Dietetics and Clinical Nutrition Commons^™

Examining Food Security, Choices And Barriers Among Community Supported Agriculture Participants During Covid- 19 In Kentucky, Martha J. Biddle, Junghee Kang, Julie Derringer, Anna Rose, Dawn Brewer, Misook L. Chung, Terry A. Lennie, Gia Mudd-Martin, Timothy A. Woods

UK CARES Faculty Publications

The coronavirus disease (COVID-19) pandemic is challenging food security. Our study’s purpose was to examine relationships among food security status, eating patterns and perceived barriers to food choices among shareholders (N = 209) in a Community Supported Agriculture (CSA) program during stay- at-home restrictions due to the pandemic. The food insecure group (n = 33) reported lower consumption of fruits/vegetables, whole grains and greater consumption of fast foods and more barriers to food choices compared to the food secure group (p < .05). A low food insecure proportion (16%) among the CSA participants suggests a potential role of a CSA program to prevent food insecurity.

Process Evaluation Of The Early Implementation Stages Of The National Diabetes Prevention Program Through Kentucky Cooperative Extension: Perceptions Of Adopters And Potential Adopters, Nicole Breazeale, Heather Norman-Burgdolf, Katherine Counts, Lovoria B. Williams

Dietetics and Human Nutrition Faculty Publications

With the growing demand for lifestyle change programs that prevent or delay Type 2 diabetes onset, community organizations with broad reach should be explored for national dissemination of the National Diabetes Prevention Program (NDPP). This study evaluates the early implementation of the NDPP through Cooperative Extension in four Kentucky counties and explores the feasibility of scaling up the program to additional counties. Using a qualitative approach, semi-structured telephone interviews were conducted with 12 Family and Consumer Sciences (FCS) Agents – four who were participating in the pilot (adopters) and eight who had no experience with the NDPP (potential adopters). Five …

Exploring Perceived Importance Of A Novel Emergency Food Program During Covid-19 And Program Recipient Characteristics, Makenzie L. Barr, Kendra Oonorasak, Kristin Hughes, Lauren Batey, Kaela Jackson, Haley Marshall, Tammy Stephenson

Dietetics and Human Nutrition Faculty Publications

Following rising unemployment rates and consequent loss of income due to COVID-19, many people have been seeking meal assistance. This study examines the impact of a community-based free meal distribution program during the pandemic in Kentucky, reviewing characteristics of recipients of the program. Demographics, health behaviors, food insecure classification, and rating of importance of the meal program were collected. Qualitative feedback on the impact of the program was collected via open response. Of the 92 participants using the meal service, the cohort was female, Black, 43 years of age (43.5 ± 15.0 years), with a household income under 30,000 USD …

Assessment Of Cultural Sensitivity In Dietetics Education, Julie Plasencia, Heather Norman-Burgdolf, Lorraine Weatherspoon

Dietetics and Human Nutrition Faculty Publications

Cultural sensitivity and competency are skills needed for agricultural professionals including nutrition and dietetics practitioners. The objective of the current study was to examine the learning transference of cultural sensitivity topics taught in a cultural foods course into case study assessments of a capstone-level course. This study is a cross-sectional, content analysis of cultural sensitivity assessment rubric (CSAR) scores for two case study assessments. The study was conducted in a landgrant, research-intensive university and 55 students (60%) from a capstone-level dietetics course participated. T-tests were used to compare CSAR scores between students who had completed a cultural foods course and …

Screen Time Parenting Practices And Associations With Preschool Children’S Tv Viewing And Weight-Related Outcomes, Cody D. Neshteruk, Gina L. Tripicchio, Stephanie Lobaugh, Amber E. Vaughn, Courtney T. Luecking, Stephanie Mazzucca, Dianne S. Ward

Dietetics and Human Nutrition Faculty Publications

The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring …

Community-Based Efforts Aim To Improve The Food Environment Within A Highly Obese Rural Appalachian County, Rachel Gillespie, Emily M. Dewitt, Heather Norman-Burgdolf, Brynnan Dunaway, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

Rural communities in Appalachia are displaying increased obesity prevalence, yet traditional interventions have not provided a broad enough impact to improve dietary consumption patterns. Therefore, expanding efforts that address the food environment and incorporate behavioral nudges through community-developed marketing strategies may be a viable mechanism to improve food and beverage choices within this unique population. This study installed shelf-wobblers across n = 5 gas stations in one rural Appalachian county in Kentucky. Smart Snacks were identified from store inventory lists utilizing the CDC Food Service Guideline for Federal Facilities calculator and were categorized into high-protein snacks, low-fat carbohydrate snacks, meal …

Effect Of The Lysosomotropic Agent Chloroquine On Mtorc1 Activation And Protein Synthesis In Human Skeletal Muscle, Michael S. Borack, Jared M. Dickinson, Christopher S. Fry, Paul T. Reidy, Melissa M. Markofski, Rachel R. Deer, Kristofer Jennings, Elena Volpi, Blake B. Rasmussen

Athletic Training and Clinical Nutrition Faculty Publications

BACKGROUND: Previous work in HEK-293 cells demonstrated the importance of amino acid-induced mTORC1 translocation to the lysosomal surface for stimulating mTORC1 kinase activity and protein synthesis. This study tested the conservation of this amino acid sensing mechanism in human skeletal muscle by treating subjects with chloroquine-a lysosomotropic agent that induces in vitro and in vivo lysosome dysfunction.

METHODS: mTORC1 signaling and muscle protein synthesis (MPS) were determined in vivo in a randomized controlled trial of 14 subjects (10 M, 4 F; 26 ± 4 year) that ingested 10 g of essential amino acids (EAA) after receiving 750 mg of chloroquine …

Consumption Of Diet And Nutrition Information In Digital Magazines Marketing To Latinx Women, Julie Plasencia, Clara Barajas, Jordan Hinton

Dietetics and Human Nutrition Faculty Publications

Objective: To examine the types of nutrition and health-related articles published in digital magazines directed toward Latinx women; and to examine the extent to which advertisements about food, nutrition, and weight-loss are prevalent in these media.

Design: A descriptive content analysis was completed for five digital magazines marketing to Latinx women. A total of 1,234 articles and 3,001 advertisements were examined for nutrition and health-related content.

Results: Early editions of digital magazines directed towards Latinx women included more advertisements than articles on the topics of food and health. Among the articles, very few (0-30%) included health and nutrition information that …

Vitamin D Promotes Skeletal Muscle Regeneration And Mitochondrial Health, Christine M. Latham, Camille R. Brightwell, Alexander R. Keeble, Brooke D. Munson, Nicholas T. Thomas, Alyaa M. Zagzoog, Christopher S. Fry, Jean L. Fry

Athletic Training and Clinical Nutrition Faculty Publications

Vitamin D is an essential nutrient for the maintenance of skeletal muscle and bone health. The vitamin D receptor (VDR) is present in muscle, as is CYP27B1, the enzyme that hydroxylates 25(OH)D to its active form, 1,25(OH)D. Furthermore, mounting evidence suggests that vitamin D may play an important role during muscle damage and regeneration. Muscle damage is characterized by compromised muscle fiber architecture, disruption of contractile protein integrity, and mitochondrial dysfunction. Muscle regeneration is a complex process that involves restoration of mitochondrial function and activation of satellite cells (SC), the resident skeletal muscle stem cells. VDR expression is strongly upregulated …

Fat And Carbohydrate Interact To Potentiate Food Reward In Healthy Weight But Not In Overweight Or Obesity, Emily E. Perszyk, Zach Hutelin, Jessica Trinh, Arsene Kanyamibwa, Sophie Fromm, Xue S. Davis, Kathryn M. Wall, Kyle D. Flack, Alexandra G. Difeliceantonio, Dana M. Small

Dietetics and Human Nutrition Faculty Publications

Prior work suggests that actual, but not estimated, energy density drives the reinforcing value of food and that energy from fat and carbohydrate can interact to potentiate reward. Here we sought to replicate these findings in an American sample and to determine if the effects are influenced by body mass index (BMI). Thirty participants with healthy weight (HW; BMI 21.92 ± 1.77; M ± SD) and 30 participants with overweight/obesity (OW/OB; BMI 29.42 ± 4.44) rated pictures of common American snacks in 120-kcal portions for liking, familiarity, frequency of consumption, expected satiety, healthiness, energy content, energy density, and price. Participants …

Alternative Community Nutrition Experiential Learning Opportunities For Dietetic Interns During Covid-19, Courtney T. Luecking, Elizabeth Combs, Heather Norman-Burgdolf

Dietetics and Human Nutrition Faculty Publications

In response to the COVID-19 pandemic, collaboration among faculty in the Department of Dietetics and Human Nutrition at the University of Kentucky yielded two, four-week virtual experiential learning opportunities with Cooperative Extension for 19 dietetic interns. Remote experiences focused on development of new programming regarding the role of nutrition in the prevention/management of the most prevalent chronic diseases affecting Kentuckians and translating an existing social marketing program that promotes quality family time through preparation of nutritious, affordable home-cooked meals. Weekly assignments took ~10 hours, included individual and groupwork, and came together to create program packages encompassing commonly used products (e.g., …

Leveraging Online Learning To Promote Systems Thinking For Sustainable Food Systems Training In Dietetics Education, Marie Spiker, Amanda Hege, Janice Giddens, Joanna Cummings, Jasia Steinmetz, Angie Tagtow, Erin Bergquist, Lauren Burns, Christina Campbell, Diane Stadler, Elizabeth Combs, Nancy Prange, Aaron Schwartz, Katie Brown, Kevin Sauer

Dietetics and Human Nutrition Faculty Publications

Educating and training a multisectoral food systems workforce is a critical part of developing sustainable, resilient, and healthy food and water systems. This paper shares perspectives from a working group of educators, learners, and food systems subject matter experts that collaborated over the course of a year to develop, pilot test, and evaluate two interactive webinar series with a multi-site cohort of dietetics interns and graduate students. The three-part webinar series format included a training webinar, a practice activity, and a synthesis webinar. In reflecting on the effectiveness of this format, we provide direct assessments of student learning from subject …

Healthy Trees – Healthy People: A Model For Engaging Citizen Scientists In Exotic Pest Detection In Urban Parks, Heather Norman-Burgdolf, Lynne K. Rieske

Dietetics and Human Nutrition Faculty Publications

Healthy Trees – Healthy People (HT-HP) is an outreach and education program created to enlist and train participants in exotic pest detection while providing them with structured opportunities to connect with urban nature and increase their physical and emotional health. HT- HP creates infrastructure to increase engagement by the urban populace in the urban tree canopy. The program solicits participants to engage in an 8-week intervention designed to expand capacity to detect non-native insect pests and pathogens, while increasing physical activity, raising awareness of healthy lifestyle choices, and improving the health of participants. Program participants were trained in tree and …

Integrating Policies, Systems, And Environments (Pse) Work Into Fcs Extension Programming: Lessons Learned From A Multi-State Training, Lisa T. Washburn, Heather Norman-Burgdolf, Karen L. Franck, Lauren E. Kennedy, Christopher T. Sneed

Dietetics and Human Nutrition Faculty Publications

Public health efforts have emphasized changes to policies, systems and environments (PSEs) to improve health behaviors for individuals and communities. Extension has increasingly emphasized these approaches, particularly for work of Family and Consumer Sciences (FCS) agents. In part, this emphasis on PSEs in Extension has been driven by SNAP-Ed and other federally funded initiatives, such as the Centers for Disease Control and Prevention (CDC) High Obesity Programs (HOP). However, broader adoption and implementation of PSEs at the local level has lagged in some states for various reasons. These include limited understanding about PSE interventions and how this work fits with …

Dietary Assessments And Their Association With Psychological Factors, Inflammation, And Cardiovascular Health Outcomes, Junghee Kang

Theses and Dissertations--Nursing

Cardiovascular diseases (CVDs), a group of disorders of the heart and blood vessels, are the leading cause of death worldwide, causing one-third of deaths each year. Diet is one of the most important behavioral risk factors for CVD. The effects of behavioral risk factors, such as diet, may lead to increased blood pressure, increased blood glucose, raised blood lipids, and overweight and obesity. Inflammation contributes to the development of CVD and can be influenced by diet. Dietary assessment indices can measure diet quality from an individual's dietary intake by scoring food and nutrient intakes. However, the mediation effects of diet …

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 …

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 …

Identification Of Infant Feeding Practices In Eastern Kentucky And Southern West Virginia That Correlate With High Weight-For-Length, Havilah R. Adkins

DNP Projects

Background: Approximately 20% of children in the United States are obese. West Virginia and Kentucky rank in the top 10 for obesity rates in children as young as 2-4 years old. Obesity increases the risk for numerous short-term health problems and impacts long-term health, development, quality of life, and life expectancy. Research indicates that obesogenic behaviors can be addressed prior to the development of obesity or significant health problems to prevent, rather than treat. Interventions targeting caregivers of infants younger than 2-years can promote early development of healthy feeding habits that persist through the developmental stages of nutrition. Before a …

“We’Re, Like, The Most Unhealthy People In The Country”: Employing An Equity Lens To Reduce Barriers To Healthy Food Access In Rural Appalachia, Kathryn Cardarelli, Emily M. Dewitt, Rachel Gillespie, Heather Norman-Burgdolf, Natalie Jones, Janet Tietyen Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts.

Methods

We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and …

Exercise For Weight Loss: Further Evaluating Energy Compensation With Exercise, Kyle D. Flack, Harry M. Hays, Jack Moreland, Douglas E. Long

Dietetics and Human Nutrition Faculty Publications

PURPOSE: This study assessed how individuals compensate for energy expended during a 12-wk aerobic exercise intervention, elucidating potential mechanisms and the role exercise dose plays in the compensatory response.

PARTICIPANTS AND DESIGN: Three-arm, randomized controlled trial among sedentary adults age 18 to 40 yr, body mass index of 25 to 35. Groups included six exercise sessions per week, two sessions per week, and sedentary control.

METHODS: Rate of exercise energy expenditure was calculated from a graded exercise test averaged across five heart rate zones. Energy compensation was calculated as the difference between expected weight loss (based on exercise energy expenditure) …

The Effect Of Dietary Nitrate And Vitamin C On Endothelial Function, Oxidative Stress And Blood Lipids In Untreated Hypercholesterolemic Subjects: A Randomized Double-Blind Crossover Study, Reem Basaqr, Michealia Skleres, Rani Jayswal, D. Travis Thomas

Athletic Training and Clinical Nutrition Faculty Publications

BACKGROUND: Vitamin C may enhance nitric oxide (NO) production through stepwise reduction of dietary nitrate (NO₃) to nitrite (NO₂) to NO. The combined effect of vitamin C and NO₃ supplementation is relatively unexplored in untreated hypercholesterolemia.

AIMS: We aimed to examine whether co-administration of vitamin C and nitrate for 4-weeks would improve endothelial function (primary outcome), plasma NO metabolites, oxidative stress, and blood lipids (secondary outcomes).

METHODS: Subjects 50–70 years of age with low density lipoprotein (LDL) > 130 mg/dL and RHI ≤ 2 were enrolled in this randomized double-blind crossover study. Subjects were assigned to …

Barriers And Facilitators Of Parent Engagement With Health Promotion In Child Care: A Mixed-Methods Evaluation, Courtney T. Luecking, Phillip Dobson, Dianne S. Ward

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: Early care and education providers cite lack of parent engagement as a central barrier to promoting healthy behaviors among young children. However, little research exists about factors influencing parent engagement with promoting healthy eating and activity behaviors in the this setting.

AIMS: This study aimed to address this gap by examining low and high parent engagement with the Healthy Me, Healthy We campaign to identify barriers and facilitators of parent engagement with the intervention.

METHOD: This comparative case study used an explanatory sequential mixed-methods approach. We created center-level parent engagement scores using process evaluation data from the effectiveness trial …

Rural Snap Participants And Food Insecurity: How Can Communities Leverage Resources To Meet The Growing Food Insecurity Status Of Rural And Low-Income Residents?, Emily M. Dewitt, Rachel Gillespie, Heather Norman-Burgdolf, Kathryn Cardarelli, Stacey A. Slone, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

The burden of obesity disproportionately influences poor health outcomes in rural communities in the United States. Various social and environmental factors contribute to inadequate food access and availability in rural areas, influencing dietary intakes and food insecurity rates. This study aims to identify patterns related to food insecurity and fruit and vegetable consumption within a SNAP-eligible and low-income, highly obese rural Appalachian community. A prospective cohort was implemented to identify gaps in resources addressing obesity and food insecurity challenges. SAS 9.4 software was used to examine differences in dietary intakes and shopping practices among SNAP participants. Among participants (n …

Policy, Systems, And Environmental Change: A Planning Tool For Community Health Implementation, Lauren E. Kennedy, Christopher T. Sneed, Karen L. Franck, Heather Norman, Lisa Washburn, Soghra Jarvandi, Janet Mullins

Dietetics and Human Nutrition Faculty Publications

Extension educators across the United States are being asked to expand their direct education efforts to include policy, systems, and environmental (PSE) changes. However, professional development opportunities and tools are needed to familiarize Extension professionals with PSE change approaches, build their capacity to implement PSE change, and make the process relevant to their work. We describe a planning tool developed for a unique multistate PSE change intervention training and designed to facilitate the process of PSE change implementation at the local level. An example of the tool and recommendations for others wishing to use it are included.

Two States, One Mission: Building Policy, Systems, And Environmental Change Capacity Of County Extension Educators, Christopher T. Sneed, Karen L. Franck, Heather Norman, Lisa Washburn, Lauren E. Kennedy, Soghra Jarvandi, Janet Mullins

Dietetics and Human Nutrition Faculty Publications

Policy, systems, and environmental (PSE) change interventions are a key part of comprehensive nutrition and health education. Although Extension educators find value in PSE approaches and report being involved in PSE work, many still indicate a lack of understanding regarding PSE approaches. We describe a unique multistate training designed to increase Extension educators' understanding, skills, and capacity related to implementing PSE change interventions. Data demonstrating success of the training are presented. Additionally, best practices for others wishing to create similar multistate programs conclude the article.

Consumption Of Added Sugars By Rural Residents Of Southwest Virginia, Maryam Yuhas, Valisa Hedrick, Jamie Zoellner

Journal of Appalachian Health

Introduction: Nationally, rural residents have high consumption of added sugars, yet the top sources have not been explored. Characterizing added-sugar intake in high sugar-sweetened beverage (SSB) consumers in rural areas is an important step to help inform interventions and policies.

Purpose: The objective of this study was to explore the top food and beverage sources of added sugar and to examine variations by sociodemographic characteristics.

Methods: This cross-sectional study analyzed data from a randomized-controlled trial to reduce SSB in eight rural Appalachian counties. Data were obtained from baseline demographic surveys and three 24-hour dietary recalls. Dietary analyses included deriving AS …

The Consequences Of Exercise-Induced Weight Loss On Food Reinforcement. A Randomized Controlled Trial, Kyle D. Flack, Harry M. Hays, Jack Moreland

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: Obesity remains a primary threat to the health of most Americans, with over 66% considered overweight or obese with a body mass index (BMI) of 25 kg/m2 or greater. A common treatment option many believe to be effective, and therefore turn to, is exercise. However, the amount of weight loss from exercise training is often disappointingly less than expected with greater amounts of exercise not always promoting greater weight loss. Increases in energy intake have been prescribed as the primary reason for this lack of weight loss success with exercise. Research has mostly focused on alterations in hormonal mediators …

Incentive Sensitization For Exercise Reinforcement To Increase Exercise Behaviors, Kyle D. Flack, Harry M. Hays, Jack Moreland

Dietetics and Human Nutrition Faculty Publications

Individuals can be sensitized to the reinforcing effects of exercise, although it is unknown if this process increases habitual exercise behavior. Sedentary men and women (body mass index: 25–35 kg/m², N = 52) participated in a 12-week aerobic exercise intervention. Exercise reinforcement was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Habitual physical activity was assessed via accelerometry. Post-intervention increases in exercise reinforcement predicted increases in physical activity bouts among those who expended over 2000 kcal per week in exercise and who compensated for less than …

Food Insecurity Among College Students With And Without Medical Disorders At A University In Appalachia, Laura Mcarthur, Melissa D. Gutschall, Kimberly Fasczewski, Anna Jackson

Journal of Appalachian Health

Objective: This study compared severity of food insecurity, characteristics, and behaviors of college students with and without diagnosed medical disorders.

Design: Data were collected using a cross-sectional online questionnaire. Variables measured were food security status, disorders, coping strategies, and perceived barriers to food access. Descriptive and inferential statistics examined associations and compared groups. Statistical significance was p≤0.05.

Setting: Data were collected at Appalachian State University in North Carolina.

Participants: The sample was 247 food insecure students, of whom 60% were females, 50% 3rd- and 4th-year students, and 75% whites.

Results: Medical disorders were reported by 67.2% of food insecure students, …

A Brief Report On A Facilitated Approach To Connect Cooperative Extension Southern Region State-Level Health Specialists, Samantha M. Harden, Lisa Washburn, Alison Berg, Ninfa Pena-Purcell, Heather Norman-Burgdolf, Nancy Franz

Dietetics and Human Nutrition Faculty Publications

Improving the nation’s health will require collaboration among many stakeholders and systems, including representatives from Cooperative Extension Services (CES). This paper describes the process of establishing a multistate collaboration and discusses initial outcomes of a third-party facilitated participatory planning meeting. State-level specialists with expertise and responsibilities in “health” promotion participated. Satisfaction with meeting format; feasibility, acceptability, and appropriateness of the proposed approach to public health impact; and general meeting feedback were collected through a survey and cultural artifacts (e.g., notes, worksheets). Preparation and attendance costs were captured. Seventeen of the 20 attendees (85%) responded to the survey and reported the …