Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
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- All Subjects: Health Sciences
- Creators: Vega-Lopez, Sonia
Description
Background. Effects of lifestyle interventions on early biomarkers of oxidative stress and CVD risk in youth with prediabetes are unknown. Objective. To evaluate the effects of a lifestyle intervention to prevent type 2 diabetes among obese prediabetic Latino adolescents on oxidized lipoproteins. Design: In a quasi-experimental design, 35 adolescents (51.4% male, age 15.5(1.0) y, body mass index (BMI) percentile 98.5(1.2), and glucose 2 hours after an oral glucose tolerance test-OGTT 141.2(12.2) mg/dL) participated in a 12-week intervention that included weekly exercise (three 60 min-sessions) and nutrition education (one 60 min-session). Outcomes measured at baseline and post-intervention were: fasting oxidized LDL and oxidized HDL (oxLDL and oxHDL) as oxidative stress variables; dietary intake of fresh fruit and vegetable (F&V) and fitness (VO2max) as behavioral variables; weight, BMI, body fat, and waist circumference as anthropometric variables; fasting glucose and insulin, 2hour glucose and insulin after an OGTT, insulin resistance (HOMA-IR), and lipid panel (triglycerides, total cholesterol, VLDL-c, LDL-c, HDL-c, and Non-HDL) as cardiometabolic variables. Results. Comparing baseline to post-intervention, significant decreases in oxLDL concentration were shown (51.0(14.0) and 48.7(12.8) U/L, p=0.022); however, the intervention did not decrease oxHDL (395.2(94.6) and 416.1(98.4) ng/mL, p=0.944). F&V dietary intake (116.4(97.0) and 165.8(91.0) g/d, p=0.025) and VO2max (29.7(5.0) and 31.6(4.7) ml*kg-1*min-1, p<0.001) significantly increased. Within-subjects correlations between changes in F&V intake and oxidized lipoproteins, adjusted for VO2max changes, were non-significant (R=-0.15, p=0.52 for oxLDL; R=0.22, p=0.25 for oxHDL). Anthropometric variables were significantly reduced (weight -1.3% p=0.042; BMI -2.2% and BMI percentile -0.4%, p=0.001; body fat -6.6% and waist circumference -1.8%, p=0.025). Cardiometabolic variables significantly improved, including reductions in glucose 2hour (-19.3% p<0.001), fasting insulin (-12.9% p=0.008), insulin 2hour (-53.5% p<0.001), and HOMA-IR (-12.5% p=0.015), with 23 participants (66%) that reverted toward a normal glucose tolerance status. Most lipid panel significantly changed (triglycerides -10.2% p=0.032; total cholesterol -5.4% p=0.002; VLDL-c -10.4% p=0.029; HDL-c -3.2% p=0.022; and Non-HDL -5.5% p=0.0007). Conclusion. The intervention resulted in differential effects on oxidized lipoproteins and significant improvements in behavioral, anthropometric and cardiometabolic variables, reducing the high metabolic risk of obese prediabetic kids.
ContributorsRenteria Mexia, Ana Maria (Author) / Shaibi, Gabriel Q (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Swan, Pamela D (Committee member) / Olson, Micah L (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2017
Description
Background: Hispanic women are at high risk for Type 2 Diabetes (T2D), in part due to their high prevalence of obesity, which may influence the development of insulin resistance and disease onset. Unhealthy eating contributes to T2D risk. Dietary patterns are the combination of total foods and beverages among individual’s over time, but there is limited information regarding its role on T2D risk factors among Hispanic women. Objective: To identify a posteriori dietary patterns and their associations with diabetes risk factors (age, BMI, abdominal obesity, elevated fasting blood glucose, and hemoglobin A1c) among overweight/obese Hispanic women. Design: Cross-sectional dietary data were collected among 191 women with or at risk for T2D using the Southwestern Food Frequency Questionnaire capturing the prior three months of intake. Dietary patterns were derived using exploratory factor analysis. Regression scores were used to explore associations between dietary patterns and diabetes risk factors. Results: The patterns derived were: 1) “sugar and fat-laden”, with high loads of sweets, drinks, pastries, and fats; 2) “plant foods and fish”, with high loads of vegetables, fruits, fish, and beans; 3) “soups and starchy dishes”, with high loads of soups, starchy foods, and mixed dishes; 4) “meats and snacks”, with high loads of red meat, salty snacks, and condiments; 5) “beans and grains”, with high loads of beans and seeds, whole-wheat and refined grain foods, fish, and alcohol; and 6) “eggs and dairy”, with high loads of eggs, dairy, and fats. The “sugar and fat-laden” and “meats and snacks” patterns were negatively associated with age (r= -0.230, p= 0.001 and r= -0.298, p<0.001, respectively). Scores for “plant foods and fish” were associated with fasting blood glucose (r= 0.152, p= 0.037). There were no other statistically significant relationships between the dietary patterns and risk factors for T2D. Conclusions: A variety of patterns with healthy and unhealthy traits among Hispanic women were observed. Being younger may play an important role in adhering to a dietary pattern rich in sugary and high-fat foods and highlights the importance of assessing dietary patterns among young women to early identify dietary traits detrimental for their health.
ContributorsArias-Gastelum, Mayra (Author) / Vega-Lopez, Sonia (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Whisner, Corrie (Committee member) / Bruening, Meg (Committee member) / Hooker, Steven (Committee member) / Arizona State University (Publisher)
Created2018
Description
Objective: Parents play a critical role in their child's diets, yet there is lack of research in
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
ContributorsEliason, Jessica (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: Despite the reported improvements in glucose regulation associated with flaxseeds (Linum usitatissimum) few clinical trials have been conducted in diabetic participants. Objective: To evaluate the efficacy of ground flaxseed consumption at attenuating hyperglycemia, dyslipidemia, inflammation, and oxidative stress as compared to a control in adults with non-insulin dependent type 2 diabetes (T2D). Design: In a randomized parallel arm controlled efficacy trial, participants were asked to consume either 28 g/d ground flaxseed or the fiber-matched control (9 g/d ground psyllium husk) for 8 weeks. The study included 17 adults (9 male, 8 females; 46±14 y; BMI: 31.4±5.7 kg/m2) with a diagnosis of T2D ≥ 6 months. Main outcomes measured included: glycemic control (HbA1c, fasting plasma glucose, fasting serum insulin, and HOMA-IR), lipid profile (total cholesterol, LDL-C, HDL-C, total triglycerides, and calculated VLDL-C), markers of inflammation and oxidative stress (TNF-alpha, TBARS, and NOx), and dietary intake (energy, total fat, total fiber, sodium). Absolute net change for measured variables (week 8 values minus baseline values) were compared using Mann-Whitney U non-parametric tests, significance was determined at p ≤ 0.05. Results: There were no significant changes between groups from baseline to week 8 in any outcome measure of nutrient intake, body composition, glucose control, or lipid concentrations. There was a modest decrease in TNF-alpha in the flaxseed group as compared to the control (p = 0.06) as well as a mild decrease in TBARS in the flaxseed as compared to the control group (p = 0.083), though neither were significant. Conclusions: The current study did not detect a measurable association between 28 g/d flaxseed consumption for 8 weeks in T2D participants and improvements in glycemic control or lipid profiles. There was a modest, albeit insignificant, decrease in markers of inflammation and oxidative stress in the flaxseed group as compared to the control, which warrants further study.
ContributorsRicklefs, Kristin (Author) / Sweazea, Karen L (Thesis advisor) / Johnston, Carol S (Committee member) / Gaesser, Glenn (Committee member) / Vega-Lopez, Sonia (Committee member) / Gonzales, Rayna (Committee member) / Arizona State University (Publisher)
Created2015
Description
It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project one identified validity evidence for the new MyWellness Key accelerometer in sixteen adults. The MyWellness Key demonstrated acceptable validity evidence when compared to a criterion accelerometer during graded treadmill walking and in free-living settings. This supports the use of the MyWellness Key accelerometer to measure physical activity. Project two evaluated validity (study 1) and test-retest reliability evidence (study 2) of the Global Physical Activity Questionnaire (GPAQ) in a two part study. The GPAQ was compared to direct and indirect criterion measures including object and subjective physical activity instruments. These data provided preliminary validity and reliability evidence for the GPAQ that support its use to assess physical activity. Project three investigated the optimal h.d-1 of accelerometer wear time needed to assess daily physical activity. Using a semi-simulation approach, data from 124 participants were used to compare 10-13 h.d-1 to the criterion 14 h.d-1. This study suggested that a minimum accelerometer wear time of 13 h.d-1 is needed to provide a valid measure of daily physical activity. Project four evaluated validity and reliability evidence of a novel method (Movement and Activity in Physical Space [MAPS] score) that combines accelerometer and GPS data to assess person-environment interactions. Seventy-five healthy adults wore an accelerometer and GPS receiver for three days to provide MAPS scores. This study provided evidence for use of a MAPS score for future research and clinical use. Project five used accelerometer data from 1,000 participants from the 2005-2006 National Health and Nutrition Examination Study. A semi-simulation approach was used to assess the effect of accelerometer wear time (10-14 h.d-1) on physical activity data. These data showed wearing for 12 h.d-1 or less may underestimate time spent in various intensities of physical activity.
ContributorsHerrmann, Stephen (Author) / Ainsworth, Barbara (Thesis advisor) / Gaesser, Glenn (Committee member) / Der Ananian, Cheryl (Committee member) / Kang, Minsoo (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2011
Description
Latino youth are disproportionately impacted by obesity, prediabetes and type 2 diabetes (T2D). Pediatric obesity is characterized by abnormal increases in pro-inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) and reductions in anti-inflammatory markers, high molecular weight adiponectin (HMW Adpn) and interleukin-10 (IL-10). Interleukin-1 receptor antagonist (IL-1ra) is an anti-inflammatory that is positively associated with obesity. IL-6, TNF-α, MCP-1 and IL-1ra have been associated with reduced insulin sensitivity and β-cell dysfunction, two central pathophysiologic mediators of glucose intolerance, while HMW Adpn and IL-10 have been associated with increased insulin sensitivity and β-cell function. The United States Diabetes Prevention Program (DPP) supported lifestyle intervention as the cornerstone approach for preventing T2D among adults with prediabetes, yet no studies to date have assessed the efficacy of an adapted DPP among Latino youth with prediabetes. In this dissertation, three studies were conducted. The first cross-sectional study among Latino youth with prediabetes and obesity (n=65) demonstrated that MCP-1 (β=-0.001, p=0.027; β=0.03, p=0.033), HMW Adpn (β=0.2, p<0.001; β=-2.2, p=0.018), and IL-1ra (β=-0.03, p=0.006; β=0.09, p=0.009) significantly predicted insulin sensitivity (measured by whole body insulin sensitivity index, WBISI) and glucose tolerance (measured by 2-hr glucose concentrations from an oral glucose tolerance test), respectively. Only HMW Adpn significantly predicted β-cell function, measured by oral disposition index, or oDI (β=0.6, p<0.001). The second study was a randomized control trial that demonstrated the efficacy of lifestyle intervention (INT, n=79) for improving oDI among Latino youth with prediabetes and obesity, compared to a usual care control (UCC, n=38) group. No differences were found for changes in WBISI (Δ0.1, p=0.899) or 2-hr glucose (Δ-7.2, p=0.260) between groups. The third study was a secondary analysis (INT n=46, UCC n=29) that demonstrated no significant effects on IL-6, TNF-α, MCP-1, HMW Adpn, IL-10, or IL-1ra (all interactions, p>0.05).
ContributorsPena, Armando (Author) / Shaibi, Gabriel Q. (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Sears, Dorothy D (Committee member) / Ayers, Stephanie L (Committee member) / Olson, Micah L (Committee member) / Arizona State University (Publisher)
Created2022
Description
Through three investigations, this dissertation examined properties of the family and early care and education center (ECEC) environments related to preschool-aged children’s cardiovascular fitness (CVF) and gross locomotor skills (GLS). Investigation one used a systematic review and meta-analysis to synthesize the effectiveness of school-based interventions at improving CVF, in preschool-aged children. For investigations two and three product- and process-based measures of GLS were collected from children in ECECs (n=16), using the progressive aerobic cardiovascular endurance run (PACER; n=144) and the CHAMPS motor skill protocol (CMSP; n=91), respectively. Investigation two and three examined family factors and ECEC factors for associations with measures of GLS, respectively.
Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
ContributorsSzeszulski, Jacob (Author) / Lee, Rebecca E (Thesis advisor) / Buman, Matthew P (Committee member) / Hooker, Steven P (Committee member) / Vega-Lopez, Sonia (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child physical activity levels, yet these efforts have not yielded consistent results. The purpose of this study was to assess the preliminary effects of a community-based intervention on light physical activity and MVPA among 6-11 year old children. Methods: The present study was part of a larger study called Athletes for Life [AFL], a family-based, nutrition-education and physical activity intervention. The present study focused on physical activity data from the first completed cohort of participants (n=29). This study was a randomized control trial in which participating children were randomized into a control (n=14) or intervention (n=15) group. Participants wore accelerometers at two time points. Intervention strategies were incorporated to increase child habitual physical activity. Analyses of covariance were performed to test for post 12-week differences between both groups on the average minutes of light physical activity and MVPA minutes per day.
Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.
Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.
Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.
Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.
ContributorsQuezada, Blanca (Author) / Crespo, Noe (Thesis advisor) / Huberty, Jennifer (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2015
Description
This project was designed to evaluate a nutrition educational tool designated to educate high school dancers about the importance of nutrition through collecting feedback from dancers during focus group discussions. The nutrition educational tool was created to be easy to read and understand, while still informing on important topics such as water intake, sleep, food groups, diets, and meal prepping. After giving a presentation of the tool to a group of high school dancers, eleven students from a high school dance team completed a survey answering questions about the tool and then participated in a group discussion that asked guided questions about their perceptions of the material presented and their suggestions for edits. Results showed that overall, the participants found this tool useful, but suggested improvements include missing information on the sleep requirement section, more suggestions for dietary restrictions, and additional details about foods and meal prepping. Overall, students found this tool useful for themselves, but results were mixed about if they would use this information in the future or share it with others. Nutrition is an important topic for high school athletes, especially dancers, and should be taught in order to keep dancers healthy.
ContributorsSandnas, Courtney (Author) / Vega-Lopez, Sonia (Thesis director) / Grant, Shauna (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-12