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ABSTRACT Fruit and vegetable intake is not uniform across levels of socioeconomic status (SES) and researchers have identified low SES as a risk factor for poor intake of fruits and vegetables. In an effort to eliminate public health disparities and increase fruit and vegetable intake, the Women, Infant, and Children

ABSTRACT Fruit and vegetable intake is not uniform across levels of socioeconomic status (SES) and researchers have identified low SES as a risk factor for poor intake of fruits and vegetables. In an effort to eliminate public health disparities and increase fruit and vegetable intake, the Women, Infant, and Children (WIC) program implemented additional food assistance programs, with a specific emphasis on fresh fruits and vegetables. The Farmers' Market Nutrition Program (FMNP) provides pre-existing WIC clients with coupons to purchase fresh, locally grown produce at farmers' markets. In addition, Congress also approved the WIC Cash Value Voucher (CVV) program, which provides WIC participants with vouchers to purchase fresh fruits and vegetables at farmers' markets or grocery stores. The purpose of this thesis was to investigate the relation of FMNP coupon use with accessibility and WIC CVV redemption rates at farmers' markets. Furthermore, this thesis addressed whether WIC shoppers redeemed a higher percentage of their WIC CVV value at farmers' markets or grocery stores. WIC CVV and FMNP issuance and redemption data were analyzed to establish overall redemption rates and total perecent of WIC CVV value redeemed. Accessibility was assessed using the Geographic Information System, which allowed me to calculate the distance that WIC participants would have to travel to redeem their FMNP coupons at FMNP-approved farmers' markets. The results showed that less than 1% of WIC shoppers redeem their WIC CVVs at farmers'markets in Arizona. However, the redemption of WIC CVV was significantly higher during the months when shoppers had the option of using both WIC CVV and FMNP coupons at farmers' markets. Furthermore, the percent of total CVV value redeemed at farmers' markets was 99%, significantly higher than grocery stores (93.5%). Average FMNP coupon redemption rates for 2008-2010 was 43.3%, well below the national average of 59%. However, my spatial analysis revealed that there was no significant association between the distance traveled to farmers' markets and FMNP redemption rates. This indicates that the distance traveled to farmers' markets is not a major barrier to redemption of FMNP coupons in Arizona.
ContributorsTucker, Wesley Jack (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Vaughan, Linda (Committee member) / Johnston, Carol S (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Mexican Americans have an increased risk for type 2 diabetes and premature cardiovascular disease (CVD). The association of hyperglycemia with traditional CVD risk factors in this population has been established, but there is limited data regarding other non-traditional CVD risk factors. Thus, this cross-sectional study was conducted to evaluate CVD

Mexican Americans have an increased risk for type 2 diabetes and premature cardiovascular disease (CVD). The association of hyperglycemia with traditional CVD risk factors in this population has been established, but there is limited data regarding other non-traditional CVD risk factors. Thus, this cross-sectional study was conducted to evaluate CVD risk among Mexican Americans by measuring concentrations of lipids, high-sensitivity C-reactive protein (hsCRP), and cholesterol in low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) subfractions. Eighty overweight/obese Mexican-American adults participating in the Maricopa Insulin Resistance Initiative were randomly selected from each of the following four groups (n = 20 per group): nomolipidemic
ormoglycemic controls (NC), dyslipidemic
ormoglycemic (DN), dyslipidemic/prediabetic (DPD) and dyslipidemic/diabetic (DD). Total cholesterol (TC) was 30% higher among DD than in NC participants (p<0.0001). The DPD group had 27% and 12% higher LDL-C concentrations than the NC and DN groups, respectively. Similarly, LDL-C was 29% and 13% higher in DD than in NC and DN participants (p=0.013). An increasing trend was observed in %10-year CVD risk with increasing degree of hyperglycemia (p<0.0001). The NC group had less cholesterol in sdLDL particles than dyslipidemic groups, regardless of glycemic status (p<0.0001). When hyperglycemia was part of the phenotype (DPD and DD), there was a greater proportion of total and HDL-C in sHDL particles in dyslipidemic individuals than in NC (p=0.023; p<0.0001; respectively). Percent 10-year CVD risk was positively correlated with triglyceride (TG) (r=0.384, p<0.0001), TC (r=0.340, p<0.05), cholesterol in sdLDL(r=0.247; p<0.05), and TC to HDL-C ratio (r=0.404, p<0.0001), and negatively correlated with HDL-C in intermediate and large HDL(r=-0.38, p=0.001; r=0.34, p=0.002, respectively). The TC/HDL-C was positively correlated with cholesterol in sdLDL particles (r=0.698, p<0.0001) and HDL-C in sHDL particles (r=0.602, p<0.0001), and negatively correlated with cholesterol in small (r=-0.35, p=0.002), intermediate (r=-0.91, p<0.0001) and large (r=-0.84, p<0.0001) HDL particles, and HDL-C in the large HDL particles (r=-0.562, p<0.0001). No significant association was found between %10-year CVD risk and hsCRP. Collectively, these results corroborate that dyslipidemic Mexican-American adults have higher CVD risk than normolipidemic individuals. Hyperglycemia may further affect CVD risk by modulating cholesterol in LDL and HDL subfractions.
ContributorsNeupane, Srijana (Author) / Vega-Lopez, Sonia (Thesis advisor) / Shaibi, Gabriel Q (Committee member) / Johnston, Carol S (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Objectives

This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.

Methods

College freshmen from two dormitories were recruited for participation from Arizona

Objectives

This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.

Methods

College freshmen from two dormitories were recruited for participation from Arizona State University’s Tempe campus. A 128-item survey assessing demographics, college life, eating and physical activity behaviors, and social connectedness was administered. In addition, participants completed up to three days of dietary recall. Multivariate linear regression models, adjusting for age, gender, race, ethnicity, highest parental education, dormitory, Pell grant status, number of dietary recalls, and availability of a weekend day of dietary recall were used to assess the relationships between residency status, social connectedness, and eating and physical activity behaviors.

Results

No associations were observed between residency status and calories, grams and percentage of calories from fat, and added sugar. There was a statistically significant association between residency status and moderate-to-vigorous physical activity (MVPA). In-state students reported 21 minutes less per day of MVPA than out-of-state students did (β=-20.85; 95% CI=-30.68, -11.02; p<0.001). There was no relationship between residency status and social connectedness. Social connectedness and eating and physical activity behaviors were not associated. Social connectedness did not mediate the relationship between residency status and eating and physical activity behaviors.

Conclusions

In-state and out-of-state students differed in their MVPA; however, this relationship was not mediated by social connectedness. Further studies are needed to confirm the relationship between MVPA and residency status. In addition, more studies are needed to assess the relationship between social connectedness and MVPA.
ContributorsNelson, Stephanie A. (Stephanie Anne), 1958- (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2016
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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

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
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Obesity prevalence is high in the United States, in part due to increased fat storage following consumption of high fat/carbohydrate (sugar) foods. Following a meal, carbohydrate stimulates its own oxidation, while simultaneously suppressing fat oxidation, ultimately leading to fat storage. Aerobic exercise preceding a meal increases fat oxidation

Obesity prevalence is high in the United States, in part due to increased fat storage following consumption of high fat/carbohydrate (sugar) foods. Following a meal, carbohydrate stimulates its own oxidation, while simultaneously suppressing fat oxidation, ultimately leading to fat storage. Aerobic exercise preceding a meal increases fat oxidation in the postprandial period, which may reduce fat storage. The ideal exercise prescription for optimal postprandial fat oxidation is unknown. The effect of low and moderate intensity continuous exercise (MIE) has been studied extensively, while the effects of high-intensity interval exercise (HIIE) on post-prandial substrate oxidation has not been examined. The purpose of this study was to compare the effects of MIE and HIIE on postprandial substrate oxidation after consumption of an isocaloric meal (2 glazed donuts; 520 kcal) in healthy adults. Ten subjects (8 males, 2 females; age=24yr, BMI=24 kg/m2) completed three conditions in random order: 1) no exercise control; 2) MIE: cycling at 60-75%HRmax; 3) HIIE: cycling at 90-95%HRmax. The duration of each exercise bout was sufficient to expend approximately 520 kcal, the energy equivalent of the donuts, which were consumed 1 hour post-exercise. Immediately after consuming the donuts, pulmonary ventilation and gas exchange were measured breath-by-breath continuously and recorded (min-by-min) for 5 hours. Repeated measures analysis of covariance was used to compare the mean differences in outcome variables accounting for gender. Absolute postprandial fat oxidation (g/5 hours) was 17.3±5.4, 27.1±9.6 and 23±1.2 for control, MIE and HIIE trials respectively, with the postprandial fat oxidation significantly greater for the two exercise conditions compared to control. Relative to baseline values, both exercise conditions resulted in cumulative net postprandial fat oxidation significantly greater than control (control = -1.79±3.99g; MIE = 11.51±8.41g, HIIE= 9.51±5.20g). Therefore, results indicate that exercise most certainly increases postprandial fat oxidation, and that exercise type, either MIE or HIIE, is not as important as total energy expended. The fact that exercise of ~1 hour was required to oxidize the amount of fat in two donuts, that required only a few minutes to consume, highlights the challenges of using exercise for weight control in an obesogenic environment.
ContributorsFleming, Jacob Michael (Author) / Johnston, Carol S (Thesis advisor) / Gaesser, Glenn A (Committee member) / Grant, Shauna (Committee member) / Arizona State University (Publisher)
Created2018
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According to a 2016 census, eight million adults conform to a vegetarian diet within the United States, and about 50% of these adults follow a vegan diet. The census determined that plant-based diets are quickly growing in popularity particularly in young adults between the ages of 18 to 34 years.

According to a 2016 census, eight million adults conform to a vegetarian diet within the United States, and about 50% of these adults follow a vegan diet. The census determined that plant-based diets are quickly growing in popularity particularly in young adults between the ages of 18 to 34 years. Many Americans are aware of the health benefits of a plant-based diet, however, the dietary risks associated with these diets are not well emphasized. Health concerns such as vitamin deficiencies and altered metabolism are heightened in vegetarian populations.

One Particular nutrient that is commonly lacking in the vegetarian diet is vitamin B12. Vitamin B12 is found mainly in animal-derived food sources such as meat, poultry, fish, dairy, and eggs. Although some vegetarians, called lacto-ovo vegetarians, consume dairy and eggs, vegans do not consume any animal products at all. Vitamin B12 deficiency can have devastating consequences on the human body due to its role as a methylation cofactor. Metabolism, DNA replication, and cancer formation all involve methylation processes.

This cross-sectional, differential study aimed to further understand the relationship between vegetarianism, vitamin B12 status, and methylation capacity in healthy adults. A group of 34 healthy adults (18 vegetarians and 16 omnivores) was recruited to analyze serum B12, homocysteine, methylmalonic acid, serum total folate, and transcobalamin II status. It was hypothesized that (1) vegetarians would have a lower vitamin B12 status, and thus, a lower methylation capacity than omnivores and that (2) low vitamin B12 status would be correlated with low methylation capacity.

The data show that vegetarians did not have significantly lower vitamin B12 methylation capacity status than omnivores. Nor was vitamin B12 status correlated with methylation capacity. However, the data revealed that diet quality had a positive influence on folate status. There was also a statistical trend (p=0.08) for homocysteine reduction in participants consuming high-quality diets. The data herein suggest that methylation capacity may be impacted by the quality of diet rather than the type of diet.
ContributorsUgarte, Noel (Author) / Johnston, Carol S (Thesis advisor) / Whisner, Corrie (Committee member) / Sweazea, Karen (Committee member) / Arizona State University (Publisher)
Created2019
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Turmeric, scientifically known as Curcuma longa, is a tropical plant that is most often consumed in India.1 The rhizome of the plant is dried and then ground into a fine, vibrant yellow powder. In addition to its function as a spice, turmeric is also used in traditional Ayervedic medicine due

Turmeric, scientifically known as Curcuma longa, is a tropical plant that is most often consumed in India.1 The rhizome of the plant is dried and then ground into a fine, vibrant yellow powder. In addition to its function as a spice, turmeric is also used in traditional Ayervedic medicine due to its unique medical properties. These unique properties are attributed to the three major constituents of turmeric: curcumin, α-isocurcumin, and β-isocurcumin.2 Curcumin (Diferuloylmethane; C21H20O6), makes up 5% of turmeric by weight, and is the most prominent active ingredient within the turmeric root. Perhaps the most intriguing characteristic about curcumin is its ability to modulate targets such as, but not limited to, transcription factors, enzymes, apoptosis genes, and growth factors.1 Modern medical research has determined curcumin to be a viable treatment and prevention method for disease such as type II diabetes mellitus, rheumatoid arthritis, liver cirrhosis, and certain cancers. However, research on turmeric’s effects on gastrointestinal health is significantly lacking. This randomized, double-blind, cross-over trial looked to see if supplemental turmeric (500 mg as dried root powder) would significantly raise breath hydrogen emission (BHE) and reduce small bowel transit time (SBTT) in 8 female adults who were suffering from chronic constipation. Although supplemental turmeric did not significantly impact BHE or SBTT, the number of bowel movements greatly increased during turmeric intervention.
ContributorsUgarte, Noel (Author) / Johnston, Carol (Thesis director) / Whisner, Corrie (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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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

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
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Vitamin B12, found only in animal products, is a water-soluble vitamin important for DNA methylation, purine and pyrimidine synthesis, and the myelination of nerves. Symptoms of vitamin B12 deficiency include anemia, gait disturbances, altered vibration proprioception, impaired vision, psychosis, depression, dementia-like illness, and ultimately death. Because vegetarians and

Vitamin B12, found only in animal products, is a water-soluble vitamin important for DNA methylation, purine and pyrimidine synthesis, and the myelination of nerves. Symptoms of vitamin B12 deficiency include anemia, gait disturbances, altered vibration proprioception, impaired vision, psychosis, depression, dementia-like illness, and ultimately death. Because vegetarians and vegans consume fewer animal products in their diet than omnivores, they are inherently more at risk for developing these symptoms of vitamin B12 deficiency. Thus, the purpose of this study is to examine the correlation between nervous system markers (balance, dexterity, and vibration sensitivity) and markers of vitamin B12 nutriture (serum B12 and serum holo-transcobalamin II) in a cross-sectional study (n=38). In addition, the impact of daily oral vitamin B12 supplementation on these markers in an 8-week randomized controlled trial was also examined (n=18). The results of the cross-sectional study revealed a moderate correlation (R=-0.351, p=0.031) between serum B12 and left-hand functional dexterity. The results of the intervention study revealed no significant time*group interactions for markers of nervous system functions and biochemical values (after the removal of outliers). In addition, the time*group interaction appeared to be larger for those individuals with a baseline serum B12 of less than 303 pmol/L. These results suggest that vitamin B12 supplementation may have a more pronounced effect on those individuals who are in a state of vitamin B12 depletion (<303 pmol/L serum concentration). In addition, the results also suggest that 8 weeks of oral supplementation is not a long enough period to create significant clinical change, and it is likely that improvements in neurological measures would require long-term supplementation.
ContributorsArnold, Taylor (Author) / Johnston, Carol (Thesis advisor) / Whisner, Corrie (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Lee, Chong (Committee member) / Aleck, Kyrieckos (Committee member) / Arizona State University (Publisher)
Created2016
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Description
The stadiometer is the gold standard human height measure, but recent studies have begun to question whether laser technology is a better tool to measure height. The purpose of this study was to investigate if the laser device has inter-rater reliability, how the laser-device measures supine height in comparison to

The stadiometer is the gold standard human height measure, but recent studies have begun to question whether laser technology is a better tool to measure height. The purpose of this study was to investigate if the laser device has inter-rater reliability, how the laser-device measures supine height in comparison to standard methods, and if the laser device will be consistent in measuring human height shorter, as seen in previous studies. Two investigators measured a total of 80 adults independently. Measurements included knee height, arm span, demi span, supine height by laser, standing height by laser and standing height by stadiometer. There was a strong inter-rater reliability for the laser height measurement: excluding one outlier r=0.998. Supine height measures done with a laser were strongly correlated with arm span, but mean values were closest between supine height and knee height (171.3cm and 171.2cm). The laser measured standing height 0.5cm shorter, on average, than the stadiometer. It is concluded that the laser device is a reliable, validated tool to measure human height, standing or supine.
ContributorsGarcia-Turner, Vanessa (Author) / Johnston, Carol S (Thesis advisor) / Mayol-Kreiser, Sandra N (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2016