Chronic low-grade inflammation is a main pathogenic link between obesity and Type 2 Diabetes (T2D) and a putative target for treatment. While a wide array of pharmacologic agents is available to manage T2D, many patients still face perturbed glycemia and subclinical inflammation. Therefore, complementary nutraceutical strategies that target inflammation, metabolism, and resolution physiology hold promise as adjunctive options to quell the disturbed immuno-metabolic milieu observed in T2D. Omega-3 polyunsaturated fatty acids (PUFAs) and anthocyanins are two dietary components evidenced to mitigate inflammation and improve T2D risk factors, through distinct and similar targets. However, the combined use of such nutraceuticals has not yet been examined in individuals with T2D. This dissertation leveraged data from a larger randomized, double-blind, placebo-controlled trial conducted between January 2022—September 2023 investigating the use of combined supplementation (active treatment; [FOM]) of anthocyanins (600 mg/d maqui berry extract) and omega-3 PUFAs (3 g/day fish oil; 2 g/d EPA, 1 g/d DHA) for 8 weeks on cytokines and mental acuity in individuals with T2D, compared to a placebo (CON). The current study examined the effects of this supplemental strategy on markers of metabolic inflammation, oxidative stress, and cardiometabolic risk. The results indicated that a marker of sustained omega-3 dietary intake and tissue accumulation termed the Omega-3 Index was inversely associated with HbA1c (? = -8.5, 95%CI -15.1, -1.4, p = 0.022) and glucose (? = -12.4, 95%CI -22.9, -0.5, p = 0.042), after adjustment for covariates at baseline across all participants with T2D in this study. However, outcomes from linear mixed model analyses demonstrated that there were no significant differences in change from baseline between FOM and CON groups at week 8 in any of the inflammatory, oxidative stress, glycemic control, or circulating lipid markers assessed in this study. These null effects were observed despite a 93% greater increase from baseline in the Omega-3 Index observed in the FOM group compared to the CON group at week 8. Therefore, the findings do not support significant treatment effects associated with 2 months of combined marine omega-3 PUFAs and maqui berry extract on inflammatory and cardiometabolic outcomes in individuals with T2D.

A Venn Diagram model has been proposed to assist athletes with self-monitoring daily changes in fluid intake by combining three of the simplest hydration markers: weight, urine color, and thirst (WUT). No study to date has examined relationships between WUT markers and urine hydration indices using a new, recently validated lavatory urine color (LUC) chart. Furthermore, this is the first study to investigate an adaptation of the WUT model for identifying low vs. high urine concentration, which is useful for athletes to determine whether they are drinking enough water on a daily basis. For five consecutive days, n=19 participants collected a first-morning urine sample before assessing body weight and thirst at home. The urine sample was later scored by each participant at the testing site after 3 mL was extracted to measure urine specific gravity (USG). Participants could score thirst as yes (1) or no (0), and urine color as darker than (1) or similar to/lighter than (0) when comparing their sample to the reference color on the LUC chart. The researchers calculated body weight change (%) from a predetermined baseline to score body weight as >-0.5% change (1) or <-0.5% change (0). Combined outcomes for the three assessments were assigned a score of 0, 1, 2, or 3 and categorized in the Venn Diagram. Scores of 0 or 1 suggest euhydration (USG <1.020) and scores of 2 or 3 suggest underhydration (USG >1.020). Median USG was 1.021 (ranging 1.003-1.035). WUT outcomes for all cases were: 5% (score 3), 33% (score 2), 53% (score 1), and 9% (score 0). WUT score 3 had optimal accuracy (100%) and WUT score 2 had fair accuracy (67%) for identifying a high urine concentration, but only 38% of cases were scored in this way. Based on the assumption that scores 2+3 should have USG >1.020 and scores 0+1 should have USG <1.020, the total accuracy of the WUT model to correctly classify urine concentration was 60%. The results indicated that athletes can use this approach to identify high urine concentration by monitoring simple hydration markers, but misclassifications may occur up to 33%.