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Description
Type 2 diabetes affects approximately 7.3% of Americans, leading to debilitating and life-threatening comorbidities. Estrogen and testosterone levels have been linked to inflammatory and oxidative stress markers, as well as glucose and insulin concentrations. The present study was designed to determine the link between sex differences, glucose control, and inflammation and oxidative stress related to daily almond ingestion among subjects with type 2 diabetes. Subjects were randomized to an intervention group, which received 1.5 oz. almonds daily for 12 weeks, or to the matched control group, which maintained their current diet. No significant differences were found in changes in glucose control in response to ingestion of almonds. However, CRP was significantly reduced by an average of 36.2% in those that received almonds daily (p = 0.017). Although not significant, women randomized to the intervention group appeared to have improvements in insulin resistance compared to women with no dietary change. Results suggest that the addition of almonds to the diet may be an effective intervention for managing inflammation associated with type 2 diabetes. The addition of almonds to the diet is a low cost intervention that is easily implemented into daily lifestyle. Due to the small sample size, additional studies are needed to determine the impact and mechanisms of almond ingestion in subjects with type 2 diabetes.
ContributorsPetersen, Katherine Nicole (Author) / Karen, Sweazea (Thesis advisor) / Carol, Johnston (Committee member) / Christy, Lespron (Committee member) / Arizona State University (Publisher)
Created2014
Description
ABSTRACT Vitamin C plays an important role in fatty acid metabolism because it is required for carnitine synthesis. Vitamin C has been shown to have an inverse relationship with weight and body fat percent in a number of studies. However, there has been limited research exploring the relationship between vitamin C status and fat oxidation. This cross-sectional study investigates the relationship between plasma vitamin C and fat oxidation in 69 participants and between plasma vitamin C and body fatness in 82 participants. Participants were measured for substrate utilization via indirect calorimetry while at rest and measured for body fatness via DEXA scan. Participants provided a single fasting blood draw for analysis of plasma vitamin C. Results did not show a significant association between vitamin C and fat oxidation while at rest, therefore the data do not support the hypothesis that vitamin C status affects fat oxidation in a resting state. However, a significant inverse association was found between vitamin C and both total body fat percent and visceral fat.
ContributorsObermeyer, Lindsay (Author) / Johnston, Carol (Thesis advisor) / Hall, Rick (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2014
Description
Dietary counseling from a registered dietitian has been shown in previous studies to aid in weight loss for those receiving counseling. With the increasing use of smartphone diet/weight loss applications (app), this study sought to investigate if an iPhone diet app providing feedback from a registered dietitian improved weight loss and bio-markers of health. Twenty-four healthy adults who owned iPhones (BMI > 24 kg/m2) completed this trial. Participants were randomly assigned to one of three app groups: the MyDietitian app with daily feedback from a registered dietitian (n=7), the MyDietitian app without feedback (n=7), and the MyPlate feedback control app (n=10). Participants used their respective diet apps daily for 8-weeks while their weight loss, adherence to self-monitoring, blood bio-markers of health, and physical activity were monitored. All of the groups had a significant reduction in waist and hip circumference (p<0.001), a reduction in A1c (p=0.002), an increase in HDL cholesterol levels (p=0.012), and a reduction in calories consumed (p=0.022) over the duration of the trial. Adherence to diet monitoring via the apps did not differ between groups during the study. Body weight did not change during the study for any groups. However, when the participants were divided into low (<50% of days) or high adherence (>50% of days) groups, irrespective of study group, the high adherence group had a significant reduction in weight when compared to the low adherence group (p=0.046). These data suggest that diet apps may be useful tools for self-monitoring and even weight loss, but that the value appears to be the self-monitoring process and not the app specifically.
ContributorsThompson-Felty, Claudia (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2014
Description
Background: The shortage of available dietetic internship (DI) positions for qualified applicants threatens the future of dietetics. Only about half of all applicants will obtain a slot. Additional internship positions are needed and can be offered only if more practitioners become preceptors. Objective: To examine the perceptions associated with the role of DI preceptor among nutrition and dietetic practitioners and identify barriers and motivators to becoming a DI preceptor in Arizona. Design: An online survey adapted from previous published instruments was administered between July and September 2011 to dietetic and nutrition professionals eligible to precept dietetic interns. Participants: RD, DTR, and school food service professionals on file with Arizona registries were invited to participate in the survey. A total of 675 subjects participated in the study. Statistical analyses performed: Chi-square analysis was used to assess differences between preceptors and non-preceptors for categorical variables. Independent t-tests were used to analyze differences between groups for continuous variables. Results: Respondents included 314 current or former preceptors and 361 non-preceptors with no significant differences in gender, age, or race between groups. Preceptors typically perceived the preceptor role more favorably than non-preceptors. Non-preceptors reported fewer benefits and more disadvantages to being a preceptor. Only 18% of non-preceptors knew how to become a mentor. Conclusions: Motivators for practitioners to become preceptors and continue in the role include personal benefits, dedication to the role and profession, and contributions to the workplace by interns. Barriers to mentoring interns include lack of compensation, increased workload, lack of support, lack of training, lack of resources, intern liability, and lack of knowledge of how to become a preceptor. Results of the study can be used to target barriers and emphasize benefits associated with the preceptor role to encourage participation in the preceptor process to make more internship positions available.
ContributorsWooden, Alissa (Author) / Winham, Donna M (Thesis advisor) / Mayol-Kreiser, Sandra N (Committee member) / Morse, Lisa M (Committee member) / Arizona State University (Publisher)
Created2012
Description
The purpose of this study was to gather qualitative data on different and novel methods used to self-monitor diet and exercise during a weight loss study. Participants who used either a traditional paper and pencil method or a smart phone weight loss app for diet and exercise tracking were recruited for focus groups. Focus group discussions centered on the liked and disliked aspects of recording, perceived behavior changes, and suggestions for improved self-monitoring. Focus groups were organized based on the method of self-monitoring. The app group tracked calorie intake and expenditure via the "Lose It" app on their smart phones. The paper & pencil group recorded exercise and food intake in a journal and self-regulated diet based on recommended servings from each food group (or exchange lists). Focus group sessions were audio-recorded, transcribed and coded by the researcher and an independent coder. Results indicated that app participants liked the convenience, affordability, and user-friendly features, but wanted more nutrition advice. App participants liked self-managing their diet, not restricting certain foods or food groups and allowing for indulgences by balancing calories and exercise. Also, they desired an accurate estimation of energy expenditure from an app, based on individual characteristics (i.e., gender and age). Participants who recorded on paper liked the size for a visual layout of food entries, but desired a technology-enhanced method with an auto-calculation of calorie intake and expenditure. They also suggested increased accountability and opportunities for social support would enhance self-monitoring. Overall, an ideal technology-assisted self-monitoring app or program would be free and include an auto-calculation of calorie intake, a gender- and age- specific estimation of calories expended, easy entry of foods from a large database, the ability to enter whole recipes, nutrition information and recommendations, and be available via phone, tablet or computer (based on personal preference).
ContributorsSterner, Danielle (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Johnston, Carol (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2012
Description
Birds have plasma glucose levels that are 1.5-2 times greater than mammals of similar body mass in addition to higher free fatty acid concentrations, both of which would typically impair endothelium-dependent vasodilation if observed in mammals. Endothelium-dependent vasodilation can be stimulated in mammals through the use of acetylcholine (ACh), which primarily acts through nitric oxide (NO) and cyclooxygenase (COX)-mediated pathways, with varying reliance on endothelial-derived hyperpolarizing factors (EDHFs). Very few studies have been conducted on small resistance systemic arteries from birds. The hypothesis was that because birds have naturally high glucose and free fatty acid concentrations, ACh-induced vasodilation of isolated arteries from mourning doves (Zenaida macroura) would be independent of endothelial-derived factors and resistant to high glucose-mediated vascular dysfunction. Small resistance mesenteric and cranial tibial (c. tibial) arteries were pre-constricted to 50% of resting inner diameter with phenyleprine then exposed to increasing doses of ACh (10-9 to 10-5 μM) or the NO donor, sodium nitroprusside (SNP; 10-12 to 10-3 μM). For both vessel beds, ACh-induced vasodilation occurred mainly through the activation of potassium channels, whereas vasodilation of mesenteric arteries additionally occurred through COX. Although arteries from both vessel beds fully dilated with exposure to sodium nitroprusside, ACh-mediated vasodilation was independent of NO. To examine the effect of high glucose on endothelium-dependent vasodilation, ACh dose response curves were conducted following exposure of isolated c. tibial arteries to either a control solution (20mM glucose) or high glucose (30mM). ACh-induced vasodilation was significantly impaired (p = 0.013) when exposed to high glucose, but normalized in subsequent vessels with pre-exposure to the superoxide dismutase mimetic tiron (10 mM). Superoxide concentrations were likewise significantly increased (p = 0.0072) following exposure to high glucose. These findings indicate that dove arteries do not appear to have endogenous mechanisms to counteract the deleterious effects of oxidative stress. Additional studies are required to assess whether endogenous mechanisms exist to protect avian vascular reactivity from systemic hyperglycemia.
ContributorsJarrett, Catherine Lee (Author) / Sweazea, Karen L (Thesis advisor) / Johnston, Carol (Committee member) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: Obesity is considered one of the most serious public health issues worldwide. Small, feasible lifestyle changes are necessary to obtain and maintain weight loss. Clinical evidence is inconclusive about whether meal preloading is an example of a small change that could potentially increase the likelihood of weight loss and weight maintenance. Objective: The aim of this study is to determine if consuming 23 grams of peanuts, as a meal preload, before a carbohydrate-rich meal will lower post prandial glycemia and insulinemia and increase satiety in the 2 hour period after a carbohydrate-rich meal. Design: 15 healthy, non-diabetic adults without any known peanut or tree nut allergies were recruited from a campus community. A randomized, 3x3 block crossover design was used. The day prior to testing participants refrained from vigorous activity and consumed a standard dinner meal followed by a 10 hour fast. Participants reported to the test site in the fasted state to complete one of three treatment meals: control (CON), peanut (NUT), or grain bar (BAR) followed one hour later by a carbohydrate-rich meal. Satiety, glucose and insulin were measured at different time points throughout the visit. Each participant had a one-week washout period between visits. Results: Glucose curves varied between treatments (p=.023). Blood glucose was significantly higher one hour after ingestion of the grain bar compared to the peanut and control treatments (p<.001). At 30 minutes after the meal, the control glucose was significantly higher than for the peanut or grain bar (p=.048). Insulin did vary significantly between treatments (p<.001). The insulin change one hour after grain bar consumption was significantly higher than after the peanut or control at the same time point (p<.001). The change in insulin one hour after peanut consumption was significantly higher than for the control treatment (p=.002). Overall satiety, expressed as the 180 minute AUC, differed significantly between treatments (p=.001). One hour after preload consumption, peanut and bar consumption was associated with greater satiety than the water control (p<.001). At 30 minutes post-meal, the grain bar was associated with greater satiety versus the water control (p=.049). The bar was also associated with greater satiety versus peanut and control at 60 and 90 minutes post-meal (p=.003 and .034, respectively). At 120 minutes post-meal, the final satiety measurement, the bar was still associated with greater satiety than the peanut preload (p=.023). Total energy intake, including test meal, on treatment days did not differ significantly between treatment (p=.233). Conclusions: Overall satiety, blood glucose and blood insulin levels differed at different time points depending on treatment. Both meal preloads increased overall satiety. However, grain bar ingestion resulted in sustained satiety, greater than the peanut preload. Grain bar ingestion resulted in an immediate glycemic and insulinemic response. However, the response was not sustained after the test meal was ingested. The results of this study suggest that a low-energy, carbohydrate-rich meal preload may have a positive impact on weight maintenance and weight loss by initiating a sustained increase in overall satiety. More research is needed to confirm these findings.
ContributorsFleming, Katie R (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2012
Description
The popularization of energy drink use as a supplement to exercise is steadily increasing, especially among young adult males. However, the effects of energy drinks on muscular performance in young adults have yet to be clearly elucidated. Eight male subjects (mean age: 23.3 ± 4.3 yrs, height: 181.0 ± 5.3 cm, fat percent 17.8 ± 5.2%, and weight 85.3 ± 12.6 kg) completed this randomized double-blinded cross over study. The purpose of this study was to determine differences in acute muscular strength and endurance and Profile of Mood States (POMS) scores between three treatments (RockStar, sugar-free RockStar, and sugar-free caffeine-free Placebo). It was hypothesized that there would be no significant differences in acute peak torque and endurance of the knee extensors and flexors or on fatigue and vigor subscores from the POMS questionnaire. Each man was tested randomly at least 1 week apart. Diet and time of day were held constant across trials. Peak torque of knee extensors and flexors at 60, 180, 240 degress/second and fatigue index and total work were calculated by performing 50 repetitions at 240 degrees/second. There were no significant differences in peak torque, fatigue index, or total work measures or in subjective measures of fatigue or vigor from the POMS between the treatments. This study indicates that RockStar energy drinks have no acute ergogenic effects in young men performing isokinetic strength or endurance testing.
ContributorsHawley, Michelle (Author) / Swan, Pamela (Thesis advisor) / Campbell, Kathryn (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2012
Description
ABSTRACT Fruit and vegetable intake is not uniform across levels of socioeconomic status (SES) and researchers have identified low SES as a risk factor for poor intake of fruits and vegetables. In an effort to eliminate public health disparities and increase fruit and vegetable intake, the Women, Infant, and Children (WIC) program implemented additional food assistance programs, with a specific emphasis on fresh fruits and vegetables. The Farmers' Market Nutrition Program (FMNP) provides pre-existing WIC clients with coupons to purchase fresh, locally grown produce at farmers' markets. In addition, Congress also approved the WIC Cash Value Voucher (CVV) program, which provides WIC participants with vouchers to purchase fresh fruits and vegetables at farmers' markets or grocery stores. The purpose of this thesis was to investigate the relation of FMNP coupon use with accessibility and WIC CVV redemption rates at farmers' markets. Furthermore, this thesis addressed whether WIC shoppers redeemed a higher percentage of their WIC CVV value at farmers' markets or grocery stores. WIC CVV and FMNP issuance and redemption data were analyzed to establish overall redemption rates and total perecent of WIC CVV value redeemed. Accessibility was assessed using the Geographic Information System, which allowed me to calculate the distance that WIC participants would have to travel to redeem their FMNP coupons at FMNP-approved farmers' markets. The results showed that less than 1% of WIC shoppers redeem their WIC CVVs at farmers'markets in Arizona. However, the redemption of WIC CVV was significantly higher during the months when shoppers had the option of using both WIC CVV and FMNP coupons at farmers' markets. Furthermore, the percent of total CVV value redeemed at farmers' markets was 99%, significantly higher than grocery stores (93.5%). Average FMNP coupon redemption rates for 2008-2010 was 43.3%, well below the national average of 59%. However, my spatial analysis revealed that there was no significant association between the distance traveled to farmers' markets and FMNP redemption rates. This indicates that the distance traveled to farmers' markets is not a major barrier to redemption of FMNP coupons in Arizona.
ContributorsTucker, Wesley Jack (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Vaughan, Linda (Committee member) / Johnston, Carol S (Committee member) / Arizona State University (Publisher)
Created2012
Description
ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative approaches to reduce CVD risk. One of these alternative approaches is Vitamin D supplementation. Current research has shown a link between Vitamin D status and CVD risk in both healthy and diseased populations. Among the possible mechanisms is a positive effect of Vitamin D on vascular endothelial function, which can be measured with noninvasive techniques such as flow-mediated dilation (FMD) of conduit vessels using high-resolution ultrasound. This dissertation is comprised of two studies. The first examines whether Vitamin D supplementation can improve FMD in older adults within a time period (two weeks) associated with peak increases in plasma Vitamin D concentrations after a single-dose supplementation. The second examines the effect of Vitamin D supplementation in people with Rheumatoid Arthritis (RA). The reason for looking at an RA population is that CVD is the leading cause of early mortality in people with RA. In the first study 29 Post-Menopausal Women received either 100,000 IU of Vitamin D3 or a Placebo. Their FMD was measured at baseline and 2 weeks after supplementation. After 2 weeks there was a significant increase in FMD in the Vitamin D group (6.19 + 4.87 % to 10.69 + 5.18 %) as compared to the Placebo group (p=.03). In the second study, 11 older adults with RA were given 100,000 IU of Vitamin D or a Placebo. At baseline and one month later their FMD was examined as well as plasma concentrations of Vitamin D and tumor necrosis factor-alpha; (TNF-alpha;). They also filled out a Quality of Life Questionnaire and underwent a submaximal exercise test on the treadmill for estimation of maximum oxygen uptake (VO2max). There was no significant change in FMD in Vitamin D group as compared to the Placebo group (p=.721). Additionally, there was no significant improvement in either plasma Vitamin D or TNF-alpha; in the Vitamin D group. There was however a significant improvement in predicted VO2max from the submaximal exercise test in the group receiving Vitamin D (p=.003). The results of these studies suggest that a single 100,000 IU dose of Vitamin D can enhance FMD within two week in older adults, but that a similar dose may not be sufficient to increase FMD or plasma Vitamin D levels in older adults with RA. A more aggressive supplementation regimen may be required in this patient population.
ContributorsRyan, Dana Meredith (Author) / Gaesser, Glenn A (Thesis advisor) / Rizzo, Warren (Committee member) / Martin, Keith (Committee member) / Larkey, Linda (Committee member) / Chisum, Jack (Committee member) / Arizona State University (Publisher)
Created2012