Nutrition Commons^™

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 …

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 …

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) …

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 …

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 …

Evaluating The Experiences Of Fcs Cooperative Extension Agents Use Of Policy, Systems And Environmental Strategies To Reduce Obesity In Rural Counties, Jordan Lynn Bressler

Theses and Dissertations--Nutrition and Food Systems

High rates of obesity are seen across the country with rural areas disproportionately affected. Based on the socio-ecological model, policy, system, and environmental approaches targeted at the population level have the potential to create more sustainable health behavior change than individual level approaches. Historically, the Cooperative Extension Service (CES) has provided direct education related to healthy eating and active living in response to high obesity rates. Utilizing the resources and infrastructure of the CES, the Centers for Disease Control challenged CESs across the country to implement PSE strategies in counties with obesity rates greater than 40% through the CDC 1416 …

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 …

Towards A Healthier Chocolate Formula Which Is Rich In Polyphenols And Low In Fat, Lakmani Tharaka Galaniha

Theses and Dissertations--Nutrition and Food Systems

Chocolate is a food that is craved by many in the world and healthy chocolates have become a current topic in the healthy eating trend. The healthiness of a chocolate depends mainly on the polyphenol, fat and sugar contents. Although the literature serves several interventions to reduce the fat content and total calorie content of chocolates, it does not provide many interventions that consider both improving the polyphenol and reducing the fat content simultaneously. Considering this gap in the literature, this research project sought to develop a chocolate that is both low in fat and high in polyphenol content, without …

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 …

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 …

Comparing Mindfulness-Enriched Weight Management To Current Standard Practices, Teresa M. Lee

Theses and Dissertations--Nutrition and Food Systems

Mindfulness-based interventions have been shown to be effective for numerous diet-related conditions. Mindfulness skills have been theorized to be helpful in improving eating behaviors, and thereby weight management. The purpose of this study was to compare the effectiveness of a mindfulness-enriched weight management program to a standard weight loss program over the course of a 12-week intervention, and weight maintenance over six months. This was a two-group randomized experimental design. One group received a standard weight loss program, while the other group received the same program with an additional mindfulness component. Follow up assessments were conducted twice at three-month intervals. …

Effectiveness Of A Face-To-Face Weight Loss Intervention Paired With Mobile Technology Among Rural Adults In Kentucky, Thomas Michael Ard

Theses and Dissertations--Nutrition and Food Systems

The obesity epidemic remains a serious issue in the United States leading to significant public health implications and costs. Few weight loss interventions paring mobile technology with face-to-face interventions have been conducted in rural communities. Yet, mobile technology interventions offer good potential for delivery but it is unclear if the combination of these weight loss strategies are beneficial. This study sought to examine how integrating mobile technology with face-to-face weight loss interventions in rural communities affects weight loss. Additionally, to determine if mobile technology paired with face-to-face interventions could increase autonomous and controlled motivation levels among adults in rural Kentucky. …

Principals' And School Food Service Workers' Perceptions Of The Implementation Of The Community Eligibility Provision, Shirlena M. Moore

Theses and Dissertations--Nutrition and Food Systems

Over the years, participation in the School Breakfast Program (SBP) has increased, on both state and national levels. The Community Eligibility Provision (CEP) offers free breakfast to all students regardless of income. The purpose of this study was to examine the perception of principals and school food service workers regarding the benefits, barriers, attitudes and beliefs about the implementation of the CEP. A survey was sent to principals and school food service workers. The majority of the participants were satisfied overall with the CEP and the nutritional quality of foods served for breakfast. The majority of the participants did not …

Comparison Of Quick Methods For Determining Body Composition In Female Collegiate Athletes And Obese Females, Mandee E. Martin

Theses and Dissertations--Nutrition and Food Systems

The Body Mass Index (BMI) is a tool used broadly by public health agencies to assess weight in populations. However, when differentiating between fat mass and fat free mass the formula (BMI = weight in kilograms/height in meters2) is not applicable. Research suggests that evaluating body fat percentage and adipose tissue deposition may provide a nuanced indication of overall health, making it more accurate on an individual basis. This study evaluated four methods (Body Mass Index, waist circumference, A Body Shape Index, and Waist to Stature Index) that assess body composition and their ability to predict body fat percentage in …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Associations Between Consumption Of Fruits And Vegetables Among Older Consumers And Farmers Market Shopping, Shu-Feng Tsao

Theses and Dissertations--Nutrition and Food Systems

The number of farmers’ markets in the United States has increased over 300% in past two decades. Many studies have also shown a positive association between an increased access to farmers’ markets and consumption of fruits and vegetables. However, few studies have explored relationships between older consumers aged 55+ whose fruit and vegetable consumption and their attendance at farmers’ markets. In Taiwan, no previous studies regarding farmers’ markets had been conducted from nutritional perspectives. The aims of this study were to determine general characteristics of farmers’ markets shoppers and their perceptions regarding the markets in Lexington, Kentucky and Taipei City, …

Promoting Healthy Home-Cooked Family Meals: Evaluation Of A Social Marketing Program Targeting Low-Income Mothers, Mollie Y. Dawahare

Theses and Dissertations--Nutrition and Food Systems

Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.

Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.

Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).

Intervention: …

Color Your Plate Nutrition Intervention: Using Exposure Interventions To Increase Fruit And Vegetable Intake In Older Adults Attending Congregate Meal Sites, Alyson D. Humphrey

Theses and Dissertations--Nutrition and Food Systems

The aims of the Color Your Plate nutrition intervention were to increase intake of fruits and vegetables and increase motivators and decrease barriers to consuming fruits and vegetables rich in older-adults who regularly attend congregate meal sites. In this quasiexperimental pilot study, a convenience sample (n=35) of older adults at two intervention and two control sites completed pre- and post-surveys. Following the five-lesson curriculum, intervention participants reported greater intakes of fruits and vegetables (mean change increase of 3.47 ± 2.38 servings/week) and significant increases in days having consumed 4.5 cups or more of fruits and vegetables (p=.0004), incorporation of fruits …

The Perceptions, Knowledge, Benefits And Barriers Of Hispanics Regarding The Dietary Guidelines For Americans, Luisyana De Amor Gamboa

Theses and Dissertations--Nutrition and Food Systems

Background: Hispanics are the largest minority group in the U.S. and by the year 2060 the number of Hispanics is projected to double. They are disproportionately affected by obesity and chronic diseases which translate into decreased quality of life, loss of work opportunities and perceptions of injustice for the Hispanic population. The Dietary Guidelines (DG) provide information to help Americans make healthy food and physical activity choices and if followed can be a means of reducing the health disparity gap. However, culturally relevant recommendations specific to Hispanics’ health and nutritional habits are often lacking. The purpose of this study was …

The Effect Of Training And Nutrition On The Body Composition Of College Football Players, Lindsey Marie Goderwis

Theses and Dissertations--Nutrition and Food Systems

The body size of American football players has changed over time. The known health implications of overweight and obesity make it important for football players to understand how to increase size without increasing body fat. The purpose of this study was to evaluate the effect of an increased emphasis on training and nutrition on the body composition of college football players. The sample included 68 football players. Paired t-tests were performed to compare percent fat and body mass index (BMI) at three points in time, all of which were during the off-season. A significant decrease in percent fat and BMI …

The Role And Impact Of Cooperative Extension In Diabetes Self-Management Education, Brittany Michelle Murray

Theses and Dissertations--Nutrition and Food Systems

Diabetes is increasing globally and nationally. Diabetes complications and costs can be reduced through modification of lifestyle risks and diabetes self-management education (DSME). The Cooperative Extension System (CES) is uniquely positioned to implement DSME. This study assessed the role and impact of the Cooperative Extension System (CES) in DSME. A survey was sent to CES professionals throughout the U.S. a total of 43 participants provided information on 73 DSME programs. Most participants were from the South (n=22, 51.16%) and Midwest (n=12, 27.91%) and most programs targeted adults with and at risk for type 2 diabetes. Most programs were developed and …

The Relationships Among Bmi, Waist Circumference, Weight Loss And Health Indicators, John R. Rupp

Theses and Dissertations--Nutrition and Food Systems

Current health recommendations encourage weight loss for overweight and obese individuals. However, the importance of weight to health is still unclear. The purpose of this study was to determine the impact of weight loss on overall health in a sample of adults who have completed a 10 or 12 week weight loss intervention. The study sample included males and females (n =99) between the ages of 27 -64 years that had a BMI of 29-45 kg/m². The study design is a secondary data analysis of data from two different behavioral weight loss interventions. Both interventions prescribed a reduced calorie diet, …