Background: Vegan and vegetarian diets have gained in popularity in recent years. Stated reasons for this include some possible health benefits and concerns of animal welfare. Though considered to be nutritionally adequate, questions remain over whether current protein recommendations of 0.8 g/kg/d are sufficient to maintain body processes and growth. Protein is unique in that it is the only macronutrient that contains nitrogen. Its status can be determined through nitrogen balance analysis of the urine if protein content of the diet is known. Nitrogen balance is considered the gold standard for determining protein intake requirements. A negative balance indicates a catabolic state, whereas a positive nitrogen balance is seen during anabolism. In healthy people, nitrogen equilibrium is desired under normal circumstances. This equilibrium reflects the net synthesis and breakdown of proteins. While nitrogen balance techniques have been used for decades, currently, there are no known studies measuring nitrogen balance and protein intake in strict vegans. Methods: Twenty vegan, inactive, male participants were recruited and received a 5-day eucaloric diet with a known protein content held constant at 0.8 g/kg/d. On day five, 24-hour urine was collected by participants and aliquoted for future analysis. Nitrogen content of the urine was determined through photometric assay and compared to the known nitrogen content of the diet to calculate nitrogen balance status. Results: Mean absolute nitrogen balance (-1.38 ± 1.22 g/d, effect size = -1.13) was significantly lower than zero (equilibrium) (p < .001). Mean relative nitrogen balance (-18.60 ± 16.96 mg/kg/d, effect size = -1.10) was significantly lower than zero (p < .001). There were no correlations seen between nitrogen balance and age, years as vegan, or fat- free mass. Conclusion: Consuming 0.8 g/kg/d of protein is insufficient to produce nitrogen balance in long-term vegans.

Background: Sugars form advanced glycation end products (AGEs) throughnatural metabolism and interactions with proteins, lipids, and nucleic acids, which accumulate in tissues and have been implicated in the etiology of chronic diseases. Due to the increased consumption of fructose and its high ability to form AGEs, a further understanding of this association is important to clarify the role of sugars in disease. The objective was to explore the association between usual fructose intake and serum levels of AGEs, as measured by carboxymethyl-lysine (CML) and methylglyoxal derivative (MG-H1), in healthy adults. Methods: This is a secondary analysis of a 15-d controlled feeding study (n=100) with participants consuming their usual diet conducted in the Phoenix metropolitan area. To assess participants’ usual diet, they were asked to complete two 7-d food diaries, which were then used to create custom 15-d menu plans administered during the feeding period. Forty participants were selected based on their 15-d mean total fructose intake for this analysis [top and bottom 20% of the sample distribution (median, IQR); high fructose (HF) n= 20, 72.6 (66.1-90.4) g/day, low fructose (LF) n= 20, 28.8 (22.7-32.2) g/day. Fasting serum collected five weeks after the feeding period were analyzed for CML and MG-H1, two well-established AGEs, using ELISA kits. A database of 549 common foods with known CML amounts was used to calculate exogenous CML intake based on daily food intake data. A general linear model was fitted to investigate the difference in serum CML and MG-H1 between LF and HF groups while adjusting for age, gender, BMI, and exogenous CML intake. Results: Participants in the HF group had significantly higher serum CML and lower MG-H1 levels compared to participants in the LF group (p=0.013 and p=0.002, respectively). This difference remained statistically significant after adjusting for covariates. Conclusions: The findings suggest that endogenous CML formation may be an explanation for the significantly higher serum CML levels in the HF compared to the LF group. This is significant in further understanding mechanisms of fructose intake and disease etiology and could have implications for at-risk populations consuming a high fructose diet.

Background: Down syndrome is the leading genetic cause of intellectual disabilities. Executive function is an area that people with Down syndrome have a diminished capacity compared to those in the general population. In recent years it has been determined that acute and chronic exercise has a small but positive effect on measures of executive function in typically developed individuals. The effect has been recorded separately in both aerobic, high-rate passive and resistance exercises in adolescents with DS but has not been compared between exercise types in adults with DS. Methods: A randomized crossover study was utilized to determine the effect of resistance exercise, assisted cycling therapy, and no exercise on executive function and enjoyment in adults with Down syndrome. Resistance Training (RT)- participants completed a total of 16- repetitions of approximately 75% of a 1-RM in the leg press, chest press, seated row, and latissimus pulldown. ACT- participants completed 30-minutes of cycling at 35% above voluntary (e.g., self-selected pace) rate. No-Training (NT)- participants spent 35-minutes playing board games. Cognitive assessments were recorded pre- and post- intervention. The Physical Activity Enjoyment Survey was collected post-intervention. Statistics: The cognitive measures and Physical Activity Self-efficacy scale were analyzed using the delta scores (pre-post) in a Linear mixed models analyais. The main effect of sequence (A, B, C) and intervention (RT, ACT, NT), and visit were assessed. Significance level was set with α=0.05. If any differences were detected, the Bonferroni post-hoc test was used to determine differences. Physical Activity Enjoyment Scale post scores were compared using a General Linear Model. Alpha was set at 0.05 with a Bonferroni post-hoc test to determine differences. A secondary analysis was conducted investigating the effect of participants that completed testing individually compared to those that completed the testing in a group setting. Results: There were no significant difference in the delta score of any of the measures. The secondary analysis also found no significant difference but showed a trend that those tested individually had opposite results than those tested in a group.

Cardiovascular disease has long been one of the leading causes of morbidity in the world and places a large burden on the health care system. Exercise has been shown to reduce the risk of developing cardiovascular disease and the risk factors associated with it. Much of the focus of research has been on aerobic exercise modalities and their effect on these risk factors, and less is known in regard to the effect of resistance training. One novel risk factor for cardiovascular disease is arterial stiffness, specifically aortic stiffness. Aortic stiffness can be measured by carotid-femoral pulse wave velocity (PWV) and central pressure characteristics such as central blood pressures and augmentation index. The objective of this study was to assess the effect that two different 12-week long resistance training interventions would have on these measurements in sedentary, overweight and obese men and women (BMI ≥ 25 kg/m2). Twenty-one subjects completed the study and were randomized into one of the following groups: control, a low repetition/high load (LRHL) group which performed 3 sets of 5 repetitions for all exercises, and a high repetition/low load (HRLL) group which performed 3 sets of 15 repetitions for all exercises. Those in the resistance training groups performed full-body exercise routines on 3 nonconsecutive days of the week. Changes in arterial stiffness, central blood pressures, and brachial blood pressures were measured before and after the 12-week intervention period. PWV showed significant group by time interaction (p= 0.024) but upon post hoc testing no significant differences were observed due to the control group confounding (control: 7.6 ± 0.8 vs. 7.1 ± 0.8, LRHL: 6.7 ± 0.5 vs. 6.9 ± 0.5, HRLL: 7.03 ± 0.67 vs. 6.59). No other significant interactions or differences were observed for any of the variables tested. Based on the results of this study a 12-week long resistance intervention training, neither high nor moderate-intensity resistance training, resulted in improvements in indices of vascular stiffness or central and peripheral blood pressures.

Background: Effective glucose management using exercise modalities in older patients with type 2 diabetes and activities of daily living (ADL) disabilities are unknown.

Purpose: The study investigated the acute effects of motor-assisted cycling and functional electrical stimulation (FES) cycling on the 2-h postprandial glucose responses compared with sitting control in older adults with type 2 diabetes and ADL disabilities.

Methods: The study used a 3×3 crossover study design. Nine participants were randomly assigned to one of the three treatment sequences: ABC, BCA, and CAB. (A, motor-assisted cycling; B, FES cycling; C, sitting control). Linear mixed models (LMM) with Bonferroni post-hoc tests were used to test the mean differences for the 2-h postprandial glucose, estimated by the area under the curve (AUC) and incremental AUC (iAUC), between intervention and control treatments after adjustment for covariates (e.g., age, sex, and race).

Results: There were significant mean differences for iAUC (p = 0.005) and AUC (p = 0.038) across motor-assisted cycling, control, and FES cycling treatments. The FES cycling had a lower mean of 2-hour postprandial iAUC as compared with sitting control (iAUC 3.98 mmol∙h/L vs 6.92 mmol∙h/L, p = 0.006, effect size [ES] = 1.72) and the motor-assisted cycling (iAUC, 3.98 mmol∙h/L vs 6.19 mmol∙h/L , p = 0.0368, ES = 1.29), respectively. The FES cycling also had a lower mean of the 2-hour postprandial AUC as compared with sitting control (AUC, 18.29 mmol∙h/L vs 20.95 mmol∙h/L, p = 0.043, ES = 0.89), but had an AUC similar to the motor-assisted cycling (18.29 mmol∙h/L vs 20.23 mmol∙h/L , p = 0.183, ES = 0.19). There were no statistical differences in iAUC (6.19 mmol∙h/L vs 6.92 mmol∙h/L) and AUC (20.23 mmol∙h/L vs 20.95 mmol∙h/L) between the motor-assisted cycling and sitting control (all p>0.05).

Conclusion: Performing 30 minutes of FES cycling on a motor-assisted bike (40 Hz, 39 rpm, 25-29 mA) significantly decreased the 2-h postprandial glucose levels in older adults with type 2 diabetes and ADL disabilities. These findings suggested that FES cycling can be a promising exercise modality for glucose management in diabetic patients with ADL disabilities.

College students experience a considerable amount of stress. Unmanaged stress is associated with poor academic performance, health risk behaviors (i.e., inadequate sleep and physical activity, alcohol consumption, poor dietary behaviors), and poor mental health. Coping with stress has become a priority among universities. The most tested stress-related programs to date have been mindfulness-based and face-to-face. These programs demonstrated significant improvements in stress, mindfulness, and self-compassion among college students. However, they may be burdensome to students as studies report low attendance and low compliance due to class conflicts or not enough time. Few interventions have used more advanced technologies (i.e., mobile apps) as a mode of delivery. The purpose of this study is to report adherence to a consumer-based mindfulness meditation mobile application (i.e., Calm) and test its effects on stress, mindfulness, and self-compassion in college students. We will also explore what the relationship is between mindfulness and health behaviors.

College students were recruited using fliers on college campus and social media. Eligible participants were randomized to one of two groups: (1) Intervention - meditate using Calm, 10 min/day for eight weeks and (2) Control – no participation in mindfulness practices (received the Calm application after 12-weeks). Stress, mindfulness, and self-compassion and health behaviors (i.e., sleep disturbance, alcohol consumption, physical activity, fruit and vegetable consumption) were measured using self-report. Outcomes were measured at baseline and week eight.

Of the 109 students that enrolled in the study, 41 intervention and 47 control participants were included in analysis. Weekly meditation participation averaged 38 minutes with 54% of participants completing at least half (i.e., 30 minutes) of meditations. Significant changes between groups were found in stress, mindfulness, and self-compassion (all P<0.001) in favor of the intervention group. A significant negative association (p<.001) was found between total mindfulness and sleep disturbance.

An eight-week consumer-based mindfulness meditation mobile application (i.e., Calm) was effective in reducing stress, improving mindfulness and self-compassion among undergraduate college students. Mobile applications may be a feasible, effective, and less burdensome way to reduce stress in college students.

Background. Effects of lifestyle interventions on early biomarkers of oxidative stress and CVD risk in youth with prediabetes are unknown. Objective. To evaluate the effects of a lifestyle intervention to prevent type 2 diabetes among obese prediabetic Latino adolescents on oxidized lipoproteins. Design: In a quasi-experimental design, 35 adolescents (51.4% male, age 15.5(1.0) y, body mass index (BMI) percentile 98.5(1.2), and glucose 2 hours after an oral glucose tolerance test-OGTT 141.2(12.2) mg/dL) participated in a 12-week intervention that included weekly exercise (three 60 min-sessions) and nutrition education (one 60 min-session). Outcomes measured at baseline and post-intervention were: fasting oxidized LDL and oxidized HDL (oxLDL and oxHDL) as oxidative stress variables; dietary intake of fresh fruit and vegetable (F&V) and fitness (VO2max) as behavioral variables; weight, BMI, body fat, and waist circumference as anthropometric variables; fasting glucose and insulin, 2hour glucose and insulin after an OGTT, insulin resistance (HOMA-IR), and lipid panel (triglycerides, total cholesterol, VLDL-c, LDL-c, HDL-c, and Non-HDL) as cardiometabolic variables. Results. Comparing baseline to post-intervention, significant decreases in oxLDL concentration were shown (51.0(14.0) and 48.7(12.8) U/L, p=0.022); however, the intervention did not decrease oxHDL (395.2(94.6) and 416.1(98.4) ng/mL, p=0.944). F&V dietary intake (116.4(97.0) and 165.8(91.0) g/d, p=0.025) and VO2max (29.7(5.0) and 31.6(4.7) ml*kg-1*min-1, p<0.001) significantly increased. Within-subjects correlations between changes in F&V intake and oxidized lipoproteins, adjusted for VO2max changes, were non-significant (R=-0.15, p=0.52 for oxLDL; R=0.22, p=0.25 for oxHDL). Anthropometric variables were significantly reduced (weight -1.3% p=0.042; BMI -2.2% and BMI percentile -0.4%, p=0.001; body fat -6.6% and waist circumference -1.8%, p=0.025). Cardiometabolic variables significantly improved, including reductions in glucose 2hour (-19.3% p<0.001), fasting insulin (-12.9% p=0.008), insulin 2hour (-53.5% p<0.001), and HOMA-IR (-12.5% p=0.015), with 23 participants (66%) that reverted toward a normal glucose tolerance status. Most lipid panel significantly changed (triglycerides -10.2% p=0.032; total cholesterol -5.4% p=0.002; VLDL-c -10.4% p=0.029; HDL-c -3.2% p=0.022; and Non-HDL -5.5% p=0.0007). Conclusion. The intervention resulted in differential effects on oxidized lipoproteins and significant improvements in behavioral, anthropometric and cardiometabolic variables, reducing the high metabolic risk of obese prediabetic kids.

Background: Cardiovascular disease (CVD) is the leading cause of mortality in the United States and remains a great public health challenge. Unhealthy lifestyle behaviors (e.g., unhealthy diet, sedentary behavior, cigarette smoking, and obesity) are associated with a greater risk of incident CVD and all-cause mortality. From the prevention strategy, maintaining a healthy lifestyle throughout a lifetime is a key to CVD prevention. Nonetheless, the prevalence of healthy lifestyle behaviors in US communities is low as 3 to 5%. Moreover, the prevalence of a healthy population among college students remains unknown. Objective: We investigated the prevalence of healthy lifestyle behaviors among college students. Methods: We recruited 747 undergraduate students from Arizona State University using a survey questionnaire. The survey questionnaire investigated demographic characteristics, body mass index, dietary habits, physical activity habits, and smoking habits. The chi-square test was used to investigate the frequency of ideal lifestyle behaviors in college students. Results: Prevalence of students who met all 4 ideal health behaviors (ideal cardiovascular health) is very low at 7.6%. Approximately 55.7% of students had only 2 or less ideal lifestyle behaviors (poor cardiovascular health). In addition, there were no statistical differences in combined ideal lifestyle behaviors across gender and different years of undergraduate studies. Conclusion: College students had a very low prevalence of healthy lifestyle behaviors. Increasing healthy low-risk students throughout college education is an important strategy to prevent chronic disease morbidity and mortality at individual and population level.

ABSTRACT
Background: Although aerobic exercise has been shown to improve the glycemic control of individuals with type 2 diabetes, a simple and effective approach to manage post-meal glycemic control remains less clear.
Purpose: This study examined the effect of 15-minute of post-meal aerobic exercise on the glycemic control and anxiety scores as compared with control trials in participants with and without type 2 diabetes.
Methods: Six adults volunteered to participate in the study (3 adults with type 2 diabetes, age = 44.33 ± 7.71; and 3 adults without type 2 diabetes, age = 31.67 ± 15.76). All participants received aerobic exercise intervention and control treatments. The aerobic exercise treatment was listening to upbeat music and dancing for 15-minutes, whereas the control participants ingested 1 gram of vitamin C 30-minutes post-meal. Glucose levels were measured at baseline, and the 10, and 15-minute mark in both exercise intervention and control conditions 30-minutes post-meal.
Results: There was a significant interaction between treatment and time on the change in glucose levels (P<0.001). There was a significant mean difference in change in glucose levels between exercise intervention and control conditions (P = 0.002). Change in glucose levels in exercise intervention was significantly decreased at 10-minute (-18 ± 4.35 vs. 1.67 ± 4.34, P = 0.009) and 15-minute (-24 ± 4.88 vs. 5.67 ± 4.88, P = 0.001) compared with control condition. Although there were no statistical differences in state anxiety scores between pre- and post-exercise intervention (p=0.42), there was a significant trend in the reduction of state anxiety scores in diabetic participants, as compared with healthy participants, after 15-minute exercise intervention (-8 vs. -1).
Conclusion: Aerobic exercise for 15-minute by dancing to music after a meal is an effective approach to controlling the blood glucose levels in type 2 diabetic and healthy persons.

Study Aim: This study examined the item difficulty and item discrimination scores for the HRFK PE Metrics cognitive assessment tool for 5th-grade students.

Materials and Methods: Ten elementary physical education teachers volunteered to participate. Based on convenience, participating teachers selected two 5th grade physical education classes. Teachers then gave students (N = 633) a 28-question paper and pencil HRFK exam using PE Metrics Standards 3 and 4. Item difficulty and discrimination analysis and Rasch Modeling were used data to determine underperforming items.

Results: Analysis suggests that at least three items are problematic. The Rasch Model confirmed this result and identified similar items with high outfit mean square values and low Point Biserial correlation values.

Conclusions: Teachers are in need of valid and reliable HRFK assessment tools. Without the removal of three items in the PE Metrics HRFK exam for 5th-grade students, complete use of the exam could offer incorrect conclusions.