Fish oil has been extensively researched for its protective effects on cognition. More recently, anthocyanins have also gained the attention of the medical community for their potential cognitive benefits. Maqui berries are one of the richest sources of anthocyanins known to science. While there are many randomized controlled trials (RCT) investigating the effects of fish oil and/or anthocyanins on cognition in various populations, there are no RCT that exclusively investigate the cognitive effects of these compounds in adults with Type 2 Diabetes (DM2). The purpose of this double-blinded, placebo-controlled RCT was to investigate the cognitive effects of maqui berry extract and fish oil supplements in adults with DM2 over the course of eight weeks. Adults with DM2 (n=29) were recruited by the researchers and randomized to either Group A or Group B. Because the study is ongoing, it is unknown which group received the intervention. The study used the Stroop Test and Trail Making Test (TMT) to measure cognition at baseline, 4 weeks, and 8 weeks. Anthropometrics, blood glucose, and hemoglobin A1C were also taken at these time points. Sixteen female participants were included in the final analysis. Neither group showed significant improvements in the cognitive tests. However, in Group A, the effect sizes were large for the change in Trail-Making Test A (0.167), Trail Making Test B (0.261), and Trail Making Test B minus A (0.296) scores. In Group A, the change in Trail Making Test B minus A scores between baseline and week 4, and between baseline and week 8 was significant (p=0.053) and produced a large effect size (0.258). The results suggest that fish oil and maqui berry extract may improve cognition in adults with DM2, but further studies with larger sample sizes are needed.

Gastrointestinal (GI) complaints are prevalent among athletes. Fermented foods with pre-or probiotic features may relieve GI symptoms by improving gut health. This study aimed is to examine the impact of a nutritional supplement containing fermented whey protein with Galacto-oligosaccharide (GOS) fiber on GI distress among well-trained athletes over time by analyzing self-reported GI complaints without a control group. This quasi-experimental clinical trial consisted of a 3-week baseline period, reflected by two baseline measurements on Day 1 and Day 22, which was followed by a 3-week intervention period, reflected by a post-intervention measurement on Day 43, in which athletes added 15g of a fermented whey protein product to their diet. The primary outcome was based on the self-reported gastrointestinal symptom rating scale (GSRS), and the secondary outcome was based on a daily questionnaire, in which daily GI complaints and exercise occurrences were reported. Tertiary outcomes included a 24-hour diet recall (ASA24) and self-reported diet quality (REAP). Outcomes obtained during baseline (Day 1 and Day 22 average) were compared to those post-intervention (Day 43). Statistical significance was set at P<0.05. A total of n=50 athletes (24.7±4.5 years) with GI issues were included in the study. Five individual items of the GSRS including abdominal pain, acid reflux, bloating, burping, and loose stools reflected significantly lower scores on Day 43 in comparison to baseline (P≤0.028). A total of 78% reported GI complaints at baseline, and 61% of the participants reported lower GI complaints on Day 43 after supplementation in comparison to baseline (P=0.004). Further research is needed to explore the potential benefits of a hydrolyzed and fermented whey protein with prebiotics in a more controlled setting among athletic populations.

Plant-based eaters are known to reap nutritional benefits due to their dietchoice, but it is important to evaluate dietary differences that may put them at a disadvantage compared to omnivores. Stark differences exist in daily intakes of protein between vegans and omnivores, which may lead to several risks including decreased strength and bone density. The purpose of this study was to analyze the differences in protein intake, lean mass, strength, and bone density in vegans versus omnivores in order to support the argument for an increased recommended daily allowance (RDA) for protein for plant-based eaters. Participants in this study were assigned to groups based on omnivorous (n = 25) or vegan (n = 19) dietary pattern. Nineteen matched pairs were created based on age and BMI. Data was collected at a single lab visit and included health history and physical activity readiness questionnaires, 24-hr food recall, and anthropometric measures. Bone mineral density (BMD) was measured using DEXA and strength was assessed using hand and Biodex dynamometers. Statistical analyses were conducted using independent samples t-tests and Pearson’s correlation tests to evaluate differences in body composition, bone density, strength, and dietary intake between the two groups with significance set at p.05. Differences were seen in daily calorie (p=.007), protein (p<.001), fat (p<.001), and fiber (p=.009) intake. Lean mass (p=.282) and bone density (p=.651) were not different between groups, but lower body strength was different (p=.008). There was a correlation between lower body strength and protein intake (p<.001), and lean mass was correlated with lower body strength (p<.001), grip strength (p<.001), and bone density (p<.001), but not i LBM (p=0.158). Correlations were also observed between BMD and lower body strength (p=.004). These data suggest that there is a significant difference between protein intake in vegans versus omnivores, which appears to have a positive association with strength. BMD also has a positive association with strength as well as lean mass. Cumulatively, the results suggest that it may be beneficial for vegans to increase daily protein intake.

Affecting nearly 1% of the world’s population, Celiac disease is an autoimmune disease that causes damage to the small intestine through the ingestion of gluten. Over time, the villi of the small intestine are destroyed which prevents nutrients from being absorbed properly leading to impaired health and growth of an individual. Currently, there is no cure for celiac disease. Those that are diagnosed with Celiac disease usually adhere to a gluten-free diet. By doing so, most manage their symptoms and minimize the damage to their small intestine. However, this diet is only effective if one is able to strictly adhere to the diet. If gluten is consumed, even on accident which is rather easy, the villi of the small intestine are damaged and individuals are at risk for a number of symptoms including chronic diarrhea, constipation, and even cognitive impairment. A cure for Celiac disease that extends beyond lifestyle changes would better help those affected and ensure their small intestine functions properly and growth of an individual is not impaired. One potential solution is medication that prevents inflammation from T cells through the blockage of cytokine signaling of interleukin-6. This thesis proposes a research project to identify a phase 3, double blind, placebo controlled trial that would test the efficacy of the potential drugs.

Food waste is gaining considerable attention from researchers in terms of its sources, its causes, and its potential effects on the environment, economy, and population health. To date, few instruments exist that allow researchers to measure food waste at the household level in reliable ways. This study aimed to assess the reliability of a newly developed self-assessment tool to measure household food waste, among participants living in Mexico. The survey tool consisted of 11 items which ask participants (N = 22) to estimate the amount of food per category that generally gets thrown away instead of eaten in the average week. Two tests of reliability were conducted, including Cronbach's Alpha for test-retest reliability, and Intra-class Correlation for internal reliability. Results varied across food categories evaluated by individual items. Items related to fresh fruit and bread products did not show reliability when testing for internal reliability or test-retest reliability. Fresh vegetables, meat and poultry products, meat alternative products, fish and seafood products, leftovers, and shelf stable foods were shown to be reliable when testing Cronbach's alpha and ICC. However, dairy products, eggs and frozen foods were inconclusive when testing for reliability. The study suggests future testing with larger sample sizes should be conducted to demonstrate reliability of the food waste self-assessment tool.

Birds have the highest blood glucose concentrations of all vertebrates. Meanwhile, birds do not develop the same physiological complications (e.g., increased oxidative stress and glycation) that mammals do when blood glucose is elevated (i.e., diabetes). Therefore, birds may serve as a negative model animal for hyperglycemic complications. The physiological reason for high blood glucose in birds remains largely unknown although several unique characteristics of birds may contribute including a lack of the insulin responsive glucose transport protein, relatively high glucagon concentrations, as well as reliance on fatty acids to sustain the high energetic demands of flight. In breaking down triglycerides for energy, glycerol is liberated, which can be converted to glucose through a process called gluconeogenesis. In addition, the extent to which birds maintain homeostatic control over blood glucose in response to extreme dietary interventions remains unclear and few dietary studies have been conducted in wild-caught birds. Using Mourning Doves (Zenaida macroura) as a model organism, this dissertation tests four hypotheses: 1) Gluconeogenesis contributes to high circulating blood glucose concentration; 2-4) similar to mammals, a fully refined carbohydrate (i.e., white bread diet); a high saturated fat diet (60% kcal from fat); and an urban-type diet comprised of a 1:1 ratio of French fries and birds seed will increase blood glucose compared to a nutritionally-balanced diet after a four-week duration. Contrary to the hypothesis, 150 mg/kg Metformin (which inhibits glycerol gluconeogenesis) increased blood glucose, but 300 mg/kg resulted in no change. However, when 2.5 mg/kg of 1,4-dideoxy-1,4-imino-D-arabinitol (DAB; a glycogenolysis inhibitor) was given with 150 mg/kg of Metformin, blood glucose was not different from the control (50 ul water). This suggests that glycerol gluconeogenesis does not contribute to the naturally high blood glucose in birds and that a low dose of Metformin may increase the rate of glycogenolysis. In addition, all three experimental diets failed to alter blood glucose compared to control diets. Collectively, these results suggest that, in addition to a negative model for diabetes complications, birds can also serve a negative model for diet-induced hyperglycemia. Future research should further examine dietary manipulation in birds while controlling for and examining different variables (e.g., species, sex, duration, diet composition, urbanization).

Water is an essential nutrient that is often overlooked. As a result of this hydration status is often forgotten as well. Becoming hypohydrated puts athletes at risk of decreased performance and potentially life-threatening heat illness. Being able to self-assess hydration status is may be instrumental in helping athletes safely optimize performance. Therefore, this study investigated, 1) the ability of an athletic population vs. trained investigators to self-diagnose underhydration, 2) the diagnostic ability of urine color (Ucol) charts as a method for diagnosing underhydration, and 3) the accuracy of participant and investigator assessments. Members of an athletic population each provided a urine sample and scored samples using both the traditional 8-color and newly developed 7-color Ucol chart. Investigators then scored the samples using the same methods. To determine the diagnostic value of the Ucol charts, Ucol scores were compared to concentration measures of Urine Specific Gravity (USG) and Urine Osmolality (Uosm). Differences in participant and investigator scores were compared using Mann-Whitney U and Spearman’s Correlation. Bland-Altman plots were drawn to assess individual differences in reporting against the mean of the two methods. Receiver Operating Characteristic (ROC) analysis was used to both determine the ability of both charts to diagnose underhydration and to determine how well participants and investigators can determine their level of hydration. Athletes reported Ucol significantly lighter compared to investigators. Investigators showed no difference in reporting between the two charts but, athletes reported less than a color shade difference. The charts performed fair (8-color) to good (7-color) at diagnosing hypohydration. Athletes reported with less accuracy compared to investigators, and Ucol classification was found to be more accurate when compared to USG. Ucol charts are a practical tool to determine hydration status. Ucol scoring is similar regardless of the type of chart used. Trained investigators reported with slightly higher accuracy on both charts compared to untrained athletes. Athletes score Ucol fair to good in comparison to investigators. Ucol scoring is similar regardless of the type of chart used. The diagnostic ability of both Ucol charts is good in relation to USG. With education, athletes may be able to improve scores.

Objective: This research examined the impact of daily ingestions of commercial high protein nutrition bars (with or without added fiber) on 24-h energy intake and satiety for one week among free-living young healthy adults. Design: In a 4-week double-blind, randomized crossover trial, 21 normal and overweight participants (Mean BMI 23.9 ± 2.7 kg/m²), free of chronic diseases, were randomized assigned to HP (high protein: 21 g protein) or HPHF (high protein high fiber: 20g, 14 g fiber) nutrition bars. Participants were included in the trial if they meet the criteria for non-smoking, and not taking prescribed medication for chronic diseases. Participants were instructed to consume commercial nutrition bars daily for seven consecutive days. Body composition was measured with a bioelectrical impedance scale at weeks 1, 3, and 5. Dietary data was recorded by the MyFitnessPal app on Wednesday, Friday, and Sunday of each week. Results: The mean energy intake for the weeks HPHF bars were consumed is significantly higher compared to baseline (1998 ± 534 vs. 1806 ± 537 respectively; p = 0.035). The mean fat mass following one week of HPHF bar consumption was significantly higher than the baseline value (18.8 ± 6.8 vs. 18.3 ± 6.7 respectively; p = 0.023) and trended higher (18.8 ± 6.8 vs. 18.3 ± 6.7 respectively; p = 0.057) in comparison to the value following one week of HP bar consumption. For the high physical activity level group (n = 10), the mean energy intakes for the baseline week and the weeks the HP and HPHF bars were consumed were 1883 ± 597 kcal, 2154 ± 712 kcal, and 2099 ± 603 kcal respectively (p ˂ 0.04; energy intakes for both bars were significantly different from baseline). Nutrient intakes differed significantly mirroring the nutrient profile for each specific bar. There are significant effects after both bars on satiety, but there were no differences between each bar. Conclusions: Sales of nutrition bars gained rapid growth and may represent a unique source for specific nutrients. However, ingestion of commercial high protein nutrition bars may increase the risk of gaining fat mass and eventual body mass over time.

Urinary tract infections (UTIs) disrupt military women’s service obligations and health. Females are more susceptible to UTIs due to their unique anatomical features and hormone fluctuations affecting vaginal flora. During phase 1 of the menstrual cycle (onset of bleeding, menstrual cycle days 1-5), estrogen levels significantly decrease and inhibit the growth of lactobacilli, good bacteria that are essential in warding off harmful bacteria and infections, particularly pathogens of UTIs. To reduce UTI onset, it is recommended to frequently urinate with sufficient urine void volume to facilitate washing out harmful bacteria from the bladder and urethra. While menstruating, increased fluid consumption to support urination frequency and void volume may be critical, as the urethra and urinary tract are more predisposed to pathogenic bacteria found. Yet, there is a lack of research investigating the impact of hydration on urinary tract health during menstruation. The study sought to examine the effects of increased water fluid intake on the uropathogenic bacterial activity of underhydrated menstruating premenopausal females. Thirteen females underwent a 2x2 randomized crossover trial to evaluate the effectiveness of a) additional 1.89 L of water fluid intake and b) maintain habitual fluid intake on two subsequent phase 1 menses. At each phase 1 menses, fluid intake was gathered on days 2 and 5 to determine the fluid amount consumed. First-morning urinations on days 3 and 6 assessed urogenital bacterial activity. Combining data collection days 2 and 5 per intervention (INT) and control (CON), the mean±SD for total fluid intake was INT 2.99±1.05 and CON 1.85±0.89, resulting in a 62% increase, p< 0.001, η2= 0.459. For days 2 and 5, a 48% and 80% increase in total fluid in from CON to INT was found, ps< 0.01. However, only four cultures detected uropathogenic bacteria from four participants, with no patterns between conditions or days, making it difficult to determine the effectiveness of the intervention. Though the intervention results were undetermined, military women’s hydration, menstruation, and urinary tract health remain prominent health concerns. Efforts to assess their fluid consumption and urination behaviors during menstruation and UTI risks are warranted.

Diabetes is the 7th leading cause of death globally. In 2018, 34.2 million Americans had type 2 diabetes. Many symptoms of diabetes are similar to those of scurvy or vitamin C deficiency. Vitamin C marginality and inadequacy are more prevalent in Type 2 Diabetes/prediabetes than with normal glucose tolerance. Intracellular vitamin C inadequacy is suspected due to competition between dehydroascorbic acid and glucose at GLUT 1 and 3 cellular receptors. Erythrocyte osmotic fragility is noted in Gulo -/- knockout mice unable to synthesize endogenous vitamin C. The ascorbate deficient red blood cells presented with low cytoskeletal B-spectrin, spherocyte appearance, and impaired deformability. This cross-sectional study investigated the relationships between diabetes status, erythrocyte osmotic fragility, and serum vitamin C status. Participants were aged 18-65, non-smoking, reported no unresolved health complications, and denied prior vitamin C supplementation. Those with T2D indicated diagnosis of >1 year. All participants provided written informed consent and the study was approved by the local Institutional Review Board in January 2021. Participants provided one fasted blood sample. Erythrocyte osmotic fragility was measured via UV/Vis spectrophotometry with various concentrations of sodium chloride (0.85% - 0.10%) to induce osmotic stress. In addition, plasma was extracted and mixed 1:1 with 10% (w/v) metaphosphoric acid in 2 mmol/L disodium EDTA and centrifuged. The supernatant was stored at -80°C until analysis with isocratic reverse-phase UV-HPLC separation. Participant characteristics did not differ significantly between groups apart from age (p< 0.01) and HbA1c (p=0.002). Data are presented for adults with T2D (n=14; 36% female; 55.5±8.2 y; 31.5±9.0 kg/m2; HbA1c: 7.4±1.9%; plasma vitamin C: 36.0±12.2 uM) and without T2D (n=16; 69% female; 38.7±13.5 y; 26.8±6.6 kg/m2; A1c: 5.4±0.3%; plasma vitamin C: 34.8±10.9uM). Erythrocyte osmotic fragility was significantly elevated (+4.4% hemolysis) in adults without T2D at 0.35% saline (p=0.039). Greater VC status (>30 uM) was associated with lower hemolysis at 0.35% NaCl (p=0.031). Erythrocyte osmotic stability was linked to greater vitamin C intake at 0.20% saline in those without T2D (p =0.019). In this pilot study, vitamin C status did not differ significantly by diabetes status. Vitamin C status was directly linked to erythrocyte osmotic stability in adults without T2D.