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Healthy lifestyle behaviors including quality nutrition have been shown to successfully prevent chronic disease or minimize symptoms. However, many physicians lack the knowledge and skills to provide adequate nutrition counseling and education for their patients. A major component of this problem is that medical schools are not required to teach nutrition education. The purpose of this feasibility study was to compare the changes in the perceived importance of nutrition in the medical field in medical students before and after participating in a week-long interactive nutrition course in order to determine if a week-long course can positively influence students’ perceptions of nutrition. Ultimately by changing these perceptions, medical students may be able to better help patients prevent chronic disease. The participants were first year medical students at the Mayo Clinic School of Medicine (Scottsdale, AZ) who chose to participate in this medical school “Selective”. The study included a five-day curriculum of case-studies, lectures from specialized health professionals, and a cooking class led by a chef who trained in France. An anonymous pre- and post-study questionnaire with five-point Likert scale questions was used to measure changes in attitudes. The data suggest that students’ perceptions regarding the importance and relevance of nutrition in the medical shifted slightly more positive after attending this Selective, although these shifts in attitude were not statistically significant. Limitations of this study include a small sample size and selection bias, which may have decreased the potential of having significant results. Both of these factors also make the results of this study less generalizable to all medical students. This study supports the need for a larger experimental study of a similar design to verify that an interactive, evidence-based nutrition class and culinary experience increases medical students’ positive perceptions of nutrition in the medical field.
ContributorsBaum, Makenna (Author) / Johnston, Carol (Thesis advisor) / Levinson, Simin (Committee member) / Sears, Dorothy (Committee member) / Arizona State University (Publisher)
Created2020
Description
The study was to analyze the extent of bacterial transport in a two-dimensional tank under saturated conditions. The experiments were done in a 2-D tank packed with 3,700 in3 of fine grained, homogenous, chemically inert sand under saturated conditions. The tank used for transport was decontaminated by backwashing with 0.6% chlorine solution with subsequent backwashing with chlorine-neutral water (tap water and Na2S2O3) thus ensuring no residual chlorine in the tank. The transport of bacteria was measured using samples collected from ports at vertical distances of 5, 15 and 25 inches (12.7, 38.1 and 63.5 cm) from the surface of the sand on both sides for the 2-D tank. An influent concentration of 105 CFU/mL was set as a baseline for both microbes and the percolation rate was set at 11.37 inches/day using a peristaltic pump at the bottom outlet. At depths of 5, 15 and 25 inches, E. coli breakthroughs were recorded at 5, 17 and 28 hours for the ports on the right side and 7, 17 and 29 hours for the ports on the left sides, respectively. At respective distances Legionella breakthroughs were recorded at 8, 22 and 35 hours for the ports on the right side and 9, 24, 36 hours for the ports on the left side, respectively which is homologous to its pleomorphic nature. A tracer test was done and the visual breakthroughs were recorded at the same depths as the microbes. The breakthroughs for the dye at depths of 5, 15 and 25 inches, were recorded at 13.5, 41 and 67 hours for the ports on the right side and 15, 42.5 and 69 hours for the ports on the left side, respectively. However, these are based on visual estimates and the physical breakthrough could have happened at the respective heights before the reported times. This study provided a good basis for the premise that transport of bacterial cells and chemicals exists under recharge practices.
ContributorsMondal, Indrayudh (Author) / Abbaszadegan, Morteza (Thesis advisor) / Dahlen, Paul (Committee member) / Delgado, Anca (Committee member) / Arizona State University (Publisher)
Created2019
Description
Objective: Migration to the United States (U.S.) has been associated with food insecurity and detrimental changes in diet quality. How these changes affect women in context of their neighborhood food environment has not been thoroughly explored. This study aimed to assess if food security is associated with diet quality and to explore if perceived food availability moderates this purported association in a sample of Mexican immigrant women.
Methods: Mexican-born women (n=57, 41±7 years) residing in the U.S. for more than 1 year self-reported food security status, monthly fast-food frequency, and their perception of fruit, vegetables, and low-fat product availability within their neighborhood via survey. Diet was assessed using the Southwest Food Frequency Questionnaire to estimate intake of fruit, vegetables, salty snacks, sugar, and healthy eating index (HEI)-2015 score. Bivariate correlations assessed the relationships between study variables. Independent samples t-tests compared dietary outcomes between women classified as food secure (n=41; high or marginal food security) and food insecure (n=16; low or very low food security). A moderation analysis assessed the effect of the perception of the neighborhood food environment on the relationship between food security and HEI-2015 score.
Results: Fifty four percent of participants worked full time and 42% had a monthly household income <$2,000. Time residing in the U.S. was 20±9 years. Relative to women classified as food secure, participants experiencing food insecurity had lower HEI-2015 (61±8 vs. 66±6; p=0.03). Albeit not significantly different, women experiencing food insecurity reported lower intake of fruit (236±178 vs. 294±239 g), vegetables (303±188 vs. 331±199 g), and salty snacks (6±5 vs. 8±10 g), as well as higher intake of sugar (99±55 vs. 96±56 g) and fast food (2.5±2.5 vs. 1.8±1.7 times per month); p>0.05 for all. Among women experiencing food insecurity, there was a trend for a lower perception of neighborhood fruit, vegetable and low-fat product availability being associated with lower HEI-2015 scores (54±6) relative to those who perceived moderate (63±6) or high (65±8) neighborhood availability of those foods (p=0.07).
Conclusions: HEI-2015 scores were associated with participants’ food security status. Findings suggest a need for better understanding of how neighborhood food availability may affect diet quality among Mexican immigrant women experiencing food insecurity.
Methods: Mexican-born women (n=57, 41±7 years) residing in the U.S. for more than 1 year self-reported food security status, monthly fast-food frequency, and their perception of fruit, vegetables, and low-fat product availability within their neighborhood via survey. Diet was assessed using the Southwest Food Frequency Questionnaire to estimate intake of fruit, vegetables, salty snacks, sugar, and healthy eating index (HEI)-2015 score. Bivariate correlations assessed the relationships between study variables. Independent samples t-tests compared dietary outcomes between women classified as food secure (n=41; high or marginal food security) and food insecure (n=16; low or very low food security). A moderation analysis assessed the effect of the perception of the neighborhood food environment on the relationship between food security and HEI-2015 score.
Results: Fifty four percent of participants worked full time and 42% had a monthly household income <$2,000. Time residing in the U.S. was 20±9 years. Relative to women classified as food secure, participants experiencing food insecurity had lower HEI-2015 (61±8 vs. 66±6; p=0.03). Albeit not significantly different, women experiencing food insecurity reported lower intake of fruit (236±178 vs. 294±239 g), vegetables (303±188 vs. 331±199 g), and salty snacks (6±5 vs. 8±10 g), as well as higher intake of sugar (99±55 vs. 96±56 g) and fast food (2.5±2.5 vs. 1.8±1.7 times per month); p>0.05 for all. Among women experiencing food insecurity, there was a trend for a lower perception of neighborhood fruit, vegetable and low-fat product availability being associated with lower HEI-2015 scores (54±6) relative to those who perceived moderate (63±6) or high (65±8) neighborhood availability of those foods (p=0.07).
Conclusions: HEI-2015 scores were associated with participants’ food security status. Findings suggest a need for better understanding of how neighborhood food availability may affect diet quality among Mexican immigrant women experiencing food insecurity.
ContributorsVerdezoto Alvarado, Adriana Patricia (Author) / Vega-Lopez, Sonia (Thesis advisor) / Ochoa, Candelaria Berenice (Committee member) / Melendez, Juana Maria (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2020
Description
According to the World Health Organization, obesity has nearly tripled since 1975 and forty-one million children under the age of 5 are overweight or obese (World Health Organization, 2018). Exercise is a potential intervention to prevent obesity-induced cardiovascular complications as exercise training has been shown to aid nitric oxide (NO) production as well as preserving endothelial function in obese mice (Silva et al., 2016). A soil-derived organic mineral compound (OMC) has been shown to lower blood sugar in diabetic mice (Deneau et al., 2011). Prior research has shown that, while OMC did not prevent high fat diet (HFD)-induced increases in body fat in male Sprague-Dawley rats, it was effective at preventing HFD-induced impaired vasodilation (M. S. Crawford et al., 2019). Six-weeks of HFD has been shown to impair vasodilation through oxidative-stress mediated scavenging of NO as well as upregulation of inflammatory pathways including inducible nitric oxide synthase (iNOS) and cyclooxygenase (Karen L. Sweazea et al., 2010). Therefore, the aim of the present study was to determine whether OMC alters protein expression of iNOS and endothelial NOS (eNOS) in the vasculature of rats fed a control or HFD with and without OMC supplementation. Six-week old male Sprague-Dawley rats were fed either a standard chow diet (CHOW) or a HFD composed of 60% kcal from fat for 10 weeks. The rats were administered OMC at doses of 0 mg/mL (control), 0.6 mg/mL, or 3.0 mg/mL added to their drinking water. Following euthanasia with sodium pentobarbital (200 mg/kg, i.p.), mesenteric arteries and the surrounding perivascular adipose tissue were isolated and prepared for Western Blot analyses. Mesenteric arteries from HFD rats had more uncoupled eNOS (p = 0.006) and iNOS protein expression (p = 0.027) than rats fed the control diet. OMC was not effective at preventing the uncoupling of eNOS or increase in iNOS induced by HFD. Perivascular adipose tissue (PVAT) showed no significant difference in iNOS protein expression between diet or OMC treatment groups. These findings suggest that OMC is not likely working through the iNOS or eNOS pathways to improve vasodilation in these rats, but rather, appears to be working through another mechanism.
ContributorsNelson, Morgan Allen (Author) / Sweazea, Karen L (Thesis advisor) / Katsanos, Christos S (Committee member) / Baluch, Debra P (Committee member) / Arizona State University (Publisher)
Created2020
Description
Fusion proteins that specifically interact with biochemical marks on chromosomes represent a new class of synthetic transcriptional regulators that decode cell state information rather than deoxyribose nucleic acid (DNA) sequences. In multicellular organisms, information relevant to cell state, tissue identity, and oncogenesis is often encoded as biochemical modifications of histones, which are bound to DNA in eukaryotic nuclei and regulate gene expression states. In 2011, Haynes et al. showed that a synthetic regulator called the Polycomb chromatin Transcription Factor (PcTF), a fusion protein that binds methylated histones, reactivated an artificially-silenced luciferase reporter gene. These synthetic transcription activators are derived from the polycomb repressive complex (PRC) and associate with the epigenetic silencing mark H3K27me3 to reactivate the expression of silenced genes. It is demonstrated here that the duration of epigenetic silencing does not perturb reactivation via PcTF fusion proteins. After 96 hours PcTF shows the strongest reactivation activity. A variant called Pc2TF, which has roughly double the affinity for H3K27me3 in vitro, reactivated the silenced luciferase gene by at least 2-fold in living cells.
ContributorsVargas, Daniel A. (Author) / Haynes, Karmella (Thesis advisor) / Wang, Xiao (Committee member) / Mills, Jeremy (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: Children’s fruit and vegetable consumption in the United States is lower than recommended. School lunch is an opportunity for students to be exposed to fruits and vegetables and potentially increase their daily intake. The purpose of this study is to examine the relationship between tray color and fruit and vegetable selection, consumption, and waste at lunch.
Methods: Study participants (n=1469) were elementary and middle school students who ate school lunch on the day of data collection. Photographs and weights (to nearest 2 g) were taken of fruits and vegetables on students’ trays before and after lunch. Trained research assistants viewed photographs and sorted trays into variable categories: color of main tray, presence/absence of secondary fruit/vegetable container, and color of secondary fruit/vegetable container. Fruit and vegetable selection, consumption, and waste were calculated using tray weights. Negative binomial regression models adjusted for gender, grade level, race/ethnicity, free/reduced price lunch status, and within-school similarities were used to examine relationships between tray color and fruit and vegetable selection, consumption, and waste.
Results: Findings indicated that students with a light tray selected (IRR= 0.44), consumed (IRR=0.73) and wasted (IRR=0.81) less fruit and vegetables. Students without a secondary fruit/vegetable container selected (IRR=0.66) and consumed (IRR=0.49) less fruit and vegetables compared to those with a secondary container. Light or clear secondary fruit and vegetable containers were related to increased selection (IRR=2.06 light, 2.30 clear) and consumption (IRR=1.95 light, 2.78 clear) compared to dark secondary containers, while light secondary containers were related to decreased waste (IRR= 0.57).
Conclusion: Tray color may influence fruit and vegetable selection, consumption, and waste among students eating school lunch. Further research is needed to determine if there is a cause and effect relationship. If so, adjusting container colors may be a practical intervention for schools hoping to increase fruit and vegetable intake among students.
Methods: Study participants (n=1469) were elementary and middle school students who ate school lunch on the day of data collection. Photographs and weights (to nearest 2 g) were taken of fruits and vegetables on students’ trays before and after lunch. Trained research assistants viewed photographs and sorted trays into variable categories: color of main tray, presence/absence of secondary fruit/vegetable container, and color of secondary fruit/vegetable container. Fruit and vegetable selection, consumption, and waste were calculated using tray weights. Negative binomial regression models adjusted for gender, grade level, race/ethnicity, free/reduced price lunch status, and within-school similarities were used to examine relationships between tray color and fruit and vegetable selection, consumption, and waste.
Results: Findings indicated that students with a light tray selected (IRR= 0.44), consumed (IRR=0.73) and wasted (IRR=0.81) less fruit and vegetables. Students without a secondary fruit/vegetable container selected (IRR=0.66) and consumed (IRR=0.49) less fruit and vegetables compared to those with a secondary container. Light or clear secondary fruit and vegetable containers were related to increased selection (IRR=2.06 light, 2.30 clear) and consumption (IRR=1.95 light, 2.78 clear) compared to dark secondary containers, while light secondary containers were related to decreased waste (IRR= 0.57).
Conclusion: Tray color may influence fruit and vegetable selection, consumption, and waste among students eating school lunch. Further research is needed to determine if there is a cause and effect relationship. If so, adjusting container colors may be a practical intervention for schools hoping to increase fruit and vegetable intake among students.
ContributorsWeight, Raquelle (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2020
Description
Prior to the first successful allogeneic organ transplantation in 1954, virtually every attempt at transplanting organs in humans had resulted in death, and understanding the role of the immune mechanisms that induced graft rejection served as one of the biggest obstacles impeding its success. While the eventual achievement of organ transplantation is touted as one of the most important success stories in modern medicine, there still remains a physiological need for immunosuppression in order to make organ transplantation work. One such solution in the field of experimental regenerative medicine is interspecies blastocyst complementation, a means of growing patient-specific human organs within animals. To address the progression of immune-related constraints on organ transplantation, the first part of this thesis contains a historical analysis tracing early transplant motivations and the events that led to the discoveries broadly related to tolerance, rejection, and compatibility. Despite the advancement of those concepts over time, this early history shows that immunosuppression was one of the earliest limiting barriers to successful organ transplantation, and remains one of the most significant technical challenges. Then, the second part of this thesis determines the extent at which interspecies blastocyst complementation could satisfy modern technical limitations of organ transplantation. Demonstrated in 2010, this process involves using human progenitor cells derived from induced pluripotent stem cells (iPSCs) to manipulate an animal blastocyst genetically modified to lack one or more functional genes responsible for the development of the intended organ. Instead of directly modulating the immune response, the use of iPSCs with interspecies blastocyst complementation could theoretically eliminate the need for immunosuppression entirely based on the establishment of tolerance and elimination of rejection, while also satisfying the logistical demands imposed by the national organ shortage. Although the technology will require some further refinement, it remains a promising solution to eliminate the requirement of immunosuppression after an organ transplant.
ContributorsDarby, Alexis Renee (Author) / Maienschein, Jane (Thesis advisor) / Robert, Jason (Thesis advisor) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2020
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
Background: Stores authorized by the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to improve the community food environments of lower-income areas by stocking healthy food items in accordance with the program’s food package guidelines. Whether greater access to WIC-authorized stores is associated with improvements in diet among children from WIC and non-WIC households is not well understood. Methods: Secondary analysis of cross-sectional data collected in 2009-2010 and 2014 for the New Jersey Child Health Study (NJCHS). Surveys from 2,211 urban households with 3-18-year-old children. Counts of WIC stores near children’s homes determined through geo-coding of store and household addresses using roadway network distances of 0.5 and 1.0 mile. Children’s consumption was categorized in age-specific deciles of quantities consumed for each food category examined: fruits, vegetables, sugar from sugar-sweetened beverages, total added sugars. Associations between counts of WIC stores and children’s consumption were examined, first for the full sample, then by household WIC participation.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
ContributorsStevens, Clinton (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Gosliner, Wendi (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2021
Description
This study was designed to examine the associations between food skills, resilience, and coping during the Covid-19 pandemic. Between April and June of 2020, a sample of 154 students, faculty, and staff from Arizona State University were surveyed. Each respondent was administered a survey containing demographic questions, a food skill questionnaire, and the 14-item Resilience Scale (RS). Results indicate that food skill was correlated with resilience (p<0.001) at an r=0.364 and r2=0.1243 and that resilience was correlated with coping during the Covid-19 pandemic (p<0.001) at an r=0.455. Correlations were also run between resilience score and the separate domains of food skill score: all domains remained significantly associated with resilience score (p<0.001) with a r=0.340 and r2=0.1173 for ‘Food Selection and Planning,’ r=0.312 and r2=0.0958 for ‘Food Preparation,’ and r=0.294 and r2=0.0767 for ‘Food Safety.’ Data seems to be consistent with contemporary research suggesting positive associations between diet quality and physiological resilience and positive associations between resilience and coping during the Covid-19 pandemic.
ContributorsPhares, Savanna Julene (Author) / Johnston, Carol (Thesis advisor) / McCoy, Maureen (Committee member) / Irving, Andrea (Committee member) / Arizona State University (Publisher)
Created2020