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Background: Rapid infant weight gain (RWG) by six months of age has been identified as one of the earliest indicators of childhood obesity. Previous research suggests that exclusive breastfeeding over formula feeding may serve a protective effect from RWG. In addition, the makeup of the infant gut microbiome may influence

Background: Rapid infant weight gain (RWG) by six months of age has been identified as one of the earliest indicators of childhood obesity. Previous research suggests that exclusive breastfeeding over formula feeding may serve a protective effect from RWG. In addition, the makeup of the infant gut microbiome may influence RWG as differences in feeding practices have been shown to alter the bacterial makeup of the gut, potentially impacting energy metabolism. However, little research has been conducted investigating the potential relationships between RWG, infant feeding practices, and the infant gut microbiome.Methods: This study was a pilot study, which included 31 mother-infant dyads who were primarily recruited from Women, Infant, and Children’s Supplemental Nutrition Program (WIC) clinics and by word of mouth in the Southwestern United States. Participants were followed over six months, with study staff conducting home study visits four times (pregnancy, two days postpartum, three weeks and six months). Mothers who participated in this study were majority White (n=40.6%), non-Hispanic or Latino (67.7%), and obtained a graduate degree (n=22.6%). Participants were included in this analysis (n=22) if they provided at least two infant fecal samples, and the study staff were able to collect infant anthropometric data at the three-week and six-month study visits. Microbial DNA from fecal samples was sequenced using the Illumina MiSeq instrument after polymerase chain reaction (PCR) amplification was performed on the V4 region of the 16S rRNA gene sequence. Statistical analysis was performed using the QIIME2 longitudinal plug-in. Results: Results of this study suggested a significant difference in weighted UniFrac between infants who were exclusively breastfed and formula-fed from birth to three weeks of age. Additionally, an exploratory statistical method identified family Prevotellaceae as a potentially volatile microbe; however, this model failed to reach significance for either RWG or mode of feeding. Overall, no additional alpha or beta diversity metrics or differential abundance of microbes by either RWG or feeding practice group was found in this study. Conclusion: Future research is warranted to further explore potential connections between RWG, infant feeding practices, and the infant gut microbiome in a longitudinal study with a larger sample size.
ContributorsToffoli, Samantha (Author) / Whisner, Corrie (Thesis advisor) / Bruening, Meg (Committee member) / Sears, Dorothy (Committee member) / Arizona State University (Publisher)
Created2021
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Background: Children in the United States have low diet quality scores and consume less than the recommended amounts of fruits, vegetables, whole grains, and dairy. The National School Lunch Program serves nearly 30 million children daily, and has the potential to improve the diet quality of children. However, there are

Background: Children in the United States have low diet quality scores and consume less than the recommended amounts of fruits, vegetables, whole grains, and dairy. The National School Lunch Program serves nearly 30 million children daily, and has the potential to improve the diet quality of children. However, there are high levels of food waste, particularly of fruits and vegetables. Purpose: The purpose of this study is to determine which menu items students are throwing away untouched most frequently. A secondary purpose of this study is to determine which menu items students are fully consuming most frequently. Methods: Student participants (n=2,881) in Arizona elementary, middle, and high schools who participated in school lunch were randomly selected to participate in the study. Student lunch trays were photographed before and after the student ate. Visual estimation was used to determine if menu items were untouched or fully consumed. Menu item names were standardized and categorized into menu categories. The frequency menu items were untouched or fully consumed were summarized in percentages by menu category, and stratified by school level. Results: Findings show that menu items within each menu category are untouched and fully consumed with different frequencies. Cold vegetable items were untouched with the greatest frequency, with 39% of all servings untouched. Some menu items were both untouched and fully consumed with high frequency. Conclusion: Food service managers can use these results to plan menus with food items that are more popular among their students to help increase consumption and decrease waste. Future research should explore the relationship between packaging and preparation with student consumption and waste. Researchers should also examine aspects of the high school food environment that may lead to increased student consumption.
ContributorsLiddicoat, Carina Marie (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc A (Committee member) / Grgich, Traci (Committee member) / Arizona State University (Publisher)
Created2022
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Description
Objective: To conduct a content analysis of nutrition marketing in school cafeterias in Arizona to understand how nutrition concepts are currently marketed to students. This is the first study to investigate the content of nutrition marketing in school cafeterias, and also the first to compare content across elementary, middle, and

Objective: To conduct a content analysis of nutrition marketing in school cafeterias in Arizona to understand how nutrition concepts are currently marketed to students. This is the first study to investigate the content of nutrition marketing in school cafeterias, and also the first to compare content across elementary, middle, and high schools. Methods: Photographs of marketing materials on display in school cafeterias were obtained from a convenient sample of 13 elementary schools, 12 middle schools, and 12 high schools. In total, n=284 examples of nutrition marketing were collected. The photographs were sorted by grade level and then coded quantitatively and qualitatively based on their purpose, visual aspects, marketing strategies used, and language and literacy aspects. Given the multiple comparisons, statistical significance was assessed with a Bonferroni adjustment of p<0.0006. Results: The average number of nutrition marketing materials within the school cafeterias was 7.7 ± 7.2. The purpose of the marketing materials ranged from promoting selection and consumption of fruits and vegetables, promoting nutrition and physical activity together, food safety, and educating about healthy eating. The sample of nutrition marketing materials emphasized selecting F/Vs over consumption of F/Vs. However, the opposite was found in marketing that exclusively promoted fruits and vegetables. The most common type of marketing in school cafeterias were flyers and most of the materials were small in size. The sample demonstrated a lack of implementation of marketing appeals in half of the sample, but the half that did utilized techniques that are known to be appealing to child and adolescent demographics, such as use of cartoons, humor, and social media/websites. 98.9% of the nutrition marketing with text were written in English and only 1.1% of the materials (n=3) were written in Spanish. Conclusion: The nutrition marketing sample demonstrated some use of social marketing principles but does not compete with the scale and scope of the child-directed food and beverage marketing that students encounter in their environment. More research is needed to better understand how to best target nutrition marketing to child and adolescent student populations.
ContributorsXavier, Raevyn Francine (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Lorts, Cori (Committee member) / Arizona State University (Publisher)
Created2021
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Description
Background: The Child and Adult Care Food Program (CACFP), as a federal nutrition assistance program, provides guidance and financial support to early childcare education centers (ECECs) who provide nutritious foods to children in care. Understanding factors that predict participating in CACFP is necessary to expanding CACFP reach. The purpose of

Background: The Child and Adult Care Food Program (CACFP), as a federal nutrition assistance program, provides guidance and financial support to early childcare education centers (ECECs) who provide nutritious foods to children in care. Understanding factors that predict participating in CACFP is necessary to expanding CACFP reach. The purpose of this study was to assess center-level predictors of ECECs participating in CACFP in Arizona to guide state-wide recruitment efforts. Methods: This study analyzed data from ECECs in Arizona in 2020 (n=2228), sourcing data from the Arizona Department of Economic Services (Quality First rating (an Arizona-based score for quality of the ECE centers), accreditation Status, highest educational attainment, enrichment center status, and total licensed capacity), Arizona Department of Education (CACFP), Arizona Department of Health and Sanitation (SNAP-Ed participation), and the US Census. Logistic regression was used to examine the association between the predictors and participating in CACFP, adjusting for SNAP-Ed eligibility by census tract. Results: Centers had a significantly greater odds of participating in CACFP if they were an enrichment site (OR=5.9; 95% CI: 4.6, 7.5), had a Quality First rating (OR=2.5; 95% CI: 2.0, 3.0), and when the highest educational attainment by staff was a bachelor’s degree or higher (OR=1.4; 95% CI: 1.1, 1.7). Discussion: The findings support indicate that certain modifiable center-level factors were related to participation in CACFP. Findings may assist possible linkages with other state-level programs to improve the recruitment and retention of ECE centers to CACFP.
ContributorsNarramore, Kala R (Author) / Bruening, Meg (Thesis advisor) / Raczynski, Erin (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2021
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Description
Hydration status serves as an essential pillar of human health. Adequate hydration reduces cardiovascular strain, improves the body's ability to thermoregulate, stabilizes mood, and may reduce the risk of physiologic diseases like that of diabetes and urolithiasis. While many studies have shown the importance of adequate fluid intake on hydration

Hydration status serves as an essential pillar of human health. Adequate hydration reduces cardiovascular strain, improves the body's ability to thermoregulate, stabilizes mood, and may reduce the risk of physiologic diseases like that of diabetes and urolithiasis. While many studies have shown the importance of adequate fluid intake on hydration status, very few have investigated the influence of dietary food moisture on hydration status. This study collected daily food diaries, daily fluid diaries, and spot urine samples over a 24hr period from 694 participants in Northwest Arkansas participating in the HYBISKUS study. Fluid and food diaries were logged in NDSR and analyzed using JMP while combined spot urine samples were analyzed using a freezing point depression osmometer to retrieve 24hr urine osmolality. Urine osmolality data was extracted from 24hr urine samples and used as the hydration status biomarker for study participants. The average contributions of water from fluids and foods in participants was 79.3 ±9.6% and 20.7 ±9.5% respectively. This study found that dietary food moisture has a significant effect on hydration status in adults with no specific macronutrient groups take precedence over any others in regard to dietary food moisture contributions. These results suggest that there are legitmate reasons to consider dietary food moisture intake when water intake recommendations are made for adults attempting to optimize health or prepare for physical exercise.
ContributorsKleinschmidt, Hunter (Author) / Kavouras, Stavros SK (Thesis advisor) / Sweazea, Karen KS (Committee member) / Katsanos, Christos CK (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Background: Smartphone diet tracking applications (apps) are increasing in popularity but may not adequately address the important concerns of proper intake and of diet quality. Two novel weight loss apps were designed based on the popular dietary frameworks: MyPlate and FoodLists. MyPlate, the dietary guidelines put forth by

Background: Smartphone diet tracking applications (apps) are increasing in popularity but may not adequately address the important concerns of proper intake and of diet quality. Two novel weight loss apps were designed based on the popular dietary frameworks: MyPlate and FoodLists. MyPlate, the dietary guidelines put forth by the U.S. government, encourages a balanced diet from five primary food groups, but does not specify intake limits. The Food Lists set upper intake limits on all food groups except vegetables, and these guidelines extend to include fats, sweets, and alcohol.

Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.

Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.

Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.

Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.

Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.

Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).

Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.
ContributorsScholtz, Cameron (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2016
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Drinking vinegar is a popularly discussed remedy for relieving heartburn symptom, as can be read on many websites; however, there has been no scientific research or theory to support its efficacy. This randomized, placebo-controlled, double-blind, cross-over research study tested the efficacy of the organic apple cider vinegar, with mother,

Drinking vinegar is a popularly discussed remedy for relieving heartburn symptom, as can be read on many websites; however, there has been no scientific research or theory to support its efficacy. This randomized, placebo-controlled, double-blind, cross-over research study tested the efficacy of the organic apple cider vinegar, with mother, on alleviation of the heartburn symptom related to Gastro-esophageal reflux disease (GERD). A minimum of one week separated the four trial arms: chili (placebo), antacid after chili meal (positive control), vinegar added to chili, and diluted vinegar after chili meal. Twenty grams of vinegar were used in both vinegar treatments, and 10 grams of liquid antacid were used in the antacid trial. A five-point Likert scale and a 10-cm visual analogue scale (VAS) were used to assess heartburn severity during a 120 minutes testing time. Seven of 15 recruited subjects' data was usable for statistical analysis (age: 39.6 ± 12.2 y, body mass index (BMI): 29.4 ± 4.2 kg/m2, waist circumference: 36.4 ± 4.1 inch). There was no statistically significant difference among the mean and incremental area-under-the-curve (iAUC) heartburn scores among different trials (Likert scale questionnaire p= .259, VAS questionnaire p= .659, iAUC Likert scale p= .184, iAUC VAS p= .326). Seven participants were further divided into antacid responder (n=4) and antacid non-responder groups (n=3). Likert scale mean heartburn score and iAUC data in antacid responder group had significant finding (p= .034 and p= .017 respectively). The significance lay between antacid and 'vinegar added to chili' trials. Effect size was also used to interpret data due to the small sample size: Likert scale: mean heartburn score= .444, iAUC= .425; VAS mean heartburn score= .232, iAUC .611. Effect size for antacid responder group was Likert scale: mean heartburn score= .967, iAUC= .936. Future research is needed to examine whether ingesting organic vinegar benefits alleviation of heartburn symptom related to GERD for people who do not respond well to antacid.
ContributorsYeh, Zoe (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Background: College freshmen are exposed to a variety of environmental and social factors that can alter changes to health habits and encourage weight gain. Weight-related conversations had with friends may be related to self-perception of weight and alterations to health behaviors, but this association has yet to be assessed in

Background: College freshmen are exposed to a variety of environmental and social factors that can alter changes to health habits and encourage weight gain. Weight-related conversations had with friends may be related to self-perception of weight and alterations to health behaviors, but this association has yet to be assessed in the college population.

Objective: This study aims to examine the relationship between friend advice about weight management, self-perception of weight, and alterations to weight change intentions, physical activity, and eating habits in college freshmen over time.

Methods: College freshmen from ASU with complete data for three time points (n=321) were found to be predominantly female (72.2%) and non-white (53.2%) with a mean age of 17.5±41. Complete data included responses for items included in analysis which were related to friend encouragement about weigh management, self-perception of weight, physical activity, eating behaviors, and weight change intentions. A longitudinal multivariate mediation analysis using negative binomial regression adjusted for sociodemographics and clustering by dorm was used to assess the relationship between 1) friend encouragement about weight management at time 1 and behavioral outcomes at time 3, 2) friend encouragement about weight management at time 1 and self-perception of weight at time 2, and 3) self-perception of weight at time 2 and behavioral outcomes at time 3.

Results: A small proportion of population perceived friend encouragement about weight loss (18.3%) and weight gain (14.4%) at time 1. Half the population (50.9%) had the self-perception of overweight at time 2. At time 3, more than half (54.3%) of individuals performed at least 60 minutes of MVPA and consumed at least ½ a serving of sugar-sweetened beverages each day, while nearly half (48.6%) consumed at least 2 servings of fruits and vegetables each day. Males perceived more friend encouragement to gain weight (27.4%; p<0.01), but more females had the self-perception of overweight (54%; p=0.04) and were attempting to lose weight (59.3%; p<0.01). Individuals who perceived friend encouragement to lose weight at time 1 had a 14.8% greater prevalence (p<0.001) of overweight perception of time two, and a 9.6% and 6.9%; decreased prevalence (p<0.001) of weight change and weight loss intentions (p=0.023) at time three respectively. Individuals who perceived friend encouragement to gain weight had a 34.9% decreased prevalence of (p<0.001) of self-perception of overweight at time 1. In individuals with the self-perception of overweight at time 2, there was a 18.1% increased prevalence (p<0.001) of consuming at least ½ a serving of sugar-sweetened beverages/day and an increased prevalence of 22.8% and 24.0% for weight change intentions and weight loss intentions at time 3 (p<0.001).

Conclusion: These findings suggest that there was not a mediation effect of self-perception of overweight in the relationship between friend encouragement about weight management and behavioral outcomes in the current sample. However, the increased prevalence of overweight perception in individuals who perceived friend encouragement about weight management may inform future interventions to focus on how weight-related conversations with friends is related to overweight perception. More research about the relationship between weight-related conversations had with friends, self-perception of weight, and health behaviors is needed to confirm these findings.
ContributorsThibodeau, Tristan (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2016