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

Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type 2 Diabetes Mellitus (T2D). Design: Thirteen women and one man (21-62 y; mean, 46.0±3.9 y) participated in this 12-week parallel-arm trial. Participants were recruited from a campus community and were healthy and not diabetic by self-report. Participants were not prescribed oral hypoglycemic medications or insulin; other medications were allowed if use was stable for > 3 months. Subjects were randomized to one of two groups: VIN (8 ounces vinegar drink providing 1.5 g acetic acid) or CON (1 vinegar pill providing 0.04 g acetic acid). Treatments were taken twice daily immediately prior to the lunch and dinner meals. Venous blood samples were drawn at trial weeks 0 and 12 to measure insulin, fasting glucose, and HbA1c. Subjects recorded fasting glucose and 2-h postprandial glycemia concentrations daily using a glucometer. Results: The VIN group showed significant reductions in fasting capillary blood glucose concentrations (p=0.05) that were immediate and sustained throughout the duration of the study. The VIN group had reductions in 2-h postprandial glucose (mean change of −7.6±6.8 mg/dL over the 12-week trial), but this value was not significantly different than that for the CON group (mean change of 3.3±5.3 mg/dL over the 12-week trial, p=0.232). HbA1c did not significantly change (p=0.702), but the reduction in HbA1c in the VIN group, −0.14±0.1%, may have physiological relevance. Conclusions: Significant reductions in HbA1c were not observed after daily consumption of a vinegar drink containing 1.5 g acetic acid in non-diabetic individuals. However, the vinegar drink did significantly reduce fasting capillary blood glucose concentrations in these individuals as compared to a vinegar pill containing 0.04 g acetic acid. These results support a therapeutic effect for vinegar in T2D prevention and progression, specifically in high-risk populations.
ContributorsQuagliano, Samantha (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on

Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on gut fermentation. In this parallel arm randomized control trial, the effects of daily ingestion of vinegar on gut fermentation markers were observed among adults at risk for type 2 diabetes in Phoenix, Arizona. Subjects (n=14) were randomly assigned to treatments consisting of a vinegar drink (1.5g acetic acid) or a placebo (2 vinegar pills containing 40mg acetic acid each). All participants were required to consume the vinegar drink (16 oz) or 2 placebo pills every day for 12 weeks. At week 12, participants filled out a questionnaire to report gastrointestinal (GI) symptoms and three consecutive breath samples were taken from each subject to measure fasting breath hydrogen (BH2) with a breath analyzer. Fasting BH2 measures for the vinegar drink group (16.1+11.8 ppm) were significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.39 (p=0.023). After adjusting for age as a confounding factor (r=0.406) and removing an outlier, fasting BH2 measures for the vinegar drink group (4.3+1.1 ppm) were still significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.35 (p=0.045). Participants in both groups reported mild changes in GI symptoms. In conclusion, adults at risk for type 2 diabetes that consume 2 tablespoons of vinegar a day may have increased gut fermentation compared to those who do not consume vinegar.
ContributorsWhite, Serena (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Martin, Keith (Committee member) / Arizona State University (Publisher)
Created2013
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ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia.

ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia. Fifteen male and female subjects were recruited, ages 20-60y, who had no prior history of gastrointestinal (GI) disease or resections impacting normal GI function, were non-smokers, were non-vegetarian/vegan, were not taking any medications known to alter (glucose) metabolism, and were free of chronic disease including diabetes. Subjects were instructed to avoid exercise, alcohol and smoking the day prior to their trials and to consume a standardized, high-carbohydrate dinner meal the eve prior. There was a one-week washout period per subject between appointments. Breath hydrogen, serum insulin and capillary glucose were assessed over 3 hours after a high-starch breakfast meal to evaluate the impact of preprandial supplementation with ACV or placebo (water). Findings confirmed the antiglycemic effects of ACV as documented in previous studies, with significantly lower mean blood glucose concentrations observed during ACV treatment compared to the placebo at 30 min (p=0.003) and 60 min (p=0.005), and significantly higher mean blood glucose concentrations at 180 min (p=0.045) postprandial. No significant differences in insulin concentrations between treatments. No significant differences were found between treatments (p>0.05) for breath hydrogen; however, a trend was observed between the treatments at 180 min postprandial where breath hydrogen concentration was visually perceived as being higher with ACV treatment compared to the placebo. Therefore, this study failed to support the hypothesis that preprandial ACV ingestion produces a higher rate of colonic fermentation within a 3 hour time period following a high-carbohydrate meal. Due to variations in experiment duration noted in other literature, an additional study of similar nature with an expanded specimen collections period, well beyond 3 hours, is warranted.
ContributorsMedved, Emily M (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2012
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To date, there have not been any studies in a human population that explore the potential of vinegar ingestion in reducing visceral fat, a common yet serious metabolic disease risk factor. However, previous research in animal models exhibit promising findings, showing that vinegar is effective at reducing visceral fat. This

To date, there have not been any studies in a human population that explore the potential of vinegar ingestion in reducing visceral fat, a common yet serious metabolic disease risk factor. However, previous research in animal models exhibit promising findings, showing that vinegar is effective at reducing visceral fat. This is thought to be due to the activation of AMPK (adenosine monophosphate protein kinase) by acetic acid, the active ingredient in vinegar. The purpose of this study was to identify if this potentially groundbreaking relationship exists in human subjects. Healthy, nonsmoking, sedentary adults between the ages 18-45 y and a waist circumference measurement greater than or equal to 33 inches for women and 38 inches for men were recruited for this study. Twenty-three participants completed this 8-week, parallel arm, randomized control trial that tested the efficacy of red wine vinegar consumption (2 tablespoons red wine vinegar, twice per day, before a meal; providing 3.6 g acetic acid) against a placebo (1 apple cider vinegar pill, twice per day, before a meal; providing 0.0225 g acetic acid) for 8 weeks. Participants were randomized into either the vinegar (VIN) or control (CON) group after being stratified by age, gender, waist circumference, and weight. Results found that the VIN group experienced a 2% decrease in visceral fat (cm3, quantified by a DXA scan), but this change did not differ significantly from that of the CON group (p=0.256). The VIN group also experienced a slight decrease in insulin compared to the CON group, but this change was not significantly different than the control change (p=0.125). However, the change in HOMA-IR trended downward in the VIN group (-16%) as compared to the CON group (+9%) (p=0.079) with a large effect size, 0.153. Other parameters did not show statistically significant results between the groups. Further research is indicated in order to examine the potential of vinegar to reduce visceral fat.
ContributorsBaker, Olivia (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2018
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Background: Acetic acid in vinegar has demonstrated antiglycemic effects in previous studies; however, the mechanism is unknown.

Objective: To determine whether acetic acid dissociates in the addition of sodium chloride and describe a flavorful vinaigrette that maintains the functional properties of acetic acid.

Design: Phase I - Ten healthy subjects

Background: Acetic acid in vinegar has demonstrated antiglycemic effects in previous studies; however, the mechanism is unknown.

Objective: To determine whether acetic acid dissociates in the addition of sodium chloride and describe a flavorful vinaigrette that maintains the functional properties of acetic acid.

Design: Phase I - Ten healthy subjects (23-40 years) taste tested five homemade vinaigrette and five commercial dressings. Perceived saltiness, sweetness, tartness, and overall tasted were scored using a modified labeled affective magnitude scale. Each dressing was tested three times for pH with a calibrated meter. Phase II – Randomized crossover trial testing six dressings against a control dressing two groups of nine healthy adult subjects (18-52 years). Height, weight and calculated body mass index (BMI) were performed at baseline. Subjects participated in four test sessions each, at least seven days apart. After a 10-hour fast, participants consumed 38g of the test drink, followed by a bagel meal. Capillary blood glucose was obtained at fasting, and every 30 minutes over a 2-hour period the test meal.

Results: Dressing pH reduced as sodium content increased. In the intervention trials, no significant differences were observed between groups (p >0.05). The greatest reduction in postprandial glycemia (~21%) was observed in the dressing containing 200 mg of sodium. Effect size was large in both group 1 (η2=0.161) and group 2 (η2=0.577).

Conclusion: The inclusion of sodium into acetic acid may impair its ability to attenuate blood glucose after a meal.
ContributorsBonsall, Amber K (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2017
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Circadian misalignments in terms of eat and sleep cycles, common occurrences among college students, are linked to adverse health outcomes. Time-restricted feeding, a form of intermittent fasting, may offer an exciting, non-pharmacologic approach to improve the health of this population by restricting eating to feeding windows that align with circadian

Circadian misalignments in terms of eat and sleep cycles, common occurrences among college students, are linked to adverse health outcomes. Time-restricted feeding, a form of intermittent fasting, may offer an exciting, non-pharmacologic approach to improve the health of this population by restricting eating to feeding windows that align with circadian biology. This study aims to fill a gap in the literature regarding the effect of early time-restricted feeding (eTRF) on college students, particularly in regard to diet quality, diet self-efficacy, and sleep quality. To test the hypothesis that eTRF would lead to an increase in all three variables, a 4-wk randomized-controlled, parallel arm trial was conducted. Thirty-five healthy college students were randomly assigned to one of two groups: the intervention group (TRF) was instructed to adhere to an 8-h feeding window aligned with the light cycle (9 am to 5 pm), and the control group (CON) was instructed to adhere to a 12-h feeding window typical of college students (10 am to 10pm). The eTRF diet was consumed ad libitum, and the participants were not instructed to avoid compensatory hyperphagia. The results showed a strong, reverse effect of eTRF on diet quality: fasting had a highly significant association with decreased diet quality. The results suggest that, under free-living conditions, college students practicing eTRF are more likely to compensate for prolonged fasting with unhealthy eating and snacking.

ContributorsGonzalez, Valeria Isabel (Author) / Johnston, Carol (Thesis director) / Hundley, Amanda (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Mood disorders are prevalent within the college student population, increasing the potential for poor academic performance among those students. Intermittent fasting, particularly time-restricted feeding (TRF) regimens, have shown promising results associated with improvements in health outcomes related to weight loss, cardiovascular health, glucose and insulin regulation, and breast cancer; however,

Mood disorders are prevalent within the college student population, increasing the potential for poor academic performance among those students. Intermittent fasting, particularly time-restricted feeding (TRF) regimens, have shown promising results associated with improvements in health outcomes related to weight loss, cardiovascular health, glucose and insulin regulation, and breast cancer; however, very limited research exits for the impact on mood states. The objective of this eight-week randomized, controlled trial was to examine the effects of a daily fasting regimen of 18 hours (six hour feeding window), compared to a daily fasting regimen of eight hours (16 hour feeding window), on the mood state of healthy college students attending Arizona State University or University of Arizona. Twenty nine students were recruited and randomized into the TRF group (n = 16) following a 16-hour fast or the control (CON) group (n = 13) following an eight-hour fast. Participants in each group were instructed to consume their first meal within an hour of waking, which would then begin their assigned feeding window. Participants were also allowed one ‘cheat day’ per week in which they were not required to follow their assigned fasting protocol, otherwise no additional dietary instructions were given; participants were permitted to consume food and beverages ad libitum throughout their feeding window. Mood state was assessed at baseline, week four, and week eight using the Profile of Mood States questionnaire and the GAD-7, specific to generalized anxiety. Of the initial 29 participants recruited, 18 completed the trial (TRF group n = 8; CON group n = 10). Data were reported through week four only, due to inconsistencies with week eight data as a result of the COVID-19 pandemic. The mood state measures did not show any statistically significant changes after four weeks. The results of this study suggest that a TRF regimen of 18 hours does not significantly impact overall or individual mood states among college students.
ContributorsChondropoulos, Kelly Nicole (Author) / Johnston, Carol (Thesis advisor) / Shepard, Tina (Committee member) / Alexon, Christy (Committee member) / Arizona State University (Publisher)
Created2021
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Background: College students face a particularly high prevalence of body dissatisfaction and weight instability increasing the risk of being unhappy and having a poor quality of life. Time-restricted feeding, a type of intermittent fasting, has gained popularity recently for sustainable weight loss without the characteristic dietary restrictions of most fad

Background: College students face a particularly high prevalence of body dissatisfaction and weight instability increasing the risk of being unhappy and having a poor quality of life. Time-restricted feeding, a type of intermittent fasting, has gained popularity recently for sustainable weight loss without the characteristic dietary restrictions of most fad diets. A limited number of randomized control trials have looked at the effects of time-restricted feeding in humans, but none have looked at how this dietary regimen impacts happiness and quality of life. Objective: The goal was to examine the effects of an 18-hour daily fasting regimen compared to an 8-hour daily fasting regimen on happiness and quality of life in college students in Arizona. Methods: Participants included 29 healthy, non-smoking, non-vaping students attending college in Arizona between October 2020 to March 2021. Of the 16 participants allocated to the time-restricted feeding intervention, 8 completed the trial. Of the 13 participants allocated to the control group, 10 completed the trial. The eating window began within one hour of waking up with a 6-hour eating window for the intervention group and 16-hour window for the control group. They could do one cheat day per week. No dietary restrictions were enforced. Participants completed the Oxford Happiness Questionnaire and the WHOQOL-BREF quality of life questionnaire at baseline, week 4, and week 8. Week 8 data were not reported due to data collection changes and cancellations related to the new safety protocols for the COVID-19 pandemic. Results: Quality of life related to social relationships improved significantly in the intervention group (p=0.026). There was a trend favoring the intervention group as well showing a possible improvement in happiness related to perceived energy levels (p=0.088). No other significant data were reported. Conclusion: Adherence to an 18-hour time-restricted feeding regimen for 8 weeks may improve quality of life related to social relationships in college students in Arizona. The results of this trial do not suggest a significant impact on overall quality of life or happiness in this population.
ContributorsDe León, Anateresa (Author) / Johnston, Carol (Thesis advisor) / Shepard, Christina (Committee member) / Grant, Shauna (Committee member) / Arizona State University (Publisher)
Created2021
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ABSTRACT

Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.

Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting

ABSTRACT

Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.

Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting morning blood pressure, biomarkers of glucose regulation, biomarkers of lipid metabolism, and anthropometric measures.

Methods. Eighteen healthy college students (age = 23 ± 4 years; BMI = 23.2 ± 2.3 kg/m2; MET = 58.8 ± 32.9 min/wk) completed this study. Participants were randomized to a daily 18-hour fasting protocol (Intervention; n = 8) or a daily 8-hour fasting protocol (Control; n = 10) for eight weeks. One ‘cheat’ day was permitted each week. Outcomes were measured at weeks 0 (baseline), 4, and 8. A non-parametric Mann Whitney U test was used to compare the week 4 change from baseline between groups. Statistical significance was set at p≤0.05.

Results. Diet quality (p = 0.030) and body weight (p = 0.016) improved from baseline to week 4 for the INV group in comparison to the CON group. The data suggest these improvements may be related to reductions in snacking frequency and increased breakfast consumption. Fasting blood glucose and hip circumference tended to improve for the INV group in comparison to the CON group (p = 0.091 and p = 0.100). However, saturated fat intake tended to increase in the INV group in comparison to the CON group (p = 0.064). Finally, there were no treatment differences between groups (p>0.05) for the 4-week change in total calories, dietary vitamin C, added sugars, resting systolic blood pressure, resting diastolic blood pressure, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, waist circumference, or MET.

Conclusion. These data, although preliminary, suggest that the 18-hour fasting protocol was effective for improving diet quality and reducing weight in comparison to the 8-hour fasting protocol in healthy college students. Future intervention trials will need to confirm these findings and determine the long-term relevance of these improvements for health outcomes.
ContributorsMayra, Selicia (Author) / Johnston, Carol (Thesis advisor) / Sears, Dorothy (Committee member) / Swan, Pamela (Committee member) / Sweazea, Karen (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2020
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Description
The popularity of intermittent fasting has grown in recent years and is a commonly discussed diet topic on the internet and social media. Time-restricted feeding (TRF) is one particular intermittent fasting regime that allows participants to pick windows of time per day in which they can eat or fast. While

The popularity of intermittent fasting has grown in recent years and is a commonly discussed diet topic on the internet and social media. Time-restricted feeding (TRF) is one particular intermittent fasting regime that allows participants to pick windows of time per day in which they can eat or fast. While current randomized controlled trials show positive effects of TRF on weight loss, body composition, glucose, insulin, and blood pressure, there is a gap in the literature of the its effect on cognition although animal studies suggest a positive effect. The purpose of this 8-week randomized controlled trial was to investigate the effect of 18-hour time-restricted feeding on healthy, Arizona State university students. Students (n= 29) were recruited by the research team and were randomized to either an 18-hour intervention (INV) group or an 8-hour control (CON) group. INV participants were instructed to consume food within the first hour of waking and cease their eating period after 6 hours to begin their 18-hour fast. Participants were not given any other dietary restrictions and were allowed to eat ad libitum during their eating periods. Cognitive tests (Stroop Test and Trail Making Test) and blood draws were taken at baseline, week 4, and week 8. The present study demonstrated high attrition, with 7 participants dropping out of the study after their baseline visit. Interruption of the COVID-19 pandemic also impacted the data analysis, with the removal of week 8 data. Despite limitations, statistically significant differences between the INV group and CON group were seen in the Trail Making Test B at week 4 (p= 0.031). Statistically significant differences were not seen in any of the other cognitive outcomes measured (Stroop Test, Trail Making Test A, serum BDNF, serum ketones). However, a significant inverse relationship was seen between serum ketones and Trail Making Test B. In conclusion, this study suggests that TRF may have a favorable effect on cognitive acuity among university students.
ContributorsKravat, Natalie (Author) / Johnston, Carol (Thesis advisor) / Gu, Haiwei (Committee member) / Sears, Dorothy (Committee member) / Arizona State University (Publisher)
Created2021