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- Creators: Arizona State University
- Member of: ASU Electronic Theses and Dissertations
This feasibility study explored the use of an evolutionary mismatch narrative in nutritional education intervention aiming to reduce ultra-processed foods in the diets of veterans with type 2 diabetes and improve diabetic outcomes. Ultra-processed foods are foods that are primarily manufactured through industrial processes. These foods are high in calories but low in nutritional content. Diets high in these foods have been linked to increased health risks. One of the major health risks is type 2 diabetes. Type 2 diabetes is a chronic disease that is developed when cells become unable to properly utilize insulin. Over time this may lead to additional health conditions such as nerve damage, cardiovascular disease, and renal disease. Evolutionary mismatch narrative nutritional intervention offers a different approach to nutritional education to help reduce ultra-processed foods in diets. This study was a randomized controlled feasibility study at the Phoenix VA. Eleven participants were enrolled and randomly selected to be given either an evolutionary mismatch narrative education intervention or general nutritional education about ultra-processed foods. 24-hour diet recalls and blood chemistry were collected and analyzed. Blood chemistry provided diabetes related measurements which included glucose, HbA1c, insulin, HOMA-IR, and C-reactive protein. Statistically significant findings in this study included percentage of ultra-processed foods decreasing for both control and experimental groups from week 0 to week 4 (p=0.014), and C-reactive protein levels between the control and experimental groups (p=0.042). However, baseline C-reactive protein concentrations were lower in the experimental group such that normalizing for group differences at baseline revealed no significant difference in C-reactive protein change between interventions (p = 1.000). There were no other statistically significant values regarding diabetes related measurements. The results from this study suggest that nutritional education in general may help decrease ultra-processed food consumption.
cognitive-communication deficits. In bilinguals, there are unique cognitive demands required to control and process two languages effectively. Surprisingly, little is known about the impact of mTBI on EF, communication, and language control in bilinguals. Therefore, the aim of this study was to examine the cognitive-communication abilities in bilinguals with a history of mTBI, identify any language control impairments, and explore the relationship between these language control impairments and domain-general cognitive control abilities. To this end, three-hundred and twenty-seven monolingual and bilingual college students with and without mTBI history participated in two experiments. In these experiments, EF, communication, and language control were examined using experimental and clinical tasks as well as self-rating scales. In Experiment 1, there was an interaction between mTBI history and language group (monolinguals vs. bilinguals) in how participants performed on a clinical measure of EF and a verbal fluency task. That is, only bilinguals with mTBI scored significantly lower on these tasks. In addition, there was a significant correlation between errors on a language switching task and performance on non-verbal EF tasks. In Experiment 2, a subgroup of bilinguals with persistent cognitive and behavioral symptoms reported greater everyday communication challenges in their first and second languages. Also, unbalanced bilinguals reported greater EF difficulties than monolinguals and balanced bilinguals regardless of mTBI history. In conclusion, bilinguals may face unique cognitive-communication challenges after mTBI. Factors related to the bilingual experience (e.g., language balance, daily language use) should be
considered in clinical evaluation and future research.