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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Comparison Of The Kentucky Nutrition Education Program Healthy Eating Index Pre- And Post- Test Data For 2012-2013, Corey Joe Shepherd

Theses and Dissertations--Nutrition and Food Systems

Nutrition education has become a topic of significant concern in today’s society. An area prominent in the interest of nutrition is the battle against food security. Programs like the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) is helping to improve its participants’ food security by providing nutrition education. Kentucky SNAP-Ed participants were asked to complete a survey and a 24-hour food recall to evaluate their knowledge in the following areas: Healthy Eating Index (HEI) scores, food resource management and nutrition practices. Each participant completed an average of 7-12 nutrition education lessons throughout the year. To graduate from the program participants …

The Interactive Effect Of A Text Message Intervention And Connectivity Among Rural Adolescents, Kara Coldiron

Theses and Dissertations--Nutrition and Food Systems

Social cohesion among peers profoundly influences decision making during adolescence. Despite this, the current research is very limited concerning the association of social cohesion and intimacy among rural adolescent peers with dietary intake and weight outcomes. This is problematic because social cohesion could be an unknown contributing factor in obesity among rural adolescents. The purpose of this study was to investigate how social cohesion and intimacy among rural adolescents in Kentucky and North Carolina affects the outcomes of a text message intervention aimed at improving fruit, vegetable, fast food and sugar sweetened beverage intake. Additionally, to determine if social cohesion …

The Utilization Of Technology As An Approach To Improve Meal Planning And Dietary Intake, Alexa Lauren Kuziel

Theses and Dissertations--Nutrition and Food Systems

The prevalence of obesity is rising in the United States and one factor that contributes to it is the lack of cooking at home and planning out meals. Since text messaging is now a main avenue of communication, it could be used to motivate people to plan out their meals and cook at home instead of consuming fast food. Current research on how weekly nudges might relate to peoples’ goals about meal preparation and dietary intake is very limited. The purpose of this study was to examine if sending weekly nudges, focusing on specific dietary goals, improves meal planning and …

Dive Into The Hunger Pool: Exploring Students’ Experiences, Coping Strategies, And Suggestions Related To Elements Of Food Security At The University Of Kentucky, The Nu Sandar Oo

Theses and Dissertations--Nutrition and Food Systems

Background: College food insecurity (CFI) is a prevalent social justice and public health issue in the U.S. with the prevalence ranging between 15-59%. Though numerous quantitative studies were first conducted in the past decade, little qualitative research was conducted to assess CFI.

Objective: To explore and deeply understand the contexts of CFI at a land-grant university in Kentucky.

Methods: This qualitative study used a validated food insecurity survey tool and hour-long focus groups that were audio recorded and transcribed. Three theoretical models were combined into an adapted model and utilized for the thematic analysis.

Results: Thirty-three students participated in one …

Utilization Of Web‐Based App To Target Obesogenic Factors In Rural Kentucky Counties With High Rates Of Obesity, Erin M. Casey

Theses and Dissertations--Nutrition and Food Systems

Due to socioeconomic disparities and geographic isolation, rural Kentucky residents bear a greater burden of poor health compared to national averages. Specifically, rural Kentucky residents are at greater risk of becoming obese and suffering from comorbidities of obesity such as type 2 diabetes, hypertension and cardiovascular disease. The purpose of the present study was two-fold. First, we the barriers to nutrition and physical activity unique to rural Kentucky counties which high proportions of obese adults (< 40%) were examined and extrapolated. Second, this information was used to develop a health and wellness app tailored to rural Kentucky counties. The objective was met via a formative assessment regarding causes for obesity in three rural Kentucky counties using focus groups. From these discussions, two major themes arose: barriers to good nutrition and physical activity, and desired web‐app features. From this assessment, FitFaceoff was developed and released into the same counties. Usage and user interaction were assessed using GoogleAnalytics™ software. Analysis revealed poor user liking and unsuccessful implementation of FitFaceoff, however further qualitative research is needed to evaluate poor user reception of FitFaceoff and possible future directions.

Assessing Malnutrition In Liver Disease Patients Being Evaluated For Transplant Using The Nutrition Focused Physical Exam, Madison Hilgendorf

Theses and Dissertations--Nutrition and Food Systems

Patients with liver disease have an increased risk for malnutrition because of side effects of the disease. The Nutrition Focused Physical Exam (NFPE) was developed for nutrition professionals to aid physicians in a nutrition-based diagnosis of malnutrition. The purpose of this study was to examine the NFPE for its validity in liver disease patients being evaluated for transplant. In addition, the NFPE was used to assess incidence and severity of malnutrition in end stage liver disease patients and compare these results to already developed malnutrition tools such as the Patient Generated-Subjective Global Assessment (PG-SGA), Triceps Skinfolds (TSF), Mid-Arm Circumference (MAC), …

Cultural Sensitivity In Cooperative Extension Nutrition Education Programming In Kentucky, Anna Caroline Durr

Theses and Dissertations--Nutrition and Food Systems

The purpose of this mixed methods study was to learn how cultural sensitivity was integrated and perceived in community nutrition education of an existing program offered by the University of Kentucky Cooperative Extension Service Nutrition Education Program. Data collection consisted of a quantitative cultural competence assessment survey tool used with nutrition education paraprofessionals (n=74), qualitative in-depth interviews of nutrition education paraprofessionals (n=8) and focus groups of Hispanic/Latino nutrition education program participants (n=39). Findings were focused in three areas; the cultural sensitivity needs of the program, the perception of nutrition education by participants and the training and professional development needs of …

Consumer Preference Of Vanilla Ice Cream, Julie Anne Martin

Theses and Dissertations--Nutrition and Food Systems

Consumers have a variety of ice cream available for purchase through retail stores, including: standard commercial, specialty store, organic, and premium commercial options. This study used a sensory analysis to solicit responses from a group of adults to determine consumer preference and acceptance of four vanilla ice creams based on taste. Consumers preferred (i) organic ice cream to standard, commercial ice cream and (ii) specialty store ice cream to standard, commercial ice cream. Additionally, consumers could identify (i) the organic ice cream when compared to the standard, commercial ice cream and (ii) the premium, commercial ice cream had more overrun …

Identifying Perceived Risks To Environmental Pollutants And Needs For Risk Communication In A Rural Appalachian Community, Elizabeth H. Travis

Theses and Dissertations--Nutrition and Food Systems

The goal of this study is to determine issues rural Appalachian residents consider most important, their perceived environmental health risk, and how community engagement can potentially improve those issues. The University of Kentucky Superfund Research Center held the Appalachian Community Health and Well-being Forum at the Letcher County Cooperative Extension Office in Eastern Kentucky. A four-member panel consisted of two local health officials, a nutrition expert, and a federal scientist; answered questions from community members. The expert panel and audience members shared concerns, success stories, and highlighted efforts to promote health in the region. Community members completed a questionnaire collecting …

Finding The Link Between Social Connectivity And Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Jordan Elizabeth Mcdonald

Theses and Dissertations--Nutrition and Food Systems

Social networks play a significant role in adolescent decision making, specifically when it comes to dietary outcomes. This study, granted by the United States Department of Agriculture (USDA), assessed the connectivity of these social networks and the impact they have on fruit and vegetable, added sugar and sugar sweetened beverage consumption. Additionally, the relationship between shopping companionship and dietary choices was studied. Positive and negative associations were found among adolescents who shop with parents or friends. It was also found that those adolescents with greater social network cohesion were found to have more negative dietary outcomes. Divulging further into the …

The School Food Environment And Its Association With Dietary Intake Among Rural Adolescents, Hannah F. Hickey

Theses and Dissertations--Nutrition and Food Systems

The school food environment has the ability to increase the consumption of fruit and vegetables in rural adolescents. This study used a survey to allow adolescents in seven rural counties to self-report their fruit and vegetable intake as well as utilizing the USDA Mathematica tool and the School Nutrition and Meal Cost Study audits to evaluate what food and beverage products were actually available to adolescents. By using these two measures, associations between fruit and vegetable intake and availability of healthy and unhealthy foods were determined. The availability of healthy snacks and beverages was found to be associated with sugar-sweetened …

Social Marketing Campaign At Farmers' Markets To Encourage Fruit And Vegetable Purchases In Rural Counties With A High Obesity Prevalence, Emily M. Dewitt

Theses and Dissertations--Nutrition and Food Systems

Farmers’ markets are one food environment venue with the potential to increase fruit and vegetable consumption among rural residents in the United States. This study used the Plate It Up Kentucky Proud social marketing campaign in six rural communities over two years to determine the association between exposure to the campaign and fruit and vegetable purchasing decisions. The availability of recipe cards at the farmers’ market was associated with influencing the purchase of fruits and vegetables (p<0.001); the recipe sample was associated with buying the ingredients for the recipe (p<0.001); taking the PIUKP food sample was associated with a willingness to prepare the food item at home (p<0.001). Utilizing social marketing strategies at farmers’ markets may be an effective way to improve fruit and vegetable intakes in rural communities.

Changes Of Percent Body Fat, Waist Circumference And Fruit And Vegetable Intake Among Division I Collegiate Female Softball Players After Nutrition Curriculum Paired With Technology, Rachel Thomas

Theses and Dissertations--Nutrition and Food Systems

Previous research has found that the quality and intake of collegiate athletes’ diets does not meet the recommended standards. Little research has been completed in regards to the diets of collegiate female softball players. The purpose of this research study was to determine if an 11-week nutrition curriculum paired with a technology could increase fruit and vegetable consumption while decreasing percent body fat and waist circumference. The sample included 14 female softball players. Paired t-test were preformed to compare fruit and vegetable intake, body fat percentage, and waist circumference pre- and post-intervention. Linear regression models were used to determine correlations …