Studies have demonstrated that anthocyanins can function as antioxidants, reduce inflammation, and improve dyslipidemia. Tart cherries are anthocyanin-rich, making them particularly attractive as a functional food to improve cardiovascular disease (CVD) risk. There have been few published studies to date examining the impact of tart cherries on biomarkers of dyslipidemia and inflammation, particularly in overweight and obese individuals at high risk for these conditions. This study evaluated the effect of consuming 100% tart cherry juice daily on blood lipids including total cholesterol, low-density lipoprotein cholesterol (LDL-C), calculated very low density lipoprotein cholesterol (VLDL-C), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and the CVD risk ratios, as well as the inflammatory biomarkers interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP), monocyte chemotactic protein-1 (MCP-1), and erythrocyte sedimentation rate (ESR) following a 4-week period. Based on the high anthocyanin content of tart cherries, it was hypothesized that the lipid and inflammatory profiles would be significantly improved following the intervention. A total of 26 men and women completed this 4-week randomized, single-blind, placebo-controlled, crossover study. Participants were randomized to drink either 8 ounces of placebo beverage or tart cherry juice daily for 4 weeks. Following a 4-week washout period, the alternate beverage was consumed. Ultimately, this investigation demonstrated no statistically significant alterations in any of the lipid or inflammatory biomarkers when analyzed across time and between interventions (p > 0.05). As expected, glucose and insulin parameters remained stable over the duration of the study, as well as self-reported physical activity level, total calorie consumption, and macronutrient intake. However, trans-fat was reported to be significantly higher during the cherry arm of the study as compared to the placebo arm (p < 0.05), potentially confounding other results. Although the results of this study were equivocal, it is feasible that a higher dose, longer treatment duration, or more susceptible target population may be required to elicit significant effects. Consequently, further investigation is necessary to clarify this research.

Among the general US population, cardiovascular disease (CVD) is the main cause of mortality for Mexican-Americans. CVD is less prevalent among Mexican-Americans than non-Hispanic Whites or African Americans. However, there is limited research regarding the factors associated with increased CVD risk among Mexican-Americans. Thus, this cross-sectional study was conducted to evaluate the effects of non-biological factors (income, education, employment, acculturation) and diet on CVD risk factors in 75 Mexican-American adults (26 males, 49 females; age=37.6±9.3 y, BMI=28.9±5.3 kg/m2, systolic BP=117±11 mmHg, diastolic BP=73±9 mmHg, LDL cholesterol=114±32 mg/dL, HDL cholesterol=44±11 mg/dL, triglycerides=115±61 mg/dL, serum glucose=92±7 mg/dL). Aside from collecting anthropometric measurements, blood pressure, and measuring fasting blood lipids, glucose, and insulin, information about participants' socioeconomic status, income, employment, education, and acculturation were gathered using a survey. Diet data was collected using the Southwestern Food Frequency Questionnaire. Weight, BMI, and waist circumference were significantly greater for those with a monthly income of <$3000 than for those earning >$3000 (81±15 kg vs. 71±15 kg; 29.8±4.6 kg/m2 vs. 26.5±5.1 kg/m2; 98±12 cm vs. 89±14 cm; respectively) and with an education level of high school graduate or less than for those with some college (84±16 kg vs. 72±14 kg; 30.6±4.2 kg/m2 vs. 26.9±4.9 kg/m2; 100±11 cm vs. 91±13 cm; respectively). HDL-C was higher for those with a monthly income of >$3000 than those earning <$3000 (49±12 mg/dL vs. 41±10 mg/dL), those with some college education than those with high school or less (47±10 mg/dL vs. 37±9 mg/dL), and for those employed than those not employed (46±10 mg/dL vs. 40±12 mg/dL). There was no association between acculturation and CVD risk factors. Percent of energy consumed from fat was greater and percent of energy from carbohydrates was lower in those earning <$3000 monthly than those earning >$3000 (32±5% vs. 29±3%; 52±8% vs. 56±4%; respectively). Greater acculturation to the Anglo culture was negatively correlated with body fat percentage (r=-0.238, p=0.043) and serum glucose (r=-0.265, p=0.024). Overall, these results suggest that factors related to sociocultural and socioeconomic status may affect cardiometabolic disease risk in Mexican-Americans living in the Phoenix metropolitan area.

Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart failure and reduced ejection fraction have failed to show benefit in HFPEF. Long term moderate intensity exercise programs have been shown to improve diastolic function in patients HFPEF. High intensity interval training (HIIT) has been shown to improve diastolic function in patients with heart failure and reduced ejection fraction. However, the effects of high intensity interval training in patients with HFPEF are unknown. Fourteen patients with HFPEF were randomized to either: (1) a novel program of high-intensity aerobic interval training (n = 8), or (2) a commonly prescribed program of moderate-intensity (MOD) aerobic exercise training (n = 6). Before and after four weeks of exercise training, patients underwent a treadmill graded exercise test for the determination of peak oxygen uptake (VO2peak), a brachial artery reactivity test for assessment of endothelium-dependent flow-mediated dilation (BAFMD), aortic pulse wave velocity assessment as an index of vascular stiffness and two-dimensional echocardiography for assessment of left ventricular diastolic and systolic function. I hypothesized that (1) high-intensity aerobic interval training would result in superior improvements in FMD, aortic pulse wave velocity, VO2peak, diastolic function and, (2) changes in these parameters would be correlated with changes in VO2peak. The principal findings of the study were that a one month long high intensity interval training program resulted in significant improvements in diastolic function as measured by two-dimensional echocardiography [pre diastolic dysfunction (DD) grade - 2.13 + 0.4 vs. post DD grade - 1.25 + 0.7, p = 0.03]. The left atrial volume index was reduced in the HIIT group compared to MOD ( - 4.4 + 6.2 ml/m2 vs. 5.8 + 10.7 ml/m2, p = 0.02). Early mitral flow (E) improved in the HIIT group (pre - 0.93 + 0.2 m/s vs. post - 0.78 + 0.3 m/s, p = 0.03). A significant inverse correlation was observed between change in BAFMD and change in diastolic dysfunction grade (r = - 0.585, p = 0.028) when all the data were pooled. HIIT appears to be a time-efficient and safe strategy for improving diastolic function in patients with heart failure and preserved ejection fraction. These data may have implications for cardiovascular risk reduction in this population.

The omega-3 fatty acids in fatty fish and fish oil, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have been associated with a reduction in risk for cardiovascular disease. Blood type is a known contributor to risk for cardiovascular events. This study evaluated the effect of fish oil supplements on cardiovascular risk markers in adults with blood types A or O. An 8-week parallel-arm, randomized, double-blind trial was conducted in healthy adult men and women with either blood type A (BTA) or blood type O (BTO). Participants were randomized to receive fish oil supplements (n=10 [3 BTA/7 BTO]; 2 g [containing 1.2 g EPA+DHA]/d) or a coconut oil supplement (n=7 [3 BTA/4 BTO]; 2 g/d). Markers that were examined included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hsCRP), and hemoglobin A1C (HbA1C). Results indicated that the percent change in LDL cholesterol was significantly greater in the coconut oil group vs the fish oil group (-14.8±12.2% vs +2.8±18.9% respectively, p=0.048). There were no other significant differences between treatment groups, or between blood types A and O, for the other cardiovascular risk markers. Further research with a larger and more diverse sample may yield a more conclusive result.

Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health and fetal outcomes for pregnant adults and adolescents. To evaluate the effectiveness of a social media intervention on improving prenatal health knowledge and dietary intake, 22 racially diverse pregnant women (59% Black and 36% White) were recruited and adolescent (n=10) outcomes compared to those of adults (n=12) across the intervention. Pre- and post-intervention nutrition knowledge questionnaires and diet recalls were completed to assess nutrition knowledge and dietary intake. When assessing dietary change across the intervention, significant decreases in fat (pre vs. post, 97.9 ± 0.2 g vs. 90.2 ± 0.2 g, P=0.047) and folate intake (pre vs. post, 537.6 ± 0.3 μg vs. 531.2 ± 0.2 μg, P=0.041) were observed while significant increases in carbohydrate (pre vs. post, 318.9 ± 0.2 g vs. 335.9 ± 0.2 g, P<0.001), calcium (pre vs. post, 851.3 ± 0.3 mg vs. 893.5 ± 0.2 mg, P<0.001) and magnesium intakes (pre vs. post, 212.9 ± 0.2 mg vs. 227.8 ± 0.2 mg, P<0.001) occurred. These time effects occurred independent of group (adolescents vs. adults) as time*group interactions were not significant (p>0.05) with the exception of sugar intake. Increases in sugar intake across the intervention were greater among the adolescent group (adolescent vs. adult, 7.9 ± 0.2 g vs. 6.0 ± 0.2 g, P=0.023). Overall nutrition knowledge was limited and confusion regarding MyPlate recommendations persisted. The inadequate dietary behaviors observed suggest that future interventions should focus education on specific dietary nutrients such as added sugars and fiber to improve dietary intakes. The best way to actively engage pregnant adolescents is unknown: however, social media has the potential to reach teens and low-income women with education that may be key in allowing interventions to change dietary habits and behaviors.

Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized controlled 12-week community-based, family-focused exercise and dietary behavior intervention program in improving the home food environment of families with children between the ages of 6 and 11 years old. A total of twenty-six adults from Phoenix, Arizona allowed research staff into their homes to assess variety of food availability, using a modified version of the Home Food Inventory and were randomized to either the AFL3 program or wait-list control group. The main outcomes of interest were change in availability of vegetables, fruits, sugar-sweetened beverages and desserts and WIC-approved breakfast cereal. There was a significant increase in the number of vegetable items (3.88 ± 0.85; p=0.006) and WIC-approved cereal items (1.16 ± 0.31; p=0.003) in the homes of the intervention participants, relative to the wait-list control group. Additionally, there was a significant decrease in the number of sugar-sweetened beverage items (1.18 ± 0.31; p=0.014) available in wait-list control participant homes. There were no other significant findings related to home food availability. Furthermore, dietary intake among adult participants did not significantly change as a result of change in home availability. In conclusion, the AFL3 intervention program was successful in eliciting small but significant changes at a household level related to vegetable and WIC-approved breakfast cereal availability.

Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child physical activity levels, yet these efforts have not yielded consistent results. The purpose of this study was to assess the preliminary effects of a community-based intervention on light physical activity and MVPA among 6-11 year old children. Methods: The present study was part of a larger study called Athletes for Life [AFL], a family-based, nutrition-education and physical activity intervention. The present study focused on physical activity data from the first completed cohort of participants (n=29). This study was a randomized control trial in which participating children were randomized into a control (n=14) or intervention (n=15) group. Participants wore accelerometers at two time points. Intervention strategies were incorporated to increase child habitual physical activity. Analyses of covariance were performed to test for post 12-week differences between both groups on the average minutes of light physical activity and MVPA minutes per day.

Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.

Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.

Background: Despite the reported improvements in glucose regulation associated with flaxseeds (Linum usitatissimum) few clinical trials have been conducted in diabetic participants. Objective: To evaluate the efficacy of ground flaxseed consumption at attenuating hyperglycemia, dyslipidemia, inflammation, and oxidative stress as compared to a control in adults with non-insulin dependent type 2 diabetes (T2D). Design: In a randomized parallel arm controlled efficacy trial, participants were asked to consume either 28 g/d ground flaxseed or the fiber-matched control (9 g/d ground psyllium husk) for 8 weeks. The study included 17 adults (9 male, 8 females; 46±14 y; BMI: 31.4±5.7 kg/m2) with a diagnosis of T2D ≥ 6 months. Main outcomes measured included: glycemic control (HbA1c, fasting plasma glucose, fasting serum insulin, and HOMA-IR), lipid profile (total cholesterol, LDL-C, HDL-C, total triglycerides, and calculated VLDL-C), markers of inflammation and oxidative stress (TNF-alpha, TBARS, and NOx), and dietary intake (energy, total fat, total fiber, sodium). Absolute net change for measured variables (week 8 values minus baseline values) were compared using Mann-Whitney U non-parametric tests, significance was determined at p ≤ 0.05. Results: There were no significant changes between groups from baseline to week 8 in any outcome measure of nutrient intake, body composition, glucose control, or lipid concentrations. There was a modest decrease in TNF-alpha in the flaxseed group as compared to the control (p = 0.06) as well as a mild decrease in TBARS in the flaxseed as compared to the control group (p = 0.083), though neither were significant. Conclusions: The current study did not detect a measurable association between 28 g/d flaxseed consumption for 8 weeks in T2D participants and improvements in glycemic control or lipid profiles. There was a modest, albeit insignificant, decrease in markers of inflammation and oxidative stress in the flaxseed group as compared to the control, which warrants further study.

Through three investigations, this dissertation examined properties of the family and early care and education center (ECEC) environments related to preschool-aged children’s cardiovascular fitness (CVF) and gross locomotor skills (GLS). Investigation one used a systematic review and meta-analysis to synthesize the effectiveness of school-based interventions at improving CVF, in preschool-aged children. For investigations two and three product- and process-based measures of GLS were collected from children in ECECs (n=16), using the progressive aerobic cardiovascular endurance run (PACER; n=144) and the CHAMPS motor skill protocol (CMSP; n=91), respectively. Investigation two and three examined family factors and ECEC factors for associations with measures of GLS, respectively.

Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.

Although past literature has examined the prevalence of campus food pantries, most have not examined student satisfaction of campus food pantries the acceptability and feasibility of the campus food pantries in the U.S. This descriptive and quasi-experimental study assessed the acceptability and feasibility of campus food pantry intervention on two campuses (Downtown Phoenix and Tempe) at Arizona State University (ASU). The acceptability measures were composed of 30 survey questions including demographics, satisfaction survey, and food insecurity questionnaires, which were abstracted from the U.S. Adult 10-Item Food Security Survey Module. The food pantry was open once a week at each site. Any ASU students who enrolled in Spring 2017 and visited a food pantry were eligible to participate in the study. A total of 39 ASU students participated in the study during January 2017 and February 2017 (48.1 % female, 42.3 % White). The number of surveys collected at each site was 52. The majority of students were first-year undergraduate students (57.9% Downtown Phoenix, 45.5% Tempe). Based on their answers to the U.S. Adult 10-Item Food Security Survey Module, 21.2% of students (n=11) indicated low food security, while 48.1% of students (n=25) indicated very low food security. Almost 70% of pantry users reported that they have experienced food insecurity. In this study, the majority (90%) of students were satisfied with the service, hours of operation, and location for both the Downtown and Tempe food pantries. Additionally, 85.7% of students reported that they need additional resources such as financial aid (49%), a career center (18.4%), health services (10.2%), and other services (8.2%). The Pitchfork Pantry operated by student, university, and community support. Total donations received between Fall 2016 and Spring 2017 were 4,600 food items. The study found that most students were highly satisfied with the campus food pantries and it was feasible to operate two pantries on the ASU campus. These findings can be used to contribute to future research into campus food pantries, which may be the solution for food insecurity intervention among college populations.