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In the context of expanding public concern about the healthfulness of food, this thesis examines how health is understood and taken up in individuals’ everyday activities of eating. Sociological frameworks emphasize the complex relations shaping health practices in context; however, a greater focus on the structured nature of practice has weakened appreciation of the agent. Food scholars investigating choice and constructions of healthy food and eating categories, highlight processes involving meaning, experience, action, and identity, at work in contexts of healthy eating. To better locate the agent of health practices, and to connect a health practices approach to healthy eating scholarship, this study draws on theory and methods from the symbolic interactionist tradition in an analysis of lived experiences of healthy eating. Using ethnographic data, including qualitative interviews with 18 adopters of the Paleo Diet, and analysis techniques from grounded theory, this study aims to add nuance to current sociological understandings of health practices. Findings reveal that subjective understandings of the relationship between food and health evolve through interpretive processes involving meaning. By connecting cultural understandings of health to personal, embodied experiences, adopters achieve multilayered understandings of healthy eating that legitimate and catalyze their commitment to their diet. Facing challenges to achieving a Paleo diet, adopters, as agents, engage in material and symbolic work to create “doable” and “livable” versions of Paleo better aligned with resources, preferences, and understandings. Adopters also construct and work to maintain valued identities surrounding their practice; however, Paleo identities are spoiled identities, as adopters sought to manage conflicting expectations of what constitutes healthy eating, and impressions of who eats a Paleo diet. This thesis demonstrates how an interactionist perspective that appreciates the processual, subjective, and interactional elements of agents’ situated and contextual practices, can be usefully brought in to investigate and inform understandings of activities affecting health. / Thesis / Doctor of Philosophy (PhD)

This research project investigated a method to promote one low-fat, high-fiber choice in a national chain fast-food restaurant. It is an extension of efforts toward large-scale dietary change. A procedural extension of a prompting strategy was used in an attempt to influence customers to choose a salad. A simple visual and print message based on themes derived from formative and pilot research at the restaurant was presented during two intervention phases of a reversal design. The message, "Be Fit and Healthy; Eat a Low-fat SALAD as Your Meal or Add a Side Salad," was displayed in colorful posters and tent cards which were placed on all the tables. Data from a comparison base in a neighboring town were obtained. A one-month follow-up phase was included in the design. Prices and in-store advertisements were identical in both locations. The existing computerized cash register system was used to obtain accurate, objective data. Daily and weekly sales percentages of several entrees were obtained. Results of analysis using a correction procedure indicate that when graphically represented, salad sales across phases increased with the introduction of the prompts, and decreased with their removal. In addition, three entrees not represented by associated prompts remained stable across phases. For Salads-combined, results indicate that sales increased about 15% and 9%, respectively, for the first and second intervention phases. Daily temperature during this project was variable. Although a comparison site was used to control for the effects of weather, results indicate that salad prompting may have increased sales more during warmer temperature. Population demographics were recorded. Analyses of the customer population during this project indicate customers were about equal by gender, and consisted primarily of white, 18-39 years old individuals. The cost for each added salad bought during the intervention was about $.22, and the cost to raise the percent of salad sales, each percent, across the four weeks was about $16.00. Future research should attempt to foster longer term behavior change and integrate multifaceted promotions. / Master of Science

No / Incremental dentine analysis utilizes tissue that does not remodel and that permits comparison, at the same age, of those who survived infancy with those who did not at high temporal resolution. Here, we present a pilot study of teeth from a 19th-century cemetery in London, comparing the merits of two methods of obtaining dentine increments for subsequent isotope determination. Covariation in ¿13C and ¿15N values suggests that even small variations have a physiological basis. We show that high-resolution intra-dentine isotope profiles can pinpoint short-duration events such as dietary change or nutritional deprivation in the juvenile years of life.

While the relationship between elevated total serum cholesterol levels and the risk for coronary heart disease (CHD) has been evident for a number of years, relatively few studies attempting to attain reductions in total serum cholesterol have utilized specific behavioral protocols. This study was conducted with 16 middle aged men (mean age = 46.4 years) with elevated total serum cholesterol (TSC) levels (x = 233 mg/dl). Multiple measures of TSC were taken. After an extended baseline phase, participants were randomly assigned to treatment conditions. One group ("Simple") received a cholesterol reduction class only (designed to stress the National Cholesterol Education Program's (NCEP) Step One Diet) and the other group ("Intensive’) received the cholesterol reduction class in addition to weekly cholesterol feedback, specific dietary feedback (shown graphically) and individually tailored goals. Dietary information was collected by individual food diaries. The results indicated that both groups reduced their TSC level (9.60% Intensive and 5.52% Simple) with no statistically significant difference between the groups. Both groups made changes in their diet yet, neither group completely met the guidelines set by the NCEP. However, there was some evidence for greater dietary adherence to the Step One diet and reaching risk (categorization) reduction goals for men in the intensive condition. Additional research has shown more intensive interventions led to substantially greater reductions (14%-16%) in TSC and dietary change. These results and prior research suggest that modest reductions in TSC can be achieved by less intensive programs that follow and/or slightly enhance the NCEP program, but that greater reductions in TSC (and reductions in CHD risk) may require programs with more intensive procedures. / Master of Science

The effectiveness of biweekly feedback regarding blood total cholesterol (TCH) to assist dietary adherence and lower blood TCH levels was assessed in a mixed population of healthy and cardiac diseased subjects (S) engaging in an unsupervised mall walking program. Based upon screening with a portable lipid analyzer (and with their physician's permission) 36 S’s (x age=63, 83% females) with TCH levels between 200-300 mg/dl were randomized to control (CG) or experimental groups (EG). The CG received instruction regarding the National Cholesterol Education Program's Step 1 low-fat, low-cholesterol diet at 0, 2, 4, 6 weeks and completed 3-day food records at 0, 4, 8 weeks. In addition to this instruction, the EG received graphic feedback regarding their TCH at 0, 2, 4, and 6 weeks. Both groups had a goal of a 10% reduction in TCH. By 8 weeks, the CG increased TCH by 2.2 mg/dl (1%) from 240.2 ± 24.8 to 242.4 ± 40.0 mg/dl while the EG decreased TCH by 11.8 mg/dl (5%) from 239.9 ± 22.6 to 228.1 ± 26.8 mg/dl. Repeated measures ANOVA showed a trend toward a lowering of TCH in the EG (time*group) [FC1,34)=3.39, p=.07]. A one-way repeated measures ANOVA for TCH within the EG between 0 and 8 weeks was significant [F(4,64)=3.14, p=.02]. Goal attainment was statistically greater in the experimental group [z=2.12: p=.0017]). Food record two-way ANOVAS revealed no significant differences between groups over time on dietary intake of fats or dietary cholesterol. Using one-way ANOVAs the experimental group demonstrated a significant pattern of initial decreases from food record 1 to food record 2 which Was maintained at food record 3. A recently reported study conducted in a structured cardiovascular exercise program (Burkett, Southard, Herbert, & Walberg, 1990) showed statistical significance over a 16 week trial period using this feedback technique. The results of the present study suggest that the findings of Burkett, et al. may be generalizable to populations participating in an unsupervised mall walking program. / Master of Science