The current research was conducted to determine if some social cognitive and psychosocial variables (e.g., maintenance self-efficacy, action planning, & depression) would accurately classify bariatric patients into one of three groups—maintenance, relapse, or recovery—related to adherence to post-surgical nutrition recommendations. One hundred sixty one female bariatric patients aged 18 years or older who had undergone surgery at least six months prior to participation were recruited for this study. Participants completed instruments that assessed social cognitive variables, psychosocial variables, and current nutrition behaviors. In general, it was hypothesized that the combination of the social cognitive and psychosocial variables would predict membership in one of the three groups. Each of the three discriminant analyses performed to test the hypotheses yielded a significant first function. The second function of the first analysis was also significant. The findings of the current study suggested that the social cognitive (54%) and psychosocial (57%) variables as well as a combination of the social cognitive and psychosocial variables (59%) were able to predict a patient's group membership at a rate better than chance. The findings, therefore, revealed that it was possible to predict group membership in terms of adherence to post-surgical nutrition recommendations at a rate better than chance. This study represented a first step toward identifying bariatric patients who were at-risk for non-adherence to nutrition recommendations, which researchers have argued is responsible for poor outcomes after bariatric surgery. Implications and recommendations for future research are discussed. / Department of Counseling Psychology and Guidance Services

The impact of habitually consuming a high protein (HP) diet at the upper limit of the acceptable macronutrient distribution range (AMDR) on kidney health is unknown. The current study was designed to test the hypothesis that long-term consumption of a diet providing 35% of energy as protein will have negative consequences on renal health, as assessed in a pig model. Methods: Adult female, non-pregnant, commercial pigs (Genesus) were randomized to receive either NP (15% energy from protein) or HP (35% energy from protein) isocaloric diets for either 4 or 8 months. Diets contained whole protein sources with an animal: plant ratio of 2:1 in the NP diet to mimic the average Canadian diet. The increased protein in the HP diet was achieved by increasing egg and dairy protein sources. Body composition was measured by dual-energy X-ray absorptiometry. Glomerular volume and kidney fibrosis were evaluated on kidney sections by quantitative image analysis. The inflammatory marker monocyte chemoattractant protein-1 (MCP-1) and the growth factor transforming growth factor beta-1(TGFβ1) were assessed in renal tissue using commercial ELISA kits. Results: Pigs given the HP diet had lower body weights and percentage of body fat. Pigs consuming the HP diet had significantly higher glomerular filtration rates (GFR) and larger kidneys. Renal MCP-1 levels and renal fibrosis also were significantly higher in pigs given the HP diet, while proteinuria and renal TGFβ1 expression did not differ. Conclusion: These findings suggest that, despite the potential benefit of the HP diet on body composition, long-term intakes of protein at the upper limit of the AMDR may compromise renal health in healthy female pigs.

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When grain production falls short of consumption expectations in self-provisioning households, a range of responses is possible. How each household selects from and manages these responses provides the theoretical and empirical focus of this thesis. Several problematic issues in the 'coping strategies' literature are addressed, including questions of response sequencing and 'discrete stages', the timing of asset sales for food, and the relationship between consumption protecting and consumption modifying strategies. Among other theoretical advances, criteria for response sequencing are identified which explain decisions about which assets to sell for food, and when, in terms of each asset's expected return rather than its immediate 'entitlement' value. This thesis is grounded in fieldwork conducted in the West African semi-arid tropics, a region characterised by seasonally, agricultural risk and market imperfections. Drought and armyworms undermined crop production in the fieldwork village in 1987/8. The community is highly stratified economically, and striking cross-sectional contrasts in household behaviour and nutritional outcomes were observed. Food secure households practice demographic, agronomic and economic diversification, which provide access to sources of food and income that are not correlated to local economic fluctuations. Consumption insecure households have narrower options and respond to production deficits by wealth depletion (asset monetisation, debt acquisition) and severe food rationing. Responses to production deficits are not confined to strategies for acquiring food. Multiple objectives - economic, nutritional and social - are retained. Nutritional adjustments are motivated by intertemporal economic priorities. The poorest households protected their assets and rationed consumption most severely: the cost of consuming resources rises as the number and value of assets owned falls. Within households, nutritional surveillance revealed that adults rationed their food consumption earlier and more severely than their children. Adult anthropometric status may therefore be a more robust predictor of food insecurity and economic stress than child anthropometry.

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Dietary assessment methods are often plagued with inconsistent or inaccurate data. Self-reported intakes are particularly susceptible to error as research has shown that humans habitually report food intake inappropriately. Self-reported intakes have been used to create energy recommendations for populations. In order to assess energy intake, a novel 4 day multimedia dietary assessment method was developed utilizing a tape-recorder and camera in an attempt to more accurately quantify energy intake than traditional methods. The Recommended Nutrient Intakes for Canadians ( RNIC) provide population mean energy estimations. An objective was to determine whether the RNIC provides an accurate index of energy requirements. Current literature suggests that the RNIC is inadequate in some populations to meet energy needs when validated against methods such as doubly-labelled water (DLW). Total energy expenditure (TEE) and body composition were determined through the use of DLW in 76 women (49--93 years) over 13 days. The multimedia diet records did not reflect true intake in these subjects as demonstrated by a mean 24% underreporting rate when compared to TEE. Mean energy expenditure (MJ/day) as determined by doubly-labelled water was significantly higher (p < 0.01) in each stratified age range when compared to reported energy intake by multimedia diet records. The use of tabulated RNIC's underestimated true energy requirements by a mean of 29%. Food and Agriculture Organization/World Health Organization energy predictions closely estimated actual TEE in the study population. This research agrees with current literature questioning the validity of self-reported dietary intake data.

Graduation date: 2000