Nutrition Commons^™

Characterization And Localization Of Cyclin B3 Transcript In Both Oocyte And Spermatocyte Of The Rainbow Trout (Oncorhynchus Mykiss), Wenzhi Guan, Liangjie Qiu, Bo Zhang, Jianbo Yao, Qing Xiao, Gaofeng Qiu

Faculty & Staff Scholarship

B-type cyclins are regulatory subunits with distinct roles in the cell cycle. To date, at least three subtypes of B-type cyclins (B1, B2, and B3) have been identified in vertebrates. Previously, we reported the characterization and expression profiles of cyclin B1 and B2 during gametogenesis in the rainbow trout (Oncorhynchus mykiss). In this paper, we isolated another subtype of cyclin B, cyclin B3 (CB3), from a cDNA library of the rainbow trout oocyte. The full-length CB3 cDNA (2,093 bp) has an open reading frame (1,248 bp) that encodes a protein of 416 amino acid residues. The CB3 transcript …

The Icook 4-H Study: An Intervention And Dissemination Test Of A Youth/Adult Out-Of-School Program, Adrienne A. White, Sarah E. Colby, Lisa Franzen-Castle, Kendra K. Kattelmann, Melissa D. Olfert, Tara A. Gould, Rebecca L. Hagedorn, Douglas R. Mathews, Jonathan Moyer, Kimberly Wilson, Kathryn Yerxa

Faculty & Staff Scholarship

Objective

To describe outcomes from intervention and dissemination of iCook 4-H.

Design

Five-state, community-based participatory research and a randomized, controlled trial followed by a 5-state, nonrandomized dissemination test of the iCook 4-H curriculum with control and treatment groups.

Setting

Community and university sites.

Participants

Youths aged 9–10 years and their adult food preparer; 228 dyads in the intervention and 74 dyads in dissemination.

Intervention(s)

Theoretical frameworks were Social Cognitive Theory and the experiential 4-H learning model. Six 2-hour, biweekly sessions on cooking, eating, and playing together followed by monthly newsletters and boosters until 24 months, expanded to 8 sessions …

Cooking And Meal Planning As Predictors Of Fruit And Vegetable Intake And Bmi In First-Year College Students, Andrea J. Hanson, Kendra K. Kattleman, Lacey A. Mccormack, Wenjun Zhou, Onikia N. Brown, Tanya M. Horacek, Karla P. Shelnutt, Tandalayo Kidd, Audrey Opoku-Acheampong, Lisa D. Franzen-Castle, Melissa D. Olfert, Sarah E. Colby

Faculty & Staff Scholarship

The objective was to determine if cooking skills and meal planning behaviors are associated with greater fruit and vegetable intake and lower body mass index (BMI) in first-year college students who are at risk for excessive weight gain. A cross-sectional analysis was conducted using baseline data from a multi-state research project aimed at preventing weight gain in first-year college students. Cooking type, frequency and confidence, self-instruction for healthful mealtime behavior intention, self-regulation of healthful mealtime behavior, and cup equivalents of fruits and vegetables (FV) were measured using validated surveys. BMI was calculated from measured height and weight. First-year students (n …

The Icook 4-H Study: Report On Physical Activity And Sedentary Time In Youth Participating In A Multicomponent Program Promoting Family Cooking, Eating, And Playing Together, Kendra K. Kattelmann, Jessica R. Meendering, Emily J. Hofer, Chase M. Merfeld, Melissa D. Olfert, Rebeca L. Hagedorn, Sarah E. Colby, Lisa Franzen-Castle, Jonathan Moyer, Douglas R. Mathews, Adrienne A. White

Faculty & Staff Scholarship

Objective

To report physical activity and sedentary time outcomes of youth in iCook 4-H.

Study Design and Setting

iCook 4-Hwas a 5-state, randomized, control–treatment, family-based childhood obesity prevention intervention promoting cooking, eating, and playing together.

Participants and Intervention

Youth aged 9–10 years and the main preparer of their meals participated in the 12-week program followed by monthly newsletters and biyearly booster sessions until 24 months.

Main Outcome Measure(s)

A total of 155 youth were fitted with an Actigraph GT3X+ accelerometer, which they wore for 7 days at baseline and 4, 12, and 24 months to measure mean daily …

Prevalence And Correlates Of Food Insecurity Among U.S. College Students: A Multi-Institutional Study, Aseel El Zein, Karla P. Shelnutt, Sarah Colby, Melissa J. Vilaro, Wenjun Zhou, Geoffrey Greene, Melissa D. Olfert, Kristin Riggsbee, Jesse Stabile Morrell, Anne E. Mathews

Faculty & Staff Scholarship

Background: College students may be vulnerable to food insecurity due to limited financial resources, decreased buying power of federal aid, and rising costs of tuition, housing, and food. This study assessed the prevalence of food insecurity and its sociodemographic, health, academic, and food pantry correlates among first-year college students in the United States. Methods: A cross-sectional study was conducted among first-year students (n = 855) across eight U.S. universities. Food security status was assessed using the U.S. Department of Agriculture Adult Food Security Survey Module. Cohen’s Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26 were used to …

Development Of The Icook 4-H Curriculum For Youth And Adults: Cooking, Eating, And Playing Together For Childhood Obesity Prevention, Lisa Franzen-Castle, Sarah E. Colby, Kendra K. Kattelmann, Melissa D. Olfert, Douglas R. Mathews, Kathryn Yerxa, Barbara Baker, Michelle Krehbiel, Tracey Lehrke, Kimberly Wilson, Sue M. Flanagan, Amber Ford, Trina Aguirre, Adrienne A. White

Faculty & Staff Scholarship

The objective was to describe the development process of a curriculum (iCook 4-H) targeted to low-income, rural, and/or diverse youths and their adult primary meal preparer to promote cooking, eating, and playing together. Lessons learned highlighted the importance of grounding the curriculum in Social Cognitive Theory and applying the experiential 4-H learning model using a multiphased, community-based participatory approach with cyclical development and evaluation, and key modifications made for dissemination and distribution. Findings across 4 testing phases over 6 years and 5 states demonstrated the time-intensive, cyclical process that required flexibility with fidelity to form a hands-on, interactive …

Dissemination Using Infographic Reports Depicting Program Impact Of A Community-Based Research Program: Eb4cast In Icook 4-H, Melissa D. Olfert, Rebecca L. Hagedorn, Makenzie L. Barr, Sarah E. Colby, Kendra K. Kattelmann, Lisa Franzen-Castle, Adrienne A. White

Faculty & Staff Scholarship

Objective

To evaluate barriers to dissemination and implementation and perceptions of the Evidence-Based Forecast Capture, Assemble, Sustain, Timelessness (eB4CAST) dissemination infographic tool as part of iCook 4-Hdissemination.

Design

Online surveys and phone interviews.

Participants

Experts (n = 35) in community research completed the survey; 13 completed the interview.

Main Outcomes Measure

Experts’ perceptions of eB4CAST reports used for iCook 4-Hdissemination.

Analysis

Frequency and thematic analysis.

Results

Survey respondents agreed (85%) that the eB4CAST infographic provided a clear understanding of iCook 4-Hand relevant information (83%). Statistics included in the infographic were reported as easily understood (66%). Respondents (83%) …

Ripple Effect Mapping Outcomes Of A Childhood Obesity Prevention Program From Youth And Adult Dyads Using A Qualitative Approach: Icook 4-H, Melissa D. Olfert, Sina J. King, Rebecca L. Hagedorn, Makenzie L. Barr, Barbara A. Baker, Sarah E. Colby, Kendra K. Kattelmann, Lisa Franzen-Castle, Adrienne A. White

Faculty & Staff Scholarship

Objective

Design

Setting

Participants …

Feasibility Of A Mhealth Approach To Nutrition Counseling In An Appalachian State, Melissa D. Olfert, Makenzie L. Barr, Rebecca L. Hagedorn, Dustin M. Long, Treah S. Haggerty, Mathew Weimer, Joseph Golden, Mary Ann Maurer, Jill D. Cochran, Tracy Hendershot, Stacey L. Whanger, Jay D. Mason, Sally L. Hodder

Faculty & Staff Scholarship

Abstract: West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with patients at seven health care clinics throughout the state. Fourteen healthcare providers and 64 patients 18 years or older with a Body Mass Index (BMI) greater than or equal to 30 and access to the Internet were recruited for this 12-week feasibility study. Patient participants logged meals and exercise into the GM application via smart phone, tablet, or computer and virtually engaged with a …

Choice Architecture In Appalachian High Schools: Evaluating And Improving Cafeteria Environments, Melissa D. Olfert, Rebecca L. Hagedorn, Emily N. Clegg, Shannon Ackerman, Cheryl Brown

Faculty & Staff Scholarship

School meals are a primary source of nutrition for many adolescents. Determining factors that influence the selection of various foods can provide insight on strategies to improve students’ cafeteria choices. This evaluation and observation was conducted at three Appalachian high schools to assess the cafeteria environment. The study developed and implemented an assessment tool created using principles of choice architecture and behavioral economics building on the work of the Cornell Center for Behavioral Economics in Child Nutrition Programs (BEN Center). The assessment tool scored eight components of the lunchroom—the exterior, hot serving area, cold serving area, salad bar, beverage area, …

The Effect Of Sodium Selenate Biofortification On Plant Yield, Mineral Content, And Antioxidant Capacity Of Culinary Herb Microgreens, Rachel G. Newman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Selenium (Se) biofortification of plants has been suggested as a method for enhancing dietary Se intake. Popular herbs such as basil (Ocimum basilicum), cilantro (Coriandrum sativum), and scallions (Allium fistulosum) are used for enhancing flavors. Microgreens are young seedlings harvested with one to two true leaves and are increasingly popular in the consumer marketplace. In this study, basil, cilantro, and scallion microgreens were treated with various concentrations of Se as sodium selenate in hydroponic conditions to investigate the effect on plant yield, mineral content (selenium, sulfur, sodium, potassium, phosphorus, calcium, magnesium, copper, iron, manganese, zinc, and boron), total phenolic compounds, …

Wish4campus: Evaluating College Food Insecurity And Promoting Solutions For Student Wellbeing, Rebecca L. Hagedorn

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Interest in college food insecurity has increased in previous years, however, little research focuses on the Appalachian and Southeastern regions of the United States resulting in limited understanding of food insecurity’s impact on college students in these regions. Additionally, resources to help food insecure students are often sparse with universities lacking evidence-based programming to implement for student benefit.

Aims: This dissertation aims to (1) investigate the correlates and behavioral consequences of food insecurity on college students at an Appalachian university, (2) expand college food insecurity research to a regional investigation in the Appalachian and Southeastern regions, and (3) develop …

Characterization Of Major Flavonols In Ramps (Allium Tricoccum), Wijdan M. Dabeek

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ramps (Allium tricoccum) is a traditional plant in the eastern Appalachian Mountains. Ramps have been used in Appalachian folk medicine for its health promoting roles in lowering blood pressure and cholesterol. Information on the chemical composition of bioactive components responsible for the potential health benefits are scarce. Analysis of the chemical composition in similar Alliumplants showed that flavonols, induced similar health benefits. Therefore, the aim of this work is to characterize major flavonol conjugates in ramps. The secondary aim is to develop a preliminary quantification protocol. Flavonol glycosides were extracted in 50% methanol and 3% acetic acid. …

Learn First, Practice Second Approach To Increase Health Professionals’ Nutrition-Related Knowledge, Attitudes, And Self-Efficacy., Madison E. Santella

Graduate Theses, Dissertations, and Problem Reports (ETD)

The aim of this study was to assess the effectiveness of a “learn first, practice second” intervention on the nutrition-related knowledge, attitudes, and self-efficacy of multidisciplinary health professionals in West Virginia, specifically highlighting the Mediterranean Diet. Data was captured via online surveys at four time points (Baseline, Post-education, Post-immersion, Follow Up). All information was self-reported. This approach consisted of 16 weeks of online education, 2 weeks of cultural immersion in Tuscany, Italy, and a 7 month return to practice period. Data were analyzed using JMP Version Pro 12.2 and SAS Version 9.3 for Windows. Repeated measures ANOVA with irregular spacing …

Apple Pomace As A Novel Aid For Western Diet-Induced Nonalcoholic Fatty Liver Disease In Young Female Sprague Dawley Rats, R. Chris Skinner

Graduate Theses, Dissertations, and Problem Reports (ETD)

Apple pomace is a “waste” byproduct of apple processing that causes environmental pollution and is costly to dispose of. Yet, apple pomace is rich in dietary fibers and antioxidants. Analysis of apple pomace’s nutritional profile indicates suitability as a potential dietary treatment for non-alcoholic fatty liver disease (NAFLD) and the more severe non-alcoholic steatohepatitis (NASH). NAFLD is the most prevalent liver disease in the world with prevalence and severity expected to increase in both adults and children. Currently, there is no approved drug treatment for NAFLD and therefore, dietary intervention is the primary treatment. The study objectives were to determine …

Community Orchards And Food Security In Appalachia, Ursula Ramsey

West Virginia Law Review

No abstract provided.

The Relationship Between Dietary Quality And Mental Health In A Young Adult Appalachian, Rachel A. Wattick

Munn Scholars Awards

No abstract provided.

Crosstalk Among Lncrnas, Micrornas And Mrnas In The Muscle ‘Degradome’ Of Rainbow Trout, Bam Paneru, Ali Ali, Rafet Al-Tobasei, Brett Kenney, Mohamed Salem

Faculty & Staff Scholarship

In fish, protein-coding and noncoding genes involved in muscle atrophy are not fully characterized. In this study, we characterized coding and noncoding genes involved in gonadogenesis-associated muscle atrophy, and investigated the potential functional interplay between these genes. Using RNA- Seq, we compared expression pattern of mRNAs, long noncoding RNAs (lncRNAs) and microRNAs of atrophying skeletal muscle from gravid females and control skeletal muscle from age-matched sterile individuals. A total of 852 mRNAs, 1,160 lncRNAs and 28 microRNAs were differentially expressed (DE) between the two groups. Muscle atrophy appears to be mediated by many genes encoding ubiquitin- proteasome system, autophagy related …

Gardening Experience Is Associated With Increased Fruit And Vegetable Intake Among First-Year College Students: A Cross-Sectional Examination, Jennifer Loso, Daniel Staub, Sarah E. Colby, Melissa D. Olfert, Kendra K. Kattelmann, Melissa Vilaro, James Colee, Wenjun Zhou, Lisa Franzen-Castle, Anne E. Mathews

Clinical and Translational Science Institute

Background—Gardening interventions have been shown to increase fruit and vegetable (F/V) intake among school-aged children. It is unknown whether these effects persist into later adolescence or adulthood, and little is known about whether gardening in later adolescence is related to F/V intake. Objective—To identify the relationship between both childhood and recent (within the past 12 months) gardening experiences and current F/V intake among college students. Design/participants—A cross-sectional evaluation of 1,121 college freshmen with suboptimal F/V consumption from eight US universities. Main outcome measures—Participants completed the National Cancer Institute Fruit and Vegetable Screener and questions about gardening experiences. Respondents were grouped …

“It’S Making Memories”: A Qualitative Investigation Of Family Mealtime Cognitions, Barriers And Strategies For Success Of Parents And School-Aged Kids, K. M. Eck, K. Spaccarotella, C. L. Delaney, Melissa D. Olfert, K. P. Shelnutt, C. Byrd-Bredbenner

Faculty & Staff Scholarship

Objective: Family meals, particularly those occurring in calm environments, are associated with numerous health benefits for both children and parents. However, families often struggle to share meals, with the frequency declining as kids get older. This qualitative research study aimed to explore the factors influencing family meal behaviors.

Methods: Parents (n=38) and school-age children (n=37) participated in focus group discussions guided by Social Cognitive Theory.

Results: Content analysis results indicate that parents and children believed family meals were important, promoted communication, and strengthened family bonds. Parents and children reported that a calm, enjoyable, conflict-free mealtime environment bolstered mealtime enjoyment and …

Low Sucrose, Omega-3 Enriched Diet Has Region-Specific Effects On Neuroinflammation And Synaptic Function Markers In A Mouse Model Of Doxorubicin-Based Chemotherapy, Tonya S. Orchard, Monica M. Gaudier-Diaz, Panchita Phuwamongkolwiwat-Chu, Rebecca Andridge, Maryam B. Lustberg, Joshua Bomser, Rachel M. Cole, Martha A. Belury, Courtney A. Devries

Faculty & Staff Scholarship

Chemotherapeutic agents such as doxorubicin may negatively affect long-term brain functioning in cancer survivors; neuroinflammation may play a causal role. Dietary approaches that reduce inflammation, such as lowering sucrose and increasing eicosapentaenoic acid plus docosahexaenoic acid (EPA + DHA), may attenuate chemotherapy-induced neuroinflammation and synaptic damage, thereby improving quality of life. Ovariectomized, C57BL/6 mice were assigned to a chemotherapy (9 mg/kg doxorubicin + 90 mg/kg cyclophosphamide) or vehicle two-injection regimen, with injections two and four weeks after starting diets. In Study 1, mice received low sucrose diets with EPA + DHA or No EPA + DHA for four to six …

Food Choice Priorities Change Over Time And Predict Dietary Intake At The End Of The First Year Of College Among Students In The U.S., Melissa J. Vilaro, Sarah E. Colby, Kristin Riggsbee, Wenjun Zhou, Carol Byrd-Bredbenner, Melissa D. Olfert, Tracey E. Barnett, Tanya Horacek, Morgan Sowers, Anne E. Matthews

Faculty & Staff Scholarship

This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant …

Genome-Wide Association Analysis With A 50k Transcribed Gene Snp-Chip Identifies Qtl Affecting Muscle Yield In Rainbow Trout, Mohamed Salem, Rafet Al-Tobasei, Ali Ali, Daniela Lourenco, Guangtu Gao, Yniv Palti, Brett Kenney, Timothy D. Leeds

Faculty & Staff Scholarship

Detection of coding/functional SNPs that change the biological function of a gene may lead to identification of putative causative alleles within QTL regions and discovery of genetic markers with large effects on phenotypes. This study has two-fold objectives, first to develop, and validate a 50K transcribed gene SNP-chip using RNA-Seq data. To achieve this objective, two bioinformatics pipelines, GATK and SAMtools, were used to identify ∼21K transcribed SNPs with allelic imbalances associated with important aquaculture production traits including body weight, muscle yield, muscle fat content, shear force, and whiteness in addition to resistance/susceptibility to bacterial cold-water disease (BCWD). SNPs ere …

“Your Body Feels Better When You Drink Water”: Parent And School-Age Children’S Sugar- Sweetened Beverage Cognitions, Kaitlyn M. Eck, Aleksandr Dinesen, Elder Garcia, Colleen L. Delaney, Oluremi A. Famodu, Melissa D. Olfert, Carol Byrd-Bredbenner, Karla P. Shelnutt

Faculty & Staff Scholarship

Sugar-sweetened beverages (SSBs) are a leading source of added sugar in the American diet. Further, ingestion of added sugars from SSBs exceeds recommendations. Thus, interventions that effectively reduce SSB consumption are needed. Focus group discussions with parents (n = 37) and school-aged children between the ages of 6 and 11 years (n = 41) from Florida, New Jersey, and West Virginia were led by trained moderators using Social Cognitive Theory as a guide. Trends and themes that emerged from the content analysis of the focus group data indicated that both parents and children felt that limiting SSBs was important to …

Detecting Body Mass Index From A Facial Photograph In Lifestyle Intervention, Makenzie L. Barr, Guodong Guo, Sarah E. Colby, Melissa D. Olfert

Faculty & Staff Scholarship

This study aimed to identify whether a research participant’s body-mass index (BMI) can be correctly identified from their facial image (photograph) in order to improve data capturing in dissemination and implementation research. Facial BMI (fBMI) was measured using an algorithm formulated to identify points on each enrolled participant’s face from a photograph. Once facial landmarks were detected, distances and ratios between them were computed to characterize facial fatness. A regression function was then used to represent the relationship between facial measures and BMI values to then calculate fBMI from each photo image. Simultaneously, BMI was physically measured (mBMI) by trained …

Integrated Analysis Of Lncrna And Mrna Expression In Rainbow Trout Families Showing Variation In Muscle Growth And Fillet Quality Traits, Ali Ali, Rafet Al-Tobasei, Brett Kenney, Timothy D. Leeds, Mohamed Salem

Faculty & Staff Scholarship

Muscle yield and quality traits are important for the aquaculture industry and consumers. Genetic selection for these traits is difficult because they are polygenic and result from multifactorial interactions. To study the genetic architecture of these traits, phenotypic characterization of whole body weight (WBW), muscle yield, fat content, shear force and whiteness were measured in ~500 fish representing 98 families from a growth-selected line. RNA-Seq was used to sequence the muscle transcriptome of different families exhibiting divergent phenotypes for each trait. We have identified 240 and 1,280 differentially expressed (DE) protein-coding genes and long noncoding RNAs (lncRNAs), respectively, in fish …

“My Tummy Tells Me” Cognitions, Barriers And Supports Of Parents And School-Age Children For Appropriate Portion Sizes, Kaitlyn M. Eck, Colleen L. Delaney, Mirian P. Leary, Oluremi A. Famodou, Melissa D. Olfert, Karla P. Shelnutt, Carol Bryd-Bredbenner

Faculty & Staff Scholarship

Larger portion sizes have increased in tandem with the rise in obesity. Elucidation of the cognitions of children and parents related to portion size is needed to inform the development of effective obesity prevention programs. This study examined cognitions of parents (n = 36) and their school-age children (6 to 11 years; n = 35) related to portion sizes via focus group discussions. Parents and children believed controlling portion sizes promoted health and weight control. Some parents felt controlling portions was unnecessary, particularly if kids were a healthy weight because kids can self-regulate intake. Barriers to serving appropriate portions identified …

Relationship Between Diet And Mental Health In A Young Adult Appalachian College Population, Rachel A. Wattick, Rebecca L. Hagedorn, Melissa D. Olfert

Faculty & Staff Scholarship

Young adults in Appalachia may face poor nutritional status due to low access to healthy food and high mental health symptoms attributed to high stress and the college environment. A cross-sectional design was used to investigate the relationship between diet intake and mental health status of this population via surveys. Participant responses (n = 1956) showed students’ mean number of depressed days over the past 30 days was 9.67 ± 8.80, and of anxious days, 14.1 ± 10.03. The mean fruit and vegetable intake was 1.80 ± 1.27 times per day and the mean added sugars intake was 1.79 ± …

Neck Circumference Positively Relates To Cardiovascular Risk Factors In College Students, Oluremi A. Famodu, Makenzie L. Barr, Sarah E. Colby, Wenjun Zhou, Ida Holaskova, Miriam P. Leary, Carol Bryd-Bredbenner, Anne E. Matthews, Melissa D. Olfert

Faculty & Staff Scholarship

The objective of this study was to determine the relationship between neck circumference (NC) and other anthropometric measures and examine cut-off points for males and females according to existing waist circumference cut-off levels in this age group. Across 8 universities, 1562 students underwent a physical assessment. Spearman rho correlations (ρ) were calculated to determine associations between NC and other continuous variables of health. Receiving operating characteristic curves were constructed to assess the optimal cut-off levels of NC of males and females with central obesity. Participants were predominantly Caucasian (67%), female (70%), and outside of Appalachia 2 (82%). Forty-one percent of …

Validation Of A Dietary Screening Tool In A Middle-Aged Appalachian Population, Melissa Ventura Marra, Sowmyanarayanan V. Thuppal, Elizabeth J. Johnson, Regan L. Bailey

Faculty & Staff Scholarship

Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45–64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls. …