# Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH OK)

> **NIH NIH R01** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2020 · $489,361

## Abstract

Project Summary / Abstract 
The Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH-OK)
Study uses a cross-cutting research design that is widely-applicable to the prevention and treatment of many
chronic co-morbidities in HIV disease. It uses a community-based participatory orientation to maximize inclusion
of minorities and other underrepresented populations, which also ensures study findings will be relevant,
actionable, and yield the greatest potential for reducing health disparities. Broadly, NOURISH-OK will elucidate
nutritional and non-nutritional behavioral risk pathways linking food insecurity to insulin resistance among low-
income people living with HIV. Its primary focus will be rigorous evaluation and manipulation of dietary intake as
an influential pathway, which is complemented by secondary investigation of additional biological pathways,
including chronic inflammation and microbiome. The study will be conducted in Oklahoma, and include HIV-
positive individuals living in urban and rural communities. It is comprised of three aims. First, the research team
will test and refine a conceptual integrated framework of food insecurity and insulin resistance to identify
significant structural, social, behavioral, and biological pathways as candidate intervention points. This aim will
be accomplished using a cross-sectional survey (n=500) and a one-month observational sub-study from the
main study sample (n=100) to collect intensive measures of dietary intake and gut microbiome samples. Data
analysis will adjust for measurement error in dietary intake using replicate recalls from the sub-study. Structural
equation modeling will be used to test the study’s overall conceptual multi-level framework of food insecurity and
insulin resistance. Second, the research team will then adapt a home-delivered grocery and cooking self-care
NOURISH-OK intervention to address key nutrition disparities and other health risk behaviors identified as
significant path contributors to insulin resistance among people living with HIV. This adaptation will be informed
by findings from the first aim, and further refined and finalized through a series of interviews and focus groups
with people living with HIV who are food insecure (n=56 qualitative study subjects). Third, the research team will
implement the 12-week NOURISH-OK intervention and assess it for feasibility, acceptability, and preliminary
impact using a randomized wait-list control design (n=270). This study will use a simple randomized wait-list
control trial design with stratification by geography (urban/rural) and further stratification in the urban group by
low and very low food security status. Primary study outcomes include insulin resistance, along with multiple
secondary outcomes that are also strongly relevant to the mission of NIDDK. These secondary outcomes include
dietary intake and nutritional status, chronic inflammation, health risk behaviors, incl...

## Key facts

- **NIH application ID:** 10132533
- **Project number:** 1R01DK127464-01
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Marianna Wetherill
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $489,361
- **Award type:** 1
- **Project period:** 2020-09-17 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10132533

## Citation

> US National Institutes of Health, RePORTER application 10132533, Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH OK) (1R01DK127464-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10132533. Licensed CC0.

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