The P30 Nutrition, Lifestyles, and Behaviors (NLB) Core is directed by Jessica Alvarez, PhD, RD and Ryan Harris, PhD.

The overall goal of the NLB Core is to accelerate translational, bio-behavioral research on nutrition, physical activity, body composition, and sleep outcomes in persons with cystic fibrosis (PwCF) during this new era of highly effective modulator therapy (HEMT). The NLB is committed to understanding the impact of health disparities and will fill a critical knowledge gap by increasing awareness through education and dissemination and supporting the integration of important lifestyle and behavioral measurements and outcomes into clinical investigations of PwCF across the lifespan.

To accomplish our core goal, we have 3 specific aims:

• Specific Aim 1. To provide training and project-specific consultation and support (assessment, collection, and interpretation) of nutrition, exercise, sleep, and other lifestyle and behavior outcomes for studies in PwCF across the lifespan within the post-HEMT era. The NLB Core is led by a highly recognized team of experts to facilitate routine collection of these lifestyle and behavioral outcomes in children and adults with CF living in Georgia. We provide training and guidance on key methodologies and offer Center investigators assistance with creating rigorous experimental designs and in data interpretation and dissemination.  
• Specific Aim 2. To enhance the utilization and integration of state-of-the-art methodologies related to nutrition, exercise physiology, sleep, and related lifestyle behaviors into clinical and translational studies in PwCF across the lifespan within the post-HEMT era. Key services provided by the NLB Core include comprehensive evaluation of exercise tolerance and physical activity (cardiopulmonary exercise testing, strength testing, actigraphy), nutrition (dietary intake analysis, body composition, nutritional status, and energy expenditure) in pediatric and adult persons living with CF. We also offer a comprehensive battery of specific validated behavioral assessments (sleep, quality of life). We will facilitate integration of NLB outcomes into study protocols whether conducted in the inpatient or outpatient setting, or even in a home-based setting.  
• Specific Aim 3. To incorporate extensive phenotyping of NLB outcomes into the longitudinal Georgia CF Data Warehouse with a focus on addressing health inequities.  During the current award, which began in late 2020, collaborations between Emory and Augusta University have resulted in 102 adults and children with CF being enrolled into our extensive Longitudinal Phenotyping Platform associated with the Georgia CF Data Warehouse that has captured numerous NLB outcomes with linked bio-specimens. During the next period, we will: 1) increase our underrepresented participant numbers and 2) extend our follow-up period beyond 1 year, which will allow us to develop the largest, unique database of bio-behavioral/nutritional outcomes in CF that can be utilized to support future studies and attract additional collaborations with investigators around the world.  

Summary of NLB Services