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No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years (X=29.8±4.9 years) with a gestational age (GA) <17 weeks were randomized to Breezing™ (N=16) or control (N=12) for 13 weeks.

No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years (X=29.8±4.9 years) with a gestational age (GA) <17 weeks were randomized to Breezing™ (N=16) or control (N=12) for 13 weeks. The Breezing™ group used a real-time metabolism tracker to obtain REE. Anthropometrics, diet, and sleep data were collected every 2 weeks. Rate of GWG was calculated as weight gain divided by total duration. Early (GA weeks 14-21), late (GA weeks 21-28), and overall (GA week 14-28) changes in macronutrients, sleep, and GWG were calculated. Mediation models were constructed using SPSS PROCESS macro using a bootstrap estimation approach with 10,000 samples. The majority of women were non-Hispanic Caucasian (78.6%). A total of 35.7% (n=10), 35.7% (n=10), and 28.6% (n=8) were normal weight, overweight, and obese, respectively, with 83.3% (n=10) and 87.5% (n=14) of the Control and Breezing™ groups gaining above IOM GWG recommendations. At baseline, macronutrient consumption did not differ. Overall (Breezing™ vs. Control; M diff=-349.08±150.77, 95% CI: -660.26 to -37.90, p=0.029) and late (M diff=-379.90±143.89, 95% CI:-676.87 to -82.93, p=0.014) changes in energy consumption significantly differed between the groups. Overall (M diff=-22.45±11.03, 95% CI: -45.20 to 0.31, p=0.053), late (M diff=-23.16±11.23, 95% CI: -46.33 to 0.01, p=0.05), and early (M diff=20.3±10.19, 95% CI: -0.74 to 41.34, p=0.058) changes in protein differed by group. Nocturnal total sleep time differed by study group (Breezing vs. Control; M diff=-32.75, 95% CI: -68.34 to 2.84, p=0.069). There was a 11.5% increase in total REE throughout the study. Early changes in REE (72±211 kcals) were relatively small while late changes (128±294 kcals) nearly doubled. Interestingly, early changes in REE demonstrated a moderate, positive correlation with rates of GWG later in pregnancy (r=0.528, p=0.052), suggesting that REE assessment early in pregnancy may help predict changes in GWG. Changes in macronutrients did not mediate the relationship between the intervention and GWG, nor did sleep mediate relationships between dietary intake and GWG. Future research evaluating REE and dietary composition throughout pregnancy may provide insight for appropriate GWG recommendations.
ContributorsVander Wyst, Kiley Bernhard (Author) / Whisner, Corrie M (Thesis advisor) / Reifsnider, Elizabeth G. (Committee member) / Petrov, Megan E (Committee member) / Buman, Matthew (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019
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Sleep is imperative for health and wellness with direct impacts on brain function, physiology, emotional well-being, performance and safety when compromised. Adolescents and young adults are increasingly affected by factors affecting the maintenance of regular sleep schedules. College and university students are a potentially vulnerable population to sleep deprivation and

Sleep is imperative for health and wellness with direct impacts on brain function, physiology, emotional well-being, performance and safety when compromised. Adolescents and young adults are increasingly affected by factors affecting the maintenance of regular sleep schedules. College and university students are a potentially vulnerable population to sleep deprivation and sleep insufficiency. Possible factors that could contribute to poor sleep hygiene include, but are not limited to, academic pressures, social activities, and increased screen time. Arguably, students are still experiencing bone mineralization, until the age of 30 or even 40 years old, which makes it more important to understand the effects that altered sleep patterns could have on continued development of bone health. It is our understanding that to date, studies assessing the risk of sleep insufficiency on bone mineral density in college students have not been conducted. We hypothesized that college-aged students, between the ages of 18-25 years, with shorter sleep durations, greater sleep schedule variability, and poorer sleep environments will have significantly lower bone mineral density. ActiGraph monitoring, via a wrist ActiWatch was used to quantitatively measure sleep habits for up to 7 consecutive days. During the week-long study participants also captured their self-reported sleep data through the use of a sleep diary. Participants were measured one time within the study for bone mineral density of the lumbar spine and total hip through a dual energy x-ray absorptiometry. This was a preliminary analysis of a larger cross-sectional analysis looked at 17 participants, of which there were 14 females and 3 males, (n=5, 1 and 11 Hispanic, Black and White, respectively). The mean age of participants was 20.8±1.7 y with an average BMI of 22.9±3.2 kg/m2. ActiWatch measurement data showed a mean daily sleep duration of participants to be 437.5 ± 43.1 (372.5 – 509.4) minutes. Mean sleep efficiency (minutes of sleep divided by minutes of time in bed) and mean number of awakenings were 87.4±4.3 (75.4-93.4) minutes and 32.1±6.4 (22.3-42.7) awakenings, respectively. The median time for wake after sleep onset (WASO) was 34.5±10.5 (18.3-67.4) minutes. The mean bone mineral density (BMD) for the hips was 1.06±0.14 (0.81-1.28) g/cm2 with a mean BMD of the lumbar spine being 1.24±0.12 (0.92-1.43) g/cm2. Age-matched Z-scores of the hips was 0.31±0.96 (-1.6-2.1) and lumbar spine was 0.53 (IQR: 0.13, 0.98; -2.25-1.55). Neither sleep duration nor sleep efficiency was significantly correlated to BMD of either locations. While WASO was positively associated with hip and spine BMD, this value was not statistically significant in this population. Overall, associations between sleep and BMD of the femur and spine were not seen in this cohort. Further work utilizing a larger cohort will allow for control of covariates while looking for potential associations between bone health, sleep duration and efficiency.

ContributorsEsch, Patricia Rose (Author) / Whisner, Corrie (Thesis director) / Petrov, Megan (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
The objective of the present study was to investigate differences in traditional and non-traditional cardiovascular disease (CVD) risk factors between Asian and non-Hispanic White young adults. The burden of CVD varies by racial/ethnic group. Traditional risk factors that increase the likelihood of developing CVD include smoking, alcohol, physical inactivity, obesity,

The objective of the present study was to investigate differences in traditional and non-traditional cardiovascular disease (CVD) risk factors between Asian and non-Hispanic White young adults. The burden of CVD varies by racial/ethnic group. Traditional risk factors that increase the likelihood of developing CVD include smoking, alcohol, physical inactivity, obesity, diabetes, high cholesterol, and high blood pressure. Suboptimal sleep is known to be a non-traditional risk factor for poor overall health, CVD risk factors, and CVD. The present study was an investigation of a cross-sectional, screening survey used for a larger community-based study on sleep and cardiovascular health. The unadjusted results examining differences in traditional CVD risk factors indicated that Asian participants were less likely to report alcohol use compared to non-Hispanic White participants. For non-traditional CVD risk factors, Asians were less likely to report experiencing sleep-related fatigue or malaise, attention impairment, daytime sleepiness, reduced motivation or energy, or concerns about their sleep compared to non-Hispanic White participants. Multivariate-analyses were conducted adjusting for sex and age. The adjusted results indicated that the Asian participants were less likely to report alcohol consumption, regular engagement in exercise, engagement in hard intensity exercise, concerns with sleep quality, and sleep difficulty-related fatigue, attention impairment, daytime sleepiness, reduced motivation, and were more likely to be obese compared to non-Hispanic White participants. The results may help guide cardiovascular prevention education provided to these groups. The data indicate the need for further longitudinal research studies on non-traditional CVD risk factors like sleep by ethnicity/race.
ContributorsSpoehr, Natalie Jane (Author) / Petrov, Megan (Thesis director) / Shin, Chanam (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
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Description
Sleep diaries and actigraphy are two common methods used to assess sleep subjectively and objectively, respectively. Compared to the gold standard of sleep assessment, polysomnography, sleep diaries and actigraphic methods are more cost-effective and simpler to use. This study aimed to compare the sleep parameters derived from actigraphy and slee

Sleep diaries and actigraphy are two common methods used to assess sleep subjectively and objectively, respectively. Compared to the gold standard of sleep assessment, polysomnography, sleep diaries and actigraphic methods are more cost-effective and simpler to use. This study aimed to compare the sleep parameters derived from actigraphy and sleep diaries (total sleep time, sleep onset latency, number of awakenings, wake after sleep onset, percentage of time awake, and sleep efficiency). Based on results from previous similar studies, it was hypothesized that the sleep diaries would overestimate the total sleep time parameter and underestimate wake parameters. Twenty healthy young adults without sleep problems volunteered to participate. The participants wore an Actiwatch 2 on their wrist and filled out a sleep diary every morning for the duration of six days. A high intraclass correlation coefficient value between subjective and objective sleep was found for the parameter total sleep time, even though total sleep time was found to be slightly overestimated by the sleep diaries. Sleep onset latency, wake after sleep onset, number of awakenings, percentage of time awake, and sleep efficiency were underestimated by the sleep diaries and did not have high correlation values. Based off of the ICC results, there does not seem to be a strong correlation between the Actiwatch 2 and the sleep diaries, but looking at the Bland Altman plots, there seems to be agreement between the methods.
ContributorsRameshkumar, Aarthi (Author) / Buman, Matthew (Thesis director) / Petrov, Megan (Committee member) / Diaz-Piedra, Carolina (Committee member) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2016-12
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For this creative project, an instructional video on relaxation techniques was created. The relaxation techniques demonstrated were intended to help patients with comorbid cancer and sleep disturbance fall asleep with greater ease. Based on a literature review, autogenic training and tai chi were chosen as the relaxation techniques to demonstrate

For this creative project, an instructional video on relaxation techniques was created. The relaxation techniques demonstrated were intended to help patients with comorbid cancer and sleep disturbance fall asleep with greater ease. Based on a literature review, autogenic training and tai chi were chosen as the relaxation techniques to demonstrate in the video project. The literature review informed what components of autogenic training and tai chi should be included in the video. A patient with cancer was asked to participate in the making of the video. The patient was guided through autogenic training and tai chi. The patient provided feedback on her experience after completing each technique. The video also included background information on the two relaxation techniques. The completed video was presented to the director of Natural Medicine and Detox in Phoenix, AZ, a naturopathic physician, and a cancer survivor. These individuals provided feedback on what they liked about the video and what they thought needed improvement. The video was posted on YouTube as a resource for patients with cancer. https://www.youtube.com/watch?v=04kYz1kSCaU
Created2016-12
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How early life is experienced and perceived can greatly affect mental and physical health outcomes. An individual is greatly influenced by their first models of what social relationships look and feel like, and with time also learn how to survive when less favorable social experiences occur. The lessons learned may

How early life is experienced and perceived can greatly affect mental and physical health outcomes. An individual is greatly influenced by their first models of what social relationships look and feel like, and with time also learn how to survive when less favorable social experiences occur. The lessons learned may lead to healthy problem solving and resilience, or it may lead to unhealthy problem-solving habits that hinder well-being. Anxious thoughts and other mental health symptoms may accompany an individual long-term and hinder an essential need for a healthy life. The first main purpose of this thesis is to examine the impact of Adverse Childhood Experiences (ACEs) on mental health (anxiety symptoms), and on sleep quality (an essential need). The second purpose of my thesis is to investigate the impact of genetics on resilience, specifically, the mu-opioid receptor gene. The first hypothesis proposed ACEs that were perceived as more traumatic and occurred more frequently would be associated with more poor sleep quality symptoms. The second hypothesis predicted that anxiety symptoms would mediate the association. The third hypothesis (exploratory) suggested that an individual’s alleles for the mu-opioid receptor gene would moderate the mediation pathway. The study was conducted with 318 participants between the ages of 18 and 35 years old. The study demonstrated a direct effect for ACEs and sleep. Anxiety mediated the association between ACEs (exposure and severity) and sleep (insomnia, quality, sleepiness), suggesting that ACEs possibly increase feelings of anxiety which, in turn, lead to worse sleep outcomes. Finally, the moderated-mediation model with OPRM1 as the moderator, was not significant for the mediation pathway A; however, there was a significant interaction with anxiety and sleep symptoms.
ContributorsBailey, Elise (Author) / Mickelson, Kristin (Thesis advisor) / Burleson, Mary (Committee member) / Petrov, Megan (Committee member) / Arizona State University (Publisher)
Created2022
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This body of research sought to explore relationships between cognitive function and physical activity (PA), sedentary behavior (SB), and sleep, independently and in conjunction, in mid-life to older adults with no known cognitive impairment. Aging is associated with cognitive decline, and lifestyle behaviors such as PA, SB, and sleep, may

This body of research sought to explore relationships between cognitive function and physical activity (PA), sedentary behavior (SB), and sleep, independently and in conjunction, in mid-life to older adults with no known cognitive impairment. Aging is associated with cognitive decline, and lifestyle behaviors such as PA, SB, and sleep, may mitigate this decline. First, a systematic review and meta-analysis was conducted to examine the effect of aerobic PA interventions on memory and executive function in sedentary adults. Second, a longitudinal study was conducted to examine the association between SB and odds of incident cognitive impairment, and SB and cognitive decline in older adults. Last, a cross-sectional study was conducted to examine the joint associations between different levels of sleep with levels of PA, and sleep with levels of sedentary time on memory and executive function. This body of research provided evidence to support the association between aerobic PA and improved cognitive function, SB and incident cognitive impairment and cognitive function declines, and the joint association of sleep and different levels of PA and ST on cognitive function by hypertension status.
ContributorsHoffmann, Nicole M (Author) / Lee, Rebecca E (Thesis advisor) / Petrov, Megan E (Thesis advisor) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2020
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Food insecurity affects more than 10 million households in the United States and has been shown to impact what and how a child is fed. Additionally, there is some evidence to suggest that food insecurity may affect how an infant is soothed (either with food or another mechanism), but no

Food insecurity affects more than 10 million households in the United States and has been shown to impact what and how a child is fed. Additionally, there is some evidence to suggest that food insecurity may affect how an infant is soothed (either with food or another mechanism), but no study has examined the possible relationship between soothing techniques and the incidence of food insecurity. To evaluate whether food security status and nighttime soothing techniques have a relationship, surveys were administered to a sample of mothers from various racial and socioeconomic backgrounds at 3-weeks, 8-weeks, and 3-months postpartum. Of the 69 participants sampled, 61 had data that could contribute to evaluations of food security status and soothing techniques used at night. A chi-square model was utilized to determine what, if any, relationship existed between the two variables. The chi-square model did not yield statistically significant results (Pearson Chi-Square= .506, p=.477) and descriptive statistics showed that just six of the 61 participants sampled did not use food to soothe at the time their baby was 3-weeks-old. Further examination of descriptive statistics revealed that, between breastfeeding and bottle-feeding as a means to soothe an infant, breastfeeding was used twice as much as bottle-feeding. For participants enrolled in the Special Supplemental Nutrition Program for Women, Infants, Children (WIC), the use of food to soothe increased at each of the three time points. Among participants found to be food-insecure, the use of breastfeeding and bottle-feeding as means to soothe varied from time point to time point. The physical and mental toll of the postpartum period may contribute to the high use of food-to-soothe among mothers seen in this study. Future research efforts in this area should examine whether the observations reported in this study are similar among larger samples, and if more mental health support for mothers has any effect on whether food is used to soothe.
ContributorsKoelbel, Megan (Author) / Whisner, Corrie (Thesis advisor) / Petrov, Megan (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2023
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Description
The relationship between sleep and physical activity is an area of growing scientific interest, particularly in the context of older adults. The importance of examining long sleep duration and its influence on physical activity in this demographic becomes increasingly relevant given rising healthcare costs. This dissertation aims to investigate this

The relationship between sleep and physical activity is an area of growing scientific interest, particularly in the context of older adults. The importance of examining long sleep duration and its influence on physical activity in this demographic becomes increasingly relevant given rising healthcare costs. This dissertation aims to investigate this intricate relationship via secondary analysis by examining the effects of moderate time-in-bed (TIB) restriction (60 minutes per night)) on various intensities of physical activity (sedentary, light, moderate, vigorous, moderate-vigorous physical activity) in older adults classified as long sleepers and average duration sleepers. It was hypothesized that moderate TIB restriction would result in differential changes in physical activity levels across various intensities, with long sleepers exhibiting increased physical activity and average sleepers displaying decreased activity, potentially influenced by alterations in TST (total sleep time) and SE (sleep efficiency). Utilizing a randomized controlled trial design, this study examined the effect of treatment changes in objectively measures activity (waist actigraphy) and subjects physical activity levels as measured by the Godin Leisure-Time Exercise Questionnaire . Eligible participants were long sleepers (sleeping > 9 hours per night) and average sleepers (sleeping 7-9 hours per night). Both types of sleepers were either randomized to TIB restriction or asked to maintain their average sleep patterns. Mean TIB restriction compared with baseline was 39.5 minutes in average sleepers and 52.9 minutes in long sleepers randomized to TIB restriction . Contrary to the original hypothesis, no significant effect of TIB restriction was observed across all physical activity levels in either long sleepers or average sleepers. However, a notable association was found between increased sleep efficiency (+0.09% [SD = ± 4.64%]) and light physical activity (±31 minutes [SD = ± 104.81, R=0.445, P < 0.007]) in long sleepers undergoing TIB restriction. While this study presents several methodological limitations, including its nature as a secondary analysis and the less-than-intended achievement of TIB restriction, it adds a valuable layer to the existing body of research on sleep and physical activity in older adults. The findings suggest that moderate TIB restriction may not be sufficiently impactful to change behavior in physical activity levels, thus highlighting the need for more nuanced, targeted research in this domain.
ContributorsPerry, Christopher (Author) / Youngstedt, Shawn D (Thesis advisor) / Petrov, Megan (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Ringenbach, Shannon (Committee member) / Arizona State University (Publisher)
Created2023
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College students are a niche of young adults, characterized by abnormal sleeping habits and inactive lifestyles. Many students entering college are as young as 18 years old and graduate by 22 years old, a window of time in which their bones are still accruing mineral. The purpose of this cross-sectional

College students are a niche of young adults, characterized by abnormal sleeping habits and inactive lifestyles. Many students entering college are as young as 18 years old and graduate by 22 years old, a window of time in which their bones are still accruing mineral. The purpose of this cross-sectional study was to determine whether sleep patterns and physical activity observed in college students (N= 52) 18-25 years old at Arizona State University influenced bone biomarkers, osteocalcin (OC) and N-terminal telopeptide of type 1 collagen (NTX-1) concentrations. Students completed various dietary and health history questionnaires including the International Physical Activity Questionnaire short form. Students wore an actigraphy watch for 7 consecutive nights to record sleep events including total sleep time, sleep onset latency and wake after sleep onset. Total sleep time had a significant, negative correlation with OC (r = -0.298, p-value =0.036) while sleep onset latency had a significant, positive correlation with NTX-1 serum concentration (r = 0.293, p-value = 0.037). Despite correlational findings, only sleep percent was found to be significant (beta coefficient = 0.271 p-value = 0.788) among all the sleep components assessed, after adjusting for gender, race, BMI and calcium intake in multivariate regression models. Physical activity alone was not associated with either bone biomarker. Physical activity*sleep onset latency interactions were significantly correlated with osteocalcin (r = 0.308, p-value =0.006) and NTX-1 (r = 0.286, p-value = 0.042) serum concentrations. Sleep percent*physical activity interactions were significantly correlated with osteocalcin (r = 0.280, p-value = 0.049) but not with NTX-1 serum concentrations. Interaction effects were no longer significant after adjusting for covariates in the regression models. While sleep percent was a significant component in the regression model for NTX-1, it was not clinically significant. Overall, sleep patterns and physical activity did not explain OC and NTX-1 serum concentrations in college students 18-25 years old. Future studies may need to consider objective physical activity devices including accelerometers to measure activity levels. At this time, college students should review sleep and physical activity recommendations to ensure optimal healthy habits are practiced.
ContributorsMahmood, Tara Nabil (Author) / Whisner, Corrie (Thesis advisor) / Dickinson, Jared (Committee member) / Petrov, Megan (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019