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- Genre: Doctoral Dissertation
- Member of: Theses and Dissertations
- Status: Published
Description
Tools designed to help match people with behaviors they identify as likely to lead to a successful behavioral outcome remain under-researched. This study assessed the effect of a participant-driven behavior-matching intervention on 1) the adoption of a new behavior related to fruit and vegetable (F&V) consumption, 2) study attrition, and 3) changes in F&V consumption. In this two-arm randomized controlled trial, 64 adults who did not meet standard F&V recommendations were allocated to an intervention (n=33) or control group (n=31). Participants in the intervention group ranked 20 F&V-related behaviors according to their perceived likelihood of engagement in the behavior and their perception of the behavior’s efficacy in increasing F&V consumption. Participants in the intervention group were subsequently shown the list of 20 behaviors in order of their provided rankings, with the highest-ranked behaviors at the top, and were asked to choose a behavior they would like to perform daily for 4 weeks. The control group chose from a random-order list of the same 20 behaviors to adopt daily for 4 weeks. During the study period, text messages were sent to all participants 90 minutes before their reported bedtime to collect Yes/No data reflecting successful behavior engagement each day. The binary repeated-measures data collected from the text messages was analyzed using mixed-effects logistic regression, differences in attrition were assessed using log-rank analysis, and change scores in F&V consumption were compared between the two groups using the Man-Whitney U test. P<0.05 indicated significance. The rate of successful behavior adoption did not differ significantly between the two groups (b=0.09, 95%CI= -0.81, 0.98, p=0.85). The log rank test results indicated that there was no significant difference in attrition between the two groups (χ2=2.68, df=1, p=0.10). F&V consumption increased significantly over the 4 weeks in the total sample (Z=-5.86, p<0.001), but no differences in F&V change scores were identified between the control and intervention groups (Z=-0.21, p=0.84). The behavior-matching tool assessed in this study did not significantly improve behavior adoption, study attrition, or F&V intake over 4 weeks.
ContributorsCosgrove, Kelly Sarah (Author) / Wharton, Christopher (Thesis advisor) / Adams, Marc (Committee member) / DesRoches, Tyler (Committee member) / Grebitus, Carola (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2023
Description
The microorganisms that colonize the gastrointestinal tract have been recognized over the last several decades to have a significant bearing on the health trajectories of the hosts that harbor them. The collection of these gut microbes display links with acute and chronic disease, garnering substantial interest in leveraging the microbiome for improved health states. How these microbes assemble as a complex community and interact with each other, and the host depends on a multitude of factors. In adulthood, diet is one of the main moderators, having a significant influence on community composition and the functional output captured in the metabolites produced and/or modified by the gut microbiome. Thus, the assembly of microbes in the gut are tightly intertwined with health. In this dissertation, I examine the impact of diet and feeding behaviors on the gut microbiome and what features may be grounding or responsive under such pressures. Specifically, I first explore the avian gut microbiome as a barometer of nutritional and environmental influence on host health. Birds have continually displayed robust physiology under dietary pressures, placing them in an important, though underutilized, position within the translational science framework. Second, I describe the association of food insecurity on gut microbiome and metabolome profiles in a diverse college-based sample. Food insecurity provides its own set of unique pressures, such as unintentional calorie restriction, and inconsistent dietary intake and access to healthy food options. Third, I examine the effect of a one vs. two-consecutive days of intermittent fasting on the gut microbiome, the plasma metabolome, and associated clinical outcomes in overweight and obese adults. Growing in scientific and lay popularity, dietary fasting has been noted to induce changes in the diversity of gut microflora and gut motility, though different fasting lengths have not been assessed in the context of the human microbiome. Overall, this collection of work underscores that the community of microbes in the gut are individualized, resilient, and baseline composition and functioning are germane to how an individual may react to a particular dietary intervention.
ContributorsMohr, Alex (Author) / Sweazea, Karen L. (Thesis advisor) / Johnston, Carol S. (Committee member) / Sears, Dorothy D. (Committee member) / Whisner, Corrie M. (Committee member) / Krajmalnik-Brown, Rosa (Committee member) / Arizona State University (Publisher)
Created2022
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
Breastfeeding is considered the optimal source of nutrition for infants because of the protection it offers against many adverse maternal and child health consequences. The greatest health benefits are associated with exclusive breastfeeding, but employees must often return to work before establishing a full milk supply. Although federal and California law mandate space and time provisions for workplace lactation accommodation, women employed in manual labor jobs, including agricultural field work, face challenges to expressing (pumping) their breast milk. Mexican-descent women, who represent more than a quarter of the California farmworker population, are particularly at risk for supplementing their breastfed infants with formula. Using a socio-ecological model (SEMBA) to guide the research process, this qualitative case study examined the experiences of five Mexican immigrant women who expressed their milk in the California agricultural workplace. The investigator conducted semi-structured interviews to explore how each level of SEMBA influenced their decision to initiate and then continue pumping in the field. Sociodemographic questionnaires were also completed for each participant. Qualitative content analysis led to the discovery of three themes: Honoring Culture, Running the Gauntlet, and Blazing a Trail. Enabling factors for milk expression in the workplace were found at all levels of SEMBA, except for the work environment. At the individual level, self-efficacy, strengthened by social support (interpersonal), was a major contributor to continuance of milk expression. Significant challenges were found at the interpersonal (coworker) and work environment levels, represented by the theme of Running the Gauntlet. Social support at the interpersonal level was provided by family members, child care providers, and WIC breastfeeding peer counselors and buffered the hardships of the workplace. Community level enablers included cultural values, reflected by the theme of Honoring Culture. Trusting in the (lactation) law at the systems level was mentioned by all study participants as a facilitator for workplace milk expression within the theme of Blazing a Trail. Improved understanding of the factors that enable or challenge success at milk expression on the job may lead to appropriate interventions that support optimal breastfeeding, especially among employees in agriculture or other manual labor jobs.
ContributorsVaughan, Janet Copeland (Author) / Reifsnider, Elizabeth (Thesis advisor) / Evans, Bronwynne C (Committee member) / Williams, Deborah L (Committee member) / Arizona State University (Publisher)
Created2023
Description
Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food, which may include inadequate finances, transportation, skills, and information. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of hunger, nutritional deficiencies, and chronic disease among vulnerable populations. This dissertation tested a novel food insecurity intervention using informational nudges to promote food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.
ContributorsRoyer, Michael F. (Author) / Wharton, Christopher (Thesis advisor) / Buman, Matthew (Committee member) / Der Ananian, Cheryl (Committee member) / MacKinnon, David (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2023
Description
The purpose of this investigation was to evaluate the influence of tap water safety perceptions on plain water intake (PWI) and hydration status in US Latinx adults. Participants (n=492; age, 28±7 y; 37.4% female) completed an Adapted Survey of Water Issues in Arizona and household watersecurity experience-based scales. A sub-sample (n=55; age, 33±14 y; body mass index, 27.77±6.60 kg·m2) completed dietary recalls on two weekdays and one weekend day via Automated Self-Administered 24-hour Dietary Assessment Tool to determine average PWI and total water intake (TWI). A 24-h urine sample was collected on one recall day and analyzed for urine osmolality (UOsm). Binary logistic regression determined odds ratios (OR) for the odds of perceiving tap water to be unsafe. Hierarchical linear regression was employed with 24-h UOsm and PWI as primary outcomes for the sub-sample. Overall, 51.2% of all participants and 52.7% of the sub-sample mistrust their tap water safety. The odds of mistrusting tap water were significantly greater (P<0.05) for each additional favorable perception of bottled over tap water (OR=1.94, 95% CI=1.50, 2.50), each additional negative home tap water experience (OR=1.32, 95% CI=1.12, 1.56), each additional use of alternatives and/or modifications to home tap water (OR=1.25, 95% CI=1.04, 1.51), and decreased water quality and acceptability (OR=1.21, 95% CI=1.01, 1.45). The odds of mistrusting tap water were significantly lower (P<0.05) for those whose primary source of drinking water is the public supply (municipal) (OR=0.07, 95% CI=0.01, 0.63) and for those with decreased water access (OR=0.56, 95% CI=0.48, 0.66). There were no differences (n=55, P>0.05) in TWI (2,678±1,139 mL), PWI (1,357±971), or 24-h UOsm (460±234 mosm·kg-1). Tap water safety perceptions did not significantly explain variance in PWI or 24-h UOsm (P > 0.05). In conclusion, Latinx mistrust in tap water safety is prevalent. Mistrust appears to be influenced by organoleptic perceptions and to lead to reliance on alternatives to the home drinking water system. Perceptions of tap water safety do not appear to be related to PWI, TWI, or hydration status in Latinx adults.
ContributorsColburn, Abigail (Author) / Kavouras, Stavros (Thesis advisor) / Buman, Matthew (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Vega-Lopez, Sonia (Committee member) / Wutich, Amber (Committee member) / Arizona State University (Publisher)
Created2022
Description
Background. Street food stands (SFS) are common ways in which people in Mexico access food, having been a part of the environment and culture of Mexican food for generations. However, no studies have used a validated assessment tool to reliably measure food and beverage availability at a variety of SFS. Nor have the availability, density, variety, and distribution of SFS and street foods and beverages been assessed across neighborhood income levels.Objective: This dissertation’s goal was to decrease gaps in knowledge about the role SFS may play in food availability in the Mexican food environment.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
ContributorsRosales Chavez, Jose Benito (Author) / Jehn, Megan (Thesis advisor) / Bruening, Meg (Thesis advisor) / Lee, Rebecca E (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2020
Description
ABSTRACT
Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.
Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting morning blood pressure, biomarkers of glucose regulation, biomarkers of lipid metabolism, and anthropometric measures.
Methods. Eighteen healthy college students (age = 23 ± 4 years; BMI = 23.2 ± 2.3 kg/m2; MET = 58.8 ± 32.9 min/wk) completed this study. Participants were randomized to a daily 18-hour fasting protocol (Intervention; n = 8) or a daily 8-hour fasting protocol (Control; n = 10) for eight weeks. One ‘cheat’ day was permitted each week. Outcomes were measured at weeks 0 (baseline), 4, and 8. A non-parametric Mann Whitney U test was used to compare the week 4 change from baseline between groups. Statistical significance was set at p≤0.05.
Results. Diet quality (p = 0.030) and body weight (p = 0.016) improved from baseline to week 4 for the INV group in comparison to the CON group. The data suggest these improvements may be related to reductions in snacking frequency and increased breakfast consumption. Fasting blood glucose and hip circumference tended to improve for the INV group in comparison to the CON group (p = 0.091 and p = 0.100). However, saturated fat intake tended to increase in the INV group in comparison to the CON group (p = 0.064). Finally, there were no treatment differences between groups (p>0.05) for the 4-week change in total calories, dietary vitamin C, added sugars, resting systolic blood pressure, resting diastolic blood pressure, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, waist circumference, or MET.
Conclusion. These data, although preliminary, suggest that the 18-hour fasting protocol was effective for improving diet quality and reducing weight in comparison to the 8-hour fasting protocol in healthy college students. Future intervention trials will need to confirm these findings and determine the long-term relevance of these improvements for health outcomes.
Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.
Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting morning blood pressure, biomarkers of glucose regulation, biomarkers of lipid metabolism, and anthropometric measures.
Methods. Eighteen healthy college students (age = 23 ± 4 years; BMI = 23.2 ± 2.3 kg/m2; MET = 58.8 ± 32.9 min/wk) completed this study. Participants were randomized to a daily 18-hour fasting protocol (Intervention; n = 8) or a daily 8-hour fasting protocol (Control; n = 10) for eight weeks. One ‘cheat’ day was permitted each week. Outcomes were measured at weeks 0 (baseline), 4, and 8. A non-parametric Mann Whitney U test was used to compare the week 4 change from baseline between groups. Statistical significance was set at p≤0.05.
Results. Diet quality (p = 0.030) and body weight (p = 0.016) improved from baseline to week 4 for the INV group in comparison to the CON group. The data suggest these improvements may be related to reductions in snacking frequency and increased breakfast consumption. Fasting blood glucose and hip circumference tended to improve for the INV group in comparison to the CON group (p = 0.091 and p = 0.100). However, saturated fat intake tended to increase in the INV group in comparison to the CON group (p = 0.064). Finally, there were no treatment differences between groups (p>0.05) for the 4-week change in total calories, dietary vitamin C, added sugars, resting systolic blood pressure, resting diastolic blood pressure, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, waist circumference, or MET.
Conclusion. These data, although preliminary, suggest that the 18-hour fasting protocol was effective for improving diet quality and reducing weight in comparison to the 8-hour fasting protocol in healthy college students. Future intervention trials will need to confirm these findings and determine the long-term relevance of these improvements for health outcomes.
ContributorsMayra, Selicia (Author) / Johnston, Carol (Thesis advisor) / Sears, Dorothy (Committee member) / Swan, Pamela (Committee member) / Sweazea, Karen (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2020
Description
Obesity is one of the most challenging health conditions of our time, characterized by complex interactions between behavioral, environmental, and genetic factors. These interactions lead to a distinctive obese phenotype. Twenty years ago, the gut microbiota (GM) was postulated as a significant factor contributing to the obese phenotype and associated metabolic disturbances. Exercise had shown to improve and revert the metabolic abnormalities in obese individuals. Also, genistein has a suggested potential anti-obesogenic effect. Studying the dynamic interaction of the GM with relevant organs in metabolic homeostasis is crucial for the design of new long-term therapies to treat obesity. The purpose of this experimental study is to examine exercise (Exe), genistein (Gen), and their combined intervention (Exe + Gen) effects on GM composition and musculoskeletal mitochondrial oxidative function in diet-induced obese mice. Also, this study aims to explore the association between gut microbial diversity and mitochondrial oxidative capacity. 132 adult male (n=63) and female (n= 69) C57BL/6 mice were randomized to one of five interventions for twelve weeks: control (n= 27), high fat diet (HFD; n=26), HFD + Exe (n=28), HFD + Gen (n=27), or HFD + Exe + Gen (n=24). All HFD drinking water was supplemented with 42g sugar/L. Fecal pellets were collected, DNA extracted, and measured the microbial composition by sequencing the V4 of the 16S rRNA gene with Illumina. The mitochondrial oxidative capacity was assessed by measuring the enzymatic kinetic activity of the citrate synthase (CS) of forty-nine mice. This study found that Exe groups had a significantly higher bacterial richness compared to HFD + Gen or HFD group. Exe + Gen showed the synergistic effect to drive the GM towards the control group´s GM composition as we found Ruminococcus significantly more abundant in the HFD + Exe + Gen than the rest of the HFD groups. The study did not find preventive capacity in either of the interventions on the CS activity. Therefore, further research is needed to confirm the synergistic effect of Exe, Exe, and Gen on the gut bacterial richness and the capacity to prevent HFD-induced deleterious effect on GM and mitochondrial oxidative capacity.
ContributorsOrtega Santos, Carmen Patricia (Author) / Whisner, Corrie M (Thesis advisor) / Dickinson, Jared M (Committee member) / Katsanos, Christos (Committee member) / Gu, Haiwei (Committee member) / Liu, Li (Committee member) / Al-Nakkash, Layla (Committee member) / Arizona State University (Publisher)
Created2021
Description
Background: Vegan and vegetarian diets have gained in popularity in recent years. Stated reasons for this include some possible health benefits and concerns of animal welfare. Though considered to be nutritionally adequate, questions remain over whether current protein recommendations of 0.8 g/kg/d are sufficient to maintain body processes and growth. Protein is unique in that it is the only macronutrient that contains nitrogen. Its status can be determined through nitrogen balance analysis of the urine if protein content of the diet is known. Nitrogen balance is considered the gold standard for determining protein intake requirements. A negative balance indicates a catabolic state, whereas a positive nitrogen balance is seen during anabolism. In healthy people, nitrogen equilibrium is desired under normal circumstances. This equilibrium reflects the net synthesis and breakdown of proteins. While nitrogen balance techniques have been used for decades, currently, there are no known studies measuring nitrogen balance and protein intake in strict vegans. Methods: Twenty vegan, inactive, male participants were recruited and received a 5-day eucaloric diet with a known protein content held constant at 0.8 g/kg/d. On day five, 24-hour urine was collected by participants and aliquoted for future analysis. Nitrogen content of the urine was determined through photometric assay and compared to the known nitrogen content of the diet to calculate nitrogen balance status.
Results: Mean absolute nitrogen balance (-1.38 ± 1.22 g/d, effect size = -1.13) was significantly lower than zero (equilibrium) (p < .001). Mean relative nitrogen balance (-18.60 ± 16.96 mg/kg/d, effect size = -1.10) was significantly lower than zero (p < .001). There were no correlations seen between nitrogen balance and age, years as vegan, or fat- free mass.
Conclusion: Consuming 0.8 g/kg/d of protein is insufficient to produce nitrogen balance in long-term vegans.
ContributorsBartholomae, Eric (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Wharton, Christopher (Committee member) / Lee, Chong (Committee member) / Kressler, Jochen (Committee member) / Arizona State University (Publisher)
Created2022