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Description
This study explores how newspapers framed the weight-loss drugs Xenical®(orlistat) and Alli® (over-the-counter orlistat) during the time period of three months prior to their approvals by the U.S. Food and Drug Administration until one year after each became available on the market. As of June 2011, orlistat is the only weight-loss drug available for long-term use in the U.S. Newspapers are influential sources of information about health issues. Agenda-setting, framing, and priming in news articles can have a powerful effect on public perceptions and behaviors. To conduct the content analysis, researchers first developed a codebook containing variables that described the sources of attribution and the features of each drug. They tested the codebook in a series of pilot tests to ensure inter-rater reliability. The sample of texts for the content analysis, drawn from LexisNexis Academic, contained 183 newspaper articles composed of 85 Xenical articles and 98 Alli articles. The overlap was 25% for inter-rater reliability as well as intra-rater reliability. Frequencies were tabulated using Predictive Analytics SoftWare, version 18.0.3. Results demonstrated that Xenical and Alli were framed differently in some critical ways. For example, there were twice as many quotes from the manufacturer for Alli than for Xenical. Researchers concluded that the reporting on Alli was heavily influenced by the manufacturer's multi-media public relations campaign in the months prior to the market-release date.
ContributorsLehmann, Jessica (Author) / Hampl, Jeffrey S. (Thesis advisor) / Bramlett-Solomon, Sharon (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2011
Description
The antioxidant, antihistamine, and chemotactic properties of vitamin C provide the theoretical basis linking vitamin C supplementation to combating the common cold; yet, the clinical evidence is mixed. To date, vitamin C intervention trials have not systematically recorded cold symptoms daily or looked at fluctuations in plasma histamine over an extended period. Also, trials have not been conducted in individuals with marginal vitamin C status. This study examined the impact of vitamin C supplementation during cold season on specific cold symptoms in a population with low plasma vitamin C concentrations. Healthy young males who were not regular smokers or training for competitive sports between the ages of 18 and 35 with below average plasma vitamin C concentrations were stratified by age, body mass index, and vitamin C status into two groups: VTC (500 mg vitamin C capsule ingested twice daily) or CON (placebo capsule ingested twice daily). Participants were instructed to fill out the validated Wisconsin Upper Respiratory Symptom Survey-21 daily for 8 weeks. Blood was sampled at trial weeks 0, 4, and 8. Plasma vitamin C concentrations were significantly different by groups at study week 4 and 8. Plasma histamine decreased 4.2% in the VTC group and increased 17.4% in the CON group between study weeks 0 and 8, but these differences were not statistically significant (p>0.05). Total cold symptom scores averaged 43±15 for the VTC group compared to 148±36 for the CON group, a 244% increase in symptoms for CON participants versus VTC participants (p=0.014). Additionally, recorded symptom severity and functional impairment scores were lower in the VCT group than the CON group (p=0.031 and 0.058, respectively). Global perception of sickness was 65% lower in the VTC group compared to the CON group (p=0.022). These results suggest that 1000 mg of vitamin C in a divided dose daily may lower common cold symptoms, cold symptom severity, and the perception of sickness. More research is needed to corroborate these findings.
ContributorsOsterday, Gillean (Author) / Johnston, Carol (Thesis advisor) / Beezhold, Bonnie (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2012
Description
The evaluation of nutritional status by dietary intake assessment is fundamental to nutrition research. Accurate assessment allows for health professional-moderated diet adjustment in order to promote disease prevention and management. However, dietary intake can be extremely challenging to measure properly as reliability and accuracy are essential. As technology use has become more prevalent in recent years, an assortment of online, web-based diet analysis methods have begun to emerge. Are these modern methods as accurate as the traditional methods? The aim of this study was to compare and contrast diet analyses from a feeding trial in which both subject-coded (using the Automated Self Administered 24 hour recall, or the ASA24) and investigator-coded (using the Food Processor diet analysis program) diet records were available. Sixty-four overweight (body mass index >27-40 kg/m2) members of a campus community between the ages of 20-45 were recruited for an 8-week parallel arm, randomized controlled trial to evaluate the impact of two different pre-dinner meal snacks on satiety, calories consumed, and contribution to modest weight loss. As part of the study requirements, participants completed 3-day food logs at four different times during the trial: pre-trial, and week 1, 4, and 8. Participants also entered their dietary information into the ASA24 website the day after the intake was recorded by hand. Nutrient intake values were compared between the ASA24 records and the handwritten food logs. All statistical analyses were performed using SPSS Statistical Analysis version 19.0; bivariate analyses and Spearman correlation analyses were utilized. Energy, macronutrient, and micronutrient intakes did correlate significantly between the two methodologies, though both under-reporting and over-reporting were found to exist. Carbohydrate and fiber intakes were under-reported by subjects; retinol, beta-carotene, and vitamin C amounts were over-reported. These results are consistent with previous findings in reporting differences and suggest that the ASA24 is a comparably accurate dietary tracking tool to the traditional diet record method.
ContributorsSchohl, Brooke (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: The shortage of available dietetic internship (DI) positions for qualified applicants threatens the future of dietetics. Only about half of all applicants will obtain a slot. Additional internship positions are needed and can be offered only if more practitioners become preceptors. Objective: To examine the perceptions associated with the role of DI preceptor among nutrition and dietetic practitioners and identify barriers and motivators to becoming a DI preceptor in Arizona. Design: An online survey adapted from previous published instruments was administered between July and September 2011 to dietetic and nutrition professionals eligible to precept dietetic interns. Participants: RD, DTR, and school food service professionals on file with Arizona registries were invited to participate in the survey. A total of 675 subjects participated in the study. Statistical analyses performed: Chi-square analysis was used to assess differences between preceptors and non-preceptors for categorical variables. Independent t-tests were used to analyze differences between groups for continuous variables. Results: Respondents included 314 current or former preceptors and 361 non-preceptors with no significant differences in gender, age, or race between groups. Preceptors typically perceived the preceptor role more favorably than non-preceptors. Non-preceptors reported fewer benefits and more disadvantages to being a preceptor. Only 18% of non-preceptors knew how to become a mentor. Conclusions: Motivators for practitioners to become preceptors and continue in the role include personal benefits, dedication to the role and profession, and contributions to the workplace by interns. Barriers to mentoring interns include lack of compensation, increased workload, lack of support, lack of training, lack of resources, intern liability, and lack of knowledge of how to become a preceptor. Results of the study can be used to target barriers and emphasize benefits associated with the preceptor role to encourage participation in the preceptor process to make more internship positions available.
ContributorsWooden, Alissa (Author) / Winham, Donna M (Thesis advisor) / Mayol-Kreiser, Sandra N (Committee member) / Morse, Lisa M (Committee member) / Arizona State University (Publisher)
Created2012
Description
The popularization of energy drink use as a supplement to exercise is steadily increasing, especially among young adult males. However, the effects of energy drinks on muscular performance in young adults have yet to be clearly elucidated. Eight male subjects (mean age: 23.3 ± 4.3 yrs, height: 181.0 ± 5.3 cm, fat percent 17.8 ± 5.2%, and weight 85.3 ± 12.6 kg) completed this randomized double-blinded cross over study. The purpose of this study was to determine differences in acute muscular strength and endurance and Profile of Mood States (POMS) scores between three treatments (RockStar, sugar-free RockStar, and sugar-free caffeine-free Placebo). It was hypothesized that there would be no significant differences in acute peak torque and endurance of the knee extensors and flexors or on fatigue and vigor subscores from the POMS questionnaire. Each man was tested randomly at least 1 week apart. Diet and time of day were held constant across trials. Peak torque of knee extensors and flexors at 60, 180, 240 degress/second and fatigue index and total work were calculated by performing 50 repetitions at 240 degrees/second. There were no significant differences in peak torque, fatigue index, or total work measures or in subjective measures of fatigue or vigor from the POMS between the treatments. This study indicates that RockStar energy drinks have no acute ergogenic effects in young men performing isokinetic strength or endurance testing.
ContributorsHawley, Michelle (Author) / Swan, Pamela (Thesis advisor) / Campbell, Kathryn (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2012
Description
Determining the factors associated with the availability of healthy and unhealthy foods in the household may help in understanding the varying complexities that contribute to obesity among children and help design interventions to impact children's food consumption behaviors. This study examined factors that are associated with the availability of healthy and unhealthy foods in children's home food environments (HFE). Data was collected from a random-digit-dial telephone survey of 1708 households, with at least one child between 3-18 years of age, located in five low-income New Jersey cities. HFE was assessed based on responses to a set of six items that measured availability of specific healthy and unhealthy foods in the respondent's home. These items contributed to construction of three HFE scales used as dependent variables in these analyses: healthy HFE, unhealthy HFE, and a ratio of healthy to unhealthy foods in the HFE. Independent variables included household socio-demographics, parental perceptions of their own weight and diet health, frequency of family meals, proximity to food outlets, and perception of access to healthy foods in the neighborhood food environment. Significant differences were observed in the HFE by race and ethnicity, with Non-Hispanic black children having fewer healthy foods and Non-Hispanic white children having more unhealthy food items available at home. Parents who reported being overweight or obese had a healthier HFE and those perceiving their own eating as healthy had more healthy and less unhealthy foods in the household. Food-secure households had more unhealthy compared to healthy foods at home. Households located farther from a supermarket had a greater number of unhealthy food items and a lower healthy/unhealthy food availability ratio. Parental perception of better access to fruits and vegetables and low-fat foods was associated with availability of a greater number of healthy food items at home. Overall, the HFE varied by parental and demographic characteristics, parental perceptions about the food environment and the actual features of the built neighborhood food environment.
ContributorsBerry, Andrea (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
Description
The purpose of this study was to gather qualitative data on different and novel methods used to self-monitor diet and exercise during a weight loss study. Participants who used either a traditional paper and pencil method or a smart phone weight loss app for diet and exercise tracking were recruited for focus groups. Focus group discussions centered on the liked and disliked aspects of recording, perceived behavior changes, and suggestions for improved self-monitoring. Focus groups were organized based on the method of self-monitoring. The app group tracked calorie intake and expenditure via the "Lose It" app on their smart phones. The paper & pencil group recorded exercise and food intake in a journal and self-regulated diet based on recommended servings from each food group (or exchange lists). Focus group sessions were audio-recorded, transcribed and coded by the researcher and an independent coder. Results indicated that app participants liked the convenience, affordability, and user-friendly features, but wanted more nutrition advice. App participants liked self-managing their diet, not restricting certain foods or food groups and allowing for indulgences by balancing calories and exercise. Also, they desired an accurate estimation of energy expenditure from an app, based on individual characteristics (i.e., gender and age). Participants who recorded on paper liked the size for a visual layout of food entries, but desired a technology-enhanced method with an auto-calculation of calorie intake and expenditure. They also suggested increased accountability and opportunities for social support would enhance self-monitoring. Overall, an ideal technology-assisted self-monitoring app or program would be free and include an auto-calculation of calorie intake, a gender- and age- specific estimation of calories expended, easy entry of foods from a large database, the ability to enter whole recipes, nutrition information and recommendations, and be available via phone, tablet or computer (based on personal preference).
ContributorsSterner, Danielle (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Johnston, Carol (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2012
Description
Birds have plasma glucose levels that are 1.5-2 times greater than mammals of similar body mass in addition to higher free fatty acid concentrations, both of which would typically impair endothelium-dependent vasodilation if observed in mammals. Endothelium-dependent vasodilation can be stimulated in mammals through the use of acetylcholine (ACh), which primarily acts through nitric oxide (NO) and cyclooxygenase (COX)-mediated pathways, with varying reliance on endothelial-derived hyperpolarizing factors (EDHFs). Very few studies have been conducted on small resistance systemic arteries from birds. The hypothesis was that because birds have naturally high glucose and free fatty acid concentrations, ACh-induced vasodilation of isolated arteries from mourning doves (Zenaida macroura) would be independent of endothelial-derived factors and resistant to high glucose-mediated vascular dysfunction. Small resistance mesenteric and cranial tibial (c. tibial) arteries were pre-constricted to 50% of resting inner diameter with phenyleprine then exposed to increasing doses of ACh (10-9 to 10-5 μM) or the NO donor, sodium nitroprusside (SNP; 10-12 to 10-3 μM). For both vessel beds, ACh-induced vasodilation occurred mainly through the activation of potassium channels, whereas vasodilation of mesenteric arteries additionally occurred through COX. Although arteries from both vessel beds fully dilated with exposure to sodium nitroprusside, ACh-mediated vasodilation was independent of NO. To examine the effect of high glucose on endothelium-dependent vasodilation, ACh dose response curves were conducted following exposure of isolated c. tibial arteries to either a control solution (20mM glucose) or high glucose (30mM). ACh-induced vasodilation was significantly impaired (p = 0.013) when exposed to high glucose, but normalized in subsequent vessels with pre-exposure to the superoxide dismutase mimetic tiron (10 mM). Superoxide concentrations were likewise significantly increased (p = 0.0072) following exposure to high glucose. These findings indicate that dove arteries do not appear to have endogenous mechanisms to counteract the deleterious effects of oxidative stress. Additional studies are required to assess whether endogenous mechanisms exist to protect avian vascular reactivity from systemic hyperglycemia.
ContributorsJarrett, Catherine Lee (Author) / Sweazea, Karen L (Thesis advisor) / Johnston, Carol (Committee member) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: Obesity is considered one of the most serious public health issues worldwide. Small, feasible lifestyle changes are necessary to obtain and maintain weight loss. Clinical evidence is inconclusive about whether meal preloading is an example of a small change that could potentially increase the likelihood of weight loss and weight maintenance. Objective: The aim of this study is to determine if consuming 23 grams of peanuts, as a meal preload, before a carbohydrate-rich meal will lower post prandial glycemia and insulinemia and increase satiety in the 2 hour period after a carbohydrate-rich meal. Design: 15 healthy, non-diabetic adults without any known peanut or tree nut allergies were recruited from a campus community. A randomized, 3x3 block crossover design was used. The day prior to testing participants refrained from vigorous activity and consumed a standard dinner meal followed by a 10 hour fast. Participants reported to the test site in the fasted state to complete one of three treatment meals: control (CON), peanut (NUT), or grain bar (BAR) followed one hour later by a carbohydrate-rich meal. Satiety, glucose and insulin were measured at different time points throughout the visit. Each participant had a one-week washout period between visits. Results: Glucose curves varied between treatments (p=.023). Blood glucose was significantly higher one hour after ingestion of the grain bar compared to the peanut and control treatments (p<.001). At 30 minutes after the meal, the control glucose was significantly higher than for the peanut or grain bar (p=.048). Insulin did vary significantly between treatments (p<.001). The insulin change one hour after grain bar consumption was significantly higher than after the peanut or control at the same time point (p<.001). The change in insulin one hour after peanut consumption was significantly higher than for the control treatment (p=.002). Overall satiety, expressed as the 180 minute AUC, differed significantly between treatments (p=.001). One hour after preload consumption, peanut and bar consumption was associated with greater satiety than the water control (p<.001). At 30 minutes post-meal, the grain bar was associated with greater satiety versus the water control (p=.049). The bar was also associated with greater satiety versus peanut and control at 60 and 90 minutes post-meal (p=.003 and .034, respectively). At 120 minutes post-meal, the final satiety measurement, the bar was still associated with greater satiety than the peanut preload (p=.023). Total energy intake, including test meal, on treatment days did not differ significantly between treatment (p=.233). Conclusions: Overall satiety, blood glucose and blood insulin levels differed at different time points depending on treatment. Both meal preloads increased overall satiety. However, grain bar ingestion resulted in sustained satiety, greater than the peanut preload. Grain bar ingestion resulted in an immediate glycemic and insulinemic response. However, the response was not sustained after the test meal was ingested. The results of this study suggest that a low-energy, carbohydrate-rich meal preload may have a positive impact on weight maintenance and weight loss by initiating a sustained increase in overall satiety. More research is needed to confirm these findings.
ContributorsFleming, Katie R (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: Research in animal models suggests that fish oil ingestion may impair immunity and increase risk for infection. To date there are no studies examining this relationship between fish oil ingestion and risk for infection in humans. Objective: The primary aim of this randomized, placebo-controlled, double-blind, parallel-arm study was to examine the effect of 400 mg of EPA and 200 mg of DHA, the main components of fish oil (FO) supplements, on the incidence of symptoms related to upper respiratory tract infections in healthy young females, at a large southwestern university. Design: Healthy young women between 18 and 38 years of age who were non-obese (mean BMI 23.7 ± 0.6 kg/m2) were recruited from an urban southwestern university campus. Subjects were non-vegetarians, non-smokers, and reported consuming less than one serving (3.5 oz) of fish per week. Participants (n=26) were randomized according to age, body weight, BMI, and daily n-3 fatty acid (FA) intake into two groups: FO (one gel capsule of 600 mg EPA/DHA per day) or CO (one placebo gel capsule of 1000 mg coconut oil per day). Participants completed a validated daily cold symptom survey, the Wisconsin Upper Respiratory Symptom Survey-21 for 8 weeks. Fasting blood samples measuring TNF-α concentrations were taken at weeks 1 and 8, when 24-hour dietary recalls were also performed. Anthropometric measurements were recorded via bioelectrical impedance at trial weeks 1, 4, and 8. Results: The 8-week trial of FO supplementation did not significantly change the average score for perception of cold symptoms between FO and CO groups (167 ± 71 and 185 ± 56, p=0.418, respectively). Plasma TNF-α levels (pg/mL) did not differ between groups (p=0.482). TNF-α levels were significantly correlated with body weight (r=0.480, p=0.037), BMI (r=0.481, p=0.037, and percent body fat (r=0.511, p=0.025) at baseline. Conclusions: Healthy young women taking a fish oil supplement of 400 mg EPA and 200 mg DHA per day over 8 weeks does not impose unintentional health consequences. These findings do not refute the American Heart Association's current recommendations for all Americans to consume two servings (3.5 oz) of a variety of oily fish per week. Depending on the type of fish, this current recommendation equates to approximately 200-300 mg per day of EPA and DHA n-3 polyunsaturated fatty acids. Additional research is needed to investigate the effects of higher dosages of fish oils on daily cold symptoms.
ContributorsGutierrez, Megan (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Martin, Keith (Committee member) / Arizona State University (Publisher)
Created2013