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Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type

Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type 2 Diabetes Mellitus (T2D). Design: Thirteen women and one man (21-62 y; mean, 46.0±3.9 y) participated in this 12-week parallel-arm trial. Participants were recruited from a campus community and were healthy and not diabetic by self-report. Participants were not prescribed oral hypoglycemic medications or insulin; other medications were allowed if use was stable for > 3 months. Subjects were randomized to one of two groups: VIN (8 ounces vinegar drink providing 1.5 g acetic acid) or CON (1 vinegar pill providing 0.04 g acetic acid). Treatments were taken twice daily immediately prior to the lunch and dinner meals. Venous blood samples were drawn at trial weeks 0 and 12 to measure insulin, fasting glucose, and HbA1c. Subjects recorded fasting glucose and 2-h postprandial glycemia concentrations daily using a glucometer. Results: The VIN group showed significant reductions in fasting capillary blood glucose concentrations (p=0.05) that were immediate and sustained throughout the duration of the study. The VIN group had reductions in 2-h postprandial glucose (mean change of −7.6±6.8 mg/dL over the 12-week trial), but this value was not significantly different than that for the CON group (mean change of 3.3±5.3 mg/dL over the 12-week trial, p=0.232). HbA1c did not significantly change (p=0.702), but the reduction in HbA1c in the VIN group, −0.14±0.1%, may have physiological relevance. Conclusions: Significant reductions in HbA1c were not observed after daily consumption of a vinegar drink containing 1.5 g acetic acid in non-diabetic individuals. However, the vinegar drink did significantly reduce fasting capillary blood glucose concentrations in these individuals as compared to a vinegar pill containing 0.04 g acetic acid. These results support a therapeutic effect for vinegar in T2D prevention and progression, specifically in high-risk populations.
ContributorsQuagliano, Samantha (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2013
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Sustaining a fall can be hazardous for those with low bone mass. Interventions exist to reduce fall-risk, but may not retain long-term interest. "Exergaming" has become popular in older adults as a therapy, but no research has been done on its preventative ability in non-clinical populations. The purpose was to

Sustaining a fall can be hazardous for those with low bone mass. Interventions exist to reduce fall-risk, but may not retain long-term interest. "Exergaming" has become popular in older adults as a therapy, but no research has been done on its preventative ability in non-clinical populations. The purpose was to determine the impact of 12-weeks of interactive play with the Wii Fit® on balance, muscular fitness, and bone health in peri- menopausal women. METHODS: 24 peri-menopausal-women were randomized into study groups. Balance was assessed using the Berg/FICSIT-4 and a force plate. Muscular strength was measured using the isokinetic dynamometer at 60°/180°/240°/sec and endurance was assessed using 50 repetitions at 240°/sec. Bone health was tracked using dual-energy x-ray absorptiometry (DXA) for the hip/lumbar spine and qualitative ultrasound (QUS) of the heel. Serum osteocalcin was assessed by enzyme immunoassay. Physical activity was quantified using the Women's Health Initiative Physical Activity Questionnaire and dietary patterns were measured using the Nurses' Health Food Frequency Questionnaire. All measures were repeated at weeks 6 and 12, except for the DXA, which was completed pre-post. RESULTS: There were no significant differences in diet and PA between groups. Wii Fit® training did not improve scores on the Berg/FICSIT-4, but improved center of pressure on the force plate for Tandem Step, Eyes Closed (p-values: 0.001-0.051). There were no significant improvements for muscular fitness at any of the angular velocities. DXA BMD of the left femoral neck improved in the intervention group (+1.15%) and decreased in the control (-1.13%), but no other sites had significant changes. Osteocalcin indicated no differences in bone turnover between groups at baseline, but the intervention group showed increased bone turnover between weeks 6 and 12. CONCLUSIONS: Findings indicate that WiiFit® training may improve balance by preserving center of pressure. QUS, DXA and osteocalcin data confirm that those in the intervention group were experiencing more bone turnover and bone formation than the control group. In summary, twelve weeks of strength /balance training with the Wii Fit® shows promise as a preventative intervention to reduce fall and fracture risk in non-clinical middle aged women who are at risk.
ContributorsWherry, Sarah Jo (Author) / Swan, Pamela D (Thesis advisor) / Adams, Marc (Committee member) / Der Ananian, Cheryl (Committee member) / Sweazea, Karen (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2014
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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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This study examined the effect of consuming pinto, black, and dark red kidney beans with white rice in comparison to a white rice only control meal on the glycemic response of adults with type 2 diabetes (T2D). These bean and rice combinations are part of many traditional diets. Seventeen subjects

This study examined the effect of consuming pinto, black, and dark red kidney beans with white rice in comparison to a white rice only control meal on the glycemic response of adults with type 2 diabetes (T2D). These bean and rice combinations are part of many traditional diets. Seventeen subjects with T2D treated by diet and/or metformin were randomly assigned to 4 treatments: white rice (control), pinto beans/rice, black beans/rice, and dark red kidney beans/rice. All treatments were portioned by weight and matched for available carbohydrate content of ∼ 50 grams. Capillary whole blood samples were collected at baseline and at 30, 60, 90, 120, 150 and 180 minutes posttreatment and assessed for glucose concentration using the YSI Stat Plus Analyzer. Net change glucose responses were significantly lower for the pinto, black, and dark red kidney bean and rice meals than control at 90, 120 and 150 minutes posttreatment (P < 0.05). Incremental area under the curve (iAUC) values were also significantly reduced for the bean/rice meals containing pinto (P < 0.01) and black beans (P < 0.05) in contrast to the rice control. Results suggest that the combination of whole beans and rice may be beneficial to those with T2D to assist with blood glucose management.
ContributorsThompson, Sharon (Author) / Winham, Donna M (Thesis advisor) / Beezhold, Bonnie (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2011
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Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level

Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level among schools without salad bars in Arizona (n=177). Multivariate binominal regression models were used to determine differences between the barriers and school level, adjusting for years at current job, enrollment of school, free-reduced eligibility rate and district level clustering. The top five barriers were not enough staff (51.4%), lack of space for salad bars (49.7%), food waste concerns (37.9%), sanitation/food safety concerns (31.3%), and time to get through the lines (28.3%) Adjusted analyses indicated two significant differences between barriers across school level: time to get through lines (p=0.040) and outside caterer/vendor (p=0.018) with time to get through lines reported more often by elementary and middle school nutrition managers and outside caterer/vendor reported most often by high school nutrition managers. There were several key barriers reported and results indicate that having an outside vendor/caterer for their meal programs and time to get through the service lines varied across school level. High schools report a higher percent of the barrier outside caterer/vendors and elementary and middle schools report a higher percent of the barrier time to get through the lines. Results indicate that research determining the approximate time it takes students to get through salad bar lines will need to be considered. More research is needed to determine if the barrier time to get through the service lines is due to selection of food items or if it is due to the enrollment size of the lunch period. Future research interventions may consider investigating food safety and sanitation concerns of middle school nutrition managers. Findings may be used to guide ways to decrease barriers in schools without salad bars.
ContributorsKebric, Kelsey (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2016
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Water makes up about 45-70% of a human body's total weight. It is estimated that 80% of the human brain's tissue is composed of water. Cognitive productivity is altered when the body is in a mere 2% dehydrated state. Several cognitive functions impacted by dehydration include: visual motor tracing, short-term

Water makes up about 45-70% of a human body's total weight. It is estimated that 80% of the human brain's tissue is composed of water. Cognitive productivity is altered when the body is in a mere 2% dehydrated state. Several cognitive functions impacted by dehydration include: visual motor tracing, short-term recall, attentiveness, and mathematic efficiency. It is estimated that 80% of the U.S. adult population endures the majority of their day in a mildly dehydrated state.

Participants were employees working full-time jobs with Arizona State University or Tri Star Motor Company. Employees had to be 18 or older were invited to join the study. Employees participating in the study lived within the the greater Phoenix area. Participants of all races, genders, activity statuses, and BMIs were encouraged to join.

A one-arm, pre-test, post-test study design was utilized. We examined whether the hydration status of participants in the intervention improved or worsened during the course of the intervention, and then attributed any such improvement or deterioration to the intervention. Urine collections from an afternoon sample were gathered before and after the one-week intervention. For the intervention, the participating offices received a water dispensing system in close proximity to employee desk spaces. A reusable water bottle was also given to each participant. Urine specific gravity (USG) was assessed in all urine samples to indicate hydration status, and all participants completed water intake surveys before and after the intervention.

From this study, the overall change in water intake over the course of the one-week intervention was 143 ounces/day. This is an average of adding two and a half 8 oz glasses of water each day of the week per participant. USG also decreased significantly at the end of the intervention in comparison to the baseline value. In the greater body of research, this study strengthens the viability of inputting a hydration station and offering reusable water bottles to employees. This cost-effective method is an easy way to incorporate employee wellness in the workplace. The benefit of employees to drink more water is numerous, including increased focus, mental reactivity, and overall mood and wellness.
ContributorsWildermuth, Kelsi (Author) / Johnston, Carol (Thesis advisor) / Dixon, Kathleen (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2018
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Vegetarian diets can provide an abundance of nutrients when planned with care. However, research suggests that vegetarian diets may have lower protein quality than omnivore diets. Current protein recommendations assume that vegetarians obtain a majority of their protein from animal products, like dairy and eggs. Studies have shown that this

Vegetarian diets can provide an abundance of nutrients when planned with care. However, research suggests that vegetarian diets may have lower protein quality than omnivore diets. Current protein recommendations assume that vegetarians obtain a majority of their protein from animal products, like dairy and eggs. Studies have shown that this assumption may not be valid. The recommended dietary allowance (RDA) may not be adequate in vegetarian populations with high protein requirements. The purpose of this study is to analyze dietary protein quality using the DIAAS (Digestible Indispensable Amino Acid Score) method in both vegetarian and omnivore endurance athletes. 38 omnivores and 22 vegetarians submitted 7-day food records which were assessed using nutrition analysis software (Food Processor, ESHA Research, Salem, OR, USA). Dietary intake data was used to calculate DIAAS and determine the amount of available dietary protein in subject diets. Dietary data was compared with the subjects’ lean body mass (obtained using DEXA scan technology), and strength (quantified using peak torque of leg extension and flexion using an isokinetic dynamometer). Statistical analyses revealed significantly higher available protein intake in the omnivore athletes (p<.001). There were significant correlations between available protein intake and strength (p=.016) and available protein intake and lean body mass (p<.001). Omnivore subjects had higher lean body mass than vegetarian subjects (p=.011). These results suggest that vegetarian athletes may benefit from higher overall protein intakes to make up for lower dietary protein quality.
ContributorsZuelke, Corinne (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2017
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ABSTRACT



Many natural interventions have been effective at lowering postprandial glucose concentrations (PPG) in research trials and, theoretically, should have favorable effects on the prevention and management of T2DM. Natural interventions include vinegar, nuts and exercise. Green tea has been demonstrated to also possessing antiglycemic effects. Thus, green

ABSTRACT



Many natural interventions have been effective at lowering postprandial glucose concentrations (PPG) in research trials and, theoretically, should have favorable effects on the prevention and management of T2DM. Natural interventions include vinegar, nuts and exercise. Green tea has been demonstrated to also possessing antiglycemic effects. Thus, green tea, and its most abundant catechin EGCG, are being consumed for its potential health benefits in cancer prevention and in its inhibitory effects on α-amylase. Many studies have found EGCG to inhibit α-amylase an enzyme needed in the breakdown of carbohydrates (CHO). Other studies have looked at EGCG and its potential for lowering PPG concentrations due to its inhibitory effects on α-amylase in both mice and humans. Yet there is no research on Matcha tea specifically. Matcha tea is green tea in powder form; hence, it is consumed in its entirety unlike traditional teas which are steeped in bags. The purpose of this study was to determine whether Macha tea impacts PPG concentrations in healthy adults. Twelve subjects completed this randomized controlled, single blinded, crossover study. On three separate occasions the twelve subjects consumed a bagel and jam with either water, Lipton green tea, or Macha tea. Fasting blood glucose was taken upon their arrival. Once the tea or water and bagel with jam were consumed PPG concentrations were measured every 30 minutes until 120 minutes were reached. Results showed no statistically significant effects on PPG concentrations in either test groups (p=.960). However, this study did not measure EGCG levels in the tea provided. Therefore, further research should be done with known EGCG amounts to see its effects on PPG concentrations to fully rule out its potential.
ContributorsRomash, Roni (Author) / Johnston, Carol (Thesis advisor) / Dixon, Kathleen (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2018
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Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal

Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues.

Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.

Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.

Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Contributorsvan Woerden, Irene (Author) / Bruening, Meg (Thesis advisor) / Hruschka, Daniel (Committee member) / Schaefer, David (Committee member) / Vega-Lopez, Sonia (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019
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Objective: It’s not well understood how youth perceive existing fruit and vegetable (FV) marketing materials available in schools. This ancillary study sought to assess the acceptability of FV marketing materials freely available to schools among adolescents in grades 6-12.

Methods: Middle and high school adolescents (n=40; 50% female; 52.5% Hispanic) in

Objective: It’s not well understood how youth perceive existing fruit and vegetable (FV) marketing materials available in schools. This ancillary study sought to assess the acceptability of FV marketing materials freely available to schools among adolescents in grades 6-12.

Methods: Middle and high school adolescents (n=40; 50% female; 52.5% Hispanic) in the Phoenix, AZ area were asked to rank marketing materials (n=35) from favorite to least favorite in four categories: table tents, medium posters, large posters and announcements. Favorites were determined by showing participants two items at a time and having them choose which they preferred; items were displayed to each adolescent in a random order. Adolescents participated in a 20-30 minute interview on their favorite items in each category based on acceptance/attractiveness, comprehension, relevance, motivation and uniqueness of the materials. A content analysis was performed on top rated marketing materials. Top rated marketing materials were determined by the number of times the advertisement was ranked first in its category.

Results: An analysis of the design features of the items indicated that most participants (84%) preferred marketing materials with more than 4 color groups. Participant preference of advertisement length and word count was varied. A total of 5 themes and 20 subthemes emerged when participants discussed their favorite FV advertisements. Themes included: likes (e.g., colors, length, FV shown), dislikes (e.g., length, FV shown), health information (e.g., vitamin shown), comprehension (e.g., doesn’t recognize FV), and social aspects (e.g., peer opinion). Peer opinion often influenced participant opinion on marketing materials. Participants often said peers wouldn’t like the advertisements shown: “…kids my age think that vegetables are not good, and they like food more than vegetables.” Fruits and vegetable pictured as well as the information in the marketing materials also influenced adolescent preference.

Conclusion: Students preferred advertisements with more color and strong visual aspects. Word count had minimal influence on their opinions of the marketing materials, while information mentioned and peer opinion did have a positive effect. Further research needs to be done to determine if there is a link between adolescent preferences on FV marketing materials and FV consumption habits.
ContributorsPisano, Sydney Alexis (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Grgich, Traci (Committee member) / Arizona State University (Publisher)
Created2019