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Nut consumption, specifically almonds, have been shown to help maintain weight and influence disease risk factors in adult populations. Limited studies have been conducted examining the effect of a small dose of almonds on energy intake and body weight. The objective of this study was to determine the influence of

Nut consumption, specifically almonds, have been shown to help maintain weight and influence disease risk factors in adult populations. Limited studies have been conducted examining the effect of a small dose of almonds on energy intake and body weight. The objective of this study was to determine the influence of pre-meal almond consumption on energy intake and weight in overweight and obese adults. In this study included 21, overweight or obese, participants who were considered healthy or had a controlled disease state. This 8-week parallel arm study, participants were randomized to consume an isocaloric amount of almonds, (1 oz) serving, or two (2 oz) cheese stick serving, 30 minutes before the dinner meal, 5 times per week. Anthropometric measurements including weight, waist circumference, and body fat percentage were recorded at baseline, week 1, 4, and 8. Measurement of energy intake was self-reported for two consecutive days at week 1, 4 and 8 using the ASA24 automated dietary program. The energy intake after 8 weeks of almond consumption was not significantly different when compared to the control group (p=0.965). In addition, body weight was not significantly reduced after 8 weeks of the almond intervention (p=0.562). Other parameters measured in this 8-week trial did not differ between the intervention and the control group. These data presented are underpowered and therefore inconclusive on the effects that 1 oz of almonds, in the diet, 5 per week has on energy intake and bodyweight.
ContributorsMcBride, Lindsey (Author) / Johnston, Carol (Thesis advisor) / Swan, Pamela (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2011
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ABSTRACT This study evaluated the LoseIt Smart Phone app by Fit Now Inc. for nutritional quality among users during an 8 week behavioral modification weight loss protocol. All participants owned smart phones and were cluster randomized to either a control group using paper and pencil record keeping, a memo grou

ABSTRACT This study evaluated the LoseIt Smart Phone app by Fit Now Inc. for nutritional quality among users during an 8 week behavioral modification weight loss protocol. All participants owned smart phones and were cluster randomized to either a control group using paper and pencil record keeping, a memo group using a memo function on their smart phones, or the LoseIt app group which was composed of the participants who owned iPhones. Thirty one participants completed the study protocol: 10 participants from the LoseIt app group, 10 participants from the memo group, and 11 participants from the paper and pencil group. Food records were analyzed using Food Processor by ESHA and the nutritional quality was scored using the Healthy Eating Index - 2005 (HEI-2005). Scores were compared using One-Way ANOVA with no significant changes in any category across all groups. Non-parametric statistics were then used to determine changes between combined memo and paper and pencil groups and the LoseIt app group as the memo and paper and pencil group received live counseling at biweekly intervals and the LoseIt group did not. No significant difference was found in HEI scores across all categories, however a trend was noted for total HEI score with higher scores among the memo and paper and pencil group participants p=0.091. Conclusion, no significant difference was detected between users of the smart phone app LoseIt and memo and paper and pencil groups. More research is needed to determine the impact of in-person counseling versus user feedback provided with the LoseIt smart phone app.
ContributorsCowan, David Kevin (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2011
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Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While

Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the design. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile) Findings showed the SSLN program was feasible and acceptable. Participants (n = 16) reported that the curriculum was fun and they learned about nutrition and PA. The retention rate was 94%. The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further testing of the theoretical model.
ContributorsStevens, Carol (Author) / Gance-Cleveland, Bonnie (Thesis advisor) / Komnenich, Pauline (Committee member) / Shaibi, Gabriel (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
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Background Hemodialysis (HD) patients elicit an oxidant-antioxidant imbalance in addition to a selenium deficiency, possibly contributing to cardiovascular disease (CVD) mortality. Objective To evaluate the effect of selenium supplementation on CVD outcomes and antioxidant status in HD patients. Design A randomized controlled intervention trial conducted from October 2012 to January

Background Hemodialysis (HD) patients elicit an oxidant-antioxidant imbalance in addition to a selenium deficiency, possibly contributing to cardiovascular disease (CVD) mortality. Objective To evaluate the effect of selenium supplementation on CVD outcomes and antioxidant status in HD patients. Design A randomized controlled intervention trial conducted from October 2012 to January 2013. Participants/setting The study included 27 maintenance HD patients (61.1+17.5y, 14M, 13F) receiving HD in the greater Phoenix, AZ area. Intervention Patients received one of three treatments daily: 2 Brazil nuts, (5g, 181µg/day of selenium as selenomethionine [predicted]), 1 tablet of selenium (200µg/day of selenium as selenomethionine), or control (3 gummy bears). Main outcome measures Antioxidant status outcome measures included total antioxidant capacity, vitamin C, and RBC and plasma glutathione peroxidase (GSH-Px). CVD outcomes measures included brain natriuretic peptide; plasma cholesterol, high density lipoprotein, low density lipoprotein, triglycerides; blood pressure, and thoracic cavity fluid accumulation. Statistical analyses performed Repeated measures ANOVA analyzed changes over time and between groups at months 0 and 2 and months 0 and 3. Results Independent analysis showed the Brazil nuts provided 11µg of selenium/day and the pill provided 266µg of selenium/day. Consequently, the Brazil nut group was combined with the placebo group. 21 patients completed 2 months of the study and 17 patients completed the study in its entirety. Data was analyzed for months 0, 1 and 2. No significant differences were noted for antioxidant status outcome measures with the exception of plasma GSH-Px. Patients receiving the selenium pill had a significant increase in plasma GSH-Px compared to the placebo group (6.0+11 and -4.0+7.6, respectively, p=0.023 for change between month 0 and month 2). No significant differences were seen in total antioxidant capacity or for CVD outcome measures over time or between groups. Conclusions These data indicate that selenium supplementation increased plasma GSH-Px concentration in HD patients; however, oxidative stress was not altered by selenium supplementation. The low vitamin C status of HD patients warrants further research, specifically in conjunction with selenium supplementation.
ContributorsSussman, Elizabeth Jessica (Author) / Johnston, Carol S (Thesis advisor) / Boren, Kenneth (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Sweazea, Karen (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2013
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Background: Evidence about the purported hypoglycemic and hypolipidemic effects of nopales (prickly pear cactus pads) is limited. Objective: To evaluate the efficacy of nopales for improving cardiometabolic risk factors and oxidative stress, compared to control, in adults with hypercholesterolemia. Design: In a randomized crossover trial, participants were assigned to a

Background: Evidence about the purported hypoglycemic and hypolipidemic effects of nopales (prickly pear cactus pads) is limited. Objective: To evaluate the efficacy of nopales for improving cardiometabolic risk factors and oxidative stress, compared to control, in adults with hypercholesterolemia. Design: In a randomized crossover trial, participants were assigned to a 2-wk intervention with 2 cups/day of nopales or cucumbers (control), with a 2 to 3-wk washout period. The study included 16 adults (5 male; 46±14 y; BMI = 31.4±5.7 kg/m2) with moderate hypercholesterolemia (low density lipoprotein cholesterol [LDL-c] = 137±21 mg/dL), but otherwise healthy. Main outcomes measured included: dietary intake (energy, macronutrients and micronutrients), cardiometabolic risk markers (total cholesterol, LDL-c, high density lipoprotein cholesterol [HDL-c], triglycerides, cholesterol distribution in LDL and HDL subfractions, glucose, insulin, homeostasis model assessment, and C-reactive protein), and oxidative stress markers (vitamin C, total antioxidant capacity, oxidized LDL, and LDL susceptibility to oxidation). Effects of treatment, time, or interactions were assessed using repeated measures ANOVA. Results: There was no significant treatment-by-time effect for any dietary composition data, lipid profile, cardiometabolic outcomes, or oxidative stress markers. A significant time effect was observed for energy, which was decreased in both treatments (cucumber, -8.3%; nopales, -10.1%; pTime=0.026) mostly due to lower mono and polyunsaturated fatty acids intake (pTime=0.023 and pTime=0.003, respectively). Both treatments significantly increased triglyceride concentrations (cucumber, 14.8%; nopales, 15.2%; pTime=0.020). Despite the lack of significant treatment-by-time effects, great individual response variability was observed for all outcomes. After the cucumber and nopales phases, a decrease in LDL-c was observed in 44% and 63% of the participants respectively. On average LDL-c was decreased by 2.0 mg/dL (-1.4%) after the cucumber phase and 3.9 mg/dL (-2.9%) after the nopales phase (pTime=0.176). Pro-atherogenic changes in HDL subfractions were observed in both interventions over time, by decreasing the proportion of HDL-c in large HDL (cucumber, -5.1%; nopales, -5.9%; pTime=0.021) and increasing the proportion in small HDL (cucumber, 4.1%; nopales, 7.9%; pTime=0.002). Conclusions: These data do not support the purported benefits of nopales at doses of 2 cups/day for 2-wk on markers of lipoprotein profile, cardiometabolic risk, and oxidative stress in hypercholesterolemic adults.
ContributorsPereira Pignotti, Giselle Adriana (Author) / Vega-Lopez, Sonia (Thesis advisor) / Gaesser, Glenn (Committee member) / Keller, Colleen (Committee member) / Shaibi, Gabriel (Committee member) / Sweazea, Karen (Committee member) / Arizona State University (Publisher)
Created2013
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The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S), represents a method for rapid diet quality assessment, however, few studies have tested its validity. The Healthy Eating Index-2005 (HEI-2005) and the Diet Quality Index Revised (DQI-R) are tools that effectively assess diet quality, however, both are complex and

The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S), represents a method for rapid diet quality assessment, however, few studies have tested its validity. The Healthy Eating Index-2005 (HEI-2005) and the Diet Quality Index Revised (DQI-R) are tools that effectively assess diet quality, however, both are complex and time consuming. The objective of this study was to evaluate the validity of the REAP-S against the HEI-2005 and the DQI-R. Fifty males, 18 to 33 years of age, completed the REAP-S as well as a 24-hour diet recall. HEI-2005 and DQI-R scores were determined for each 24-hour recall. Scores from the REAP-S were evaluated against the HEI-2005 and DQI-R scores using Spearman rank order correlations and chi square. Modifications were also made to the original method of scoring the REAP-S to evaluate how the correlations transformed when certain questions were removed. The correlation coefficient for REAP-S and the HEI-2005 was 0.367 (P=0.009), and the correlation coefficient for REAP-S and the DQI-R was 0.323 (P=0.022). Chi square determined precision of the REAP-S to the HEI-2005 for overall diet quality at 64% and 62% for the DQI-R and REAP-S. Scores that were considered extreme (n=21) by the HEI-2005 (scores <40 and >60) had 76% precision with REAP-S. The correlation for the modified version of scoring REAP-S with the overall HEI-2005 and DQI-R were 0.395 (P=0.005) and 0.417 (P=0.003) respectively. Chi square statistics revealed the REAP-S accurately captured the diets of high quality versus low quality with 64% precision to the HEI-2005 and 62% of the DQI-R. When evaluating the modified REAP-S scores against the extreme HEI-2005 scores, precision increased to 81%. It appears the REAP-S is an acceptable tool to rapidly assess diet quality. It has a significant, moderate correlation to both the HEI-2005 and the DQI-R, with strong precision as well. Both correlation and precision is strengthened when values are compared to only the extreme scores of the HEI-2005; however, more research studies are needed to evaluate the validity of REAP-S in a more diverse population and to evaluate if changes to select questions can improve its accuracy in assessing diet quality.
ContributorsFawcett, Rachael (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
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The evaluation of nutritional status by dietary intake assessment is fundamental to nutrition research. Accurate assessment allows for health professional-moderated diet adjustment in order to promote disease prevention and management. However, dietary intake can be extremely challenging to measure properly as reliability and accuracy are essential. As technology use has

The evaluation of nutritional status by dietary intake assessment is fundamental to nutrition research. Accurate assessment allows for health professional-moderated diet adjustment in order to promote disease prevention and management. However, dietary intake can be extremely challenging to measure properly as reliability and accuracy are essential. As technology use has become more prevalent in recent years, an assortment of online, web-based diet analysis methods have begun to emerge. Are these modern methods as accurate as the traditional methods? The aim of this study was to compare and contrast diet analyses from a feeding trial in which both subject-coded (using the Automated Self Administered 24 hour recall, or the ASA24) and investigator-coded (using the Food Processor diet analysis program) diet records were available. Sixty-four overweight (body mass index >27-40 kg/m2) members of a campus community between the ages of 20-45 were recruited for an 8-week parallel arm, randomized controlled trial to evaluate the impact of two different pre-dinner meal snacks on satiety, calories consumed, and contribution to modest weight loss. As part of the study requirements, participants completed 3-day food logs at four different times during the trial: pre-trial, and week 1, 4, and 8. Participants also entered their dietary information into the ASA24 website the day after the intake was recorded by hand. Nutrient intake values were compared between the ASA24 records and the handwritten food logs. All statistical analyses were performed using SPSS Statistical Analysis version 19.0; bivariate analyses and Spearman correlation analyses were utilized. Energy, macronutrient, and micronutrient intakes did correlate significantly between the two methodologies, though both under-reporting and over-reporting were found to exist. Carbohydrate and fiber intakes were under-reported by subjects; retinol, beta-carotene, and vitamin C amounts were over-reported. These results are consistent with previous findings in reporting differences and suggest that the ASA24 is a comparably accurate dietary tracking tool to the traditional diet record method.
ContributorsSchohl, Brooke (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
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Grains are a major dietary staple in many cultures and countries. Corn can be consumed as either a fruit, vegetable, or grain. In the case of the Corn and Heart Health Study (CHS), the effect of corn flour was examined. The study used three varieties of corn flour (whole grain,

Grains are a major dietary staple in many cultures and countries. Corn can be consumed as either a fruit, vegetable, or grain. In the case of the Corn and Heart Health Study (CHS), the effect of corn flour was examined. The study used three varieties of corn flour (whole grain, refined, and a refined plus bran blend), provided by the North American Millers Association (NAMA), to examine the effectiveness of corn flour on lowering low-density lipoprotein (LDL) cholesterol as well as its effects on the diversity of the gut microbiome. The objective of this analysis was to determine the magnitude of change between pre- and post- intervention serum blood samples and the changes in alpha (within-sample) diversity in the gut microbiome. The study utilized a randomized-single blinded, crossover model. The study was 16 weeks long, with three 4-week long treatment periods with two-week washout periods in between. During each treatment period blood samples, stool samples, a diet record, and questionnaires were collected from participants. Two blood samples were collected at the beginning and end of each treatment period to account for potential day to day changes on LDL cholesterol. For the purpose of this study, the results of blood and fecal analysis were used to determine the effectiveness of the intervention. Fecal analysis using the Shannon Index showed that there was no significant difference in the within-sample microbiome diversity by corn flour type (H=2.86, p=0.72). Pre-treatment plasma LDL levels were subtracted from post-treatment levels and analyzed using a general linear model that controlled for sequence, period and a nested (ID[sequence]) variable to account for the within-person crossover design. This showed that the bran-enriched flour had the highest mean reduction in LDL cholesterol while the refined and whole grain flour resulted in increases in LDL cholesterol. The change in LDL cholesterol for bran-enriched flour was significantly different from the refined flour (Mean Difference of -14.97 mg/dL; P=.041). The results of this study indicate that refined corn flour enriched with bran could be a recommended addition to the diet to prevent cardiovascular disease and reduce LDL cholesterol in individuals who are at low risk.
ContributorsHarris, Michelle Lynn (Author) / Whisner, Corrie (Thesis advisor) / Grant, Shauna (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2024
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This thesis explores the potential anti-inflammatory effects of daily vinegar ingestion in healthy adults over a 4-week period, with a focus on cytokine levels, innate immunity markers, and C-reactive protein (CRP). Participants were healthy, non-smoking adults (n=28, 18-41 years of age) free of chronic disease. Participants were randomized to the

This thesis explores the potential anti-inflammatory effects of daily vinegar ingestion in healthy adults over a 4-week period, with a focus on cytokine levels, innate immunity markers, and C-reactive protein (CRP). Participants were healthy, non-smoking adults (n=28, 18-41 years of age) free of chronic disease. Participants were randomized to the active treatment group (VIN; two tablespoons liquid vinegar at mealtime twice daily; n=16) or the control group (CON; one commercial vinegar tablet daily; n=12). A fasting blood sample was collected at the start and completion of the 4-week intervention, and serum was analyzed for 15 cytokines and C-reactive protein (CRP). Fluctuations in the anti-inflammatory cytokines (e.g., IL-4, IL-10, IL-5, and IL-13) did not differ between treatment groups during the trial; however, notable reductions in two pro-inflammatory cytokines were observed at week 4 for VIN participants in comparison to CON participants. IL-1 trended lower for VIN versus CON participants (-2.7±6.0 and 1.0±6.6 pg/ml respectively, p=0.102), and IL-12p40 was reduced significantly during the trial in VIN versus CON participants (-5.7±12.5 and +1.04±9.8 pg/ml; p=0.051). The rise in CRP at week 4 for all participants, while not statistically significant, underscores the complexity of the relationship between inflammatory markers. These findings suggest that daily vinegar ingestion may afford greater resilience to inflammatory conditions (as indicated by increasing CRP concentrations). Recommendations for future research include expanding participant pools, extending intervention periods, and conducting more comprehensive studies to unravel the intricate dynamics of vinegar's impact on inflammatory processes.
ContributorsCoven, Hannah (Author) / Johnston, Carol (Thesis advisor) / Shepard, Tina (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2024
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Immigrants and their U.S.-born children account for 26% of the American population as of 2020. Despite this large proportion, 14% of immigrants live below the federal poverty line compared to 12% of U.S.-born citizens. The immigrant population is vulnerable to food and housing insecurity and limited access to social services

Immigrants and their U.S.-born children account for 26% of the American population as of 2020. Despite this large proportion, 14% of immigrants live below the federal poverty line compared to 12% of U.S.-born citizens. The immigrant population is vulnerable to food and housing insecurity and limited access to social services and medical care, on top of navigating the increasingly convoluted immigration system. Migrant women and children are especially at risk for systemic, poverty-related adversities. Periods of pregnancy and postpartum are particularly financially straining due to employment disruptions and additional expenses. Migrant mothers experience adverse health outcomes due to chronic stress, unstable living situations, integration barriers, and an unfavorable occupational environment during pregnancy. In addition to the postpartum needs of a new mother and her baby, these challenges may be barriers to maintaining breastfeeding. The unanticipated COVID-19 pandemic exasperated many existing systemic inequities and brought additional hardship. This study aims to investigate breastfeeding rates among immigrant mothers compared to U.S.-born mothers and other social disparities that affect health. While this study did not find a statistical difference between breastfeeding adherence and immigrant status during the COVID-19 pandemic, other risk factors relating to maternal-child health were identified. Immigrant families were more likely to experience job or income loss and a higher frequency of food insecurity compared to families with U.S.-born parents. The risks of being impoverished greatly reduce the incidence of breastfeeding, which can offer tremendous health benefits both to mother and baby. Most immigrants migrating to the U.S. are ethnic minorities who face additional societal disparities in culture, employment, economic stability, safety, and healthcare. The burden of social determinants of health that impact this population is not unique to adults. The moment a child is born into an immigrant family, particularly if they are also an ethnic minority, they inherit risk factors that can impact their entire lifespan. Ultimately, the risks associated with pregnancy and infant feeding are issues of social justice and health equity.
ContributorsFahmy, Gabriella (Author) / Whisner, Corrie (Thesis advisor) / Schuster, Roseanne (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2023