Low water intake and underhydration are public health issues that may increase risk for diseases such as Type 2 Diabetes Mellitus. Studies suggest that high vasopressin (AVP) levels associated with low water intake may contribute to hyperglycemia. This study explored the physiological system by which AVP impairs glucose regulation through a single-blind randomized, counterbalanced, crossover design. This is a pilot and feasibility study of AVP infusion at increasing incremental rates, which was completed to determine the rate of infusion for the cross-over study. Participants completed a control and experimental trial. The experimental trial included a 3-hour AVP infusion and a 2-hour euglycemic-hyper insulinemic clamp at the end of the first hour versus control of 0.9% sodium chloride replacing AVP. In both trials, blood samples were taken every 5 minutes to measure glucose, as well as 7 other time points of insulin infusion. Two participants completed the pilot (47.5±3.5 years, 172.5 ±7.5cm, 82.5±17.7kg, 27.5±3.5 kg/m2, 5.1±0.64% HbA1c), and 3 participants completed the cross-over study (49±1.7 years, 173.7±6.7cm, 80.4±150kg, 26.5±3.2kg/m2, 5.3±0.2% HbA1c), all females. The rate of AVP infusion for the cross-over study was 12.5 mU/min. Compared to the control, the AVP trial blood glucose trended higher towards the end of the experiment, as did glucose metabolism, plasma osmolality, and plasma volume. Blood pressure was slightly higher in the AVP trial versus the saline, while plasma sodium and potassium levels did not differ. Total plasma protein seemed higher in the saline trials than in the AVP trials. This study supports the notion that increased levels of vasopressin over time may increase blood glucose. This could lead to supplementation of type 2 diabetes interventions with increased water intake.

In this thesis project, I have created a cookbook that provides Polycystic Ovarian Syndrome-friendly recipes and explains how the consumption of the right foods can help to naturally balance the hormonal imbalances that are offset. For those with PCOS, diet matters because there are certain foods that significantly help with lowering one’s internal inflammation, and other foods that do just the opposite. Therefore, fueling our bodies with foods that are anti-inflammatory and manage insulin resistance is key to a solution that works from the inside out. The creation of this cookbook is to compile easy and delicious recipes that I have created for my PCOS diet. In recent years, many have been using the Mediterranean Diet, Keto Diet, and DASH Diet as guidelines for recommendations and substitutions due to elimination of saturated fats, processed food, and refined sugar. These alterations make a powerful tools to address internal inflammation, menstrual regulation, and other components of PCOS. Though this cookbook does not strictly follow the diet plans, the recipes are made with strong consideration of them and are easily replicable with stricter restrictions and even healthier options, should one want.

The "Development of Resources for Travelers with Severe Dietary Restrictions" focuses on the development of the service, Allergy Voyage. The service hosts restaurant menus for users with food allergies to view, helping them feel safer and confident while dining, while simultaneously increasing restaurant revenue. The creative project sought to utilize Tierce's personal experience with severe dietary restrictions and entrepreneurial skills to provide concierge-based services for others suffering from food allergies.

Introduction: The incidence of type 2 diabetes (T2D) in youth is projected to increase through 2060, especially in minority youth. Every Little Step Counts (ELSC) has demonstrated efficacy in reducing T2D risk factors in Latino youth. Documenting the adaptation of ELSC to a family diabetes prevention program (FDPP) could support future adaptation and scaling of FDPPs.Purpose: To describe the process that guided the adaptation of a culturally grounded evidenced-based DPP tailored to Latino families, with the aim of using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to classify adaptations. Methods/Design: The approach that guided the adaptation involved community-based participatory research (CBPR) and phases commonly used to adapt health interventions. Inductive and deductive content analysis guided by the FRAME was conducted on data collected throughout the phases to identify and classify adaptations. Data was then triangulated with the entities involved in the adaptation, analyzed to determine the frequency and proportion of adaptations across the FRAME categories and levels, and cross tabulated. Results: A total of N=66 adaptations were identified. Adaptations occurred with the highest frequency during the grant preparation and after the pilot study. Most adaptations were led by both the academic institution and community partners. Content modifications were most common. Prominent reasons for adaptation included organization/setting time constraints and integrating community partners’ and interventionists’ feedback. Discussion: Study results align with the CBPR approach that guided the adaptation and the ELSC core tenet of integrating community partnerships throughout all aspects of the intervention. To efficiently track adaptations, consensus as to what constitutes varying levels of adaptation granularity (i.e., macro, meso, micro) is needed. While tracking adaptations can be time and resource intensive, tracking adaptations may support the development of strategies to tie adaptations to outcomes. Conclusion: It is critical to determine when adaptations are needed to avoid a “culture of adaptation hyperactivity”. There is an opportunity to analyze past and future ELSC adaptations to better understand the intervention’s core tenets and the relationship between adaptations and outcomes. Future ELSC adaptations would benefit from considering how to incorporate feedback from diverse stakeholders and populations in preparation for scaling.