Digital Commons Network^™

Sex Differences In Cardiometabolic Risk Factors In Youth With Obesity, Lucrecia Valdez

Theses and Dissertations--Nutrition and Food Systems

Background: The prevalence of hypertension in children and adolescents is rising, with 13% having elevated blood pressure and 5% having hypertension. Sex differences play a role in cardiovascular diseases in adults but are not well defined in youth. The objective of this study is to identify sex differences in obesity-mediated cardiometabolic risk factors in adolescents. Methods: This is a pilot study of n=82 youth with obesity recruited from a High BMI Clinic. Clinical data and blood samples were collected at a single time point. Serum sterols were quantified via LC-MS/MS. Number of cardiometabolic risk factors were evaluated. Data are mean …

Ideal Body Weight And Body Fat Percentage Predict Relative Energy Deficiency In Sport (Red-S) Scores In Collegiate Athletes, Emily Norman

Theses and Dissertations--Nutrition and Food Systems

Background: Low energy availability (LEA) is the underlying cause of Relative Energy Deficiency in Sport (RED-S) which negatively affects athletes' physiological function, health, and performance. RED-S results from inadequate dietary intake to support energy expenditure for daily living, growth, and optimal performance. It occurs in both male and female athletes, with or without disordered eating. However, screening and diagnosis in athletes can be difficult. Objective: This study aims to identify strong predictors of RED-S and assess its prevalence in collegiate male and female athletes. Methods: A total of 270 NCAA athlete test points from mixed sports were evaluated for RED-S …

Milk Thistle Supplementation And Exercise To Influence Bilirubin And Body Weight Outcomes, Don Arthur Matutina

Theses and Dissertations--Nutrition and Food Systems

Background: Traditional obesity treatment is ineffective as rates are still on the rise, thus necessitating novel treatments. Plasma bilirubin, once thought as only a clinical marker of liver disease, is now considered an important hormone, correlated with better outcomes within certain metabolic disease states such as cardiovascular disease and diabetes. This is largely due to bilirubin’s role in promoting fatty acid oxidation via its interaction with PPARα and its antioxidant capacities to reduce lipid peroxidation. Possible methods of mildly increasing plasma bilirubin may provide a novel obesity treatment. Objective: To evaluate if Silmarin supplementation via milk thistle, exercise, or a …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

Attentional Bias, Inhibitory Control, And Food Reinforcement As Mechanisms Promoting Eating Behavior After Exercise, Kylie F. L. Mcfee

Theses and Dissertations--Nutrition and Food Systems

Background: Excess weight and obesity are serious health conditions characterized by modifiable and nonmodifiable risk factors. Exercise is a common method for achieving weight loss; however, results are not always achieved due to post-exercise compensatory behaviors. Increased energy intake (EI) is thought to be the main compensatory behavior hindering weight loss among overweight and obese adults. It is important to determine and understand the mechanisms behind energy compensation following exercise, as this will allow for the discovery of future interventions that may provide individuals with ways to improve exercise as a weight loss treatment.

Objective: To determine if a single …

Leveraging Community Health Workers’ Expertise In The Community To Address Food Insecurity In Appalachia, Alexis Kimbro Scott

Theses and Dissertations--Nutrition and Food Systems

Residents of the Appalachian region of Kentucky are disproportionately affected by poor social determinants of health that contribute to the persistence of food insecurity and diet related diseases in this region. Poverty levels persist in rural areas of the Appalachian region while they improve throughout the rest of the United States. As this further perpetuates food insecurity in rural Appalachia, it is critical to identify culturally sensitive solutions to food insecurity. Utilizing Community Health Workers (CHWs), lay members of the community who have deep understanding of the communities they live in and serve, may be the answer to this problem. …

Maximal Strength Training Increases Metabolic Energy Expenditure In Sedentary Adults Classified As Obese, Robert E. Anderson Iii

Theses and Dissertations--Nutrition and Food Systems

Background: Metabolic adaptations reduce resting and non-resting energy expenditure to account for approximately 120 kcal/day. Weight loss promotes greater skeletal muscle efficiency, reducing the energy cost of physical activity and is correlated with declines in skeletal muscle glucose oxidation. Maximal Strength Training (MST) has the potential to upregulate glucose utilization and may offset these metabolic adaptations. Objective: To determine if MST offsets markers of metabolic adaptation by increasing resting and non-resting energy expenditure in sedentary individuals classified as obese. Methods: Five (5) participants (2 females, 3 males), ages 18-35 years, with obesity (BMI 30–45 kg/m2) were enrolled in an 8-week …

“It’S Just Part Of Our Hospitality:” Examination Of Cultural Factors That May Inform Future Initiatives To Improve Health Outcomes In A Rural Appalachian Community, Lauren Cassidy Batey

Theses and Dissertations--Nutrition and Food Systems

Diet and physical activity are influenced by a person’s culture and may contribute to the presence of health disparities within a geographic region. Health disparities are evident in Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving diet quality and increasing physical activity have improved health outcomes in diverse groups, yet interventions considering geographically tied cultures, like Appalachia, are limited. This study aims to identify specific aspects of Appalachian culture that influence health outcomes to inform and increase success of health focused interventions. Five focus groups were conducted in one rural Appalachian community in summer 2021. Grounded …

The Effect On Incorporating Fresh Fruits And Vegetables Into An Emergency Food Box Program In Rural Appalachia Kentucky, Zixuan Li

Theses and Dissertations--Nutrition and Food Systems

About 1 in 8 Kentuckians experiencing food insecurity. Low-income Appalachian Kentuckians often utilize food assistance programs and community resources to obtain food and they have lack regular access to fresh food, especially fruits and vegetables. Of concern is nutrition quality and the ability to use food items. The study aimed to explore if and how low-income Appalachian Kentuckians living in a food desert utilized their standard food pantry box as well as a supplemental box of free fresh produce. The study was done through distribution of supplemental fruit and vegetable boxes along with their emergency food box seven different times …

Farmers’ Market Incentive Program As An Intervention For Improving Behavior Regarding Fruit And Vegetable Consumption In Children And Adolescents, Madison Blades

Theses and Dissertations--Nutrition and Food Systems

Background: Previous research shows that there is low consumption of fruits and vegetables in children and adolescents, specifically those residing in the state of Kentucky which is ranked the lowest of all states in fruit and vegetable (F/V) consumption. The lack of F/V in a diet of someone during their developmental ages can result in negative health outcomes in the future.

Objective: To determine if the use of a farmers’ market incentive program as a nutritional intervention affects the consumption of F/V in children and adolescents.

Methods: 261 children and adolescents, ages 3-14, from 160 families participated in a 10-week …

Nutritional Status In Critical Care Of Covid-19 Patients, Dolph Lewis Davis Iii

Theses and Dissertations--Nutrition and Food Systems

Critical care nutrition is a poorly researched, and such a sudden pandemic event requiring manipulation of nutritional status via propofol-induced sedation for mechanical ventilation is potentially impactful on patient outcomes. This paper seeks to provide context to the impact of critical care protocols on the nutritional status of obese patients suffering from COVID-19.

Pilot Study: The Role Of Online Grocery Shopping In Meal Planning & Prepartion: Utilizing Text Message Based Behavioral Nudges, Brittany Nikole Cox

Theses and Dissertations--Nutrition and Food Systems

Purpose: To examine if an online grocery shopping intervention improves meal planning and preparation and subsequent dietary intake. The primary hypothesis was that online shopping can improve meal planning and meal preparation habits while also improving dietary intake.

Method: Participants were randomized to either online only (O), online plus nutritional nudges (O+I), or standard brick and mortar (BM). Those in the O+I arm received behavioral nudges three (3) times per week and were part of a Facebook group assisting them with meal planning, nutrition education, and reminders to shop online. The O arm only received reminders to shop online, and …

Examining Motivations And Barriers For Online Grocery Shopping Among Urban And Rural Populations Of Kentucky, North Carolina, And Maryland, J.B. Pitts

Theses and Dissertations--Nutrition and Food Systems

The online grocery industry grew exponentially alongside the COVID-19 pandemic in the U.S. With the implications of this growth still unclear, this study aimed to identify key influences and barriers towards the adoption of online grocery shopping, and to understand how online grocery shopping may affect food security and dietary intake. Across seven counties in Kentucky, North Carolina, and Maryland, 183 participants were surveyed about their usage of online grocery shopping before and after COVID-19, their opinions about online grocery shopping, their dietary intake, and food security. Survey answers were stratified between SNAP and non-SNAP recipients and urban and rural …

Family And Consumer Sciences Extension Agents Perception Of A Sustainable Eating Curriculum For Kentuckians, Lindley Barker

Theses and Dissertations--Nutrition and Food Systems

The population is rapidly increasing all over the world. As foods are produced for us to consume, the food system generates negative environmental impacts at each step. The extent of damage generated by food production depends on the amount of land, water, and energy depleted. These environmental impacts can result in reduced quantities of food produced, damages to the land and water used to grow/produce food, pollution of food, and food waste. All of which impact the amount of product produced. Thereby, shifting food-related behaviors of consumers toward sustainable eating may be a way to promote the health of people …

In-Store Marketing Campaign To Promote The Purchase Of Healthy Foods And Beverages At Convenience Stores In Rural Kentucky, Brynnan Nicole Jacobs Dunaway

Theses and Dissertations--Nutrition and Food Systems

The prevalence of obesity is greater in rural communities, and current health promotion interventions have not shown broad positive impacts on dietary patterns in these areas. Focusing community-based efforts on unconventional food retailers is a unique avenue to encourage healthier food choices in rural populations. This study used shelf-wobblers to market healthier snack and beverage items at convenience stores (n=5) in a rural Kentucky county. Selection of healthy snacks and beverages from the store inventory was conducted using the CDC Food Service Guidelines for Federal Facilities calculator. Items were sorted into four categories: meal replacement snacks, high-protein snacks, low-fat carbohydrate …

Assessing Self-Perceived Nutrition-Related Lifestyle Behaviors And Knowledge Of University Music Students Following A Targeted Presentation, Gretchen Trumbo

Theses and Dissertations--Nutrition and Food Systems

Although proven that nutrition can impact physical health, limited research examines the relationship between nutrition-related lifestyle behaviors, nutrition knowledge, and the prevalence of injury in university music students. The objective of this study is to evaluate nutrition-related lifestyle behaviors and self-perceived nutrition knowledge of university music students before and after a targeted nutrition education session. A baseline Qualtrics survey was administered to undergraduate and graduate music students (18+ years) via the University of Kentucky School of Music Listserv to gather data related to demographics, anthropometrics, history of playing-related injury, nutrition knowledge, attitudes, beliefs, and behaviors. A nutrition education presentation, focused …

Procuring Produce In A Rural, Appalachian County: A Thematic Analysis Of Community Member Experiences, Caroline Blincoe

Theses and Dissertations--Nutrition and Food Systems

Rates of obesity and other health disparities are exceptionally high in rural Appalachian counties compared to the nation as a whole. One causal factor of these health disparities in Appalachian counties is the inequitable allocation of healthy food. Food insecurity and the local food environment are large drivers for obesity experienced by Martin County, Kentucky residents. Successful socioecological model (SEM) and policy, systems, and environmental (PSE) interventions have shown promising results in reducing obesity and enhancing food security in this population. Through the transcription of semi-structured focus group interviews, thematic analysis aimed to obtain perspectives on the local food system. …

Exploring The Relationships Between Cultural Values And Diet Patterns Among Mexican And Cuban Immigrants In Kentucky, Nasreen Omran

Theses and Dissertations--Nutrition and Food Systems

The number of Latinx in the U.S. is expected to grow to about 28 percent of the population by the year 2060. As the number of Latinx increases in the U.S. it is important to understand how cultural beliefs influence dietary behaviors as Latinx are disproportionately affected by diet related disease such as diabetes mellitus, cancer, and cardiovascular disease. The aim of this secondary data analysis is to examine the relationship between family values, gender roles, and religious values on diet patterns in adult Mexican and Cuban immigrants in Kentucky utilizing the Mexican American Cultural Values Scale. The study findings …

Evaluation Of Kentucky Grown Soft Red Winter Wheat With Sensory Evaluation For Bread-Making Capabilities And Quality, Asa Conkwright Iii

Theses and Dissertations--Nutrition and Food Systems

Soft red winter (SRW) wheat is a type of wheat that is best suited to grow in Kentucky. However, due to its low protein content, it is an undesirable flour for bread and is usually used for cakes, cookies, crackers, and pastries. This is problematic because this limits the ability for commercial bakers to have a local source of flour, forcing them to purchase from sources outside the state. In doing so, bakers are sacrificing freshness and quality. It also removes the opportunity to keep profits in Kentucky, contributing to the state’s economy. The purpose of this study was to …

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Nutrition and Food Systems

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment, …

Energy Compensation With Exercise Is Not Dependent On Dose, H. Michael Hays

Theses and Dissertations--Nutrition and Food Systems

Background: Exercise induced weight loss is often less than expected due to a coordinated set of compensatory mechanisms that serve to maintain energy homeostasis. The extent to which exercise frequency, duration, intensity and exercise energy expenditure (ExEE) influences the compensatory response to an exercise-induced energy deficit (energy compensation) is controversial. Determining how these variables impact energy compensation would help health care providers prescribe exercise with greater probability of creating a sustained negative energy balance and subsequent weight loss.

Methods: 44 Overweight/obese men and women (BMI=25-35kg/m²) aged 18 to 40 years were randomized to perform aerobic exercise 2 or 6 days/week …

An Educational Pilot Intervention To Increase Environmental Health Literacy Among Rural Kentucky Youth Attending Summer Camp, Ashley Rose Mattingly

Theses and Dissertations--Nutrition and Food Systems

Risk factors, including exposure to environmental pollutants, poor dietary and overall health outcomes, and low environmental health literacy (EHL), place the rural Appalachian youth population at increased risk for chronic diseases. Implementation of nutrition and pollution curriculum into two week-long summer day camps for youth ages 5-12 years that focus around healthy lifestyles and environmental stewardship has the potential to increase health protective action in this community. This research utilized qualitative interviews of 30 Kids on the Creek Camp attendees to determine the efficacy of the implementation of an active learning lesson to increase EHL by explaining the link between …

Appetite-Regulating Hormones In Energy Compensation With Exercise, Jack Moreland

Theses and Dissertations--Nutrition and Food Systems

Background: The appetite-regulating hormones may influence compensatory increases in energy intake with exercise, although this causal relationship has been difficult to prove in a longitudinal trial.

Methods: 37 participants (29 female) aged 18 to 40 years performed aerobic exercise 6 days (6d), 2 days (2d), or 0 days per week for 12-weeks. Concentrations of ghrelin, leptin, glucagon-like peptide 1 (GLP-1), and insulin were assessed before (fasting, minute 0) and after a standardized meal at minute 15, 30, 45, 60, 90, 120, 150, and 180. Linear mixed-effects models were used to model the relationships between time point (12 weeks vs. baseline) …

Cardiac Effects Of Obesity During Pregnancy In C57bl/6j Mice, Kayla Lynn Dudick

Theses and Dissertations--Nutrition and Food Systems

Objective: Pregnancy requires profound cardiac and metabolic adaptation. Left ventricular (LV) mass is increased in response to pregnancy, but is not associated with cardiac damage. In contrast, obesity-mediated cardiac hypertrophy is pathological. Data from animal studies indicate dietary fatty acid composition may have a protective effect during states of extreme cardiac physiological adaptation. In contrast, aberrant cardiac metabolism is a hallmark of disease. Over a third of reproductive-age women in the United States are obese, but there is a paucity of data describing the effect of obesity on maternal cardiac adaptation to pregnancy. The objective of this study was to …

Berrycare: A Sustainable Community-Academia Nutrition Based Collaborative Program To Promote Well-Being In Older Adults, Abbey L. Moellering

Theses and Dissertations--Nutrition and Food Systems

With medical advancement and technology, generations are living longer. The process of aging is accompanied by development of chronic disease, reduced physical function, and increased risk of mortality. Older adults do not meet dietary requirements for fruits and vegetables due to lack of access, early satiety, socioeconomic factors, etc. Without proper attainment of fruit and vegetable recommendations, older adults are placed at risk of chronic disease. Interventions exist to help bridge the gap between older adult nutrition and currently established dietary guidelines. Built environments, such as community gardens, have received attentions in the public health arena as a successful way …

The Impact Of A Fruit And Vegetable Farmers' Market Voucher Prescription Program On A Low-Income Rural Population, Kevin Anthony Richie

Theses and Dissertations--Nutrition and Food Systems

Objective: Measures the impact of the Farmers’ Market Voucher program on weight, body mass index, waist circumference, during the 2016 summer on a rural, low-income population residing in Appalachian Kentucky.

Background: Rural communities often have limited access to fresh fruits and vegetables (FV) which contributes to low levels of consumption. FV are calorie poor, nutrient dense and are inversely associated with inflammation markers, obesity, hypertension, and high blood glucose levels. Appalachian rural communities have a higher prevalence of obesity, diabetes, strokes, and death by heart attack when compared to the U.S. Farmers’ markets

Methods: Pre-experimental intervention design examining FV consumption …

A Comparison Of Body Composition Estimates Between The Norland Dxa, The Idxa, And The Bodpod® In Overweight To Obese Adults, Jalyn Mason

Theses and Dissertations--Nutrition and Food Systems

Background: Body composition measures include fat mass (FM), fat free mass (FFM), and percent body fat (%BF), which are markers of health status and disease risk. Accurate body composition assessment is needed to evaluate an individual’s health and the efficacy of treatment strategies. Objective: Compare body composition estimates obtained from the Norland DXA, BodPod®, and iDXA before and after a 12-week exercise intervention. Subjects/setting: Overweight to obese (BMI 25–35 kg/m²) sedentary men and women (n=30) aged 18 to 40 years were recruited from central KY. Main outcome measure: Agreement in FM, FFM, and %BF between Norland DXA, iDXA, …

Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda

Theses and Dissertations--Nutrition and Food Systems

The Center for Disease Control and Prevention (CDC) reports indicate that 8% and 6.3% of Kentuckians consume enough fruits and vegetables, respectively. The Plate It Up! Kentucky Proud (PIUKP) project is a recipe-development project that aims to boost produce consumption by incorporating local fruits and vegetables. The purpose of this study was to implement promotional strategies using PIUKP recipes at farmers’ markets and determine their effects on consumers’ intent of purchasing and preparing the produce. The study was conducted at nine farmers’ markets across Kentucky (n=300) in collaboration with Cooperative Extension agents/assistants.

The consumers’ impression of the sample was positively …

Pilot Study Of Text Message Nudges As A Way To Improve Weight Loss Outcomes, Madison Copher

Theses and Dissertations--Nutrition and Food Systems

Weight loss programs for women are on the rise, including both face to face and online programs. However, current research is limited on the process measures and content which produce adherence and the largest outcomes. With obesity on the rise in the United States, it is important to understand out health coaches can strengthen their programs to better support the obese population in their weight loss journey. The purpose of this pilot study was to develop and test the acceptability of text message nudges among women participating in an online weight loss program; determine how dose may be associated with …

Tanglewood Trail Walking And Voucher Program, Kelci Marie Mchugh

Theses and Dissertations--Nutrition and Food Systems

Rural Appalachian populations have greater rates of obesity and chronic diseases attributed to lesser consumption of fruits and vegetables (F/V) and physical inactivity. Barriers to F/V consumption and physical activity include poor access and affordability. To help overcome these barriers, a community-initiated walking and farmers market F/V voucher program was implemented.

Participants were encouraged to walk (1.2 miles roundtrip) to the local farmers market to redeem a $10 voucher which could only be spent on F/V. The 16-week program (June – Sept) included 121 participants. Data was analyzed by creating two groups, low-engagers and high-engagers that differed significantly in the …