Depression has been linked to a significant burden of disease, loss of life, and decreased efficacy of treatment for its comorbidities. Empirical evidence has mounted over the past several decades supporting health benefits from vinegar ingestion, including improvements in blood glucose management, blood cholesterol levels, and inflammation indicators. To date, there have not been any studies in human populations that explore the potential relationship between daily vinegar ingestion and changes in depression indicators and blood metabolomics. This blinded, randomized controlled trial examined the impact of twice-daily vinegar ingestion on mental health measures in healthy young adults recruited from a metropolitan setting. Participants (n=28; aged 25.8±7.0 y; body mass index [BMI] >23 kg/m2) were stratified by age, gender, and BMI and randomly assigned to the liquid (VIN) or pill (CON) groups. VIN participants ingested 2 tablespoons of red wine vinegar (~1550 mg acetic acid; Pompeian Inc., Appendix J) diluted in 8-12 ounces of water, consumed with food at mealtimes twice daily (total ~3100mg acetic acid daily). CON participants consumed 1 vinegar pill daily (22.5 mg acetic acid; Spring Valley, Appendix J). The study lasted four weeks, and anthropometric measurements were conducted in a fasted state at weeks 0 and 4. Study adherence varied slightly (90±17% and 100±14% for VIN and CON respectively, p=0.084); hence, adherence was controlled for in all subsequent analyses. Changes in L-tryptophan (p=0.777, η2=0.003), peripheral serotonin levels (p=0.348, η2=0.035), GABA (p=0.403, η2=0.028), and gut-mediated short-chain fatty acids acetic acid (p=0.355, η2=0.034), and propionic acid (p=0.383, η2=0.031), did not differ significantly between VIN and CON groups respectively with the exception of isobutyric acid (p=0.0374, q=0.0473). However, Patient Health Questionnaire (PHQ-9) depression scores improved significantly for VIN participants in comparison to CON participants (-0.5±1.3 vs. +0.7±2.4 cm [p=0.026] and -0.4±0.7 vs. +0.3±1.0% [p=0.045]. Although these differences between groups are modest, which would be expected given the short study duration, changes were not driven by pharmacological or lifestyle interventions, suggesting the benefits of vinegar ingestion on mental health symptomology and the blood metabolome.

This thesis explores the potential anti-inflammatory effects of daily vinegar ingestion in healthy adults over a 4-week period, with a focus on cytokine levels, innate immunity markers, and C-reactive protein (CRP). Participants were healthy, non-smoking adults (n=28, 18-41 years of age) free of chronic disease. Participants were randomized to the active treatment group (VIN; two tablespoons liquid vinegar at mealtime twice daily; n=16) or the control group (CON; one commercial vinegar tablet daily; n=12). A fasting blood sample was collected at the start and completion of the 4-week intervention, and serum was analyzed for 15 cytokines and C-reactive protein (CRP). Fluctuations in the anti-inflammatory cytokines (e.g., IL-4, IL-10, IL-5, and IL-13) did not differ between treatment groups during the trial; however, notable reductions in two pro-inflammatory cytokines were observed at week 4 for VIN participants in comparison to CON participants. IL-1 trended lower for VIN versus CON participants (-2.7±6.0 and 1.0±6.6 pg/ml respectively, p=0.102), and IL-12p40 was reduced significantly during the trial in VIN versus CON participants (-5.7±12.5 and +1.04±9.8 pg/ml; p=0.051). The rise in CRP at week 4 for all participants, while not statistically significant, underscores the complexity of the relationship between inflammatory markers. These findings suggest that daily vinegar ingestion may afford greater resilience to inflammatory conditions (as indicated by increasing CRP concentrations). Recommendations for future research include expanding participant pools, extending intervention periods, and conducting more comprehensive studies to unravel the intricate dynamics of vinegar's impact on inflammatory processes.

Low water intake and underhydration are public health issues that may increase risk for diseases such as Type 2 Diabetes Mellitus. Studies suggest that high vasopressin (AVP) levels associated with low water intake may contribute to hyperglycemia. This study explored the physiological system by which AVP impairs glucose regulation through a single-blind randomized, counterbalanced, crossover design. This is a pilot and feasibility study of AVP infusion at increasing incremental rates, which was completed to determine the rate of infusion for the cross-over study. Participants completed a control and experimental trial. The experimental trial included a 3-hour AVP infusion and a 2-hour euglycemic-hyper insulinemic clamp at the end of the first hour versus control of 0.9% sodium chloride replacing AVP. In both trials, blood samples were taken every 5 minutes to measure glucose, as well as 7 other time points of insulin infusion. Two participants completed the pilot (47.5±3.5 years, 172.5 ±7.5cm, 82.5±17.7kg, 27.5±3.5 kg/m2, 5.1±0.64% HbA1c), and 3 participants completed the cross-over study (49±1.7 years, 173.7±6.7cm, 80.4±150kg, 26.5±3.2kg/m2, 5.3±0.2% HbA1c), all females. The rate of AVP infusion for the cross-over study was 12.5 mU/min. Compared to the control, the AVP trial blood glucose trended higher towards the end of the experiment, as did glucose metabolism, plasma osmolality, and plasma volume. Blood pressure was slightly higher in the AVP trial versus the saline, while plasma sodium and potassium levels did not differ. Total plasma protein seemed higher in the saline trials than in the AVP trials. This study supports the notion that increased levels of vasopressin over time may increase blood glucose. This could lead to supplementation of type 2 diabetes interventions with increased water intake.

Time restricted eating (TRE) is an increasingly popular diet strategy that has shown promise for weight loss and improving metabolic health. The impact of TRE on bone health has not been extensively studied, and the goal of this experiment is to provide more insight into this subject. 32 10-week old female mice were randomly assigned to 4 groups (n = 8). These included low fat diet fed ad-libitum, low fat time restricted feeding (TRF), high fat diet fed ad-libitum, and high fat TRF. The mice adhered to these diets for 9 weeks, with the TRF groups having access to food for 8 hours per day until the sacrifice. At nine weeks, the TRF mice had significantly lowered body weight, improved body composition, and a lower fasting blood glucose. The TRF groups also experienced significant improvements in the trabecular bone density of the tibia, femur, and L3 vertebral body. This was found alongside reductions in osteoclast count and activity in the TRF mice. When compared to a baseline group of 10-week old mice, it was found that the TRF group had significantly less bone loss relative to the ad-libitum fed mice. Improvements in metabolic health, gut barrier function, and inflammation may have all contributed to the observed improvements in bone health. These results reveal a promising and previously unrecognized dietary tool to improve bone health and counteract age-related bone loss.

Oral health encompasses a wide variety of conditions with two of the primary conditions being enamel degradation and periodontal disease. These ailments are intertwined and are known to be prevented by a combination of good oral hygiene and a balanced diet. Despite this, incidence rates of oral health conditions in both high and low-and-middle income countries remain high. Periodontal disease prevention is of particular relevance due to its correlation with cardiovascular disease. One highly popular diet that could serve as an alternative strategy in combatting these oral health conditions is intermittent fasting. Intermittent fasting has shown promise in decreasing systemic inflammation and blood glucose levels, both of which are correlated with periodontal disease and enamel degradation. To explore this relationship between intermittent fasting and oral health a 9-week experimental protocol with 4 randomly established groups was completed. These groups included ad libitum high and low-fat groups, and time restricted feeding high and low-fat groups. After the 9-week protocol the mice were sacrificed, and their intact jaws and gingiva tissue were isolated. Three primary methods were used to quantify the effects of intermittent fasting on oral health: comparing the enamel density between groups, comparing the alveolar bone recession between groups, and comparing the gene expression of periodontal disease markers between groups. Body composition and fasting blood glucose levels of the mice were also quantified. We found that the fasting groups had lower average fasting blood glucose levels and maintained a more physiologically ideal body composition. Despite this, the oral health analyses did not have any consistent significant results. The results of this study suggest that despite intermittent fasting’s role in blood glucose levels and body composition regulation, it has minimal effects on enamel degradation and periodontal disease development.

The medicinal use of vinegar dates to ancient times, and empirical evidence has mounted over the past several decades supporting health benefits from vinegar ingestion, including reductions in blood glucose, blood pressure, and blood cholesterol. Additionally, although clinical trial data are mixed, there are several reports demonstrating reductions in body mass and fat mass with daily vinegar ingestion. This blinded, randomized placebo-controlled trial examined the impact of daily vinegar ingestion on anthropometric measures in healthy young adults recruited from a campus population. Participants (n=28; aged 25.8±7.0 y; body mass index [BMI] > 23 kg/m2) were stratified by age, sex, and BMI and randomly assigned to the liquid [VIN] or pill [CON] groups. VIN participants diluted 2 tablespoons of red wine vinegar (750 mg acetic acid; Pompeian Inc.) in 8-12 ounces of water to drink with food at mealtime twice daily. CON participants consumed 1 vinegar pill daily (22.5 mg acetic acid; Spring Valley). All participants provided written consent for this IRB approved trial. The study lasted four weeks, and anthropometric measurements were conducted in a fasted state at weeks 0 and 4. Study adherence varied slightly (90±17% and 100±14% for VIN and CON respectively, p=0.029); hence, adherence was controlled for in all analyses. Changes in BMI (-0.1±0.5 and +0.1±0.3 kg/m2, p=0.127) and body weight (-0.3±1.4 and +0.1±1.1 kg, p=0.158) did not differ significantly between VIN and CON groups, respectively. However, both waist circumference and percent body fat were reduced significantly for VIN participants in comparison to CON participants (-0.5±1.3 vs. +0.6±2.4 cm [p=0.026]and -0.4±0.7 vs. +0.3±1.0% [p=0.045]. Although the observed differences between groups are modest, the study was short in duration and this protocol did not apply energy restriction or exercise interventions, suggesting a possible benefit of vinegar ingestion on adiposity.

Tools designed to help match people with behaviors they identify as likely to lead to a successful behavioral outcome remain under-researched. This study assessed the effect of a participant-driven behavior-matching intervention on 1) the adoption of a new behavior related to fruit and vegetable (F&V) consumption, 2) study attrition, and 3) changes in F&V consumption. In this two-arm randomized controlled trial, 64 adults who did not meet standard F&V recommendations were allocated to an intervention (n=33) or control group (n=31). Participants in the intervention group ranked 20 F&V-related behaviors according to their perceived likelihood of engagement in the behavior and their perception of the behavior’s efficacy in increasing F&V consumption. Participants in the intervention group were subsequently shown the list of 20 behaviors in order of their provided rankings, with the highest-ranked behaviors at the top, and were asked to choose a behavior they would like to perform daily for 4 weeks. The control group chose from a random-order list of the same 20 behaviors to adopt daily for 4 weeks. During the study period, text messages were sent to all participants 90 minutes before their reported bedtime to collect Yes/No data reflecting successful behavior engagement each day. The binary repeated-measures data collected from the text messages was analyzed using mixed-effects logistic regression, differences in attrition were assessed using log-rank analysis, and change scores in F&V consumption were compared between the two groups using the Man-Whitney U test. P<0.05 indicated significance. The rate of successful behavior adoption did not differ significantly between the two groups (b=0.09, 95%CI= -0.81, 0.98, p=0.85). The log rank test results indicated that there was no significant difference in attrition between the two groups (χ2=2.68, df=1, p=0.10). F&V consumption increased significantly over the 4 weeks in the total sample (Z=-5.86, p<0.001), but no differences in F&V change scores were identified between the control and intervention groups (Z=-0.21, p=0.84). The behavior-matching tool assessed in this study did not significantly improve behavior adoption, study attrition, or F&V intake over 4 weeks.

Sleep is an essential biological requirement to sustain human life and a critical component for athletes. There has been a rising trend for poor sleep in the general population and the problem persists as well within the athletic population. Research has demonstrated numerous benefits of optimized sleep on athletic performance and athlete wellness. Further investigation of potential dietary strategies to improve self-perceived sleep quality is warranted. This study examined the differences in perceived sleep quality and wellness between a 3-week baseline period and after a 3-week supplementation period, in which participants consumed a dietary supplement containing fermented whey protein + galacto-oligosaccharides (GOS) + casein protein daily. Validated questionnaires, namely, Athens Insomnia Scale (AIS), Physical Health Questionnaire (PHX), Kessler-6 Mental Stress Scale (K6) were used to measure perceived sleep quality and wellness on Day 1, Day 22 and Day 43. Additionally, multiple 24-h dietary recalls (ASA24), and food quality using the validated Rapid Eating Assessments for Participants (REAP) questionnaire, were used to assess dietary patterns throughout the study, while exercise occurrence was tracked through a self-developed daily questionnaire. A total of 54 healthy active adults (age=18-35yrs) experiencing gastro-intestinal (GI) complaints were included in the trial, and 50 participants were included in the final analysis. Significantly lower AIS-8 total scores were found on Day 43 compared to Day 22 while controlled for Day 1 (Day 43: 4.36 ± 3.68 versus Day 22: 5.02 ± 4.11, F=4.379 (1, 50), p=0.042), while no differences were found for wellbeing (p≥ 0.180). Dietary intake, food quality and exercise frequency did not change over time (p≥0.080). These results suggested that a daily protein + GOS supplement was associated with a decrease in AIS-8 total scores suggesting improved perceived sleep quality among athletes after 3 weeks. A controlled research study should confirm these results in the future. More research is required to assess the effects of protein + prebiotic supplementation on sleep parameters among athletes.

Fish oil has been extensively researched for its protective effects on cognition. More recently, anthocyanins have also gained the attention of the medical community for their potential cognitive benefits. Maqui berries are one of the richest sources of anthocyanins known to science. While there are many randomized controlled trials (RCT) investigating the effects of fish oil and/or anthocyanins on cognition in various populations, there are no RCT that exclusively investigate the cognitive effects of these compounds in adults with Type 2 Diabetes (DM2). The purpose of this double-blinded, placebo-controlled RCT was to investigate the cognitive effects of maqui berry extract and fish oil supplements in adults with DM2 over the course of eight weeks. Adults with DM2 (n=29) were recruited by the researchers and randomized to either Group A or Group B. Because the study is ongoing, it is unknown which group received the intervention. The study used the Stroop Test and Trail Making Test (TMT) to measure cognition at baseline, 4 weeks, and 8 weeks. Anthropometrics, blood glucose, and hemoglobin A1C were also taken at these time points. Sixteen female participants were included in the final analysis. Neither group showed significant improvements in the cognitive tests. However, in Group A, the effect sizes were large for the change in Trail-Making Test A (0.167), Trail Making Test B (0.261), and Trail Making Test B minus A (0.296) scores. In Group A, the change in Trail Making Test B minus A scores between baseline and week 4, and between baseline and week 8 was significant (p=0.053) and produced a large effect size (0.258). The results suggest that fish oil and maqui berry extract may improve cognition in adults with DM2, but further studies with larger sample sizes are needed.