Dietetics and Clinical Nutrition Commons^™

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.

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 …

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 …

Contributions Of Early Care And Education Programs To Diet Quality In Children Aged 3 To 4 Years In Central North Carolina, Courtney T. Luecking, Stephanie Mazzucca, Amber E. Vaughn, Dianne S. Ward

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: Parents and early care and education (ECE) are the key influencers of young children's diets, but there is limited information about how each contribute to children's overall diet quality.

OBJECTIVE: This study aimed to determine what proportion of children's dietary intake occurs within the ECE setting and whether diet quality is higher at ECE centers and, consequently, on weekdays than weekends.

DESIGN: This cross-sectional analysis of a larger cluster randomized controlled trial used multiple 24-hour dietary intakes measured through a combination of the Dietary Observation in Child Care protocol and parent-reported food diaries.

PARTICIPANTS/SETTING: Participants (N=840) included children aged …

Communication Of Professional Readiness In Dietetics And Human Nutrition Undergraduates: A Pilot Study, Heather Norman-Burgdolf, Emily M. Dewitt, Nathan L. Vanderford, Julie Plasencia

Dietetics and Human Nutrition Faculty Publications

Learning experiences within the dietetics and human nutrition undergraduate curricula develop knowledge and skills pertinent to student career goals. Core competency requirements are extensively assessed in these programs, yet the communication of transferable skills gained and student professional readiness are rarely examined. The purpose of this study was to evaluate undergraduate students' perceived professional readiness following six professional development workshops on transferable skills and career preparedness communicated through resumes and personal statements. In this pilot study, twelve upper-level dietetics and human nutrition students self-assessed their resumes and personal statements with rubrics and completed surveys before and after the intervention. Following …

Genetic Variations In The Dopamine Reward System Influence Exercise Reinforcement And Tolerance For Exercise Intensity, Kyle D. Flack, Christopher Pankey, Kelsey Elise Ufholz, Luann Johnson, James N. Roemmich

Dietetics and Human Nutrition Faculty Publications

Background: Exercise is a reinforcing behavior and finding exercise highly reinforcing is characteristic of habitual exercisers. Genotypes related to dopamine metabolism moderate the reinforcing value of behaviors, but genetic moderators of exercise reinforcement have not been established.

Purpose: Determine whether singular nucleotide polymorphisms (SNPs) that moderate central reward pathways and pain neurotransmission are associated with exercise reinforcement, tolerance for exercise intensity, and usual physical activity.

Methods: Adults (n = 178) were measured for the reinforcing value of exercise relative to sedentary activities (RRV_exercise), minutes of moderate-to-vigorous physical activity (MVPA) and completed the Preference for and Tolerance …

Increasing The Reinforcing Value Of Exercise In Overweight Adults, Kyle D. Flack, Kelsey Elise Ufholz, Luann Johnson, James N. Roemmich

Dietetics and Human Nutrition Faculty Publications

Objectives: This study determined whether a moderate- or high-dose exercise program increases exercise reinforcement. Increasing the relative reinforcing value of exercise (RRV_exercise; i.e., incentive sensitization of exercise) may increase the usual physical activity (PA) participation. Preference and/or tolerance for the intensity of exercise was also assessed.

Design: Sedentary men and women (body mass index, BMI: 25–35 kg/m²) were randomized into parallel exercise training groups expending either 300 (n = 18) or 600 (n = 18) kcal/exercise session, five sessions/week, for 12 weeks.

Methods: The RRV_exercise was determined by how much …

Inducing Incentive Sensitization Of Exercise Reinforcement Among Adults Who Do Not Regularly Exercise—A Randomized Controlled Trial, Kyle D. Flack, Kelsey Elise Ufholz, Luann Johnson, James N. Roemmich

Dietetics and Human Nutrition Faculty Publications

Background

Increasing exercise reinforcement, or decreasing sedentary reinforcement, may reduce sedentary activity and promote habitual exercise. Repeated exposures to a reinforcer may increase its reinforcing value (i.e., incentive sensitization). It is not yet known whether incentive sensitization occurs for exercise or factors associated with incentive sensitization for exercise reinforcement. The purpose was to determine whether exercise exposures increase exercise reinforcement relative to a sedentary alternative and whether this sensitization of exercise reinforcement would alter physical or sedentary behavior. This work also determined whether exercise dose, intensity, and preference and tolerance for exercise intensity were associated with incentive sensitization of exercise. …

Nutrition And Environmental Pollution Extension Curriculum Improved Diet-Related Behaviors And Environmental Health Literacy, Dawn Brewer, Hannah Bellamy, Anna Hoover, Annie Koempel, Lisa Gaetke

Dietetics and Human Nutrition Faculty Publications

Kentucky experiences some of the nation’s worst health outcomes related to obesity, diabetes, high blood pressure, and other age-related chronic diseases linked with oxidative stress and inflammation, which in turn are associated with poor diet, lack of physical activity, and exposure to certain environmental pollutants. In the Commonwealth, deteriorating infrastructure, inappropriate waste disposal, and potential occupational injury related to mining, agriculture, and other regionally important industries exacerbate the need for residents to have basic knowledge of potential environmental health threats. Unfortunately, community-level understanding of the complex connections between environmental exposures and health is limited, with many Kentuckians unaware that the …

A Mentor-Led Text-Messaging Intervention Increases Intake Of Fruits And Vegetables And Goal Setting For Healthier Dietary Consumption Among Rural Adolescents In Kentucky And North Carolina, 2017, Alison A. Gustafson, Stephanie B. Jilcott Pitts, Kristen Mcquerry, Oyinlola Babtunde, Janet Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction—Text-messaging interventions hold promise for successful weight loss interventions. However, there is limited research on text-messaging interventions to improve dietary intake among rural adolescents, who are at greater risk for obesity and related risk factors. The goal of this study was to test an eight-week, mentor-led text-messaging intervention among 14–16-year-old rural adolescents: the “Go Big and Bring It Home” Project to improve fruit and vegetable and healthy beverage intake. Methods and Materials—Eight rural high schools in eastern Kentucky and eastern North Carolina participated (n = 4 were randomized as intervention schools and n = 4 were randomized as control …

Association Between Spatial Access To Food Outlets, Frequency Of Grocery Shopping, And Objectively-Assessed And Self-Reported Fruit And Vegetable Consumption, Jared T. Mcguirt, Stephanie B. Jilcott Pitts, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Because supermarkets are a critical part of the community food environment, the purpose of this paper is to examine the association between accessibility to the supermarket where participants were surveyed, frequency of shopping at the supermarket, and self-reported and objectively-assessed fruit and vegetable consumption. Accessibility was assessed using Geographic Information Systems (GIS) measured distance and multiple versions of the modified Retail Food Environment Index (mRFEI), including a localized road network buffer version. Frequency of shopping was assessed using self-report. The National Cancer Institute Fruit and Vegetable screener was used to calculate daily servings of fruits and vegetables. Skin carotenoids were …

Direct Effects Of The Home, School, And Consumer Food Environments On The Association Between Food Purchasing Patterns And Dietary Intake Among Rural Adolescents In Kentucky And North Carolina, 2017, Alison Gustafson, Stephanie Jilcott Pitts, Jordan Mcdonald, Hannah Ford, Paige Connelly, Rachel Gillespie, Emily Liu, Heather M. Bush, Candace Brancato, Toyin Babatande, Janet Mullins

Dietetics and Human Nutrition Faculty Publications

Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United …

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 …

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 …

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 …

Food Venue Choice, Consumer Food Environment, But Not Food Venue Availability Within Daily Travel Patterns Are Associated With Dietary Intake Among Adults, Lexington Kentucky 2011, Alison A. Gustafson, Jay W. Christian, Sarah Lewis, Kate Moore, Stephanie Jilcott

Dietetics and Human Nutrition Faculty Publications

OBJECTIVE: The retail food environment may be one important determinant of dietary intake. However, limited research focuses on individuals' food shopping behavior and activity within the retail food environment. This study's aims were to determine the association between six various dietary indicators and 1) food venue availability; 2) food venue choice and frequency; and 3) availability of healthy food within food venue.

METHODS: In Fall, 2011, a cross-sectional survey was conducted among adults (n=121) age 18 years and over in Lexington, Kentucky. Participants wore a global position system (GPS) data logger for 3-days (2 weekdays and 1 weekend day) to …

Validation Of Food Store Environment Secondary Data Source And The Role Of Neighborhood Deprivation In Appalachia, Kentucky, Alison A. Gustafson, Sarah Lewis, Corey Wilson, Stephanie Jilcott-Pitts

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: Based on the need for better measurement of the retail food environment in rural settings and to examine how deprivation may be unique in rural settings, the aims of this study were: 1) to validate one commercially available data source with direct field observations of food retailers; and 2) to examine the association between modified neighborhood deprivation and the modified retail food environment score (mRFEI).

METHODS: Secondary data were obtained from a commercial database, InfoUSA in 2011, on all retail food outlets for each census tract. In 2011, direct observation identifying all listed food retailers was conducted in 14 …

Food Store Environment Modifies Intervention Effect On Fruit And Vegetable Intake Among Low-Income Women In North Carolina, Alison A. Gustafson, Joseph Sharkey, Carmen D. Samuel-Hodge, Jessica C. Jones-Smith, Jianwen Cai, Alice S. Ammerman

Dietetics and Human Nutrition Faculty Publications

Background. The aim of the study is to determine how the food store environment modifies the effects of an intervention on diet among low-income women. Study Design. A 16-week face-to-face behavioral weight loss intervention was delivered among low income midlife women. Methods. The retail food environment for all women was characterized by (1) the number and type of food stores within census tracts; (2) availability of healthy foods in stores where participants shop; (3) an aggregate score of self-reported availability of healthy foods in neighborhood and food stores. Statistical Analyses. Multivariable linear regression was used to …

The Effect Of A Motivational Intervention On Weight Loss Is Moderated By Level Of Baseline Controlled Motivation, Kelly H. Webber, Jeanne M. Gabriele, Deborah F. Tate, Mark B. Dignan

Dietetics and Human Nutrition Faculty Publications

BACKGROUND: Clinic-based behavioral weight loss programs are effective in producing significant weight loss. A one-size-fits-all approach is often taken with these programs. It may be beneficial to tailor programs based on participants' baseline characteristics. Type and level of motivation may be an important factor to consider. Previous research has found that, in general, higher levels of controlled motivation are detrimental to behavior change while higher levels of autonomous motivation improve the likelihood of behavior modification.

METHODS: This study assessed the outcomes of two internet behavioral weight loss interventions and assessed the effect of baseline motivation levels on program success. Eighty …