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Dietary protein is known to increase postprandial thermogenesis more so than carbohydrates or fats, probably related to the fact that amino acids have no immediate form of storage in the body and can become toxic if not readily incorporated into body tissues or excreted. It is also well documented that

Dietary protein is known to increase postprandial thermogenesis more so than carbohydrates or fats, probably related to the fact that amino acids have no immediate form of storage in the body and can become toxic if not readily incorporated into body tissues or excreted. It is also well documented that subjects report greater satiety on high- versus low-protein diets and that subject compliance tends to be greater on high-protein diets, thus contributing to their popularity. What is not as well known is how a high-protein diet affects resting metabolic rate over time, and what is even less well known is if resting metabolic rate changes significantly when a person consuming an omnivorous diet suddenly adopts a vegetarian one. This pilot study sought to determine whether subjects adopting a vegetarian diet would report decreased satiety or demonstrate a decreased metabolic rate due to a change in protein intake and possible increase in carbohydrates. Further, this study sought to validate a new device called the SenseWear Armband (SWA) to determine if it might be sensitive enough to detect subtle changes in metabolic rate related to diet. Subjects were tested twice on all variables, at baseline and post-test. Independent and related samples tests revealed no significant differences between or within groups for any variable at any time point in the study. The SWA had a strong positive correlation to the Oxycon Mobile metabolic cart but due to a lack of change in metabolic rate, its sensitivity was undetermined. These data do not support the theory that adopting a vegetarian diet results in a long-term change in metabolic rate.
ContributorsMoore, Amy (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Thesis advisor) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2012
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Description
In 2002, a scientifically derived food guide pyramid for vegetarians, the Modified Food Guide for Lacto-ovo-vegetarians and Vegans was published and well received. Now that 10 years have passed, new scientific literature regarding the bioavailability of the nutrients of key concern in vegetarian diets has been published, and the graphical

In 2002, a scientifically derived food guide pyramid for vegetarians, the Modified Food Guide for Lacto-ovo-vegetarians and Vegans was published and well received. Now that 10 years have passed, new scientific literature regarding the bioavailability of the nutrients of key concern in vegetarian diets has been published, and the graphical format of the nation's food guide has evolved from a pyramid shape into a circular plate. The objective of this research was to examine the post-2002 literature regarding the bioavailability of key nutrients in vegetarian diets; to use this information to update the recommendations made in the 2002 Modified Food Guide Pyramid for Lacto-ovo-vegetarians and Vegans; and to adapt this revised food plan to the new USDA MyPlate format. This process involved reviewing the scientific literature to determine if the DRIs for the nutrients of key concern in vegetarian diets are adequate for the vegetarian population and using this information to develop new recommendations for vegetarians if necessary, analyzing the nutrient content of representative foods in different food groups, reconfiguring the food groups so that foods with like nutrient components were grouped together, determining the number of servings of each food group required to meet vegetarians' nutrient requirements at three caloric levels, and developing sample menus. A circular plate graphic, the Vegetarian Plate, was designed to illustrate the recommendations of this updated food guide. This updated, scientifically derived food guide provides a sound base for diet planning for lacto-ovo-vegetarians and vegans. Further research is needed to assess the Vegetarian Plate's adequacy for children, pregnant and lactating women, athletes, and individuals with medical conditions or chronic diseases.
ContributorsFladell, Lauren (Author) / Johnston, Carol (Thesis advisor) / Vaughan, Linda (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2013
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Description
ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is

ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is a polyunsaturated fatty acid that is beneficial at reducing body weight and in lowering many cardiovascular risk factors like atherosclerosis. The present study was designed to examine the change in plasma concentrations of leptin, nitric oxide, and the antioxidant superoxide dismutase in addition to examining the association between leptin and NO in healthy normal weight adult female subjects before and following omega 3 intakes. Participants were randomly assigned to either a fish oil group (600 mg per day) or a control group (1000 mg of coconut oil per day) for 8 weeks. Results showed no significant difference in the percent change of leptin over the 8 week supplementation period for either group (15.3±31.9 for fish oil group, 7.83±27 for control group; p=0.763). The percent change in NO was similarly not significantly altered in either group (-1.97±22 decline in fish oil group, 11.8±53.9 in control group; p=0.960). Likewise, the percent change in superoxide dismutase for each group was not significant following 8 weeks of supplementation (fish oil group: 11.94±20.94; control group: 11.8±53.9; p=0.362). The Pearson correlation co-efficient comparing the percent change of both leptin and NO was r2= -0.251 demonstrating a mildly negative, albeit insignificant, relationship between these factors. Together, these findings suggest that daily supplementation with 600 mg omega 3 in healthy females is not beneficial for improving these cardiovascular risk markers. Future studies in this area should include male subjects as well as overweight subjects with larger doses of fish oil that are equivalent to three or more servings per week. The importance of gender cannot be underestimated since estrogen has protective effects in the vasculature of females that may have masked any further protective effects of the fish oil. In addition, overweight individuals are often leptin-resistant and develop impaired vasodilation resulting from superoxide-mediated scavenging of nitric oxide. Therefore, the reported antioxidant and weight loss properties of omega 3 supplementation may greatly benefit overweight individuals.
ContributorsAlanbagy, Samer (Author) / Sweazea, Karen (Thesis advisor) / Johnston, Carol (Committee member) / Shepard, Christina (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2014
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The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma

The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma exacerbation which can result in severe morbidity. Most human rhinovirus types utilize Intercellular Adhesion Molecule-1 (ICAM-1) as a receptor to enter cells and initiate infection. Expression of this cell-surface protein is elevated in the respiratory tract of asthma patients. The theoretical basis for this research is the observation that plasma measures of the soluble form of Intercellular Adhesion Molecule-1 (sICAM-1) decrease in response to vitamin C supplementation. As rhinovirus infection occurs in the upper respiratory tract, the primary aim of this study was to evaluate change in sICAM-1 concentration in nasal lavage of asthmatic individuals in response to vitamin C supplementation. Otherwise healthy asthmatic adults between the ages of 18-65 years who were not currently using steroidal nasal sprays, smoking, or actively training for competitive sports were recruited from a university community and surrounding area to participate in an 18-day double-blind randomized placebo-controlled supplement study with a parallel arm design. 13 subjects were stratified based on age, gender, BMI and baseline plasma vitamin C level to receive either 500 mg vitamin C twice daily (VTC, n=7) or placebo (PLC, n=6). Biochemical measures included nasal lavage sICAM-1, plasma sICAM-1, plasma histamine, and plasma vitamin C. Survey measures included Wisconsin Upper Respiratory Symptom Survey-21 to assess colds, Daytime Symptom Diary Scale to assess asthma symptoms, and measures of diet quality including a vitamin C food frequency questionnaire and Rapid Eating Assessment for Participants. No between group comparison of means reached significance (Mann-Whitney U test, p>0.05). Nasal lavage sICAM-1 levels were decreased in VTC group by 37% at study day 4, although this finding did not reach significance. Findings in this study can be used to develop future investigations into the response of nasal lavage sICAM-1 to vitamin C supplementation.
ContributorsGnant, Lindsay (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Chang, Yung (Committee member) / Arizona State University (Publisher)
Created2014
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Description
ABSTRACT



Objective: This research examined the effectiveness of a weight loss diet incorporating high protein pasta and breakfast cereal products as compared to a weight loss diet using conventional versions of gluten-free pasta and breakfast cereal.

Design: In a

ABSTRACT



Objective: This research examined the effectiveness of a weight loss diet incorporating high protein pasta and breakfast cereal products as compared to a weight loss diet using conventional versions of gluten-free pasta and breakfast cereal.

Design: In a 6-week parallel-arm food trial (representing the first phase of a 12-week cross-over trial), 26 overweight and obese (Mean BMI 43.1 ± 12.4 kg/m²) participants, free of related comorbidities, were randomly assigned to the Zone diet (~29% energy intake from protein) or a control diet (~9% energy from protein). Participants were included in the trial if they satisfied the criteria for elevated risk for metabolic syndrome (top half of the TG/HDL ratios of all who were tested). Participants were instructed to eat prepared meals (total of 7 cereal packets and 14 pasta meals weekly) that included patented food technologies for the Zone diet and commercially available gluten-free rice pasta and a conventional name brand boxed cereal for the control diet. Body composition was measured with a bioelectrical impedance scale at weeks 1, and 6. Food records and diet adherence were recorded daily by the participants.

Results: Both the Zone and control diets resulted in significant weight loss (-2.9 ± 3.1 kg vs. -2.7 ± 2.6 kg respectively) over time (p = 0.03) but not between groups (p = 0.96). Although not statistically significant, the Zone diet appears to have influenced more weight loss at trial weeks 3, 4, and 5 (p = 0.46) than the control diet. The change in FFM was significant (p = 0.02) between the Zone and control groups (1.4 ± 3.6 kg vs. -0.6 ± 1.5 kg respectively) at week-6. Study adherence did not differ significantly between diet groups (p = 0.53).

Conclusions: Energy-restricted diets are effective for short-term weight loss and high protein intake appears to promote protein sparing and preservation of FFM during weight loss. The macronutrient profile of the diet does not appear to influence calorie intake, but it does appear to influence the quality of weight loss. Other measures of body composition and overall health outcomes should be examined by future studies to appropriately identify the potential health effects between these diet types.
ContributorsJames, Andrew (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the

Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.

Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.

Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.

Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).

Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors

Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors and outdoors.

Initial FB and HS were assessed in NCAA-DI female soccer athletes (n=10) of a single team in temperate, dry conditions (55-68°F, 18-48% humidity) who were monitored during 3 practices of equal estimated energy expenditure (EE): two outdoors in direct SUR (cold/moderate temperatures) and one indoors without SUR (moderate temperatures). Humidity, temperature, and wet bulb globe temperature (WBGT – a measurement partly based on SUR, including ambient temperature/relative humidity) were recorded using Heat Stress Meters placed in the direct sun or in the shade. Each athlete’s semi-nude dry body weight was recorded before and after exercise. Urine samples were taken before, after, and the morning after. Urine specific gravity (USG) was tested to assess HS. Athletes wore combined heart rate and activity monitors to estimate EE and were provided ad libitum water and/or a zero-calorie sports drink. Their total intake included weights of consumed food and drink. Sweat rate was calculated using body weight change and intakes of liquids minus urine losses/hour.

Two-way repeated measures ANOVA analyzed group-level differences. No significance was found in total FB (1.01±0.32 L/hr) or EE/hr (444±97.1 kcal/hr) across all days (p>0.05). In analyzing individual athlete results, 40% had consistent USG >1.025 (p=0.001) suggesting potential dehydration. These 4 athletes selected water as their beverage, of which is known that consuming only water does not stimulate drinking behavior as does electrolyte drinks. The remaining 60% were overall not dehydrated (USG <1.025) but must be aware of incidental dehydration in hotter temperatures.

The conclusion is that in low-moderate temperatures, athletes self-regulate drinking habits and achieve fluid balance during exercise with or without sun radiation. However, athletes with average USG >1.025 are likely to remain dehydrated in moderate temperatures. The findings suggest that more education would benefit these athletes by ensuring hydration in any environment.
ContributorsOlzinski, Stephanie (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools

Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools support people in identifying interventions that work for them, personally.

One approach to support such personalization is via self-experimentation using single-case designs. ‘Hack Your Health’ is a tool that guides individuals through an 18-day self-experiment to test if an intervention they choose (e.g., meditation, gratitude journaling) improves their own psychological well-being (e.g., stress, happiness), whether it fits in their routine, and whether they enjoy it.

The purpose of this work was to conduct a formative evaluation of Hack Your Health to examine user burden, adherence, and to evaluate its usefulness in supporting decision-making about a health intervention. A mixed-methods approach was used, and two versions of the tool were tested via two waves of participants (Wave 1, N=20; Wave 2, N=8). Participants completed their self-experiments and provided feedback via follow-up surveys (n=26) and interviews (n=20).

Findings indicated that the tool had high usability and low burden overall. Average survey completion rate was 91%, and compliance to protocol was 72%. Overall, participants found the experience useful to test if their chosen intervention helped them. However, there were discrepancies between participants’ intuition about intervention effect and results from analyses. Participants often relied on intuition/lived experience over results for decision-making. This suggested that the usefulness of Hack Your Health in its current form might be through the structure, accountability, and means for self-reflection it provided rather than the specific experimental design/results. Additionally, situations where performing interventions within a rigorous/restrictive experimental set-up may not be appropriate (e.g., when goal is to assess intervention enjoyment) were uncovered. Plausible design implications include: longer experimental and phase durations, accounting for non-compliance, missingness, and proximal/acute effects, and exploring strategies to complement quantitative data with participants’ lived experiences with interventions to effectively support decision-making. Future work should explore ways to balance scientific rigor with participants’ needs for such decision-making.
ContributorsPhatak, Sayali Shekhar (Author) / Buman, Matthew P (Thesis advisor) / Hekler, Eric B. (Committee member) / Huberty, Jennifer L (Committee member) / Johnston, Erik W., 1977- (Committee member) / Swan, Pamela D (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Most American children consume less than the recommend amount of fruits and vegetables (F&V), 74% and 84%, respectively. Eating too few F&V in childhood is associated with increased risk of cardiovascular disease, hypertension, respiratory symptoms, and some cancers later in life. Adequate F&V consumption favorably impacts antioxidant status, gut flora,

Most American children consume less than the recommend amount of fruits and vegetables (F&V), 74% and 84%, respectively. Eating too few F&V in childhood is associated with increased risk of cardiovascular disease, hypertension, respiratory symptoms, and some cancers later in life. Adequate F&V consumption favorably impacts antioxidant status, gut flora, mood, and cognitive functioning. Nutrients such as vitamin C and fiber are only naturally occurring in plant foods. For many children, school lunches are an important source of F&V. This pilot study assessed the feasibility of providing condiments to increase children’s consumption of salad bar F&V in an elementary school cafeteria at lunchtime. The trial site was a single Title 1 elementary school in a large, urban district in the greater Phoenix metropolitan area. Taste tests were conducted on three convenience samples of children in grades 3 – 7, aged 8 – 12 years (n=57) to identify the most popular condiment flavors. The five highest rated flavors were made available daily at a “flavor station” in the school’s lunchroom for three consecutive weeks during the Fall 2018 semester. Descriptive and inferential statistics were used to analyze data. A cost analysis was conducted for capital outlays related to the flavor station. School employee perceptions of F&V and the flavor station were assessed via posttest online surveys. Peanut butter was rated the best tasting condiment by children and was the only condiment that increased in popularity throughout the intervention. Overall, daily F&V consumption increased 17 g per child. There was a linear increase in F&V consumption during the study (r=0.986; P=0.014). As a proportion of the total F&V selected, F&V waste decreased by nearly 3%. The average daily cost of providing the flavor station was $0.09 per student. Sixty-five percent of school staff felt that the flavor station should continue at their school. Peanut butter is an affordable, nutrient-dense food that accommodates the USDA Food and Nutrition Service meal patterns and nutrition standards, and thus, is a viable strategy for increasing F&V consumption and decreasing F&V waste. The results herein inform the development of future interventions to improve the palatability of F&V for children.
ContributorsScholtz, Cameron (Author) / Johnston, Carol (Thesis advisor) / Alexon, Christy (Committee member) / Hooker, Steven (Committee member) / Schwake, David (Committee member) / Swan, Pamela (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Objectives: To investigate the potential of vinegar supplementation as a means for reducing visceral fat in healthy overweight and obese adults, and to evaluate its effects on fasting blood glucose and fasting insulin.

Subjects and Methods: Forty-five sedentary overweight and obese adult participants with a waist circumference greater than 32

Objectives: To investigate the potential of vinegar supplementation as a means for reducing visceral fat in healthy overweight and obese adults, and to evaluate its effects on fasting blood glucose and fasting insulin.

Subjects and Methods: Forty-five sedentary overweight and obese adult participants with a waist circumference greater than 32 inches for women and 37 inches for men were randomly assigned to one of two groups, the vinegar group (VIN, n=21) or the control group (CON, n=24), and instructed to consume either two tablespoons of liquid red wine vinegar (3.6g acetic acid) or a control pill (0.0225g acetic acid) twice daily at the beginning of a meal for 8 weeks. Participants were also instructed to maintain normal diet and physical activity levels. Anthropometric measures, dual-energy x-ray absorptiometry (DXA) scans, blood samples, and 24-hour dietary recalls were collected at baseline and at end of trial. A compliance calendar was provided for daily tracking of vinegar supplementation.

Results: Compliance to vinegar supplementation averaged 92.7 ±13.3% among the VIN group and 89.1 ±18.9% among the CON group. There were no statistically significant differences in anthropometric measurements between baseline and week 8: weight (P=0.694), BMI (P=0.879), and waist circumference (P=0.871). Similarly, DXA scan data did not show significant changes in visceral fat (P=0.339) or total fat (P=0.294) between baseline and week 8. The VIN group had significant reductions in fasting glucose (P=0.003), fasting insulin (P <0.001), and homeostatic model assessment of insulin resistance scores (P <0.001) after treatment.

Conclusions: These data do not support the findings from previous studies that indicated a link between vinegar supplementation and increased fat metabolism, specifically visceral fat reduction.
ContributorsGonzalez, Lisa Ann (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2019