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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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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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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
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
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The effects of iron and chromium blood concentrations have been linked to blood glucose control in diabetics. It is suggested that iron causes oxidative stress in the beta cells of the pancreas and adipocytes creating insulin insufficiency and resistance. Chromium is believed to increase the action of insulin

The effects of iron and chromium blood concentrations have been linked to blood glucose control in diabetics. It is suggested that iron causes oxidative stress in the beta cells of the pancreas and adipocytes creating insulin insufficiency and resistance. Chromium is believed to increase the action of insulin through its biologically active molecule chromodulin. Both of these mechanisms are not clear. This 20 week case study tests the feasibility of combining iron depletion therapy followed by chromium supplementation to improve insulin sensitivity. This single case study followed a protocol of two blood donations separated by eight weeks followed by chromium supplementation of 250 µg of chromium picolinate once a day four weeks after the second blood donation. Fasting blood draws were taken at baseline, post blood draws and pre and post chromium supplementation. Results were not promising for the first hypothesis of lowering HbA1c, but the results were promising for the second hypothesis of improving insulin sensitivity by lowering the HOMA score.
ContributorsJarrett, Nia (Author) / Johnston, Carol (Thesis advisor) / Lespron, Christy (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2015
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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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Description
There are limited studies exploring the direct relationship between coconut oil and cholesterol concentrations. Research in animals and a few intervention trials suggest that coconut oil increases the good cholesterol (high density lipoprotein, HDL) and thus reduces the risk of cardiovascular disease. Preliminary research at Arizona State University (ASU) has

There are limited studies exploring the direct relationship between coconut oil and cholesterol concentrations. Research in animals and a few intervention trials suggest that coconut oil increases the good cholesterol (high density lipoprotein, HDL) and thus reduces the risk of cardiovascular disease. Preliminary research at Arizona State University (ASU) has found similar results using coconut oil as a placebo, positive changes in HDL cholesterol concentrations were observed.

The goal of this randomized, double blind, parallel two arm study, was to further examine the beneficial effects of a 2g supplement of coconut oil taken each day for 8 weeks on cholesterol concentrations, specifically the total cholesterol to HDL cholesterol ratio, compared to placebo.

Forty-two healthy adults between 18-40 years of age, exercising less than 150 minutes each week, non smoking, BMI between 22-35 and not taking any medications that could effect blood lipids were recruited from the ListServs at ASU. Participants were randomized to receive either a placebo capsule of flour or a coconut oil capsule (Puritan’s Pride brand, coconut oil softgels, 2g each) and instructed to take the capsules for 8 weeks.

Results indicated no significant change in total cholesterol to HDL ratio between baseline and 8 weeks in the coconut oil and placebo groups (p=0.369), no significant change in HDL (p=0.648), no change in LDL (p=0.247), no change in total cholesterol (p=0.216), and no change in triglycerides (p=0.369).

Blood lipid concentrations were not significantly altered by a 2g/day dosage of coconut oil over the course of 8 weeks in healthy adults, and specifically the total cholesterol to HDL ratio did not change or improve.
ContributorsShedden, Rachel (Author) / Johnston, Carol (Thesis advisor) / Lespron, Christy (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2017
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Description
ABSTRACT

Objective: The purpose of this randomized, placebo-controlled trial was to investigate the effect a daily coconut oil supplement (2 grams) would have on a common serum marker of systemic inflammation (C-reactive protein) and an indicator of oxidative stress (TBARS) when compared to the control group receiving a placebo capsule (white

ABSTRACT

Objective: The purpose of this randomized, placebo-controlled trial was to investigate the effect a daily coconut oil supplement (2 grams) would have on a common serum marker of systemic inflammation (C-reactive protein) and an indicator of oxidative stress (TBARS) when compared to the control group receiving a placebo capsule (white flour) in healthy, sedentary adults between the ages of 18-40 in Phoenix, Arizona.

Design: This study was designed as secondary analyses of blood samples originally collected to study the effects of coconut oil supplementation on blood lipids and body composition. The original study consisted of 32 healthy, adult volunteers recruited from the Arizona State University campus in Phoenix, Arizona. Participants followed no food restrictions or special diets, exercised less than 150 minutes per week, had no diagnoses of chronic disease, were not taking statin medications, were non-smokers, and no female participants were pregnant. Participants were randomized into either the Coconut Oil group (CO) or the Placebo group (PL) at week 0, and baseline blood samples and anthropometric measurements were obtained. Each participant completed an 8-week protocol consisting of two supplement capsules daily (coconut oil or placebo). Final fasting blood samples and anthropometric measurements were taken at week 8. This study analyzed the blood samples for measurements of C-reactive protein (CRP) and thiobarbituric reactive substance (TBARS).

Results: Eight weeks of 2 grams per day coconut oil supplementation, in comparison to placebo treatment, did not significantly reduce serum CRP ( -13% and +51% respectively, p=0.183) but did significantly increase TBARS ( +16% and -27% respectively, p=0.049).

Conclusions: Coconut oil supplementation (2 g/day) may impact lipid peroxidation as indicated by an increase in plasma TBARS concentration. Future trials are necessary to corroborate these results using other indices of fatty peroxide formation.
ContributorsNorman, Lisa (Author) / Johnston, Carol (Thesis advisor) / Shepard, Christina (Committee member) / Ellis, Melissa (Committee member) / Arizona State University (Publisher)
Created2017
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Introduction: The incidence of type 2 diabetes (T2D) in youth is projected to increase through 2060, especially in minority youth. Every Little Step Counts (ELSC) has demonstrated efficacy in reducing T2D risk factors in Latino youth. Documenting the adaptation of ELSC to a family diabetes prevention program (FDPP) could support

Introduction: The incidence of type 2 diabetes (T2D) in youth is projected to increase through 2060, especially in minority youth. Every Little Step Counts (ELSC) has demonstrated efficacy in reducing T2D risk factors in Latino youth. Documenting the adaptation of ELSC to a family diabetes prevention program (FDPP) could support future adaptation and scaling of FDPPs.Purpose: To describe the process that guided the adaptation of a culturally grounded evidenced-based DPP tailored to Latino families, with the aim of using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to classify adaptations. Methods/Design: The approach that guided the adaptation involved community-based participatory research (CBPR) and phases commonly used to adapt health interventions. Inductive and deductive content analysis guided by the FRAME was conducted on data collected throughout the phases to identify and classify adaptations. Data was then triangulated with the entities involved in the adaptation, analyzed to determine the frequency and proportion of adaptations across the FRAME categories and levels, and cross tabulated. Results: A total of N=66 adaptations were identified. Adaptations occurred with the highest frequency during the grant preparation and after the pilot study. Most adaptations were led by both the academic institution and community partners. Content modifications were most common. Prominent reasons for adaptation included organization/setting time constraints and integrating community partners’ and interventionists’ feedback. Discussion: Study results align with the CBPR approach that guided the adaptation and the ELSC core tenet of integrating community partnerships throughout all aspects of the intervention. To efficiently track adaptations, consensus as to what constitutes varying levels of adaptation granularity (i.e., macro, meso, micro) is needed. While tracking adaptations can be time and resource intensive, tracking adaptations may support the development of strategies to tie adaptations to outcomes. Conclusion: It is critical to determine when adaptations are needed to avoid a “culture of adaptation hyperactivity”. There is an opportunity to analyze past and future ELSC adaptations to better understand the intervention’s core tenets and the relationship between adaptations and outcomes. Future ELSC adaptations would benefit from considering how to incorporate feedback from diverse stakeholders and populations in preparation for scaling.
ContributorsDiaz, Monica (Author) / Shaibi, Gabriel Q (Thesis advisor) / Bruening, Meg (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2024
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Background: Research has found that nearly a quarter of the American population follows a gluten-free diet in some capacity, while only about 1% of the population is diagnosed with celiac disease. Although the amount of research-based evidence supporting any health benefits of a gluten-free diet in an individual without a

Background: Research has found that nearly a quarter of the American population follows a gluten-free diet in some capacity, while only about 1% of the population is diagnosed with celiac disease. Although the amount of research-based evidence supporting any health benefits of a gluten-free diet in an individual without a gluten- related disorder is limited, the number of people claiming to follow a gluten-free diet continues to rise. Also, despite an increasing belief that gluten is harmful for health, the potentially undesirable effects of gluten substitutions used in gluten-free foods are largely unknown. Due to the protein network encapsulating starch granules, gluten is thought to lengthen the amount of time needed during starch digestion, thereby reducing postprandial glycemia. Therefore, it is predicted that breads containing gluten will produce a lower glycemic response compared to gluten-free breads. Aim: The aim of this study was to investigate the glycemic response of gluten-free bread made with different types of flour compared to bread made with gluten-containing wheat flour. Methods: This study involved a 3-week, randomized, single blind crossover study in which 17 healthy individuals were asked to consume a different type of bread each week, 2 of which were gluten-free. Blood glucose was taken by finger prick at fasting as a baseline measurement, then for 2 hours after bread consumption in 30-minute increments. Results: Across the three groups, there was no significant difference in iAUC values after 120 minutes (p=0.192 ). The greatest mean was seen in the gluten-containing bread (145.3 ± 82.6), then the gluten-free bread made with rice flour (125.5 ± 62.8), and lastly the gluten-free bread made with potato and fava bean flour (112.4 ± 64.5). Conclusion: The inconsistent results of this study compared to previous, similar studies suggests that the postprandial glycemic response of gluten-free products can not be generalized as a whole, but instead is dependent on the type of product and the ingredients used to replace the gluten. Although the results did not show a significant difference, it does argue against the belief that gluten-free products are invariably better for health in the general, non-gluten sensitive population.
ContributorsWaznik, Lauren LaRue (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2019