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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
Background: Twenty-four hour urinary sucrose and fructose (24uSF) has been developed as a dietary biomarker for total sugars intake. Collection of 24-h urine is associated with high costs and heavy participant burden, while collection of spot urine samples can be easily implemented in research protocols. The aim of

Background: Twenty-four hour urinary sucrose and fructose (24uSF) has been developed as a dietary biomarker for total sugars intake. Collection of 24-h urine is associated with high costs and heavy participant burden, while collection of spot urine samples can be easily implemented in research protocols. The aim of this thesis is to investigate the utility of uSF biomarker measured in spot urine. Methods: 15 participants age 22 to 49 years completed a 15-day feeding study in which they consumed their usual diet under controlled conditions, and recorded the time each meal was consumed. Two nonconsecutive 24-hour urines, where each urine void was collected in a separate container, were collected. Four timed voids (morning, afternoon, evening, and next day) were identified based on time of void and meal time. Urine samples were measured for sucrose, fructose and creatinine. Variability of uSF excretion was assessed by coefficient of variation (%CV) and variance ratios. Pearson correlation coefficient and multiple linear regression were used to investigate the association between uSF in each timed void and corresponding 24uSF excretion. Results: The two-day mean uSF was 50.6 mg (SD=29.5) for the 24-h urine, and ranged from 4.5 to 7.5 mg/void for the timed voids. The afternoon void uSF had the lowest within-subject variability (49.1%), and lowest within- to between-subject variance ratio (0.2). The morning and afternoon void uSF had the strongest correlation with 24-h uSF for both mg/void (r=0.80 and r=0.72) and mg/creatinine (r=0.72 and r=0.67), respectively. Finally, the afternoon void uSF along with other covariates had the strongest predictive ability of 24-h uSF excretion (mg/void) (Adjusted R2= 0.69; p=0.002), whereas the morning void had the strongest predictive ability of 24-h uSF excretion (mg/g creatinine) (adjusted R2= 0.58; p=0.008). Conclusions: The afternoon void uSF had the most favorable reproducibility estimates, strong correlation with 24uSF excretion, and explained greatest proportion of the variability in 24uSF. USF in mg/void may be better to use than uSF in mg/g creatinine as a biomarker in spot urine. These findings need to be confirmed in a larger study, and in a study population with a wide range of sugars intake.
ContributorsAverill, Annalisa (Author) / Tasevska, Natasha (Thesis advisor) / Shepard, Christina (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns

Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns of added sugars intake on TEI and BMI is unknown. Research on added sugars has relied on self-report dietary assessments with limited days of dietary data, resulting in unreliable estimates. The purpose of this thesis was to describe patterns of added sugars consumption, and to investigate the relationship between dietary sugars, eating patterns, TEI, and BMI using 15-days of dietary data from a feeding study. Methods: 40 participants age 18 to 70 years completed a 15-d highly controlled feeding study which imitated their normal diet, while recording meal times. Meals and snacks were coded based on participant identified, time-of-day, and meal content specific criteria. All consumed foods and beverages were carefully weighed and entered into the Nutrition Data System for Research (NDSR) for analysis. Pearson correlation, independent t-test, one-way repeated measures analysis of variance (ANOVA) with post hoc tests, and multiple linear regressions were used to investigate the association between patterns of added sugars and energy intake, as well as eating frequency (EF), with TEI and BMI. Results: 15-d median added sugars intake was 9.7% of total calories. The highest contribution to added sugars intake (% of g/d) came from snacks (44%) in women and from afternoon (39%) consumption in men. The highest contribution to TEI came from dinner (30%) and afternoon (34%) consumption in women, and from lunch (31%) or dinner (30%) and afternoon (35%) consumption in men. Total eating occasion (EO) frequency had a negative association with TEI (r = -0.31) and no association with % energy from added sugars. In multivariate regression models, besides sex, % energy from beverages only (Adjusted R2 = 0.41) and % added sugars from dinner (Adjusted R2 = 0.39) were significant predictors of TEI, while none of the variables were associated with BMI. Conclusion: Changing one’s pattern of eating, (EF and % energy from beverages only and % added sugars from dinner), may reduce TEI, potentially reducing BMI.
ContributorsGunnerson, Hannah Marie (Author) / Tasevska, Natasha (Thesis advisor) / Johnston, Carol (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated

Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated with healthier dietary behaviors among age-ineligible children (5-18-years-old) in WIC households. Consumption frequency of fruits, vegetables, 100% juice, sugar-sweetened beverages (SSBs), and energy-dense snacks (sweet and salty snacks) among children from WIC and income-qualifying non-WIC households were compared.

Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households

Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.

Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).

Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
ContributorsSteeves, Stephanie N (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / DeWeese, Robin (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between total sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the

Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between total sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the effect of physical activity on this association. Fifty seven free-living healthy subjects 20 to 68 years old, participated in a 15-day highly controlled feeding study, consuming their habitual diet, provided by the research metabolic kitchen. Dietary sugars were estimated using Nutrition Data System for Research (NDSR). Subjects collected eight 24-hour urine samples measured for urinary sucrose and fructose. Physical activity was assessed daily using a validated 15-day log that inquired about 38 physical activities across six domains; home activities, transportation, occupation, conditioning, sports and leisure. The mean total sugars intake and added sugars intake of the sample was 112.2 (33.1) g/day and 65.8 (29.0) g/day (9.7%EI), respectively. Significant moderate positive correlation was found between 15-d mean total sugars intake and 8-day mean 24uSF (r = 0.56, p < 0.001). Similarly, added sugars were moderately correlated with 24uSF (r = 0.56, p < 0.001), while no correlation was found between naturally-occurring sugars and 24uSF (r = 0.070, p < 0.001). In a linear multiple regression, total and added sugars each explained 30% of variability in 24uSF (Adjusted R2, p value; total sugars: 0.297, 0.001; added sugars: 0.301, p < 0.001). Physical activity had no effect on the association between dietary and urinary sugars in neither the correlation nor the linear regression analysis. 24uSF can be used as a biomarker for total and added sugars consumption in US adults, although its predictability was weaker compared to findings involving UK adults. No evidence was found showing that physical activity levels affect the association between 24uSF and total sugars intake in US adults. More detailed investigation through future feeding studies including subjects with wide range of sugars intake and of different ethnic/racial backgrounds are needed to better understand the characteristics of the biomarker and its uses.
ContributorsMohan, Chitra (Author) / Tasevska, Natasha (Thesis advisor) / Ainsworth, Barbara (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Objectives: This study examines weight loss strategies (eating, physical activity (PA), or both) adopted by overweight or obese (OWOB) parents and children in relation to age, income, gender, education, and race/ethnicity in a predominantly low-income and high minority sample. We also examine if OWOB parent-child dyads employed the same strategies

Objectives: This study examines weight loss strategies (eating, physical activity (PA), or both) adopted by overweight or obese (OWOB) parents and children in relation to age, income, gender, education, and race/ethnicity in a predominantly low-income and high minority sample. We also examine if OWOB parent-child dyads employed the same strategies to lose weight, and how these strategies vary by demographic variables.

Methods: Data was compiled from the New Jersey Childhood Obesity Study (NJCOB). A random digit dial household phone survey was used to select 1,708 households with at least one child aged 3-18 years from five cities in New Jersey. There were 231 OWOB parent-child dyads in this sample. Bivariate and multivariate analyses were performed to determine the demographic variables significantly associated with the type of weight loss strategy chosen.

Results: Males had higher odds of using PA and both eating and PA when compared to females. Higher income adults had higher odds of using all types of weight loss strategies compared to lower income adults. Adults with college education had higher odds of using eating and both eating and PA when compared to those with high school education. Older children (6-11 and 12-19 years) had higher odds of using PA when compared to younger children (2-5 years). Children of foreign-born parents (> 10 years in the US) had higher odds of using eating to lose weight compared to the children of US born parents. Children overall had higher odds of adopting a weight loss strategy if it was also adopted by the parent. In subgroup analysis, parent-child dyads had higher odds of adopting similar strategies among older children (12-19) and among girls, but this association did not hold true for younger children (2-11 years) and among boys for PA.

Conclusion: Older OWOB children (12-19) and female children had higher odds of adopting their parents’ weight loss strategies. Younger children did not follow the same pattern as their parents and among boys concordance was observed only for eating strategies. Results from the study may inform future family-based weight management interventions.
ContributorsDwaik, Noor (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Vitamin D deficiency has been previously associated with a higher Alzheimer’s disease (AD) risk, a condition marked by dependent living and severe cognitive impairment. AD is histologically defined by the presence of brain amyloid beta (Aβ) plaques and neurofibrillary tangles. Ways to enhance Aβ clearance have been examined in order

Vitamin D deficiency has been previously associated with a higher Alzheimer’s disease (AD) risk, a condition marked by dependent living and severe cognitive impairment. AD is histologically defined by the presence of brain amyloid beta (Aβ) plaques and neurofibrillary tangles. Ways to enhance Aβ clearance have been examined in order to sustain cognition and delay AD onset. In vitro and in vivo studies suggest that vitamin D might enhance brain Aβ transportation to the periphery by up-regulating P-glycoprotein production. The purpose of this study was to examine the effect of vitamin D supplementation on plasma Aβ in an older population.

This study was a parallel-arm, double-blinded, randomized control trial. Participants consumed either a vitamin D supplement or placebo once a week for eight weeks (n=23). Only vitamin D insufficient (serum total 25-OH, D < 30 ng/mL) people were included in the study, and all participants were considered to be cognitively normal (MMSE scores > 27). Serum total 25-OH, D and plasma Aβ1-40 measurements were recorded before and after the eight-week trial. The plasma Aβ1-40 change was compared between the vitamin D group and control group.

The vitamin D group experienced a 45% greater change in plasma Aβ1-40 than the control group. The effect size was 0.228 when controlling for baseline plasma Aβ1-40 (p=0.045), 0.197 when controlling for baseline plasma Aβ1-40 and baseline physical activity (p=0.085), and 0.179 when controlling for baseline plasma Aβ1-40, baseline physical activity, and age (p=0.116). In conclusion, vitamin D supplementation might increase brain Aβ clearance in humans, but physical activity and age also appear to modulate Aβ metabolism.
ContributorsMiller, Brendan Joseph (Author) / Johnston, Carol (Thesis advisor) / Whisner, Corrie (Committee member) / Tasevska, Natasha (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Background: Sugars form advanced glycation end products (AGEs) throughnatural metabolism and interactions with proteins, lipids, and nucleic acids, which accumulate in tissues and have been implicated in the etiology of chronic diseases. Due to the increased consumption of fructose and its high ability to form AGEs, a further understanding of

Background: Sugars form advanced glycation end products (AGEs) throughnatural metabolism and interactions with proteins, lipids, and nucleic acids, which accumulate in tissues and have been implicated in the etiology of chronic diseases. Due to the increased consumption of fructose and its high ability to form AGEs, a further understanding of this association is important to clarify the role of sugars in disease. The objective was to explore the association between usual fructose intake and serum levels of AGEs, as measured by carboxymethyl-lysine (CML) and methylglyoxal derivative (MG-H1), in healthy adults. Methods: This is a secondary analysis of a 15-d controlled feeding study (n=100) with participants consuming their usual diet conducted in the Phoenix metropolitan area. To assess participants’ usual diet, they were asked to complete two 7-d food diaries, which were then used to create custom 15-d menu plans administered during the feeding period. Forty participants were selected based on their 15-d mean total fructose intake for this analysis [top and bottom 20% of the sample distribution (median, IQR); high fructose (HF) n= 20, 72.6 (66.1-90.4) g/day, low fructose (LF) n= 20, 28.8 (22.7-32.2) g/day. Fasting serum collected five weeks after the feeding period were analyzed for CML and MG-H1, two well-established AGEs, using ELISA kits. A database of 549 common foods with known CML amounts was used to calculate exogenous CML intake based on daily food intake data. A general linear model was fitted to investigate the difference in serum CML and MG-H1 between LF and HF groups while adjusting for age, gender, BMI, and exogenous CML intake. Results: Participants in the HF group had significantly higher serum CML and lower MG-H1 levels compared to participants in the LF group (p=0.013 and p=0.002, respectively). This difference remained statistically significant after adjusting for covariates. Conclusions: The findings suggest that endogenous CML formation may be an explanation for the significantly higher serum CML levels in the HF compared to the LF group. This is significant in further understanding mechanisms of fructose intake and disease etiology and could have implications for at-risk populations consuming a high fructose diet.
ContributorsWeigand, Bethany (Author) / Tasevska, Natasha (Thesis advisor) / Sweazea, Karen (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2021