce Mediterranean diet among US firefighters, informing recommendations for the US fire service and potentially other similar workforces

Effect of a Nutrition Intervention on Mediterranean Diet Adherence Among Firefighters: A Cluster Randomized Clinical Trial

US firefighters are a working population at risk of chronic diseases, including obesity, cardiovascular disease, and cancer. This risk may be mitigated by a healthy diet

Emerging Aspects of Food and Nutrition on Gut Microbiota

The human gastrointestinal tract contains a highly complex ecosystem that harbors various microorganisms, which together create a unique environment within each individual. There is growing awareness that dietary habits are one of the essential factors contributing to the microbial diversity and community configuration that ultimately affects human health. From an evolutionary perspective, human dietary history can be viewed as a central factor in the selection of the gut microbial community and stabilization of the mutualistic host-microbial interaction, that together drive host phenotype. Herein, current knowledge concerning the influence of major dietary macrostructure and individual food ingredients is presented. This knowledge will provide perspectives for personalized gut microbiota management and, ultimately, movement toward an era of personalized nutrition and medicine