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- Creators: Ravel, Maurice, 1875-1937
Description
Diet quality is closely intertwined with overall health status and deserves close examination. Healthcare providers are stretched thin in the current stressed system and would benefit from a validated tool for rapid assessment of diet quality. The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S) represents one such option. The objective of the current study was to evaluate the effectiveness of the REAP-S and Healthy Eating Index 2010 (HEI-2010) for scoring the diet quality of omnivorous, vegetarian and vegan diets. Eighty-one healthy male and female subjects with an average age of 30.9 years completed the REAP-S as well as a 24-hour dietary recall. REAP-S and HEI-2010 scores were calculated for each subject and evaluated against each other using Spearman correlations and Chi Square. Further analysis was completed to compare diet quality scores of the HEI-2010 and REAP-S by tertiles to examine how closely these two tools score diet quality. The mean HEI-2010 score was 47.4/100 and the mean REAP-S score was 33.5/39. The correlation coefficient comparing the REAP-S to the HEI-2010 was 0.309 (p=0.005), and the REAP-S exhibited a precision of 44.4% to the HEI-2010 for diet quality. The REAP-S significantly correlated with the HEI-2010 for whole fruit (r=0.247, p=0.026), greens and beans (r=0.276, p=0.013), seafood proteins (r=0.298, p=0.007), and fatty acids (r=0.400, p<0.001). When evaluated by diet type, the REAP-S proved to have increased precision in plant-based diets, 50% for vegetarian and 52% for vegan, over omnivorous diets (32%). The REAP-S is a desirable tool to rapidly assess diet quality in the community setting as it is significantly correlated to the HEI-2010 and requires less time, labor and money to score and assess than the HEI-2010. More studies are needed to evaluate the precision and validity of REAP-S in a broader, more diverse population.
ContributorsBliss, Courtney (Author) / Johnston, Carol (Thesis advisor) / Tasevska, Natasha (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2015
Description
Background: Twenty-four hour urinary sucrose and fructose (24uSF) has been developed as a dietary biomarker for total sugars intake. Collection of 24-h urine is associated with high costs and heavy participant burden, while collection of spot urine samples can be easily implemented in research protocols. The aim of this thesis is to investigate the utility of uSF biomarker measured in spot urine. Methods: 15 participants age 22 to 49 years completed a 15-day feeding study in which they consumed their usual diet under controlled conditions, and recorded the time each meal was consumed. Two nonconsecutive 24-hour urines, where each urine void was collected in a separate container, were collected. Four timed voids (morning, afternoon, evening, and next day) were identified based on time of void and meal time. Urine samples were measured for sucrose, fructose and creatinine. Variability of uSF excretion was assessed by coefficient of variation (%CV) and variance ratios. Pearson correlation coefficient and multiple linear regression were used to investigate the association between uSF in each timed void and corresponding 24uSF excretion. Results: The two-day mean uSF was 50.6 mg (SD=29.5) for the 24-h urine, and ranged from 4.5 to 7.5 mg/void for the timed voids. The afternoon void uSF had the lowest within-subject variability (49.1%), and lowest within- to between-subject variance ratio (0.2). The morning and afternoon void uSF had the strongest correlation with 24-h uSF for both mg/void (r=0.80 and r=0.72) and mg/creatinine (r=0.72 and r=0.67), respectively. Finally, the afternoon void uSF along with other covariates had the strongest predictive ability of 24-h uSF excretion (mg/void) (Adjusted R2= 0.69; p=0.002), whereas the morning void had the strongest predictive ability of 24-h uSF excretion (mg/g creatinine) (adjusted R2= 0.58; p=0.008). Conclusions: The afternoon void uSF had the most favorable reproducibility estimates, strong correlation with 24uSF excretion, and explained greatest proportion of the variability in 24uSF. USF in mg/void may be better to use than uSF in mg/g creatinine as a biomarker in spot urine. These findings need to be confirmed in a larger study, and in a study population with a wide range of sugars intake.
ContributorsAverill, Annalisa (Author) / Tasevska, Natasha (Thesis advisor) / Shepard, Christina (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2018
Description
Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public health concerns, including inadequate fruit and vegetable consumption. The United States Department of Agriculture's (USDA) Fresh Fruit and Vegetable Program (FFVP) provides fruits and vegetables as snacks at least twice per week in low-income elementary schools. In addition to increasing fruit and vegetable consumption behaviors at school, children participating in the FFVP have been found to make more requests for fruits and vegetables in grocery stores and at home, suggesting the impact of the program extends beyond school settings. The purpose of this multicase study was to describe key stakeholders' perceptions about creating PPPs between schools and nearby retailers to cross-promote fruits and vegetables in low-income communities, using the FFVP. Semi-structured interviews were conducted with participants from three cases groups: grocery store/produce managers (n=10), district FFVP personnel (n=5) and school FFVP personnel (n=12). Data were analyzed using a directed content analysis approach using constructs from the Health Belief Model, including benefits, barriers, strategies, and motivation. While findings varied by case group, key benefits of creating a PPP included the potential to increase store sales, to enhance public relations with the community, and to extend the impact of the FFVP to settings outside of schools. Barriers included offering expensive produce through the FFVP, time/labor-associated costs, and needing approval from authorities and supervisors. Strategies for developing a PPP included using seasonal produce and having clear instructions for teachers and staff. Stakeholders reported being motivated to create a PPP by the potential to improve health outcomes in children and by wanting to help the community. Both objective and subjective measures were suggested to measure the success of such a partnership. Finally, the educational component of the USDA's Supplemental Nutrition Assistance Program (SNAP-Ed) has the potential to serve as a catalyst for organizing a PPP between FFVP-participating schools and nearby grocery stores.
ContributorsGruner, Jessie (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Evans, Browynne (Committee member) / Bruening, Meg (Committee member) / Tasevska, Natasha (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2017
Description
Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns of added sugars intake on TEI and BMI is unknown. Research on added sugars has relied on self-report dietary assessments with limited days of dietary data, resulting in unreliable estimates. The purpose of this thesis was to describe patterns of added sugars consumption, and to investigate the relationship between dietary sugars, eating patterns, TEI, and BMI using 15-days of dietary data from a feeding study. Methods: 40 participants age 18 to 70 years completed a 15-d highly controlled feeding study which imitated their normal diet, while recording meal times. Meals and snacks were coded based on participant identified, time-of-day, and meal content specific criteria. All consumed foods and beverages were carefully weighed and entered into the Nutrition Data System for Research (NDSR) for analysis. Pearson correlation, independent t-test, one-way repeated measures analysis of variance (ANOVA) with post hoc tests, and multiple linear regressions were used to investigate the association between patterns of added sugars and energy intake, as well as eating frequency (EF), with TEI and BMI. Results: 15-d median added sugars intake was 9.7% of total calories. The highest contribution to added sugars intake (% of g/d) came from snacks (44%) in women and from afternoon (39%) consumption in men. The highest contribution to TEI came from dinner (30%) and afternoon (34%) consumption in women, and from lunch (31%) or dinner (30%) and afternoon (35%) consumption in men. Total eating occasion (EO) frequency had a negative association with TEI (r = -0.31) and no association with % energy from added sugars. In multivariate regression models, besides sex, % energy from beverages only (Adjusted R2 = 0.41) and % added sugars from dinner (Adjusted R2 = 0.39) were significant predictors of TEI, while none of the variables were associated with BMI. Conclusion: Changing one’s pattern of eating, (EF and % energy from beverages only and % added sugars from dinner), may reduce TEI, potentially reducing BMI.
ContributorsGunnerson, Hannah Marie (Author) / Tasevska, Natasha (Thesis advisor) / Johnston, Carol (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2019
Description
Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated with healthier dietary behaviors among age-ineligible children (5-18-years-old) in WIC households. Consumption frequency of fruits, vegetables, 100% juice, sugar-sweetened beverages (SSBs), and energy-dense snacks (sweet and salty snacks) among children from WIC and income-qualifying non-WIC households were compared.
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
ContributorsSteeves, Stephanie N (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / DeWeese, Robin (Committee member) / Arizona State University (Publisher)
Created2019
Description
Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between total sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the effect of physical activity on this association. Fifty seven free-living healthy subjects 20 to 68 years old, participated in a 15-day highly controlled feeding study, consuming their habitual diet, provided by the research metabolic kitchen. Dietary sugars were estimated using Nutrition Data System for Research (NDSR). Subjects collected eight 24-hour urine samples measured for urinary sucrose and fructose. Physical activity was assessed daily using a validated 15-day log that inquired about 38 physical activities across six domains; home activities, transportation, occupation, conditioning, sports and leisure. The mean total sugars intake and added sugars intake of the sample was 112.2 (33.1) g/day and 65.8 (29.0) g/day (9.7%EI), respectively. Significant moderate positive correlation was found between 15-d mean total sugars intake and 8-day mean 24uSF (r = 0.56, p < 0.001). Similarly, added sugars were moderately correlated with 24uSF (r = 0.56, p < 0.001), while no correlation was found between naturally-occurring sugars and 24uSF (r = 0.070, p < 0.001). In a linear multiple regression, total and added sugars each explained 30% of variability in 24uSF (Adjusted R2, p value; total sugars: 0.297, 0.001; added sugars: 0.301, p < 0.001). Physical activity had no effect on the association between dietary and urinary sugars in neither the correlation nor the linear regression analysis. 24uSF can be used as a biomarker for total and added sugars consumption in US adults, although its predictability was weaker compared to findings involving UK adults. No evidence was found showing that physical activity levels affect the association between 24uSF and total sugars intake in US adults. More detailed investigation through future feeding studies including subjects with wide range of sugars intake and of different ethnic/racial backgrounds are needed to better understand the characteristics of the biomarker and its uses.
ContributorsMohan, Chitra (Author) / Tasevska, Natasha (Thesis advisor) / Ainsworth, Barbara (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2019
Description
Objectives: This study examines weight loss strategies (eating, physical activity (PA), or both) adopted by overweight or obese (OWOB) parents and children in relation to age, income, gender, education, and race/ethnicity in a predominantly low-income and high minority sample. We also examine if OWOB parent-child dyads employed the same strategies to lose weight, and how these strategies vary by demographic variables.
Methods: Data was compiled from the New Jersey Childhood Obesity Study (NJCOB). A random digit dial household phone survey was used to select 1,708 households with at least one child aged 3-18 years from five cities in New Jersey. There were 231 OWOB parent-child dyads in this sample. Bivariate and multivariate analyses were performed to determine the demographic variables significantly associated with the type of weight loss strategy chosen.
Results: Males had higher odds of using PA and both eating and PA when compared to females. Higher income adults had higher odds of using all types of weight loss strategies compared to lower income adults. Adults with college education had higher odds of using eating and both eating and PA when compared to those with high school education. Older children (6-11 and 12-19 years) had higher odds of using PA when compared to younger children (2-5 years). Children of foreign-born parents (> 10 years in the US) had higher odds of using eating to lose weight compared to the children of US born parents. Children overall had higher odds of adopting a weight loss strategy if it was also adopted by the parent. In subgroup analysis, parent-child dyads had higher odds of adopting similar strategies among older children (12-19) and among girls, but this association did not hold true for younger children (2-11 years) and among boys for PA.
Conclusion: Older OWOB children (12-19) and female children had higher odds of adopting their parents’ weight loss strategies. Younger children did not follow the same pattern as their parents and among boys concordance was observed only for eating strategies. Results from the study may inform future family-based weight management interventions.
Methods: Data was compiled from the New Jersey Childhood Obesity Study (NJCOB). A random digit dial household phone survey was used to select 1,708 households with at least one child aged 3-18 years from five cities in New Jersey. There were 231 OWOB parent-child dyads in this sample. Bivariate and multivariate analyses were performed to determine the demographic variables significantly associated with the type of weight loss strategy chosen.
Results: Males had higher odds of using PA and both eating and PA when compared to females. Higher income adults had higher odds of using all types of weight loss strategies compared to lower income adults. Adults with college education had higher odds of using eating and both eating and PA when compared to those with high school education. Older children (6-11 and 12-19 years) had higher odds of using PA when compared to younger children (2-5 years). Children of foreign-born parents (> 10 years in the US) had higher odds of using eating to lose weight compared to the children of US born parents. Children overall had higher odds of adopting a weight loss strategy if it was also adopted by the parent. In subgroup analysis, parent-child dyads had higher odds of adopting similar strategies among older children (12-19) and among girls, but this association did not hold true for younger children (2-11 years) and among boys for PA.
Conclusion: Older OWOB children (12-19) and female children had higher odds of adopting their parents’ weight loss strategies. Younger children did not follow the same pattern as their parents and among boys concordance was observed only for eating strategies. Results from the study may inform future family-based weight management interventions.
ContributorsDwaik, Noor (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2016
Description
Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast food. The Social Ecological Model (SEM) was created as a framework for health promotion interventions. The SEM organizes factors that can influence health into five layers: intrapersonal factors, interpersonal processes, institutional/organizational factors, community factors, and public policy. Each layer can influence dietary behaviors and other layers.
This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.
Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.
The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.
Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.
The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
ContributorsLorts, Cori Elizabeth (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Adams, Marc (Committee member) / Hooker, Steven (Committee member) / Roberto, Anthony (Committee member) / Tasevska, Natasha (Committee member) / Arizona State University (Publisher)
Created2017
ContributorsRavel, Maurice, 1875-1937 (Composer) / Goulart, Renato (Arranger)
ContributorsRavel, Maurice, 1875-1937 (Composer)