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- All Subjects: Nutrition
- All Subjects: healthcare
- Creators: Levinson, Simin
Description
Diet quality is closely intertwined with overall health status and deserves close examination. Healthcare providers are stretched thin in the current stressed system and would benefit from a validated tool for rapid assessment of diet quality. The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S) represents one such option. The objective of the current study was to evaluate the effectiveness of the REAP-S and Healthy Eating Index 2010 (HEI-2010) for scoring the diet quality of omnivorous, vegetarian and vegan diets. Eighty-one healthy male and female subjects with an average age of 30.9 years completed the REAP-S as well as a 24-hour dietary recall. REAP-S and HEI-2010 scores were calculated for each subject and evaluated against each other using Spearman correlations and Chi Square. Further analysis was completed to compare diet quality scores of the HEI-2010 and REAP-S by tertiles to examine how closely these two tools score diet quality. The mean HEI-2010 score was 47.4/100 and the mean REAP-S score was 33.5/39. The correlation coefficient comparing the REAP-S to the HEI-2010 was 0.309 (p=0.005), and the REAP-S exhibited a precision of 44.4% to the HEI-2010 for diet quality. The REAP-S significantly correlated with the HEI-2010 for whole fruit (r=0.247, p=0.026), greens and beans (r=0.276, p=0.013), seafood proteins (r=0.298, p=0.007), and fatty acids (r=0.400, p<0.001). When evaluated by diet type, the REAP-S proved to have increased precision in plant-based diets, 50% for vegetarian and 52% for vegan, over omnivorous diets (32%). The REAP-S is a desirable tool to rapidly assess diet quality in the community setting as it is significantly correlated to the HEI-2010 and requires less time, labor and money to score and assess than the HEI-2010. More studies are needed to evaluate the precision and validity of REAP-S in a broader, more diverse population.
ContributorsBliss, Courtney (Author) / Johnston, Carol (Thesis advisor) / Tasevska, Natasha (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2015
Description
Dietary counseling from a registered dietitian has been shown in previous studies to aid in weight loss for those receiving counseling. With the increasing use of smartphone diet/weight loss applications (app), this study sought to investigate if an iPhone diet app providing feedback from a registered dietitian improved weight loss and bio-markers of health. Twenty-four healthy adults who owned iPhones (BMI > 24 kg/m2) completed this trial. Participants were randomly assigned to one of three app groups: the MyDietitian app with daily feedback from a registered dietitian (n=7), the MyDietitian app without feedback (n=7), and the MyPlate feedback control app (n=10). Participants used their respective diet apps daily for 8-weeks while their weight loss, adherence to self-monitoring, blood bio-markers of health, and physical activity were monitored. All of the groups had a significant reduction in waist and hip circumference (p<0.001), a reduction in A1c (p=0.002), an increase in HDL cholesterol levels (p=0.012), and a reduction in calories consumed (p=0.022) over the duration of the trial. Adherence to diet monitoring via the apps did not differ between groups during the study. Body weight did not change during the study for any groups. However, when the participants were divided into low (<50% of days) or high adherence (>50% of days) groups, irrespective of study group, the high adherence group had a significant reduction in weight when compared to the low adherence group (p=0.046). These data suggest that diet apps may be useful tools for self-monitoring and even weight loss, but that the value appears to be the self-monitoring process and not the app specifically.
ContributorsThompson-Felty, Claudia (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2014
Description
Water makes up about 45-70% of a human body's total weight. It is estimated that 80% of the human brain's tissue is composed of water. Cognitive productivity is altered when the body is in a mere 2% dehydrated state. Several cognitive functions impacted by dehydration include: visual motor tracing, short-term recall, attentiveness, and mathematic efficiency. It is estimated that 80% of the U.S. adult population endures the majority of their day in a mildly dehydrated state.
Participants were employees working full-time jobs with Arizona State University or Tri Star Motor Company. Employees had to be 18 or older were invited to join the study. Employees participating in the study lived within the the greater Phoenix area. Participants of all races, genders, activity statuses, and BMIs were encouraged to join.
A one-arm, pre-test, post-test study design was utilized. We examined whether the hydration status of participants in the intervention improved or worsened during the course of the intervention, and then attributed any such improvement or deterioration to the intervention. Urine collections from an afternoon sample were gathered before and after the one-week intervention. For the intervention, the participating offices received a water dispensing system in close proximity to employee desk spaces. A reusable water bottle was also given to each participant. Urine specific gravity (USG) was assessed in all urine samples to indicate hydration status, and all participants completed water intake surveys before and after the intervention.
From this study, the overall change in water intake over the course of the one-week intervention was 143 ounces/day. This is an average of adding two and a half 8 oz glasses of water each day of the week per participant. USG also decreased significantly at the end of the intervention in comparison to the baseline value. In the greater body of research, this study strengthens the viability of inputting a hydration station and offering reusable water bottles to employees. This cost-effective method is an easy way to incorporate employee wellness in the workplace. The benefit of employees to drink more water is numerous, including increased focus, mental reactivity, and overall mood and wellness.
Participants were employees working full-time jobs with Arizona State University or Tri Star Motor Company. Employees had to be 18 or older were invited to join the study. Employees participating in the study lived within the the greater Phoenix area. Participants of all races, genders, activity statuses, and BMIs were encouraged to join.
A one-arm, pre-test, post-test study design was utilized. We examined whether the hydration status of participants in the intervention improved or worsened during the course of the intervention, and then attributed any such improvement or deterioration to the intervention. Urine collections from an afternoon sample were gathered before and after the one-week intervention. For the intervention, the participating offices received a water dispensing system in close proximity to employee desk spaces. A reusable water bottle was also given to each participant. Urine specific gravity (USG) was assessed in all urine samples to indicate hydration status, and all participants completed water intake surveys before and after the intervention.
From this study, the overall change in water intake over the course of the one-week intervention was 143 ounces/day. This is an average of adding two and a half 8 oz glasses of water each day of the week per participant. USG also decreased significantly at the end of the intervention in comparison to the baseline value. In the greater body of research, this study strengthens the viability of inputting a hydration station and offering reusable water bottles to employees. This cost-effective method is an easy way to incorporate employee wellness in the workplace. The benefit of employees to drink more water is numerous, including increased focus, mental reactivity, and overall mood and wellness.
ContributorsWildermuth, Kelsi (Author) / Johnston, Carol (Thesis advisor) / Dixon, Kathleen (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2018
Description
Background: The Academy of Nutrition and Dietetics states that it is possible for a vegetarian to obtain the recommended amount of nutrients with a properly planned diet but nutrient deficiencies, such as vitamin B12 deficiency, may occur if diet planning is not optimal. An early indicator of B12 deficiency is raised homocysteine concentrations in blood which can cause health issues.
Objective: The amino acid methionine is consumed via dietary protein. Methionine is used in the biosynthesis of other proteins. After a removal of a methyl group, it makes homocysteine. Slightly raised homocysteine may promote greater synthesis of glutathione, an important endogenous antioxidant protectant. It can then be recycled back into methionine or converted into cysteine with the addition of various B-vitamins such as vitamin B12, folic acid, and vitamin B6. Cysteine then uses outside sources of glutamate and glycine to create glutathione (GSH). With the catalyst glutathione peroxidase it donates an electron and becomes the oxidized form, glutathione disulfide (GSSG). It can then convert back to GSH with the aid of glutathione reductase by using the reduced form of nicotinamide adenine dinucleotide phosphate (NADPH) as an electron donor. This study will examine glutathione levels in omnivores and vegetarians and see if it is related to vitamin B12 and homocysteine levels.
Design: This cross-sectional study encompassed 16 omnivores and 17 vegetarians from Phoenix, Arizona. A vegetarian diet was defined as one that excludes red meat, poultry, pork and seafood but allows dairy products and/or eggs; the diet had to be followed for at least one year. An omnivore diet is defined as eats meat daily. Participants completed a diet questionnaire and a vitamin B12, B6 and folate food questionnaire and provided a fasting blood sample.
Results: The mean plasma B12 and homocysteine did not differ between diet groups. Glutathione was significantly lower among vegetarians in comparison to omnivores, 1.9±0.5 and 2.3±0.7 mmol respectively (p=0.046).
Conclusions: The hypothesis was shown to be incorrect that vegetarians would have a higher glutathione level than omnivores as a result of their modest consumption of vitamin B12. The implications of a reduced glutathione status are discussed.
Objective: The amino acid methionine is consumed via dietary protein. Methionine is used in the biosynthesis of other proteins. After a removal of a methyl group, it makes homocysteine. Slightly raised homocysteine may promote greater synthesis of glutathione, an important endogenous antioxidant protectant. It can then be recycled back into methionine or converted into cysteine with the addition of various B-vitamins such as vitamin B12, folic acid, and vitamin B6. Cysteine then uses outside sources of glutamate and glycine to create glutathione (GSH). With the catalyst glutathione peroxidase it donates an electron and becomes the oxidized form, glutathione disulfide (GSSG). It can then convert back to GSH with the aid of glutathione reductase by using the reduced form of nicotinamide adenine dinucleotide phosphate (NADPH) as an electron donor. This study will examine glutathione levels in omnivores and vegetarians and see if it is related to vitamin B12 and homocysteine levels.
Design: This cross-sectional study encompassed 16 omnivores and 17 vegetarians from Phoenix, Arizona. A vegetarian diet was defined as one that excludes red meat, poultry, pork and seafood but allows dairy products and/or eggs; the diet had to be followed for at least one year. An omnivore diet is defined as eats meat daily. Participants completed a diet questionnaire and a vitamin B12, B6 and folate food questionnaire and provided a fasting blood sample.
Results: The mean plasma B12 and homocysteine did not differ between diet groups. Glutathione was significantly lower among vegetarians in comparison to omnivores, 1.9±0.5 and 2.3±0.7 mmol respectively (p=0.046).
Conclusions: The hypothesis was shown to be incorrect that vegetarians would have a higher glutathione level than omnivores as a result of their modest consumption of vitamin B12. The implications of a reduced glutathione status are discussed.
ContributorsManley, Rachel Christine (Author) / Johnston, Carol (Thesis advisor) / Levinson, Simin (Committee member) / Barth, Christina (Committee member) / Arizona State University (Publisher)
Created2019
Description
The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking screening tool studies geared towards use in the medical setting. Screening questions from these studies were compiled and modified into a survey that was distributed to healthcare professionals through the nationwide HEAL (Health Professional Education, Advocacy, Linkage) Trafficking listserv. Each screening tool study demonstrated benefits and disadvantages that were helpful in the sampling and selection of screening tool questions. The small sample size and a lack of data on the attitudes of medical professionals on sex trafficked victims were noted as limitations to this study. Further implications for this study would include validating the screening tool questions in a medical setting to determine the sensitivity of the survey in identifying patients as possible sex trafficking victims.
ContributorsCatano, Karen Samantha (Co-author) / Byun, Jiwon (Co-author) / Roe-Sepowitz, Dominique (Thesis director) / Lee, Maurice (Committee member) / School for the Science of Health Care Delivery (Contributor) / College of Integrative Sciences and Arts (Contributor) / W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Forty collegiate gymnasts were recruited for a nutrition and health study. Participants must have been at least eighteen years old at Arizona State University (ASU) in the club or team gymnastics program. The Institutional Review Board (IRB) reviewed and accepted my survey in order to hand out to the gymnasts. The ASU club and team coach and the ASU study team also approved my survey. As soon as the survey was approved, it was emailed to all of the gymnasts. ASU gymnasts were surveyed on nutritional knowledge and personal health. Subjects answered a quiz on nutrient needs and serving sizes. Personal questions consisted of height, weight, injuries, body image, and typical meal plans. Gymnasts were given a $10 compensation to increase the participation. We found that only 16% of gymnasts surveyed scored a 70% or higher on their nutritional knowledge. Although these gymnasts do not have adequate knowledge, the majority consume a healthy diet. Diets included fruits, vegetables, protein-rich foods, and few high fat and sugary foods. Four of the gymnasts had one or fewer injuries in the past two years, although, four gymnasts also had three or more injuries. No correlation was found between diet and injuries. There was also no correlation between the gymnast's nutritional knowledge and their health.
ContributorsKugler, Natalie K. (Author) / Levinson, Simin (Thesis director) / Berger, Christopher (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
The transition from high school to college is, for many, a drastic change in lifestyle, social networks, and dietary choices. The prevalence of obesity in college students has been steadily increasing. Freshmen weight gains have been associated with a decrease in fruits and vegetables and an increase in unhealthy items such as desserts, alcohol, and late night snacking after dinner. A survey of college students was constructed to gauge students' perceptions of nutrition how these perceptions influenced dietary practices and behaviors. Survey results indicated that awareness of nutrition and health does not translate to dietary practices, aligning with results from previous studies. Several sex differences were noted in regards to dietary choices and perceptions, knowledge seeking behavior, and sources of information. While there were some similarities, it is clear from the results obtained that men and women have different approaches and thoughts with regard to nutrition. The results showed that college students who actively seek our nutritional information are more likely to do so in the form of social media or Internet sources. This study could be useful for those planning on conducting college-based nutritional programs in that the results indicate patterns and trends that should be taken into consideration in order for a successful nutrition intervention
ContributorsKeahon, Gabriela Estrada (Author) / Jehn, Megan (Thesis director) / Williams, Deborah (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2015-05
Description
Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.
ContributorsTomlinson, Rachel Laiku (Author) / Pine, Katie (Thesis director) / Trinh, Mai (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2017-05
Description
This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.
ContributorsThomas, Christy Maria (Author) / Reddy, Swapna (Thesis director) / Essary, Alison (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Nutritional support offered before and during chemotherapy treatment is proven to improve the outcomes of treatment (Bernhardson, 2016). This project seeks to examine current forms of nutritional support offered to patients, as well as the models of care and support teams in cancer treatment centers. The basis for this project incorporated personal experiences at M.D. Anderson Cancer Center in Gilbert, Arizona as well as research into the work of clinical oncology dietitians. An intense interest in food videos and blogs also informed this project, and was incorporated in the hope of providing chemotherapy patients a platform to discover recipes specific to their unique situation. The combination of this research was utilized to create several videos which demonstrated specific recipes beneficial for patients as well as creating a platform for this particular population. While nutritional support can take multiple forms, the focus of nutritional support surrounds symptom management. The common side effects of chemotherapy such as nausea, mucositis (mouth sores), and extreme weight loss were taken into account. Recipes were formulated to directly address these conditions and each recipe was broken down into the benefits of both macronutrients and micronutrients. In addition to formulating specific recipes and videos, barriers to proper nutritional support were examined and explained. These barriers include understaffing of clinical dietitians at cancer treatment centers, a patient's lack of transportation to and from treatments, as well as an overwhelming viewpoint that nutritional support is only required for extreme cases of malnutrition. Combatting these barriers and offering more forms of nutritional support will help to increase a patient's positive response to treatment, manage their symptoms, and improve their overall quality of life.
ContributorsMonteilh, Christina Eleanor (Author) / Levinson, Simin (Thesis director) / Martinelli, Sarah (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12