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.

Background. Research suggests that non-O blood types are at an increased risk of thrombosis and related health complications in cardiovascular disease (CVD). This is due in part to higher concentrations of von Willebrand factor (VWF), an important factor involved in blood clotting. Objective. The purpose of this study was to examine the effects of a vegetarian-like diet on blood coagulation and other health parameters in adults with type A blood compared to type O blood over a four week intervention. Given the lack of previous research on blood type and diet, it was hypothesized that no difference in blood coagulation would be observed. Design. This study was a randomized, parallel arm, dietary intervention using healthy, omnivorous adults with blood types A and O. A total of 39 subjects completed the study. Subjects were randomized into two groups: a vegetarian-like diet group made up of 12 type As and 12 type Os and an omnivorous control diet group made up of 11 type As and 12 type Os. At weeks 0 and 4, fasting blood was drawn and analyzed for prothrombin time (PT), activated partial thromboplastin time (APTT), von Willebrand factor (VWF), total cholesterol, LDL, HDL, triglycerides, and CRP. In addition, subjects were weighed and filled out a FFQ at weeks 0 and 4. Results. After adhering to a vegetarian-like diet for four weeks, type Os had a significant increase in PT (+0.24±0.32 sec/ p=0.050), whereas type As saw no significant change. There was a trend of weight loss for type Os in the vegetarian-like diet group (-1.8±2.6 lb/ p=0.092) and significant weight loss for type As (-0.9±2.1 lb/ p=0.037). Both blood types O and A experienced significant decreases in BMI (-0.3±0.4/ p=0.092 and -0.2±0.3/ p=0.037, respectively). No change was seen in APTT, VWF, total cholesterol, LDL, HDL, triglycerides, or CRP. Conclusion. Type Os saw an increase in PT, perhaps indicating a reduction in risk of thrombosis and its related health complications. Type As were less responsive to the dietary intervention and may require more rigid dietary guidelines or a longer time on such a diet to see the benefits.

Background: Research in animal models suggests that fish oil ingestion may impair immunity and increase risk for infection. To date there are no studies examining this relationship between fish oil ingestion and risk for infection in humans. Objective: The primary aim of this randomized, placebo-controlled, double-blind, parallel-arm study was to examine the effect of 400 mg of EPA and 200 mg of DHA, the main components of fish oil (FO) supplements, on the incidence of symptoms related to upper respiratory tract infections in healthy young females, at a large southwestern university. Design: Healthy young women between 18 and 38 years of age who were non-obese (mean BMI 23.7 ± 0.6 kg/m2) were recruited from an urban southwestern university campus. Subjects were non-vegetarians, non-smokers, and reported consuming less than one serving (3.5 oz) of fish per week. Participants (n=26) were randomized according to age, body weight, BMI, and daily n-3 fatty acid (FA) intake into two groups: FO (one gel capsule of 600 mg EPA/DHA per day) or CO (one placebo gel capsule of 1000 mg coconut oil per day). Participants completed a validated daily cold symptom survey, the Wisconsin Upper Respiratory Symptom Survey-21 for 8 weeks. Fasting blood samples measuring TNF-α concentrations were taken at weeks 1 and 8, when 24-hour dietary recalls were also performed. Anthropometric measurements were recorded via bioelectrical impedance at trial weeks 1, 4, and 8. Results: The 8-week trial of FO supplementation did not significantly change the average score for perception of cold symptoms between FO and CO groups (167 ± 71 and 185 ± 56, p=0.418, respectively). Plasma TNF-α levels (pg/mL) did not differ between groups (p=0.482). TNF-α levels were significantly correlated with body weight (r=0.480, p=0.037), BMI (r=0.481, p=0.037, and percent body fat (r=0.511, p=0.025) at baseline. Conclusions: Healthy young women taking a fish oil supplement of 400 mg EPA and 200 mg DHA per day over 8 weeks does not impose unintentional health consequences. These findings do not refute the American Heart Association's current recommendations for all Americans to consume two servings (3.5 oz) of a variety of oily fish per week. Depending on the type of fish, this current recommendation equates to approximately 200-300 mg per day of EPA and DHA n-3 polyunsaturated fatty acids. Additional research is needed to investigate the effects of higher dosages of fish oils on daily cold symptoms.

Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on gut fermentation. In this parallel arm randomized control trial, the effects of daily ingestion of vinegar on gut fermentation markers were observed among adults at risk for type 2 diabetes in Phoenix, Arizona. Subjects (n=14) were randomly assigned to treatments consisting of a vinegar drink (1.5g acetic acid) or a placebo (2 vinegar pills containing 40mg acetic acid each). All participants were required to consume the vinegar drink (16 oz) or 2 placebo pills every day for 12 weeks. At week 12, participants filled out a questionnaire to report gastrointestinal (GI) symptoms and three consecutive breath samples were taken from each subject to measure fasting breath hydrogen (BH2) with a breath analyzer. Fasting BH2 measures for the vinegar drink group (16.1+11.8 ppm) were significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.39 (p=0.023). After adjusting for age as a confounding factor (r=0.406) and removing an outlier, fasting BH2 measures for the vinegar drink group (4.3+1.1 ppm) were still significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.35 (p=0.045). Participants in both groups reported mild changes in GI symptoms. In conclusion, adults at risk for type 2 diabetes that consume 2 tablespoons of vinegar a day may have increased gut fermentation compared to those who do not consume vinegar.

ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative approaches to reduce CVD risk. One of these alternative approaches is Vitamin D supplementation. Current research has shown a link between Vitamin D status and CVD risk in both healthy and diseased populations. Among the possible mechanisms is a positive effect of Vitamin D on vascular endothelial function, which can be measured with noninvasive techniques such as flow-mediated dilation (FMD) of conduit vessels using high-resolution ultrasound. This dissertation is comprised of two studies. The first examines whether Vitamin D supplementation can improve FMD in older adults within a time period (two weeks) associated with peak increases in plasma Vitamin D concentrations after a single-dose supplementation. The second examines the effect of Vitamin D supplementation in people with Rheumatoid Arthritis (RA). The reason for looking at an RA population is that CVD is the leading cause of early mortality in people with RA. In the first study 29 Post-Menopausal Women received either 100,000 IU of Vitamin D3 or a Placebo. Their FMD was measured at baseline and 2 weeks after supplementation. After 2 weeks there was a significant increase in FMD in the Vitamin D group (6.19 + 4.87 % to 10.69 + 5.18 %) as compared to the Placebo group (p=.03). In the second study, 11 older adults with RA were given 100,000 IU of Vitamin D or a Placebo. At baseline and one month later their FMD was examined as well as plasma concentrations of Vitamin D and tumor necrosis factor-alpha; (TNF-alpha;). They also filled out a Quality of Life Questionnaire and underwent a submaximal exercise test on the treadmill for estimation of maximum oxygen uptake (VO2max). There was no significant change in FMD in Vitamin D group as compared to the Placebo group (p=.721). Additionally, there was no significant improvement in either plasma Vitamin D or TNF-alpha; in the Vitamin D group. There was however a significant improvement in predicted VO2max from the submaximal exercise test in the group receiving Vitamin D (p=.003). The results of these studies suggest that a single 100,000 IU dose of Vitamin D can enhance FMD within two week in older adults, but that a similar dose may not be sufficient to increase FMD or plasma Vitamin D levels in older adults with RA. A more aggressive supplementation regimen may be required in this patient population.