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The omega-3 fatty acids in fatty fish and fish oil, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have been associated with a reduction in risk for cardiovascular disease. Blood type is a known contributor to risk for cardiovascular events. This study evaluated the effect of fish oil supplements on cardiovascular

The omega-3 fatty acids in fatty fish and fish oil, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have been associated with a reduction in risk for cardiovascular disease. Blood type is a known contributor to risk for cardiovascular events. This study evaluated the effect of fish oil supplements on cardiovascular risk markers in adults with blood types A or O. An 8-week parallel-arm, randomized, double-blind trial was conducted in healthy adult men and women with either blood type A (BTA) or blood type O (BTO). Participants were randomized to receive fish oil supplements (n=10 [3 BTA/7 BTO]; 2 g [containing 1.2 g EPA+DHA]/d) or a coconut oil supplement (n=7 [3 BTA/4 BTO]; 2 g/d). Markers that were examined included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hsCRP), and hemoglobin A1C (HbA1C). Results indicated that the percent change in LDL cholesterol was significantly greater in the coconut oil group vs the fish oil group (-14.8±12.2% vs +2.8±18.9% respectively, p=0.048). There were no other significant differences between treatment groups, or between blood types A and O, for the other cardiovascular risk markers. Further research with a larger and more diverse sample may yield a more conclusive result.
ContributorsHerring, Dana (Author) / Johnston, Carol (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2014
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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

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
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Description
Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional

Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional breakfast at school amongst youth using a survey assessing possible predictors (i.e. parental education, morning activities, race), the ASA-kids 24-hr dietary recall, and height and weight measurements. A total of fifty-eight participants (aged 13.5±1.6 years; 55.2% male) were recruited at after school library programs and Boys and Girls Clubs in the Phoenix, Arizona Metro Area during 2014. The main outcomes measured were BMI percentile, total calories, iron, sodium, carbohydrates, added sugar, and fiber. In the study, the prevalence of consumption of an additional breakfast at school at least once a week or more was 32.7%. There were no significant differences between the consumption of an additional breakfast and not an additional breakfast amongst the main outcomes measures. The directionality of the relationship between the consumption of an additional breakfast and overweight/obesity amongst youth was inverse (OR = 0.309; p-value = 0.121), but this was not significant. This study found that the consumption of an additional breakfast at school is not contributing to overweight/obesity in youth, nor does it alter overall caloric and nutrient intake. School breakfast programs are important for providing breakfast and key nutrients to youth.
ContributorsSimpson, Julie (Author) / Bruening, Meg (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Rider, Linda (Committee member) / Arizona State University (Publisher)
Created2015
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Description
ABSTRACT

Asthma is a high-stress, chronic medical condition; 1 in 12 adults in the United States combat the bronchoconstriction from asthma. However, there are very few strong studies indicating any alternative therapy for asthmatics, particularly following a cold incidence. Vitamin C has been proven to be effective for other high-stress

ABSTRACT

Asthma is a high-stress, chronic medical condition; 1 in 12 adults in the United States combat the bronchoconstriction from asthma. However, there are very few strong studies indicating any alternative therapy for asthmatics, particularly following a cold incidence. Vitamin C has been proven to be effective for other high-stress populations, but the asthmatic population has not yet been trialed. This study examined the effectiveness of vitamin C supplementation during the cold season on cold incidence and asthmatic symptoms. Asthmatics, otherwise-healthy, who were non-smokers and non-athletes between the ages of 18 and 55 with low plasma vitamin C concentrations were separated by anthropometrics and vitamin C status into two groups: either vitamin C (500 mg vitamin C capsule consumed twice per day) or control (placebo capsule consumed twice per day). Subjects were instructed to complete the Wisconsin Upper Respiratory Symptom Survey-21 and a short asthma symptoms questionnaire daily along with a shortened vitamin C Food Frequency Questionnaire and physical activity questionnaire weekly for eight weeks. Blood samples were drawn at Week 0 (baseline), Week 4, and Week 8. Compliance was monitored through a calendar check sheet. The vitamin C levels of both groups increased from Week 0 to Week 4, but decreased in the vitamin C group at Week 8. The vitamin C group had a 19% decrease in plasma histamine while the control group had a 53% increase in plasma histamine at the end of the trial, but this was not statistically significant (p>0.05). Total symptoms recorded from WURSS-21 were 129.3±120.7 for the vitamin C and 271.0±293.9, but the difference was not statistically significant (p=0.724). Total asthma symptoms also slightly varied between the groups, but again was not statistically significant (p=0.154). These results were hindered by the low number of subjects recruited. Continued research in this study approach is necessary to definitively reject or accept the potential role of vitamin C in asthma and cold care.
ContributorsEarhart, Kathryn Michelle (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Availability and accessibility of foods in the home influence dietary behaviors. However, much of the literature involving measurement of the home food environment (HFE) has examined only self-reported data, and home food inventory tools have not been used to assess behavior change intervention efficacy. Thus, this quasi-experimental study was conducted

Availability and accessibility of foods in the home influence dietary behaviors. However, much of the literature involving measurement of the home food environment (HFE) has examined only self-reported data, and home food inventory tools have not been used to assess behavior change intervention efficacy. Thus, this quasi-experimental study was conducted to test the preliminary efficacy of a 10-week dietary behavioral intervention on the HFE, measured through the presence of fruits, vegetables, and sources of sugars in the household. Participants included 23 parents (21 females; age=36±5.5) of children 6-11 years old living in an ethnically diverse community within a Southwestern metropolitan area. Sociodemographic information was collected at baseline using a survey. A modified version of the Home Food Inventory was completed in the homes of participants by trained research assistants at baseline and following termination of the intervention. Relative to baseline, the intervention resulted in significant increases in availability of different types of fruits (7.7±3.2 vs. 9.4±3.1; p=0.004) and high fiber/low sugar cereal (2.3±1.4 vs. 2.7±1.4; p=0.033). There was a significant reduction in availability of sugar-sweetened beverages (3.2±1.9 vs. 1.7±1.3; p=0.004), and an increase in the number of households with accessible 100% fruit juice (3 vs. 17 households; p=0.001) and bottled/contained water (9 vs. 22 households; p<0.001). Moreover, there were meaningful changes in the number of households with accessible chocolate milk (7 vs. 0), strawberry milk (3 vs. 0), and diet soda pop (2 vs. 0). There was a significant increase in the number of households with accessible ready-to-eat vegetables (8 vs. 19 households; p=0.007), and ready-to-eat fruit (8 vs. 17; p=0.022), and a significant reduction in available prepared desserts (3.0±2.0 vs. 1.7±1.3; p=0.005), and candy (2.0±1.7 vs. 0.6±0.7; p<0.001). There were no significant changes in availability of vegetables and sugar-laden cereals, or accessibility of fresh fruit, fresh vegetables, dry cereal, candy, soda pop, desserts, and sports/fruit drinks. Overall, results suggest that the current dietary behavior change intervention resulted in positive changes in the HFE. Further research to confirm these results in a randomized controlled trial is warranted.
ContributorsCassinat, Rachel (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meredith (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Long term high fat diets (HFD) are correlated with the development of diabetes

and kidney disease. However, the impact of short term high fat intake on the etiology of kidney disease has not been well-studied. Therefore, this study examined the impact of a six week HFD (60% fat) on kidney structure

Long term high fat diets (HFD) are correlated with the development of diabetes

and kidney disease. However, the impact of short term high fat intake on the etiology of kidney disease has not been well-studied. Therefore, this study examined the impact of a six week HFD (60% fat) on kidney structure and function in young male Sprague-Dawley rats. Previous studies have shown that these animals develop indices of diabetes compared to rats fed a standard rodent chow (5% fat) for six weeks. The hypothesis of this study is that six weeks of HFD will lead to early stages of kidney disease as evidenced by morphological and functional changes in the kidney. Alterations in morphology were determined by measuring structural changes in the kidneys (changes in mass, fatty acid infiltration, and structural damage). Alterations in kidney function were measured by analyzing urinary biomarkers of oxidative RNA/DNA damage, renal tissue lipid peroxidation, urinary markers of impaired kidney function (urinary protein, creatinine, and hydrogen peroxide (H2O2)), markers of inflammation (tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6)), as well as cystatin C, a plasma biomarker of kidney function. The results of these studies determined that short term HFD intake is not sufficient to induce early stage kidney disease. Beyond increases in renal mass, there were no significant differences between the markers of renal structure and function in the HFD and standard rodent chow-fed rats.
ContributorsCrinigan, Catherine (Author) / Sweazea, Karen (Thesis advisor) / Johnston, Carol (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Research related to food deserts, areas with limited access to healthy and affordable food options, has focused primarily on issues of healthy food access, food quality and pricing, dietary outcomes, and increased risk for chronic diseases among residents. However, upstream challenges that might play a major role in the

Research related to food deserts, areas with limited access to healthy and affordable food options, has focused primarily on issues of healthy food access, food quality and pricing, dietary outcomes, and increased risk for chronic diseases among residents. However, upstream challenges that might play a major role in the creation and perpetuation of food deserts, namely problems in the supply chain, have been less considered. In this qualitative study, researchers conducted semi-structured interviews with local produce supply chain representatives to understand their perspectives on the barriers to, and potential solutions for, supplying affordable produce to underserved areas in Phoenix, AZ. Through industry and academic experts, six representatives of the supply chain were identified and recruited to take part in one-hour interviews. Interviews were audio-recorded, transcribed, and coded into categories using a general inductive approach. Using the qualitative analysis software NVIVO to assist in data analysis, themes and subthemes emerged. Results suggested that considerable barriers exist among the representatives for supplying fresh, affordable produce in Phoenix-area food deserts, including minimum delivery requirements beyond the needs of the average small store, a desire to work with high-volume customers due to transportation and production costs, and the higher price point of produce for both store owners and consumers. Conversely, opportunities were identified that could be important in overcoming such barriers, including, tax or economic incentives that would make distribution into food deserts financially viable, infrastructural support for the safe handling and storage of fresh foods at existing retail outlets, and the development of novel distribution mechanisms for producers such as mobile markets and food hubs. Future research is needed to determine if these findings are representative of a larger, more diverse sample of Arizona produce supply chain representatives.
ContributorsLacagnina, Gina (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Hughner, Renee (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2015
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Description
The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma

The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma exacerbation which can result in severe morbidity. Most human rhinovirus types utilize Intercellular Adhesion Molecule-1 (ICAM-1) as a receptor to enter cells and initiate infection. Expression of this cell-surface protein is elevated in the respiratory tract of asthma patients. The theoretical basis for this research is the observation that plasma measures of the soluble form of Intercellular Adhesion Molecule-1 (sICAM-1) decrease in response to vitamin C supplementation. As rhinovirus infection occurs in the upper respiratory tract, the primary aim of this study was to evaluate change in sICAM-1 concentration in nasal lavage of asthmatic individuals in response to vitamin C supplementation. Otherwise healthy asthmatic adults between the ages of 18-65 years who were not currently using steroidal nasal sprays, smoking, or actively training for competitive sports were recruited from a university community and surrounding area to participate in an 18-day double-blind randomized placebo-controlled supplement study with a parallel arm design. 13 subjects were stratified based on age, gender, BMI and baseline plasma vitamin C level to receive either 500 mg vitamin C twice daily (VTC, n=7) or placebo (PLC, n=6). Biochemical measures included nasal lavage sICAM-1, plasma sICAM-1, plasma histamine, and plasma vitamin C. Survey measures included Wisconsin Upper Respiratory Symptom Survey-21 to assess colds, Daytime Symptom Diary Scale to assess asthma symptoms, and measures of diet quality including a vitamin C food frequency questionnaire and Rapid Eating Assessment for Participants. No between group comparison of means reached significance (Mann-Whitney U test, p>0.05). Nasal lavage sICAM-1 levels were decreased in VTC group by 37% at study day 4, although this finding did not reach significance. Findings in this study can be used to develop future investigations into the response of nasal lavage sICAM-1 to vitamin C supplementation.
ContributorsGnant, Lindsay (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Chang, Yung (Committee member) / Arizona State University (Publisher)
Created2014
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Description
There are multivariate factors that not only play a role in an individual's ability to lose weight, but may create barriers to his or her success. One such factor is internalized weight bias (IWB), which is inversely associated with weight loss outcomes and body satisfaction, and directly associated with psychosocial

There are multivariate factors that not only play a role in an individual's ability to lose weight, but may create barriers to his or her success. One such factor is internalized weight bias (IWB), which is inversely associated with weight loss outcomes and body satisfaction, and directly associated with psychosocial maladjustments such as depression and binge eating. This study examined the relationship between internalized weight bias and weight loss outcomes using a coding scheme developed for an online weight loss forum to see whether results would be consistent with self-administered surveys that measure IWB. The coding scheme was developed using an exploratory factor analysis of a survey composed of existing measures of IWB. Participants' posts within an online weight loss forum were coded and participants given a weekly IWB score that was compared to weekly weight loss using mixed model analysis. No significance was found between IWB and weight loss outcomes in this study, however, the coding scheme developed is a novel approach to measuring IWB, and the categories identified from latent constructs of IWB may be used in the future to determine the dimensions that exist within it. Ultimately, a better understanding of IWB could lead to the development of targeted weight loss interventions that address the beliefs and attitudes held by individuals who experience it.
ContributorsEscajeda, Janessa (Author) / Hekler, Eric (Thesis advisor) / Barroso, Cristina (Thesis advisor) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2015
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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

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