Most American children consume less than the recommend amount of fruits and vegetables (F&V), 74% and 84%, respectively. Eating too few F&V in childhood is associated with increased risk of cardiovascular disease, hypertension, respiratory symptoms, and some cancers later in life. Adequate F&V consumption favorably impacts antioxidant status, gut flora, mood, and cognitive functioning. Nutrients such as vitamin C and fiber are only naturally occurring in plant foods. For many children, school lunches are an important source of F&V. This pilot study assessed the feasibility of providing condiments to increase children’s consumption of salad bar F&V in an elementary school cafeteria at lunchtime. The trial site was a single Title 1 elementary school in a large, urban district in the greater Phoenix metropolitan area. Taste tests were conducted on three convenience samples of children in grades 3 – 7, aged 8 – 12 years (n=57) to identify the most popular condiment flavors. The five highest rated flavors were made available daily at a “flavor station” in the school’s lunchroom for three consecutive weeks during the Fall 2018 semester. Descriptive and inferential statistics were used to analyze data. A cost analysis was conducted for capital outlays related to the flavor station. School employee perceptions of F&V and the flavor station were assessed via posttest online surveys. Peanut butter was rated the best tasting condiment by children and was the only condiment that increased in popularity throughout the intervention. Overall, daily F&V consumption increased 17 g per child. There was a linear increase in F&V consumption during the study (r=0.986; P=0.014). As a proportion of the total F&V selected, F&V waste decreased by nearly 3%. The average daily cost of providing the flavor station was $0.09 per student. Sixty-five percent of school staff felt that the flavor station should continue at their school. Peanut butter is an affordable, nutrient-dense food that accommodates the USDA Food and Nutrition Service meal patterns and nutrition standards, and thus, is a viable strategy for increasing F&V consumption and decreasing F&V waste. The results herein inform the development of future interventions to improve the palatability of F&V for children.

Background: Nearly 95% of Americans will develop hypertension, and 67% will not seek treatment. Furthermore, hypertension is the leading risk factor for coronary heart disease. While previous studies have increased the use of blood pressure medication among patients that have received hypertension education, medications may not work for everyone. Due to the life-threatening nature of this condition, it is essential to find an effective alternative for treatment. The purpose of this study was to examine the impact of organometallic complex supplementation on hypertension and left ventricular hypertrophy in 6-week old male Sprague-Dawley rats that were fed either standard rodent chow or a high fat diet for 10 weeks at a university in Arizona.

Methods: Forty-two healthy six-week old male Sprague-Dawley rats were randomly assigned to one of three groups: plain water control, 0.6 mg/ml organometallic complex or 3.0 mg/ml organometallic complex as soon as they arrived. Each rat was then housed individually to prevent the sharing of microbiota through coprophagia. Rats in each treatment group were further divided into two dietary groups that were fed either a high fat diet containing 60% kcal fat that was changed every three days or standard rodent chow. Researchers were not blind to which rat was in each group. At the end of the 10-week study, rats were euthanized with an overdose of sodium pentobarbital (200 mg/kg, i.p.). Heart, left ventricle of the heart, liver, and spleen masses were recorded for each animal. Data were analyzed by two-way ANOVA using SigmaPlot 10.0 software.

Results: At the conclusion of this study, the left ventricle mass of the rats in the high fat diet group were significantly larger than those in the chow group. Neither dose of the organometallic complex supplement prevented these effects induced by high fat feeding.

Conclusion: The organometallic complex supplement was not effective at mitigating the effects of a high fat diet on cardiac hypertrophy in rats. Therefore, this supplement should not be used to treat cardiac hypertrophy.

In my creative project, I decided to shadow a naturopathic doctor to experience what the process of naturopathic treatment entails. I conducted interviews with patients and Dr. Raisanen to explore their backgrounds and motivations, and read studies he recommended that explained some of the science behind his methods of treatment, such as fasting, dietary adjustment (a plant based diet), sodium and saturated/trans fats reduction, caffeine reduction, exercise, stress modulation, supplements, and sleep adjustments. I wrote small expositional summaries on these studies. I also took measurements recorded by Dr. Raisanen through the course of treatments with different patients to produce visuals of changes in body composition. I finally produced a small handout with Dr. Raisanen's help that summarized on a page the basics of lifestyle changes that a naturopathic doctor would want a patient to undertake.

Cardiovascular disease (CVD) is characterized by impaired vasodilation and the development of atherosclerosis.78 A diet high in saturated fat, such as palmitate, contributes to this by promoting inflammation and oxidative stress in human vascular smooth muscle cells (VSMC). 11,12,84,88 The inflammation cascade that occurs increases pro-inflammatory cytokines, like tumor necrosis factor alpha (TNF-alpha) and increases proinflammatory enzymes like cyclooxygenase 2 (COX-2) contributing to inflammation, oxidative stress, blood pressure shifts, and atherosclerosis.11,12,69,84 Palmitate has been found to upregulate TNF-alpha,85 and COX-2. 11,12, 84

In various studies, sumac, a Mediterranean spice and known antioxidant,39,7,66,67 has been shown to have antioxidant properties through its ability to inhibit reactive oxygen species (ROS) such as superoxide.39,7,66,67 Sumac has also been found to reduce TNF-alpha.100 Results from a study of hypertensive human subjects fed a sumac supplement showed a decrease in blood pressure.59

In the current study, COX-2 levels were determined to evaluate the level of inflammation in response to palmitate when primary aortic human vascular smooth muscle cells (HAoVSM) were treated with sumac. The treatments included: vehicle (bovine serum albumin), 100 µM palmitate, and 10, 20, 40, 60, and 80 µg/mL sumac. Sumac did not alter COX-2 protein levels between vehicle and sumac groups. Additional studies were designed to examine whether 80 µg/mL sumac could reverse impaired vasodilation caused by 10 weeks of high fat intake, consisting of 60% of total calories from fat, in Sprague-Dawley rats. Mesenteric arteries were isolated and exposed to sumac. High fat diet (HFD) arteries had impaired vasodilation compared to arteries from chow-fed fats. HFD arteries exposed to sumac had similar endothelium-dependent vasodilation responses as those not exposed to sumac, however, there were trends for improved vasodilation. I suggest that sumac likely exhibits antioxidant capabilities that prevent superoxide from decreasing the bioavailability of nitric oxide in the vasculature, thus promoting endothelium-dependent vasodilation and preventing the creation of more harmful reactive oxygen species. Isolated arteries from chow fed rats developed irreversible vasodilation when exposed to sumac and were therefore not responsive to pre-constriction with phenylephrine (PE) likely related to nitrates and gallic acid naturally present in sumac whereby inhibiting PE.