Medicine and Health Sciences Commons^™

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 …

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 …

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.

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 …

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 …

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 …

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 …

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 …

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 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 …

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), …

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 …

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 …

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. …

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 …

Adolescent Food Purchasing Patterns And The Association With Dietary Intake And Body Mass Index In Rural Communities In Kentucky And North Carolina, Paige M. Connelly

Theses and Dissertations--Nutrition and Food Systems

The local food environment plays an important role in the health of adolescents, especially in rural areas. Often, rural areas lack the accessibility and availability of healthy food choices, making a healthy lifestyle difficult to achieve. This study presents a cross-sectional survey of rural adolescents in 8 counties in Kentucky and North Carolina to determine the association between food store choice, body mass index (BMI), and key dietary outcomes. Although BMI had no association with food store choice, those who infrequently shopped at gas stations, convenience stores, and fast food restaurants consumed significantly less added sugar (p < 0.05) than those who shopped at those stores more regularly. Increasing the availability and accessibility of food venues with healthy food options such as supermarkets may decrease added sugar intake among rural adolescents.