Dietetics and Clinical Nutrition Commons^™

Marketing Strategies To Encourage Rural Residents Of High-Obesity Counties To Buy Fruits And Vegetables In Grocery Stores, Emily Liu, Tammy Stephenson, Jessica Houlihan, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.

Methods

A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.

Results …

A Community-Based Marketing Campaign At Farmers Markets To Encourage Fruit And Vegetable Purchases In Rural Counties With High Rates Of Obesity, Kentucky, 2015-2016, Emily M. Dewitt, Margaret Louise Mcgladrey, Emily Liu, Nicole Rachael Peritore, Kelly H. Webber, Brooke F. Butterworth, Ann Vail, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

Availability of farmers markets may increase fruit and vegetable consumption among rural residents of the United States. We conducted a community-based marketing campaign, Plate it Up Kentucky Proud (PIUKP), in 6 rural communities over 2 years to determine the association between exposure to the campaign and fruit and vegetable purchases, adjusted for Supplemental Nutrition Assistance Program recipient status. Logistic regression was used to examine the odds of the PIUKP campaign influencing purchases. Awareness of the PIUKP marketing campaign was significantly associated with a willingness to prepare fruits and vegetables at home. Using marketing strategies at farmers markets may be an …

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.

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 …

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 …

Connecting Self-Efficacy Of Dietary Choices And The Association With Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Rachel Gillespie

Theses and Dissertations--Nutrition and Food Systems

Determining the level of belief one has in themselves, or their self-efficacy, can be a key factor to improve certain dietary patterns and choices in the rural youth population. Sugar sweetened food and beverage consumption continues to rise and fruit and vegetable intake remains a struggle in rural areas; addressing both the food environment and adolescents’ self-efficacy could have a lasting impact on changing the nature of a generation of rural student’s food and beverage choices. This study measured self-efficacy levels of (n=425) adolescents in rural Kentucky and North Carolina using the Youth Impact Questionnaire and dietary intake using the …

The Effects Of A 16-Week Introductory Nutrition Course On Dietary Habits And Body Composition Of College Students, Emily Ashton

Theses and Dissertations--Nutrition and Food Systems

As the rates of obesity continue to increase among adolescents and young adults, adopting healthy dietary and lifestyle habits is necessary in order to prevent obesity-related chronic disease later in life. Although several studies have addressed nutrition education and its effect on weight in college students, few studies have assessed percent fat as it relates to a semester-long nutrition course. As such, the effectiveness of a formal introductory nutrition course on lifestyle habits and percent fat of college students was examined. The current study aimed to address the relationship between percent body fat and nutrition education over the course of …

Evaluation Of A Primary Care Based Diabetes Education Program, Claire Pfister

DNP Projects

The improved management of diabetes is a critical clinical and economic challenge facing our healthcare system. Educating patients with diabetes to self-manage their disease is a vital component of diabetes care. The purpose of this DNP practice improvement project was to evaluate an innovative health care delivery method of individualized diabetes self-management education (DSME) in primary care. The approach combined individual DSME with a registered dietician and routine diabetes care with the primary care provider into one patient appointment. System data was reviewed to compare referral and attendance patterns of group and individual methods. Changes in clinical indicators of A1C, …

Exploring Body Mass Index Changes In Left Ventricular Assist Device Patients, Raquel E. Thomas, Corrine Hanson, Glenda Woscyna, Brian D. Lowes

The VAD Journal

Background: Current treatment options for end-stage heart failure, such as transplantation, can be limited by obesity guidelines. Mechanical devices such as Left Ventricular Assistive Devices (LVAD) can bridge heart failure patients to transplantation, however, after implantation; some patients may experience weight gain that precludes them from transplantation. Therefore, the objective of this study was to evaluate weight changes after the implantation of an LVAD.

Methods: A retrospective review of 130 patients receiving an LVAD were divided into two groups based on BMI at the time of implantation: obese (>30 kg/m²) and non-obese (/m²). Patients were …

Color Your Plate: A Pilot Nutrition Education Intervention To Increase Fruit And Vegetable Intake Among Older Adults Participating In The Congregate Meal Site Program In Kentucky Senior Centers, Emily Dickens

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study was to determine if the amount and variety of fruit and vegetable intake increased among community-dwelling older adults participating in Kentucky’s congregate meal site program following a series of educational nutrition lessons. A convenience sample (n=35) of community-dwelling older adults at two intervention (n=19) and two control (n=16) senior centers in central Kentucky participated in this quasi-experimental pre-post pilot study. Following the intervention there was a trend towards increased self-reported intake in the variety of fruit and vegetables among the intervention group (range:0.03±3.31 to 1.32±2.75 servings per week); a significant increase in the number of …

Perceived Stress, Caffeine Consumption, And Gpa Of Undergraduate Students At A Large Public University, Emma Simpson

Theses and Dissertations--Nutrition and Food Systems

Evidence suggests that college students may increase caffeine consumption to cope with the stress and demands of college. The relationships between perceived stress, caffeine consumption, and GPA were examined in students at a large public university. Students were surveyed to determine perceived stress (Cohen’s Perceived Stress Questionnaire), beliefs about caffeine, caffeine consumption, workload in and outside of the classroom, and GPA. Surveys were administered at the beginning of the semester and again at midterm. Based on Cohen’s 40-point scale, average stress scores increased from 15.95 ± 6.34 at the beginning of the semester to 18.89 ± 6.94 at midterms. Additionally, …

Breastfeeding Practices Among Native Hawaiians And Pacific Islanders, Ingrid K. Adams, Chizimuzo T.C. Okoli, Akilah Dulin Keita, Ana Maria Linares, Keiko Tanaka, Joshua R. Polanin, Annie Koempel

Dietetics and Human Nutrition Faculty Publications

Background. Breastfeeding is associated with a decreased risk of obesity in the early and adult years. Native Hawaiians and Pacific Islanders (NHPI) experience high rates of obesity which is often obfuscated with aggregated data. Using disaggregated data, we examined breastfeeding practices among NHPI. Methods. Seven databases and reference lists were searched. Two independent researchers extracted relevant studies based on predetermined criteria. Nine studies met our inclusion criteria and a meta-analysis was conducted using random-effects, inverse-various weighted models. Results. Few studies disaggregated NHPI populations when examining breastfeeding practices. Most studies were cross-sectional and our search yielded no randomized or quasirandomized control …

The Effect Of Curcumin On Cardiovascular Health In Obese Men, Marilyn S. Campbell

Theses and Dissertations--Kinesiology and Health Promotion

Cardiovascular disease is the leading cause of death in the United States, and conventional treatment often emphasizes pharmaceutical approaches. Research has recently started exploring non-pharmaceutical approaches, including nutritional interventions. This research study was conducted to test the effectiveness of a novel nutritional approach, curcumin, on the improvement of cardiovascular health in young, obese males (BMI≥30 kg/m²). This study included 22 men, matched based on BMI and randomly assigned to the intervention (n=11) or placebo group (n=11). The intervention consisted of 12 weeks of curcumin supplementation (1.0 g/day) with fenugreek added to enhance the curcumin bioavailability; the placebo consisted …

Evaluation Of Diet Composition Of Pediatric Cancer Survivors As A Need For Nutrition Counseling, Sean O'Nan

Theses and Dissertations--Nutrition and Food Systems

Prior research has shown that pediatric cancer survivors face a multitude of longterm effects from treatment of their disease. Many of these conditions can be treated or managed through proper nutrition, however patients of the DanceBlue Kentucky Children's Hospital Hematology/Oncology Clinic do not see a registered dietitian. This study looked at food and drink consumption of the past 30 days by the patient using the NHANES Dietary Screener Questionnaire to see if they met nutrition recommendations as outlined by the 2015‐2020 Dietary Guidelines for Americans. Results from the study found that off‐treatment pediatric cancer survivors (n=21) failed to meet …

Evaluation Of A Diabetes Self-Management Program For Hispanics In Lexington Kentucky: A Pilot Study, Miguel A. Gamboa Oropeza

Theses and Dissertations--Nutrition and Food Systems

Hispanics are more affected by diabetes than non-Hispanic whites and they tend to experience more severe complications. Research shows that although self-management is poor among ethnic minorities, it is even more so among Hispanics. The “Taking Ownership of Your Diabetes” (TOYD) program has been shown to be successful in helping individuals manage their diabetes. However, no work has been conducted with Hispanic audiences in Kentucky. TOYD program allows individuals to modify lifestyle risks and solve problems related to diabetes management. The program was translated from English to Spanish. Hispanics males and females between ages 19 to 75 years …

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m²) seen by one surgical service over a two and …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

The Dietary Habits And Nutrition Education Levels Of Parents Of Pre-School Children At A Community Head Start Program, Lisa Renee Keys

Kaleidoscope

The health of America’s youth is jeopardized as obesity, often beginning in childhood, becomes a major epidemic. Parents have exceptional influence on their children, especially nutritionally, which impacts how their children grow and develop. Parents with minimal nutrition education and who do not practice healthy eating habits may unintentionally influence their children in practices that could lead to nutrition-related disease and/or obesity. This research evaluated the dietary habits and nutrition knowledge of parents of preschoolers at a community Head Start program in Lexington, KY, which served a high percentage of Hispanic children. The parents were given a survey evaluating their …

Linking The Home And Neighborhood Food Environments Regarding Dietary Intake Among Rural Adolescents, Matthew James Saulnier

Theses and Dissertations--Nutrition and Food Systems

Home availability of both healthful and unhealthful foods may influence consumption among rural adolescent populations. In conjunction, the availability of food in an individual’s local food environment has the potential to significantly impact what is procured for the home and eaten away from the home. The purpose of this study was to determine how in-store food availability and parental purchases influences home availability and, ultimately, dietary intake among adolescents. This study measured perceived home availability, using the University of Minnesota Project EAT Survey, and dietary intake, using the NHANES Dietary Screener Questionnaire, of (n=28) adolescent participants in two Kentucky counties …

Nutritional Assessment Of Preschool Children In An Urban Ecuadorian Community, Elizabeth A. Bronner

Theses and Dissertations--Nutrition and Food Systems

Objectives: The goal of this project was to determine the nutritional needs of preschool age children to help guide intervention development. The research aims were 1) to examine and describe young child (ages one to five) nutritional status as it relates to key nutrients associated with stunting and wasting; 2) to determine what key macro- and micro-nutrient deficiencies (primarily iron and zinc) are associated with wasting and stunting.

Methodology:

Study sample: Sixty-seven families with children ages one to five who participating in routine health care clinic visits during the UK Shoulder to Shoulder Global health brigade visits.

Study …

Millennial Consumer Preference: Waffle Fries Vs. Potato Wedges, Emily Rogers

Lewis Honors College Capstone Collection

For this experiment, two groups of paid volunteers, aged 18-34, provided written quantitative and qualitative data on preferences between waffle fries (test) and potato wedges (control). Each participant provided demographic information and then answered a series of questions, using a hedonic rating scale or by composing a written response. Participants also provided qualitative data about what influenced their preference between the test and control. The experiment confirmed the hypothesis was correct: Millennials prefer waffle fries over potato wedges. It also confirms that Millennials prefer a unique, crunchy, crispy, and decreased potato filled product. Millennial consumers reported significant preference of the …

Fruit And Vegetable Consumption Of Division I Collegiate Football And Volleyball Players Pre- And Post-Deregulation Of Snacks By The Ncaa, Emily Ludwig

Theses and Dissertations--Nutrition and Food Systems

The deregulation of snacks by the National Collegiate Athletic Association (NCAA) permits institutions to provide enhanced snacks incidental to participation. Athletes may now have the opportunity to improve their diet quality. The purpose of this research was to assess the consumption of fruits and vegetables as well as body composition of Division I collegiate athletes. The sample included 19 American football players and 8 volleyball players. Paired t-tests were performed to compare fruit intake, vegetable intake, and body fat percentage pre- and post-deregulation of snacks. Linear regression models were used to determine correlations between change in fruit intake and change …

Servsafe® Exam: Student's Memory Retention Two Years Later, Laura E. Tincher

Theses and Dissertations--Nutrition and Food Systems

This study analyzed the memory retention of University of Kentucky Dietetic and Hospitality students as it relates to food safety and sanitation knowledge originally presented on the ServSafe® certification exam. Dietetic and hospitality students take the ServSafe® certification course during the sophomore year of their degree program, but they are responsible for the sanitation and food safety information throughout their entire program of undergraduate study. The final sample consisted of 25 participants, with 84% (n=21) in the Dietetics program and 16% (n=4) in the Hospitality, Management and Tourism program. The mean difference in total score, domain one, domain two, domain …

Food Security Factors Affect Growth In Young Children In An Ecuadorian Indigenous Community, Whitney Jeannine Asher

Theses and Dissertations--Nutrition and Food Systems

Inadequate nutrition in preschool-aged children in an urban indigenous community outside of Santo Domingo, Ecuador has a negative impact on growth and development. Nutritional assessments have shown that children are underweight and that there are some effects of stunting and wasting in the population. This study was conducted to assess the extent of food security in this indigenous community in preparation for addressing two of the Millennium Development Goals for 2015: reducing the under-five child mortality rate by two-thirds and eradicating extreme poverty and hunger. An aim was to validate on-site assessment measures in this indigenous community regarding geographic circumstances, …

Impact Of The Healthy Hunger-Free Kids Act On Changes In The Phytochemical Content Of School Lunch Menus And Implications Of Science-Based Nutrition Education On Promoting Student Identification Of Foods High In Phytochemicals, Siddhi Lalit Shroff

Theses and Dissertations--Nutrition and Food Systems

Concern that youth do not have enough fruit and vegetable intake lead to two strategies implemented to influence intake in the school environment: the Healthy Hunger-Free Kids Act (HHFKA) and Fighting with Food: Battling Chemical Toxicity with Good Nutrition program (FF), which could influence phytochemical content and knowledge regarding phytochemicals, respectively. Individual food logs (n=468) were assessed upon completion of FF curriculum to determine whether students were able to correctly apply their nutrition knowledge regarding FF. Menus from one district were analyzed pre-HHFKA and post-HHFKA in elementary (n=156), middle (n=171), and high schools (n=171), for change in the frequency of …

Feasibility And Acceptability Of An Early Childhood Obesity Prevention Intervention: Results From The Healthy Homes, Healthy Families Pilot Study, Akilah Dulin Keita, Patricia M. Risica, Kelli L. Drenner, Ingrid Adams, Gemma Gorham, Kim M. Gans

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children's health behaviors.

METHODS: We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years) to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up.

RESULTS: 39 (78%) parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, P = 0.001) and …

Farmers' Market Use Is Associated With Fruit And Vegetable Consumption In Diverse Southern Rural Communities, Stephanie B. Jilcott Pitts, Alison A. Gustafson, Qiang Wu, Mariel Leah Mayo, Rachel K. Ward, Jared T. Mcguirt, Ann P. Rafferty, Mandee F. Lancaster, Kelly R. Evenson, Thomas C. Keyserling, Alice S. Ammerman

Dietetics and Human Nutrition Faculty Publications

Background

While farmers’ markets are a potential strategy to increase access to fruits and vegetables in rural areas, more information is needed regarding use of farmers’ markets among rural residents. Thus, this study’s purpose was to examine (1) socio-demographic characteristics of participants; (2) barriers and facilitators to farmers’ market shopping in southern rural communities; and (3) associations between farmers’ market use with fruit and vegetable consumption and body mass index (BMI).

Methods

Cross-sectional surveys were conducted with a purposive sample of farmers’ market customers and a representative sample of primary household food shoppers in eastern North Carolina (NC) and the …