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- All Subjects: Nutrition
- Creators: Wardenaar, Floris
- Member of: Theses and Dissertations
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
Description
Water is an essential nutrient that is often overlooked. As a result of this hydration status is often forgotten as well. Becoming hypohydrated puts athletes at risk of decreased performance and potentially life-threatening heat illness. Being able to self-assess hydration status is may be instrumental in helping athletes safely optimize performance. Therefore, this study investigated, 1) the ability of an athletic population vs. trained investigators to self-diagnose underhydration, 2) the diagnostic ability of urine color (Ucol) charts as a method for diagnosing underhydration, and 3) the accuracy of participant and investigator assessments. Members of an athletic population each provided a urine sample and scored samples using both the traditional 8-color and newly developed 7-color Ucol chart. Investigators then scored the samples using the same methods. To determine the diagnostic value of the Ucol charts, Ucol scores were compared to concentration measures of Urine Specific Gravity (USG) and Urine Osmolality (Uosm). Differences in participant and investigator scores were compared using Mann-Whitney U and Spearman’s Correlation. Bland-Altman plots were drawn to assess individual differences in reporting against the mean of the two methods. Receiver Operating Characteristic (ROC) analysis was used to both determine the ability of both charts to diagnose underhydration and to determine how well participants and investigators can determine their level of hydration. Athletes reported Ucol significantly lighter compared to investigators. Investigators showed no difference in reporting between the two charts but, athletes reported less than a color shade difference. The charts performed fair (8-color) to good (7-color) at diagnosing hypohydration. Athletes reported with less accuracy compared to investigators, and Ucol classification was found to be more accurate when compared to USG. Ucol charts are a practical tool to determine hydration status. Ucol scoring is similar regardless of the type of chart used. Trained investigators reported with slightly higher accuracy on both charts compared to untrained athletes. Athletes score Ucol fair to good in comparison to investigators. Ucol scoring is similar regardless of the type of chart used. The diagnostic ability of both Ucol charts is good in relation to USG. With education, athletes may be able to improve scores.
ContributorsPesek, Kathryn Margaret (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2022
Description
Heat acclimatization can be induced by targeting a core temperature 38.5°C for at least 60 minutes per day lasting 5 to 21 days, complementary to normal exercise activity. However, consistently meeting this threshold on consecutive days may be difficult for athletes. The objective of this study was to evaluate the efficacy of four single-bout heating protocols to reach a core temperature 38.5°C. The study was set up as a non-randomized field study, factoring in the September-October outdoor desert conditions, Tempe, AZ, USA. Environmental conditions were measured using a Kestrel heat stress tracker. Protocols were constituted out of 3 elements: PAS – passive heat exposure in a tent (54±1°C), EH - exercise in hot condition with high intensity interval training (HIIT) outdoors in the heat in a tent with a ventilator (43±1°C), EM – exercise in moderate conditions with HIIT indoors (22±0.4°C). All participants performed protocols in the following order: 1) PAS 60-min; 2) EH-PAS (EH 30-min + PAS 30-min); 3) EH 60-min, and 4) EM 60-min. A cycle ergometer was used for HIIT (2-min warm-up followed by 7x2-min sprints with 2-min relative rest between sprints during the first 30 min and stationary cycling for the second 30 min), with a self-selected workload at 80-100 rpm and similar heart rate (HR) response during exercise testing for EH: 146±10, EM: 142±13, and EH-PAS: 142±13 (P>0.05). A total of 10 active male students (25±3 years old) reported no difference between protocols for baseline Tc (P=0.37) and HR (P=0.28). During the first 30-min, Tc was significantly different between protocols (average ranging from 37.3-37.6°C, P=0.01), but from a practical perspective, differences were limited. During the second 30-min session, the Tc for EH (38.5±0.4°C) and EH-PAS (38.6±0.4°C) were significantly higher from EM (38.1±0.4°C) and PAS alone (37.8±0.4°C), P<0.001. The average HR (bpm) was significantly lower in PAS (110±17) and EH (136±13) during the second half of the protocols compared to the EH (151±10) and EM (149±16), P<0.001. In conclusion, exercise alone vs. a combination of exercise and passive heating in hot conditions resulted both in a body temperature 38.5°C, but the combination was more efficient since participants exercised for only 30-minutes.
ContributorsNavarro, Sonia (Author) / Wardenaar, Floris (Thesis advisor) / Kavouras, Stavros (Committee member) / Vanos, Jennifer (Committee member) / Arizona State University (Publisher)
Created2022
Description
The purpose of this study was to evaluate the impact of improved hydration on endurance performance and mood in physically active adults. Participants (n = 72; age, 21.0 ± 3.0; 22.2% female) completed two two-mile run trials separated by exactly a week. Before each trial, participants provided a urine sample from the day before the run and a sample from the morning of the run. These samples were analyzed for urine osmolality (UOsm), urine specific gravity (USG), and urine color (Ucol). UOsm and USG levels determined if the participants were placed in either the euhydrated or underhydrated group after the first trial. Those assigned to the euhydrated group were instructed to maintain their current fluid intake levels and those in the underhydrated group were instructed to increase fluid intake levels before the second trial. However, results were grouped by if they improved or maintained their hydration or not. The subjects also completed a Profile of Mood States (POMS) questionnaire before and after each trial to determine mood. Based on conditioning requirements for group assignment, 38% of subjects were classified as underhydrated. There were significant differences between the two trials for both subjects that improved and worsened their hydration in UOsm, USG, Ucol, and thirst (P < 0.05). The group with improved hydration ran -15 ± 67 sec faster in the second trial, while the group that worsened hydration ran 4 ± 26 sec slower in the second trial. When these differences were compared between the two groups with a t-test, there was a trend for statistical differences with a one-way t-test analysis (P = 0.06). When results were split by sex no statistically significant differences were observed (male: -10.8 ± 63.6 sec; female: -29.4 ± 94.8 sec; P > 0.05). Improved hydration did not result in statistically significant difference in TMD or any of the individual mood sub-scales for either group for both males and females (P > 0.05). In conclusion, increased fluid intake to optimize hydration status may affect endurance exercise in young, healthy adults in a two-mile run, but no effect was seen on mood.
ContributorsDoyle, Amanda Ann (Author) / Kavouras, Stavros (Thesis advisor) / Alexon, Christy (Committee member) / Wardenaar, Floris (Committee member) / Arizona State University (Publisher)
Created2022
Description
Gastrointestinal (GI) complaints are prevalent among athletes. Fermented foods with pre-or probiotic features may relieve GI symptoms by improving gut health. This study aimed is to examine the impact of a nutritional supplement containing fermented whey protein with Galacto-oligosaccharide (GOS) fiber on GI distress among well-trained athletes over time by analyzing self-reported GI complaints without a control group. This quasi-experimental clinical trial consisted of a 3-week baseline period, reflected by two baseline measurements on Day 1 and Day 22, which was followed by a 3-week intervention period, reflected by a post-intervention measurement on Day 43, in which athletes added 15g of a fermented whey protein product to their diet. The primary outcome was based on the self-reported gastrointestinal symptom rating scale (GSRS), and the secondary outcome was based on a daily questionnaire, in which daily GI complaints and exercise occurrences were reported. Tertiary outcomes included a 24-hour diet recall (ASA24) and self-reported diet quality (REAP). Outcomes obtained during baseline (Day 1 and Day 22 average) were compared to those post-intervention (Day 43). Statistical significance was set at P<0.05. A total of n=50 athletes (24.7±4.5 years) with GI issues were included in the study. Five individual items of the GSRS including abdominal pain, acid reflux, bloating, burping, and loose stools reflected significantly lower scores on Day 43 in comparison to baseline (P≤0.028). A total of 78% reported GI complaints at baseline, and 61% of the participants reported lower GI complaints on Day 43 after supplementation in comparison to baseline (P=0.004). Further research is needed to explore the potential benefits of a hydrolyzed and fermented whey protein with prebiotics in a more controlled setting among athletic populations.
ContributorsClear, Anna Marie Grace (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Committee member) / Arizona State University (Publisher)
Created2023
Description
Sleep is an essential biological requirement to sustain human life and a critical component for athletes. There has been a rising trend for poor sleep in the general population and the problem persists as well within the athletic population. Research has demonstrated numerous benefits of optimized sleep on athletic performance and athlete wellness. Further investigation of potential dietary strategies to improve self-perceived sleep quality is warranted. This study examined the differences in perceived sleep quality and wellness between a 3-week baseline period and after a 3-week supplementation period, in which participants consumed a dietary supplement containing fermented whey protein + galacto-oligosaccharides (GOS) + casein protein daily. Validated questionnaires, namely, Athens Insomnia Scale (AIS), Physical Health Questionnaire (PHX), Kessler-6 Mental Stress Scale (K6) were used to measure perceived sleep quality and wellness on Day 1, Day 22 and Day 43. Additionally, multiple 24-h dietary recalls (ASA24), and food quality using the validated Rapid Eating Assessments for Participants (REAP) questionnaire, were used to assess dietary patterns throughout the study, while exercise occurrence was tracked through a self-developed daily questionnaire. A total of 54 healthy active adults (age=18-35yrs) experiencing gastro-intestinal (GI) complaints were included in the trial, and 50 participants were included in the final analysis. Significantly lower AIS-8 total scores were found on Day 43 compared to Day 22 while controlled for Day 1 (Day 43: 4.36 ± 3.68 versus Day 22: 5.02 ± 4.11, F=4.379 (1, 50), p=0.042), while no differences were found for wellbeing (p≥ 0.180). Dietary intake, food quality and exercise frequency did not change over time (p≥0.080). These results suggested that a daily protein + GOS supplement was associated with a decrease in AIS-8 total scores suggesting improved perceived sleep quality among athletes after 3 weeks. A controlled research study should confirm these results in the future. More research is required to assess the effects of protein + prebiotic supplementation on sleep parameters among athletes.
ContributorsChan, Yat (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Committee member) / Arizona State University (Publisher)
Created2023
Description
The human body has temperature-regulating mechanisms working to maintain body core temperature around 37°C. This ensures optimal bodily function. Disruption to core temperature however, initiates a cascade of events to return to baseline. The objective of this study is to evaluate the efficacy of cooling strategies to induce the fastest reductions in core temperature. The study was set up as a randomized field study. Core temperature was measured using an E-Celsius core temperature capsule. Environmental conditions were measured using a Kestrel heat stress tracker. Following completion of a heat-stress protocol, participants underwent one of the four randomized cooling protocols. These cooling protocols consisted of: 1) wearing an ice vest (18°C), 2) applying an icy towel directly to the back of the neck (24°C) in combination with hand/forearm water immersion (15°C), 3) a combination of ice vest, icy towel and hand/forearm water immersion, or 4) sitting in a thermoneutral room (20°C). In all cooling interventions, participants consumed 16oz of an ice slurry (0°C) within 10 minutes of the initiation of the protocol. The control group consumed only room temperature water- ad libitum. A total of 10 active males (25 ± 3 years old) reported no difference between baseline body core temperatures after each heating intervention (P=0.23). Average core temperature and heart rate differed, though not statistically significant between treatments (P>0.05). No significant differences were noted between cooling rates (P=0.51). Skin temperature (Tsk) average and decrement was found to be statistically significant (P<0.001).
ContributorsCaballero, Rachel (Author) / Wardenaar, Floris (Thesis advisor) / Kavouras, Stavros (Committee member) / Vanos, Jennifer (Committee member) / Arizona State University (Publisher)
Created2022
Description
More than 200 hikers are rescued annually in the greater Phoenix area. This study
examined the impact of hiking in hot (HOT), dry temperatures versus moderate (MOD)
temperatures on dietary intake behaviors as well as markers of heat stress. Twelve
recreational mountain hikers climbed “A” Mountain four consecutive times (4-miles) on
a HOT day (WBGT=31.6 °C) and again on a MOD day (WBGT= 19.0 °C). Simulated
food and fluid behavior allowed participants to bring what they normally would for a 4-
mile hike and to consume both ad libitum. The following heat stress indicators (mean
difference; p-value), were all significantly higher on the HOT hike compared to the MOD
hike: average core temperature (0.6 °C; p=0.002), average rating of perceived exertion
(2.6; p=0.005), sweat rate (0.54; p=0.01), and fluid consumption (753; p<0.001). On the
HOT hike, 42% of the participants brought enough fluids to meet their individual
calculated fluid needs, however less than 20% actually consumed enough to meet those
needs. On the MOD hike, 56% of participants brought enough fluids to meet their needs,
but only 33% actually consumed enough to meet them. Morning-after USG samples
≥1.020 indicating dehydration on an individual level showed 75% of hikers after the
HOT hike and 67% after the MOD hike were unable to compensate for fluids lost during
the previous day’s hike. Furthermore, participant food intake was low with only three
hikers consuming food on the hot hike, an average of 33.2g of food. No food was
consumed on the MOD hike. These results demonstrate that hikers did not consume
enough fluids to meet their needs while hiking, especially in the heat. They also show
heat stress negatively affected hiker’s physiological and performance measures. Future
recommendations should address food and fluid consumption while hiking in the heat.
examined the impact of hiking in hot (HOT), dry temperatures versus moderate (MOD)
temperatures on dietary intake behaviors as well as markers of heat stress. Twelve
recreational mountain hikers climbed “A” Mountain four consecutive times (4-miles) on
a HOT day (WBGT=31.6 °C) and again on a MOD day (WBGT= 19.0 °C). Simulated
food and fluid behavior allowed participants to bring what they normally would for a 4-
mile hike and to consume both ad libitum. The following heat stress indicators (mean
difference; p-value), were all significantly higher on the HOT hike compared to the MOD
hike: average core temperature (0.6 °C; p=0.002), average rating of perceived exertion
(2.6; p=0.005), sweat rate (0.54; p=0.01), and fluid consumption (753; p<0.001). On the
HOT hike, 42% of the participants brought enough fluids to meet their individual
calculated fluid needs, however less than 20% actually consumed enough to meet those
needs. On the MOD hike, 56% of participants brought enough fluids to meet their needs,
but only 33% actually consumed enough to meet them. Morning-after USG samples
≥1.020 indicating dehydration on an individual level showed 75% of hikers after the
HOT hike and 67% after the MOD hike were unable to compensate for fluids lost during
the previous day’s hike. Furthermore, participant food intake was low with only three
hikers consuming food on the hot hike, an average of 33.2g of food. No food was
consumed on the MOD hike. These results demonstrate that hikers did not consume
enough fluids to meet their needs while hiking, especially in the heat. They also show
heat stress negatively affected hiker’s physiological and performance measures. Future
recommendations should address food and fluid consumption while hiking in the heat.
ContributorsPelham, Emily Claire (Author) / Wardenaar, Floris (Thesis advisor) / Whisner, Corrie (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2020
Description
The assessment and evaluation of dietary intake and nutrition knowledge in female athletes is especially important due to the high prevalence of inadequate intake in this population (Black et al., 2019). This study evaluated 1) the relationship of nutrition knowledge and dietary intake among collegiate female athletes at the National Collegiate Athletic Association (NCAA) Division I, National Junior College Athletic Association (NJCAA), and Club sport levels and 2) the impact of competition level on this relationship as well. Participants (NCAA DI, n=51; NJCAA, n = 36; Club, n = 37) in this study answered two questionnaires, the Nutrition Sport Knowledge Questionnaire (NSKQ) and the Rapid Eating Assessment for Participants (REAP) questionnaire to assess knowledge and dietary intake. Participants also provided anthropometric and demographic information. The NSKQ was scored as a whole and for each of the four subcategories. REAP was scored both by tallying the number of “usually/often” frequency responses and given a numeral score to estimate diet quality. Statistical analysis was conducted using Kruskal-Wallis, Chi-square and Spearman’s correlation tests to compare differences within subgroups of participants and evaluate any relationships that may exist between nutrition knowledge and dietary intake with significance set at p≤0.05. Differences in nutrition knowledge between competition groups were significant, H(2)= 16.94, p< 0.001. NCAA DI (p<0.001) and Club (p<0.001) athletes had higher nutrition knowledge than athletes at the NJCAA level. This was true for overall knowledge as well as knowledge subcategories. However, minimal relationships between nutrition knowledge and dietary intake were found. The overall correlation value was rs(118)= -0.10 (95%CI: -0.28 to 0.08), p>0.05. This suggests those with higher nutrition knowledge did not necessarily have better dietary intake. Improvements in the assessment of nutrition knowledge and quick assessment of dietary quality and the relation between both is needed.
ContributorsSkinner, Jensen Drew (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2020
Description
This study aimed to investigate the effects of specific macronutrient feedings on competitive golf performance and perceived levels of fatigue and alertness. Participants played three, nine hole rounds of golf, consuming an isocaloric beverage as a control (CON), with the addition of carbohydrate (CHO), or combination of protein and carbohydrate (COM). Physiological and performance measurements were taken before, during, and following each nine hole round. Performance measurements include driving accuracy (DA), driving distance (DD), iron accuracy (IA), chipping accuracy (CA), and putting accuracy (PA). Pre-golf hydration status (urine specific gravity [USG]) and Sweat Rate during golf performance showed no significant differences between trials. All nine hole rounds were performed in ~2 hours. Environmental conditions were similar for all three testing days (mean WBGT=10.946). No significant differences were seen in Driving Distance, Driving Accuracy, and Iron Accuracy for all nine holes between groups receiving different macronutrient feedings. Chipping Accuracy was significantly better in CON trial compared to CHO (p=0.004) and COM (p=0.019). No significant differences were seen in putting make percentages. COM trial significantly lowered Perceived Levels of Fatigue (p=0.019) compared to CON. The CHO trial showed significant improvements in DA compared to CON (13.7 vs. 44.1, p=0.012) and COM (13.7 vs. 33.6, p=0.004) in the first four holes. In the last five holes, the COM trial showed significant improvements in DA compared to CHO (17.5 vs. 29.7, p=0.007). Low Handicap golfers (3 +/- 3) performed significantly better than High Handicap golfers (14 +/- 3.6) in DD (265 vs. 241, p<0.001), DA (15.0 vs. 29.3, p=0.004), IA (15.2 vs. 25.2, p<0.001), CA (52.0 vs. 61.5, p=0.027), and PA 5ft (64% vs. 40%, p=0.003). High Handicap players showed no significant differences between the three trials for any golf performance measurements. Low Handicap players showed significant improvements in DA for COM trial compared to CON trial (13.6 vs. 27.6, p=0.003). The results suggest that carbohydrates at the start and a combination of carbohydrate and protein is beneficial at the second part of 9 holes to improve golf performance and maintain levels of fatigue, however, it needs to be investigated how this knowledge will relate to playing more holes.
ContributorsThompsett, Daniel James (Author) / Wardenaar, Floris (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Hondula, David M. (Committee member) / Arizona State University (Publisher)
Created2020