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Background:The second an individual is born, the gut microbiome starts acquiring unique characteristics, including microbial richness and evenness. In addition, it has been found that during infancy, the mode of delivery, antibiotic exposure, feeding patterns, and environment play a role in such development. However, infancy is still an understudied population

Background:The second an individual is born, the gut microbiome starts acquiring unique characteristics, including microbial richness and evenness. In addition, it has been found that during infancy, the mode of delivery, antibiotic exposure, feeding patterns, and environment play a role in such development. However, infancy is still an understudied population related to the gut microbiota, specifically its’ connection to two modifiable factors-sleep-wake patterns and its’ interconnection with feeding practices in the first year of life. Methods: This secondary data analysis from a randomized longitudinal intervention study assessed the efficacy of a home-based education program in preventing the onset of childhood obesity. A convenience sample of 40 Hispanic mother and infant dyads were recruited to participate in an additional collection of fecal samples to evaluate associations between lifestyle/behavioral factors in infancy and gut microbiome composition in toddlerhood. Total sleep duration and feeding practices (breastmilk and formula) were assessed at one, six, and twelve months. In addition, alpha and beta diversity metrics were assessed from infant stool samples collected at 36 months. Results: This study found some significant and trending values for pairwise comparisons of alpha (Shannon Diversity Index) and beta (Bray Curtis and Jaccard Distance). Sleep-wake adequacy consisted of 14-17 total hours of sleep in 24 hours at one month and 12-16 hours for six and twelve months of age. No significant values were identified at one month of age. However, six and twelve months demonstrated significant observations for gut microbial richness and evenness. Trending differences (p=.06, Shannon Diversity Index) persisted in infants receiving adequate sleep at six months but for different feeding modalities. Faith’s PD, Pielou’s measure, and observed OTUs were three additional alpha-diversity metrics performed in all groups. Observed OTUs (p=.03) and Faith’s PD (p=.03) were significant at twelve months, demonstrating an increased microbial feature in infants receiving adequate sleep. Conclusion: The findings from this study may show how different timestamps in the first year of life may create gut microbial milestones. However, the interrelation between sleep-wake patterns, feeding modalities, and gut microbiome development is limited; further investigation is needed to monitor close changes and potentially create a criterion
ContributorsAlanis, Victoria (Author) / Whisner, Corrie M. (Thesis advisor) / Petrov, Megan E. (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2022
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OBJECTIVE: In 2020, the COVID-19 pandemic disrupted the health and wellbeing offamilies and communities alike. The purpose of this qualitative research study was to better understand the perspectives and experiences of Arizona mothers who gave birth and transitioned to parenthood during the COVID-19 pandemic. METHODS: This research study was a

OBJECTIVE: In 2020, the COVID-19 pandemic disrupted the health and wellbeing offamilies and communities alike. The purpose of this qualitative research study was to better understand the perspectives and experiences of Arizona mothers who gave birth and transitioned to parenthood during the COVID-19 pandemic. METHODS: This research study was a qualitative thematic analysis. Arizona residents aged 18 and older who gave birth after March 2020 and spoke English proficiently were eligible to participate in this research study. Participants completed a 90-minute virtual interview, answering questions about their overall perinatal experiences during the pandemic. Interviews were recorded, transcribed and reviewed for accuracy. A codebook of themes was created. The transcriptions were analyzed and coded using Delve software. RESULTS: In total, 18 interviews were coded for this study when saturation was reached. The average participant age was 31.78 ± 5.52 years and was predominantly White (89%). In total, 61% reported experiencing birth-related trauma and approximately 60% of participants were able to take parental leave, while 40% did not. Four principal themes emerged from data describing the transition to parenthood during the COVID-19 pandemic: 1) Maternal Experiences During COVID, 2) Navigating the Support System, 3) Perinatal Healthcare Insufficiencies, and 4) Retrospective Insights. Of these four primary themes, fourteen associated subthemes were also identified. CONCLUSION: The transition to parenthood is a multidimensional ecosystem centered around maternal and infant wellbeing with family, friends, community, and healthcare providers serving as primary influences. Inadequate healthcare, broken social networks, and diminished health promotion skills that bridge families to the care and support to thrive in parenthood have been reduced during the pandemic as women in this study exhibited poor mental health, faded self-efficacy, and reduced access to care.
ContributorsHoovler, Megan (Author) / Bruening, Meg (Thesis advisor) / Bever, Jennie (Committee member) / Reifsnider, Elizabeth (Committee member) / Arizona State University (Publisher)
Created2022
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The glycation of plasma proteins leading to the production of advanced glycation end products (AGEs) and subsequent damage is a driving factor in the pathophysiology of diabetic complications. The overall research objective was to elucidate the mechanisms by which birds prevent protein glycation in the presence of naturally high plasma

The glycation of plasma proteins leading to the production of advanced glycation end products (AGEs) and subsequent damage is a driving factor in the pathophysiology of diabetic complications. The overall research objective was to elucidate the mechanisms by which birds prevent protein glycation in the presence of naturally high plasma glucose concentrations. This was accomplished through the specific purpose of examining the impact of temperature and glucose concentration on the percent glycation of chicken serum albumin (CSA) in comparison to human serum albumin (HSA). Purified CSA and HSA solutions prepared at four different glucose concentrations (0 mM, 5.56 mM, 11.11 mM, and 22.22 mM) were incubated at three different temperatures (37.0°C, 39.8°C, and 41.4°C) on separate occasions for seven days with aliquots extracted on days 0, 3, and 7. Samples were analyzed by LC-ESI-MS for percent glycation of albumin. The statistically significant interaction between glucose concentration, temperature, albumin type, and time as determined by four-way repeated measures ANOVA (p = 0.032) indicated that all independent variables interacted to affect the mean percent glycation of albumin. As glucose concentration increased, the percent glycation of both HSA and CSA increased over time at all temperatures. In addition, HSA was glycated to a greater extent than CSA at the two higher glucose concentrations examined for all temperature conditions. Temperature differentially affected percent glycation of HSA and CSA wherein glycation increased with rising temperatures for HSA but not CSA. The results of this study suggest an inherent difference between the human and chicken albumin that contributes to the observed differences in glycation. Further research is needed to characterize this inherent difference in an effort to elucidate the mechanism by which birds protect plasma proteins from glycation. Future related work has the potential to lead to the development of novel therapies to prevent or reverse protein glycation prior to the formation of AGEs in humans, thus preventing the development and devastating effects of numerous diabetic complications.
ContributorsZuck, Jessica (Author) / Sweazea, Karen (Thesis advisor) / Johnston, Carol (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2016
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College weight gain and obesity are significant problems impacting our society, leading to a considerable number of comorbidities during and after college. Gut microbiota are increasingly recognized for their role in obesity and weight gain. Currently, research exploring the gut microbiome and its associations with dietary intake and

College weight gain and obesity are significant problems impacting our society, leading to a considerable number of comorbidities during and after college. Gut microbiota are increasingly recognized for their role in obesity and weight gain. Currently, research exploring the gut microbiome and its associations with dietary intake and body mass index (BMI) is limited among this population. Therefore, the purpose of this study was to assess associations between the gut microbiome, BMI, and dietary intake in a population of healthy college students living in two dorms at Arizona State University (n=90). Cross-sectional analyses were undertaken including 24-hour dietary recalls and anthropometrics (height, weight and BMI). High throughput Bacterial 16S rRNA gene sequencing of fecal samples was performed to quantify the gut microbiome and analyses were performed at phyla and family levels. Within this population, the mean BMI was 24.4 ± 5.3 kg/m2 and mean caloric intake was 1684 ± 947 kcals/day. Bacterial community analysis revealed that there were four predominant phyla and 12 predominant families accounting for 99.3% and 97.1% of overall microbial communities, respectively. Results of this study suggested that a significant association occurred between one principal component (impacted most by 22 microbial genera primarily within Firmicutes) and BMI (R2=0.053, p=0.0301). No significant correlations or group differences were observed when assessing the Firmicutes/Bacteroidetes ratio in relation to BMI or habitual dietary intake. These results provide a basis for gut microbiome research in college populations. Although, findings suggest that groups of microbial genera may be most influential in obesity, further longitudinal research is necessary to more accurately describe these associations over me. Findings from future research may be used to develop interventions to shift the gut microbiome to help moderate or prevent excess weight gain during this important life stage.
ContributorsHotz, Ricci-Lee (Author) / Whisner, Corrie (Thesis advisor) / Bruening, Meredith (Committee member) / Vega-Lopez, Sonia (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2016
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Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health

Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health and fetal outcomes for pregnant adults and adolescents. To evaluate the effectiveness of a social media intervention on improving prenatal health knowledge and dietary intake, 22 racially diverse pregnant women (59% Black and 36% White) were recruited and adolescent (n=10) outcomes compared to those of adults (n=12) across the intervention. Pre- and post-intervention nutrition knowledge questionnaires and diet recalls were completed to assess nutrition knowledge and dietary intake. When assessing dietary change across the intervention, significant decreases in fat (pre vs. post, 97.9 ± 0.2 g vs. 90.2 ± 0.2 g, P=0.047) and folate intake (pre vs. post, 537.6 ± 0.3 μg vs. 531.2 ± 0.2 μg, P=0.041) were observed while significant increases in carbohydrate (pre vs. post, 318.9 ± 0.2 g vs. 335.9 ± 0.2 g, P<0.001), calcium (pre vs. post, 851.3 ± 0.3 mg vs. 893.5 ± 0.2 mg, P<0.001) and magnesium intakes (pre vs. post, 212.9 ± 0.2 mg vs. 227.8 ± 0.2 mg, P<0.001) occurred. These time effects occurred independent of group (adolescents vs. adults) as time*group interactions were not significant (p>0.05) with the exception of sugar intake. Increases in sugar intake across the intervention were greater among the adolescent group (adolescent vs. adult, 7.9 ± 0.2 g vs. 6.0 ± 0.2 g, P=0.023). Overall nutrition knowledge was limited and confusion regarding MyPlate recommendations persisted. The inadequate dietary behaviors observed suggest that future interventions should focus education on specific dietary nutrients such as added sugars and fiber to improve dietary intakes. The best way to actively engage pregnant adolescents is unknown: however, social media has the potential to reach teens and low-income women with education that may be key in allowing interventions to change dietary habits and behaviors.
ContributorsEllis, Megan (Author) / Whisner, Corrie M (Thesis advisor) / Bruening, Meg (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2016
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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

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.
ContributorsPelham, Emily Claire (Author) / Wardenaar, Floris (Thesis advisor) / Whisner, Corrie (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2020
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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

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
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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

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.
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
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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

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.
ContributorsWeight, Raquelle (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2020
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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

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.
ContributorsStevens, Clinton (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Gosliner, Wendi (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2021