Background: Twenty-four hour urinary sucrose and fructose (24uSF) has been developed as a dietary biomarker for total sugars intake. Collection of 24-h urine is associated with high costs and heavy participant burden, while collection of spot urine samples can be easily implemented in research protocols. The aim of this thesis is to investigate the utility of uSF biomarker measured in spot urine. Methods: 15 participants age 22 to 49 years completed a 15-day feeding study in which they consumed their usual diet under controlled conditions, and recorded the time each meal was consumed. Two nonconsecutive 24-hour urines, where each urine void was collected in a separate container, were collected. Four timed voids (morning, afternoon, evening, and next day) were identified based on time of void and meal time. Urine samples were measured for sucrose, fructose and creatinine. Variability of uSF excretion was assessed by coefficient of variation (%CV) and variance ratios. Pearson correlation coefficient and multiple linear regression were used to investigate the association between uSF in each timed void and corresponding 24uSF excretion. Results: The two-day mean uSF was 50.6 mg (SD=29.5) for the 24-h urine, and ranged from 4.5 to 7.5 mg/void for the timed voids. The afternoon void uSF had the lowest within-subject variability (49.1%), and lowest within- to between-subject variance ratio (0.2). The morning and afternoon void uSF had the strongest correlation with 24-h uSF for both mg/void (r=0.80 and r=0.72) and mg/creatinine (r=0.72 and r=0.67), respectively. Finally, the afternoon void uSF along with other covariates had the strongest predictive ability of 24-h uSF excretion (mg/void) (Adjusted R2= 0.69; p=0.002), whereas the morning void had the strongest predictive ability of 24-h uSF excretion (mg/g creatinine) (adjusted R2= 0.58; p=0.008). Conclusions: The afternoon void uSF had the most favorable reproducibility estimates, strong correlation with 24uSF excretion, and explained greatest proportion of the variability in 24uSF. USF in mg/void may be better to use than uSF in mg/g creatinine as a biomarker in spot urine. These findings need to be confirmed in a larger study, and in a study population with a wide range of sugars intake.

Cardiovascular disease (CVD) is the primary killer of Americans. As such, alternative means of a dietary approach to preventing or mitigating the development of CVD is clearly needed in addition to the ongoing recommendation for increased consumption of fruits and vegetables. Many studies suggest that fungi have the potential to decrease morbidity and mortality associated with CVD. Specifically, white button mushrooms, viz., Agaricus bisporus, are fairly common and inexpensive and full of untapped possibilities for efficacy although much additional research is needed. With antioxidants, e.g., selenium, and beta-glucans, viz., indigestible polysaccharides, white button mushrooms contain a plethora of bioactive ingredients that confer a potentially strong tool against the debilitating social impact of CVD.
The objective of this thesis was to establish protocols and a valid experimental design for testing whether dietary mushrooms could, in fact, be protective against CVD risk. Specifically, a case-study approach was used to validate this experimental method to test white button mushrooms and their impact on blood lipid levels and the inflammatory response. This dietary study involved preparation of two soups: a placebo, broth-based soup and one with one cup of white button mushrooms per cup of soup to provide one and a half cups of soup (and mushrooms) per day to each participant. The soup was prepared in The Kitchen Café at the ASU Downtown Campus (Phoenix, AZ).
After preparing the soup, the next goal was recruitment through listserv, local advertisements, flyers, and word of mouth of participants to test the overall plan. Over fifteen people responded; however, only one candidate met the inclusion criteria of someone at high risk of developing CVD and agreed to participate in the study. The participant visited the nutrition laboratory in downtown Phoenix (550 N. 5th Street). Anthropometric data and an initial blood draw were completed, and fourteen 1.5 cup containers of mushroom soup were dispensed to the participant. After two weeks, the individual returned and the same procedures were executed to include anthropometry and blood analysis. Even though the subject did not show changes in blood markers of CVD risk (lipids and inflammatory markers), the hypothesis for the thesis that the study design would be effective was accepted. Thus, the procedure was successful and validated and will be used in the future study.

The purpose of this study was to determine the ratio of vegetable to fruit incorporated during a fresh vegetable and/or fruit juice diet. Juicing is the process of extracting the liquid part of a plant, fruit, or vegetable. Food can be ground, pressed, and spun to separate the liquid from the pulp. A juice diet involves juicing and consuming a variety of vegetables and fruits. The primary objective of this study was to gather information about the ratio of vegetable to fruit incorporated in freshly made juices during a juice diet. Therefore, the study survey inquired about various topics related to ingredient ratio during a juice diet. The survey data allowed for examination of the relationships between ingredient ratio and certain variables (e.g. gender, age, length of time juicing, juice fast participation, health effects, etc.). The study participants were recruited using online social media. Facebook was the primary method for reaching the online juicing community. A written invitation was distributed in several health related Facebook groups encouraging any person with experience juicing to complete an anonymous survey. This post was also shared via Twitter and various health related websites. The study survey data was used to examine the relationships between ingredient ratio and specific variables. The survey data showed participants had varying levels of experience with juicing. The responses indicated many participants were familiar with juice fasting and many participants completed more than one juice fast. Based on the survey response data, the most common ratio of vegetable to fruit incorporated by the participants during a juice diet was 80% vegetable to 20% fruit. The majority of participants indicated daily consumption of freshly made juice containing 70% -100% vegetables. Based on the survey response data, beginner juicers may be less inclined to incorporate organic produce into their juice diet compared to advanced juicers. The majority of participants reported positive health benefits during a juice diet. Some of the positive health benefits indicated by participants include weight loss, increased energy, and a positive impact on disease symptoms. Some of the negative side effects experienced by participants during a juice diet include frequent urination, headache, and cravings. Cross tabulation calculations between the ratio of ingredients and several variables covered by the study survey demonstrated statistical significance (i.e. length of time juicing, frequency of drinking juice, juice fast participation, number of juice fasts completed, servings of vegetables/fruit in a juice, percent of organic vegetables/fruit used in a juice, perceived positive side effects, and perceived negative side effects). This study provided insight about the average ratio of vegetable to fruit incorporated by participants during a juice diet. When analyzing the data it is important to consider the survey data was self-reported. Therefore, every result and conclusion is based on the individual perceptions of the study participants. In future experimentation, the use of medical tests and blood work would be useful to determine the biological and biochemical effects of drinking raw vegetable and/or fruit juice on the human body.

Pediatric obesity is a continuing concern in the United States. Preventative intervention methods in the form of nutrition education, including hands-on cooking lessons may improve personal choices for healthy eating. This study assessed the effectiveness of Arizona State University’s Camp CRAVE, a one-week course promoting healthy eating and teaching basic cooking skills. Children ages 9-13years (mean 10.3years, n=31) participated in a pre- and post-test survey to assess if the one-week course would increase self-efficacy to cook at home and increase knowledge of nutrition. The course showed significant increase in the participants’ nutrition knowledge and preference for healthier food options. There was a significant improvement in the children’s confidence levels to prepare meals at home. Further research on family socioeconomic status and parental perception of cooking at home would be beneficial.

ABSTRACT

Objective: The purpose of this randomized, placebo-controlled trial was to investigate the effect a daily coconut oil supplement (2 grams) would have on a common serum marker of systemic inflammation (C-reactive protein) and an indicator of oxidative stress (TBARS) when compared to the control group receiving a placebo capsule (white flour) in healthy, sedentary adults between the ages of 18-40 in Phoenix, Arizona.

Design: This study was designed as secondary analyses of blood samples originally collected to study the effects of coconut oil supplementation on blood lipids and body composition. The original study consisted of 32 healthy, adult volunteers recruited from the Arizona State University campus in Phoenix, Arizona. Participants followed no food restrictions or special diets, exercised less than 150 minutes per week, had no diagnoses of chronic disease, were not taking statin medications, were non-smokers, and no female participants were pregnant. Participants were randomized into either the Coconut Oil group (CO) or the Placebo group (PL) at week 0, and baseline blood samples and anthropometric measurements were obtained. Each participant completed an 8-week protocol consisting of two supplement capsules daily (coconut oil or placebo). Final fasting blood samples and anthropometric measurements were taken at week 8. This study analyzed the blood samples for measurements of C-reactive protein (CRP) and thiobarbituric reactive substance (TBARS).

Results: Eight weeks of 2 grams per day coconut oil supplementation, in comparison to placebo treatment, did not significantly reduce serum CRP ( -13% and +51% respectively, p=0.183) but did significantly increase TBARS ( +16% and -27% respectively, p=0.049).

Conclusions: Coconut oil supplementation (2 g/day) may impact lipid peroxidation as indicated by an increase in plasma TBARS concentration. Future trials are necessary to corroborate these results using other indices of fatty peroxide formation.

There are limited studies exploring the direct relationship between coconut oil and cholesterol concentrations. Research in animals and a few intervention trials suggest that coconut oil increases the good cholesterol (high density lipoprotein, HDL) and thus reduces the risk of cardiovascular disease. Preliminary research at Arizona State University (ASU) has found similar results using coconut oil as a placebo, positive changes in HDL cholesterol concentrations were observed.

The goal of this randomized, double blind, parallel two arm study, was to further examine the beneficial effects of a 2g supplement of coconut oil taken each day for 8 weeks on cholesterol concentrations, specifically the total cholesterol to HDL cholesterol ratio, compared to placebo.

Forty-two healthy adults between 18-40 years of age, exercising less than 150 minutes each week, non smoking, BMI between 22-35 and not taking any medications that could effect blood lipids were recruited from the ListServs at ASU. Participants were randomized to receive either a placebo capsule of flour or a coconut oil capsule (Puritan’s Pride brand, coconut oil softgels, 2g each) and instructed to take the capsules for 8 weeks.

Results indicated no significant change in total cholesterol to HDL ratio between baseline and 8 weeks in the coconut oil and placebo groups (p=0.369), no significant change in HDL (p=0.648), no change in LDL (p=0.247), no change in total cholesterol (p=0.216), and no change in triglycerides (p=0.369).

Blood lipid concentrations were not significantly altered by a 2g/day dosage of coconut oil over the course of 8 weeks in healthy adults, and specifically the total cholesterol to HDL ratio did not change or improve.

ABSTRACT



Objective: This research examined the effectiveness of a weight loss diet incorporating high protein pasta and breakfast cereal products as compared to a weight loss diet using conventional versions of gluten-free pasta and breakfast cereal.

Design: In a 6-week parallel-arm food trial (representing the first phase of a 12-week cross-over trial), 26 overweight and obese (Mean BMI 43.1 ± 12.4 kg/m²) participants, free of related comorbidities, were randomly assigned to the Zone diet (~29% energy intake from protein) or a control diet (~9% energy from protein). Participants were included in the trial if they satisfied the criteria for elevated risk for metabolic syndrome (top half of the TG/HDL ratios of all who were tested). Participants were instructed to eat prepared meals (total of 7 cereal packets and 14 pasta meals weekly) that included patented food technologies for the Zone diet and commercially available gluten-free rice pasta and a conventional name brand boxed cereal for the control diet. Body composition was measured with a bioelectrical impedance scale at weeks 1, and 6. Food records and diet adherence were recorded daily by the participants.

Results: Both the Zone and control diets resulted in significant weight loss (-2.9 ± 3.1 kg vs. -2.7 ± 2.6 kg respectively) over time (p = 0.03) but not between groups (p = 0.96). Although not statistically significant, the Zone diet appears to have influenced more weight loss at trial weeks 3, 4, and 5 (p = 0.46) than the control diet. The change in FFM was significant (p = 0.02) between the Zone and control groups (1.4 ± 3.6 kg vs. -0.6 ± 1.5 kg respectively) at week-6. Study adherence did not differ significantly between diet groups (p = 0.53).

Conclusions: Energy-restricted diets are effective for short-term weight loss and high protein intake appears to promote protein sparing and preservation of FFM during weight loss. The macronutrient profile of the diet does not appear to influence calorie intake, but it does appear to influence the quality of weight loss. Other measures of body composition and overall health outcomes should be examined by future studies to appropriately identify the potential health effects between these diet types.

Nutrition instruction has become more accessible; it is no longer relegated to the doctor’s office, dietitian briefing, outpatient clinic, or hospital. Now it is available in people’s hands, pockets, and purses via their smartphone. Since nutrition instruction has become more accessible, health professionals and members of the general public are increasingly interested in using smartphone apps to assist with health-related dietary changes. With more and more of the population required to follow certain dietary recommendations and/or monitor specific nutrient intake, commercially available apps may be a useful and cost-effective resource for the public. The purpose of this four-week intervention was to determine if the popular calorie counter app, MyFitnessPal, can be used to reduce sodium intake to ≤ 2,300 mg/day compared to the traditional paper-and-pencil method. This four-week randomized parallel trial enrolled 30 generally healthy adults who were 18 to 80 years of age. Participants were randomly assigned to the MyFitnessPal (“APP”) group or to the paper (“PAP”) group and required to meet three times with the researcher for screening, baseline (start), and completion of the study. There was a significant difference in the mean urinary sodium change between the APP group and the PAP group from the start of the intervention to the completion (-24.0±32.6 and 8.5±41.9 mmol/g creatinine respectively, p = 0.027). Other positive trends that resulted from the intervention included a decline in dietary sodium in both groups and a higher adherence in the APP group compared to the PAP group regarding recording method. The MyFitnessPal app proved to be a useful tool in reducing and/or monitoring sodium intake. Thus, this trial reinforces the potential of this app to be used for monitoring other nutrients, but further research needs to be conducted.

The omega-3 fatty acids in fatty fish and fish oil, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have been associated with a reduction in risk for cardiovascular disease. Blood type is a known contributor to risk for cardiovascular events. This study evaluated the effect of fish oil supplements on cardiovascular risk markers in adults with blood types A or O. An 8-week parallel-arm, randomized, double-blind trial was conducted in healthy adult men and women with either blood type A (BTA) or blood type O (BTO). Participants were randomized to receive fish oil supplements (n=10 [3 BTA/7 BTO]; 2 g [containing 1.2 g EPA+DHA]/d) or a coconut oil supplement (n=7 [3 BTA/4 BTO]; 2 g/d). Markers that were examined included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hsCRP), and hemoglobin A1C (HbA1C). Results indicated that the percent change in LDL cholesterol was significantly greater in the coconut oil group vs the fish oil group (-14.8±12.2% vs +2.8±18.9% respectively, p=0.048). There were no other significant differences between treatment groups, or between blood types A and O, for the other cardiovascular risk markers. Further research with a larger and more diverse sample may yield a more conclusive result.

ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is a polyunsaturated fatty acid that is beneficial at reducing body weight and in lowering many cardiovascular risk factors like atherosclerosis. The present study was designed to examine the change in plasma concentrations of leptin, nitric oxide, and the antioxidant superoxide dismutase in addition to examining the association between leptin and NO in healthy normal weight adult female subjects before and following omega 3 intakes. Participants were randomly assigned to either a fish oil group (600 mg per day) or a control group (1000 mg of coconut oil per day) for 8 weeks. Results showed no significant difference in the percent change of leptin over the 8 week supplementation period for either group (15.3±31.9 for fish oil group, 7.83±27 for control group; p=0.763). The percent change in NO was similarly not significantly altered in either group (-1.97±22 decline in fish oil group, 11.8±53.9 in control group; p=0.960). Likewise, the percent change in superoxide dismutase for each group was not significant following 8 weeks of supplementation (fish oil group: 11.94±20.94; control group: 11.8±53.9; p=0.362). The Pearson correlation co-efficient comparing the percent change of both leptin and NO was r2= -0.251 demonstrating a mildly negative, albeit insignificant, relationship between these factors. Together, these findings suggest that daily supplementation with 600 mg omega 3 in healthy females is not beneficial for improving these cardiovascular risk markers. Future studies in this area should include male subjects as well as overweight subjects with larger doses of fish oil that are equivalent to three or more servings per week. The importance of gender cannot be underestimated since estrogen has protective effects in the vasculature of females that may have masked any further protective effects of the fish oil. In addition, overweight individuals are often leptin-resistant and develop impaired vasodilation resulting from superoxide-mediated scavenging of nitric oxide. Therefore, the reported antioxidant and weight loss properties of omega 3 supplementation may greatly benefit overweight individuals.