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Depression is one of the most debilitating disorders among youth. Many factors impact depression risk, and dietary quality is one of the most significant modifiable factors. This work was to investigate whether diet quality, including protein, sugar, vegetables, and omega-3 fatty acids’ intake, had any effect on the development of depression. Data from 82 subjects were used for analysis. There was no significant relationship between Dietary Quality Index (p=.21, n=82) and depression based on this research. Results included total protein (p=.77, n=82), animal-based protein (p=.77, n=82), vegetable-based protein (p=.29, n=82), total sugar (p=.55, n=78), added sugar (p=.48, n=78), total vegetable (p=.56, n=82) and omega3 fatty acids (p=.92, n=82). These results were not up to expectations and did not conform to previous findings. Future research should be performed with a larger sample size among the college-aged population to determine the relationship between dietary factors and depression risk.

This thesis applies stable isotope analysis to the study of diet from a rural Roman estate, Vagnari (1st – 4th centuries AD), in southern Italy. The major objectives of this research are to identify the types of food eaten in the Vagnari skeletal sample from stable isotope ratios, as well as to explore individual variation in diet in the sample. Isotopic composition of collagen and carbonate indicate a diet heavy in C₃ plants with the incorporation of some animal-based proteins. Isotopes of carbon from collagen (δ¹³C) were relatively consistent across the sample, with some variation according to burial type. Nitrogen (δ¹⁵N) values varied with age-at-death and the number of grave goods buried with an individual, suggesting possible status-based variation in diet. Carbon isotopes from carbonate (δ¹³Cₐₚ) suggested variation in total diet with increased age-at-death. Isotope ratios from Vagnari were also compared with other Imperial Italian sites to situate the diet within a broader Roman context. Isotopically, diets at Vagnari were most similar to other inland and rural sites, and distinct from coastal urban diets based on marine fish. These results indicate the diversity in foods eaten in the Roman Empire, both at a local site level and between different settlements. Studying diet from Vagnari provides another window into the lives of people who lived and worked on industrial estates, and bolsters knowledge of the diets of rural residents, which are underrepresented in the literature. / Thesis / Master of Arts (MA)

Anxiety disorders, including generalized anxiety disorder (GAD), are prevalent mental health conditions with a complex etiology. The gut microbiota and diet have emerged as important factors in modulating anxiety symptoms. This thesis aimed to investigate the relationship between gut microbiota composition and anxiety symptoms in the context of GAD. This involved an in silico analysis of a cohort of GAD patients and healthy controls, coupled with experiments using a microbiota-humanized mouse model. A comprehensive in silico analysis was conducted using basic statistics and machine learning techniques on the human cohort. The analysis explored the associations between anxiety symptoms and various factors, including demographics, dietary intake, gastrointestinal symptoms, inflammatory markers, stool metabolites, microbiota composition, and PICRUSt2 microbiota predicted function. GAD patients exhibited higher gut microbiota abundance of Bacteroides, which was positively associated to carbohydrate degradation pathways. Machine learning analysis identified abdominal pain as a key indicator for distinguishing GAD donors. Moreover, anxiety symptoms were negatively correlated with inulin intake in GAD patients, altogether suggesting an association between a carbohydrate degradation imbalance in the GAD microbiota, abdominal pain, and anxiety symptoms. To investigate further, germ-free mice were colonized with stool samples from healthy controls and GAD patients, and they were fed either a low or high-fiber (inulin) diet. Assessments included behavioral tests, microbiota analysis, colonic gene expression, and mucus degradation. Bacteroides abundance positively correlated with anxiety-like behavior, mucus degradation, and expression of colonic genes related to immune activation, pain, and intestinal permeability, further supporting the results observed in the donor cohort. Improvements in metabolic parameters were also observed in mice fed high-fiber diet. Furthermore, we found that inulin dosage played a crucial role in mediating the observed immune activation and anxiety-like behavior, with excessive inulin supplementation showing a detrimental effect. This study provides insights into the complex relationship between dietary fiber, gut microbiota composition, and anxiety symptoms in mice and humans. Further studies are needed to determine optimal dosages of inulin supplementation as a potential therapeutic approach for managing anxiety symptoms. / Dissertation / Doctor of Philosophy (Medical Science) / Generalized anxiety disorder (GAD) is a common anxiety disorder that has complex causes. There's growing evidence that gut bacteria, known as microbiota, along with diet, can impact anxiety symptoms. In our study, we explored this connection by examining a group of GAD patients and healthy individuals, and by conducting experiments using a mouse model. We found that GAD patients have a microbiota with higher levels of Bacteroides and higher ability to feed from carbohydrates compared to healthy controls. We believe this is associated to abdominal pain and higher anxiety symptoms. To explore this in more depth, we introduced the gut microbiota from GAD patients and healthy controls into mice with no previous microbiota. Because we also found that GAD patients who ate foods with more specific fiber (inulin) content had less anxiety symptoms, we fed them a low or high-inulin diet and assessed anxiety-like behavior. We found that Bacteroides levels were associated with high anxiety-like behavior and gene expression in the colon associated to inflammation and pain in mice, further supporting the results found in the humans. Although more research is still needed, this study helps us better understand how the interaction between dietary fiber and gut bacteria can affect anxiety.

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Hospital readmission rates are being used to indicate quality of care by healthcare facilities in recent years. Increase in incidence and hospitalizations of patients with diverticular disease (DD) has caused burden to hospital resources. High fiber diets have been a part of the recommended therapy for patients to reduce symptoms and complications of DD. Analysis of the effect of high fiber diet education on hospital readmission of patients with a diagnosis of DD (N=68) was conducted. Chi-square analysis determined that high fiber diet education was not associated with readmission (x2=0.567, P=0.452). T-tests determined that men were more likely to be readmitted than women (P=0.029). A higher BMI was also observed in patients who were readmitted compared to those not readmitted (P=0.006). While high fiber diet education was not associated with readmission, males and patients with a higher BMI were significantly associated with hospital readmission.

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