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- All Subjects: Nutrition
- Creators: Adams, Marc
Effect of a Wii Fit® intervention on balance, muscular fitness, and bone health in middle-aged women
Description
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
Description
The gold standard for bone measurement is DXA (dual energy X-ray absorptiometry). Typically, to observe changes in bone by DXA, a minimum of a 4-month intervention is required. Serum osteocalcin (OST) (a bone formation marker) and quantitative ultrasound (QUS) of the calcaneus can be used as indicators of bone change but the sensitivity and time course of these indices to short term interventions are unknown. The purpose of this study was twofold: to compare monthly changes in OST and QUS in response to jump training and to evaluate the relationship between DXA, OST and QUS. Young women with QUS t-scores less than 1.0 were randomized into a jump training (J) (n=16) or control (C) (n=16). J consisted of a progressive routine of 1 and 2-footed jumping performed 3 days per week for 4 months. Body composition, QUS and OST were measured at baseline, and monthly for 4 months. DXA and 24-hour dietary recalls were completed at baseline and 4 months. Low attrition rate (12.5%) and high compliance (98%) with the exercise intervention was recorded. No significant correlations between QUS and OST existed. No significant differences were observed between groups at baseline in body composition or bone variables. Monthly increases in OST were observed but there were no significant differences over time between groups in any bone variables. OST and QUS may be indicative of short term bone changes but these variables were not specifically sensitive to the jumping intervention in this population of women.
ContributorsHeumann, Kristin Joelle (Author) / Swan, Pamela D (Thesis advisor) / Alvar, Brent (Committee member) / Chisum, Jack (Committee member) / Lee, Chong (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2011
Description
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
Description
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.
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
Description
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.
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
Description
The objective of this study was to evaluate and compare the content of nutrition marketing materials within the cafeterias of schools in Central Arizona. By collecting photographs of marketing material from three elementary schools, one K-8 school, three middle schools and three high schools, 59 pieces of nutrition marketing were gathered. The schools chosen were a convenience sample and selected from schools that were already participating in ASU' s School Lunch Study. The photographs were sorted by grade level and then coded quantitatively and qualitatively for their purpose, visual components, strategies used and relevance. Results from this novel study provided insight into prevalence, size, textual content, educational content, strategies for fruit and vegetable marketing, messaging and overall design of existing nutrition marketing within the sample schools. This study found that the prevalence of nutrition marketing within all school cafeterias appeared to be low, particularly within elementary and middle schools. Diverse types of messaging were present among elementary, middle and high schools and a variety of appeals were utilized with little consistency. Many of the strategies used in the nutrition marketing appeared disconnected from the population it was intended to appeal to. Educational components were notably lacking within middle school cafeterias but were often effectively integrated into high school nutrition marketing. The results are unique to this population, and further research is required to evaluate the content of existing nutrition material on a larger scale, so efforts can be made to improve the persuasiveness of nutrition marketing in promoting fruit and vegetable consumption.
ContributorsXavier, Raevyn Francine (Author) / Bruening, Meg (Thesis director) / Adams, Marc (Committee member) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast food. The Social Ecological Model (SEM) was created as a framework for health promotion interventions. The SEM organizes factors that can influence health into five layers: intrapersonal factors, interpersonal processes, institutional/organizational factors, community factors, and public policy. Each layer can influence dietary behaviors and other layers.
This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.
Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.
The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.
Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.
The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
ContributorsLorts, Cori Elizabeth (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Adams, Marc (Committee member) / Hooker, Steven (Committee member) / Roberto, Anthony (Committee member) / Tasevska, Natasha (Committee member) / Arizona State University (Publisher)
Created2017
Description
Obesity is currently a prevalent health concern in the United States. Essential to combating it are accurate methods of assessing individual dietary intake under ad libitum conditions. The acoustical monitoring system (AMS), consisting of a throat microphone and jaw strain sensor, has been proposed as a non-invasive method for tracking free-living eating events. This study assessed the accuracy of eating events tracked by the AMS, compared to the validated vending machine system used by the NIDDK in Phoenix. Application of AMS data toward estimation of mass and calories consumed was also considered. In this study, 10 participants wore the AMS in a clinical setting for 24 hours while all food intake was recorded by the vending machine. Results indicated a correlation of 0.76 between number of eating events by the AMS and the vending machine (p = 0.019). A dependent T-test yielded a p-value of 0.799, illustrating a lack of significant difference between these methods of tracking intake. Finally, number of seconds identified as eating by the AMS had a 0.91 correlation with mass of intake (p = 0.001) and a 0.70 correlation with calories of intake (p = 0.034). These results indicate that the AMS is a valid method of objectively recording eating events under ad libitum conditions. Additional research is required to validate this device under free-living conditions.
ContributorsSteinke, Amanda (Author) / Johnston, Carol (Thesis advisor) / Votruba, Susanne (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2013
Description
Among its many roles in the body, ascorbic acid functions as a cofactor in carnitine and catecholamine synthesis, metabolites involved in fat oxidation and mood regulation, respectively. Given that fat oxidation and mood affect one's feelings of vigor, I hypothesized that those with lower levels of plasma ascorbic acid would be less likely to exercise at high levels than individuals with adequate or high levels of vitamin C. To test this, I conducted a double-blind, placebo-controlled intervention. A group of healthy, non-smoking males between the ages of 18 and 40 were put on a vitamin C-restricted diet for two weeks and then randomized to a control group that received placebo capsules for six weeks or an intervention group that received 500 mg of vitamin C daily for six weeks. The men were restricted from eating foods high in vitamin C, instructed to wear a pedometer daily and to record their step counts, and to take a pill daily (either the placebo or vitamin C supplement). Unexpectedly, the subjects receiving the intervention had lower step counts than the control group; the control group, rather than the vitamin C group, significantly (p=0.017) increased their steps at week 8 compared to week 2. However, I also estimated daily Metabolic Equivalent Tasks (METs), and subjects receiving the placebo had lower MET outputs than subjects receiving vitamin C at the end of the trial, in spite of having higher step counts. This means the intensity of their activity was higher, based on METs expenditure. Additionally, depression scores (POMS-D) as measured by the Profile of Mood States (POMS) questionnaire were significantly higher (p=0.041) among subjects receiving the placebo at the end of the study. These latter results are consistent with my expectations that subjects with higher levels of plasma vitamin C would have improved mood and higher energy output than subjects with low levels of vitamin C.
ContributorsNetland, Heidi (Author) / Johnston, Carol S (Thesis advisor) / Swan, Pamela D (Committee member) / Hampl, Jeffery S (Committee member) / Arizona State University (Publisher)
Created2011
Description
Tools designed to help match people with behaviors they identify as likely to lead to a successful behavioral outcome remain under-researched. This study assessed the effect of a participant-driven behavior-matching intervention on 1) the adoption of a new behavior related to fruit and vegetable (F&V) consumption, 2) study attrition, and 3) changes in F&V consumption. In this two-arm randomized controlled trial, 64 adults who did not meet standard F&V recommendations were allocated to an intervention (n=33) or control group (n=31). Participants in the intervention group ranked 20 F&V-related behaviors according to their perceived likelihood of engagement in the behavior and their perception of the behavior’s efficacy in increasing F&V consumption. Participants in the intervention group were subsequently shown the list of 20 behaviors in order of their provided rankings, with the highest-ranked behaviors at the top, and were asked to choose a behavior they would like to perform daily for 4 weeks. The control group chose from a random-order list of the same 20 behaviors to adopt daily for 4 weeks. During the study period, text messages were sent to all participants 90 minutes before their reported bedtime to collect Yes/No data reflecting successful behavior engagement each day. The binary repeated-measures data collected from the text messages was analyzed using mixed-effects logistic regression, differences in attrition were assessed using log-rank analysis, and change scores in F&V consumption were compared between the two groups using the Man-Whitney U test. P<0.05 indicated significance. The rate of successful behavior adoption did not differ significantly between the two groups (b=0.09, 95%CI= -0.81, 0.98, p=0.85). The log rank test results indicated that there was no significant difference in attrition between the two groups (χ2=2.68, df=1, p=0.10). F&V consumption increased significantly over the 4 weeks in the total sample (Z=-5.86, p<0.001), but no differences in F&V change scores were identified between the control and intervention groups (Z=-0.21, p=0.84). The behavior-matching tool assessed in this study did not significantly improve behavior adoption, study attrition, or F&V intake over 4 weeks.
ContributorsCosgrove, Kelly Sarah (Author) / Wharton, Christopher (Thesis advisor) / Adams, Marc (Committee member) / DesRoches, Tyler (Committee member) / Grebitus, Carola (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2023