Adolescence is an important developmental period for executive function as well as establishing lifelong health habits like diet and exercise. However, connections between exercise, executive function and dietary behaviors have not yet been adequately studied in adolescents, especially in terms of exercise duration. This research seeks to establish how 30 versus 60 minutes of exercise affects the association between executive function, calorie consumption and food-specific inhibition. The current research uses a within-participant design and linear mixed modeling to test the impact of exercise bout duration and executive function on calorie consumption and food-specific inhibition (food Go/No-Go accuracy and reaction time). This paper concludes that for adolescents, there may be a small impact of EF on dietary behaviors. It also concludes that 30 versus 60 minutes of non-cognitively demanding exercise (i.e., treadmill running) does not affect these associations in meaningful ways. Overall, the practical advantages of 30 minutes versus 60 minutes of exercise may make this a better recommendation for teens, but additional research on the impact of exercise is needed to inform these recommendations.

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Supplemental Nutrition Assistance Program (SNAP)-authorized store environments could be improved to favor consumer purchase of healthy products. Engaging with the key intermediaries who can use marketing-mix and choice-architecture (MMCA) strategies to encourage low-income consumers to purchase healthy products aligned with the Dietary Guidelines for Americans (DGA), 2015-2020 is essential. This PhD research describes five investigations that explored the perspectives of food store owners, managers, and corporate or independent businesses (e.g., retailers) to inform healthy food retail approaches: (1) a systematic review of the literature (1980-2017) identified social-ecological influencers of food store retailers' decision-making and ability to use MMCA strategies to encourage healthy dietary purchases in the United States (US); (2) SNAP-authorized retailers' perceived feasibility and costs to implement healthy MMCA strategies in rural stores were assessed (n=29); (3) SNAP-authorized retailers' healthy food and beverage perceptions and DGA-aligned product offerings were documented; (4) prevalent SNAP-authorized food store retailers in the US and between two states were identified to inform settings where healthy food retail approaches could reach numerous SNAP consumers; (5) and the availability of corporate social responsibility commitments to use MMCA strategies to improve consumers' diet quality among prevalent SNAP-authorized food store chains was explored. The collective findings from the review and four studies were that multiple social-ecological factors (e.g., skills/knowledge, consumers, suppliers) influenced US retailers' decision-making and ability to use MMCA strategies that favor healthy products. Rural retailers perceived prompting and proximity (e.g., labeling and location) strategies as feasible and less costly compared to other MMCA strategies. Some misalignments of healthy food perceptions and food store availability were identified and indicated a need for trainings to enhance the success of healthy food retail programs. To reach numerous SNAP consumers, healthy food retail programs should target nontraditional (e.g., non-grocery) food stores with varied approaches by state. However, few prevalent SNAP-authorized retailers have made public, voluntary commitments to reduce obesity and may reflect a low readiness to engage in partnerships to establish healthy food retail environments. Future research should document approach to and the impact of using MMCA strategies to encourage healthier consumer purchases on business outcomes among diverse store contexts. / Doctor of Philosophy / Supplemental Nutrition Assistance Program (SNAP) consumers are low-income Americans who could benefit from exposure to store cues or marketing-mix and choice-architecture (MMCA) strategies that ‘make the healthy choice the easy choice’. However, food store owners, managers, and businesses (e.g. retailers) ultimately decide if they will initiate and continue MMCA changes. This research prioritized the retailer perspective to inform healthy food retail approaches. A systematic review of literature (1980-2017) explored multifaceted influencers of food store retailers’ decision-making and ability or willingness to use MMCA strategies to encourage healthier dietary purchases in the United States (US). Additionally, four original research investigations were conducted: (1) a mixed-methods and cross-sectional investigation in rural, central Virginia assessed SNAP-authorized retailers’ perceived feasibility and costs to implement MMCA strategies that encourage healthy consumer purchases in stores; (2) an investigation of SNAP-authorized retailers’ healthy food and beverage perceptions and healthy food store offerings informed healthy food retail approaches in this setting; (3) an examination of prevalent SNAP-authorized food store retailers in the US and between two US states informed targeted healthy food retail approaches that could benefit numerous SNAP consumers; and (4) the availability of corporate social responsibility commitments to use MMCA strategies to promote consumer health among prevalent SNAP-authorized food store chains was explored. Main findings of these investigations indicated that there are multiple factors (e.g., skills/knowledge, consumers, suppliers) that influence US retailers’ decision-making. Also, rural retailers perceived prompting and proximity (e.g., healthy food labeling and moving healthy foods to an ideal location) strategies as feasible and low cost. There were some misalignments of healthy food perceptions and food store availability, indicating a need for trainings to enhance the likelihood for healthy food retail programs to succeed. In approaching SNAP-authorized retailers for partnership opportunities, targeting nontraditional (e.g., non-grocery) settings may reach more consumers and varied approaches by state are warranted. However, many of these prevalent SNAP retailers lack publicly available commitments to reduce obesity which may hinder partnership approaches. Future work should document approach to and the impact of using MMCA strategies to encourage healthier consumer purchases on diet quality and business outcomes among diverse store contexts.

Low-income and minority youth are disproportionately affected by low food access, low dietary quality, and high levels of obesity. The Expanded Food and Nutrition Education Program (EFNEP) is designed specifically to assist limited resource youth and adult audiences to acquire the knowledge, skills, attitudes, and changed behavior necessary for nutritionally sound diets, and to contribute to their personal development and improvement of the overall family diet and nutritional well-being by using a peer-education model (USDA, 2012). To date, little published research exists on dietary patterns and food access among youth who participated in EFNEP. The specific research goals of this study were to: 1) explore baseline dietary and physical activity self-efficacy and behaviors of youth EFNEP participants and compare to national trends, 2) examine differences in self-efficacy and behaviors based on socio-demographic factors and food availability, and 3) determine the association between food availability and dietary behavior. This study consisted of conducting surveys with 1,864 low-income youth, ages 7 to 14 years old, across Virginia prior to participation in an obesity-prevention program. The survey consisted of a 55-item written pre, post-test instrument that had been previously tested for validity and reliability. Most participants reported availability across all food groups, with the exception of meat and beans (41.4%) and dessert (48.3%). Significantly less than half of participants reported not meeting dietary behavior thresholds for the following food groups: grains (27.0%); whole grain (19.7%); low-fat milk (31.5%); vegetables (18.2%); colored vegetables (15.3%); and baked foods (31.7%). Availability of meats and beans and fruits were higher among Latinos than non-Latinos. Younger participants reported a higher consumption of sugar-sweetened beverages and screen time; however, the children had participated in physical activity. Participants who reported a higher availability of fruits and vegetables at home also participated in physical activities at least once a day. This study provided insight into the availability of food, as well as food consumption among low-income audiences across Virginia, based on youth EFNEP reporting. The results highlighted the importance of strategic interventions to improve the availability of nutritious foods and obesity prevention strategies to enhance self-efficacy and intake of nutritious foods among low-income youth. / Ph. D.

The purpose of this research was to examine psychosocial and body weight correlates of dietary behavior in low-income tri-ethnic women. In Study 1, a semi-quantitative food frequency questionnaire (FFQ) was developed and validated against diet records in 95 college women and 50 low-income postpartum women. Pearson's correlations were 0.42 among college women and 0.45 among low-income women. Cross-classification of participants into quartiles resulted in 76% of college women and 79% of low-income women being classified correctly. These results suggested that the FFQ was valid for dietary assessment among young women in the southwestern United States. In Study 2, approximately 160 mothers were recruited in the hospital 0-1 days following childbirth, and prepregnancy weight and demographic information were obtained. Weight was measured at 6 months and 1 year postpartum; psychosocial factors were assessed at 1 year. Diet during pregnancy and postpartum was assessed via food frequency questionnaires administered at 1.5 months, and at 6 and 12 months postpartum, respectively. From pregnancy to postpartum, % calories from fat (delta = +1.1%, p<0.05) and added sugar (delta = +2.0%, p<0.05) increased. A greater percentage of lactating than non-lactating women (64% vs. 38%, p<0.05) met recommendations for fruits during pregnancy. Mean intakes of calcium, vitamin A and dairy foods were higher in women who had retained <10% of their prepregnancy weight at 1 year postpartum than in those who had gained [greater-than or equal to] 10%. During late postpartum, women in the highest tertile of compliance with dietary recommendations had a more positive body image (p<0.041) than those in the lowest tertile, and less neglect of self-care (p<0.001), weight-related distress (p<0.006), stress (p<0.009), depressive symptoms (p<0.020), and perceived barriers to weight loss (p<0.039). These findings suggest that the transition from pregnancy to postpartum is associated with a negative impact on dietary behavior in low-income women. Intakes of calcium, vitamin A and dairy foods may be associated with lower weight retention in postpartum. Furthermore, psychosocial variables may influence adherence to dietary guidelines during this time. / text

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Childhood obesity is a major national and worldwide public health crisis. The occurrence of childhood obesity, caused to large extent by an imbalance between caloric intake and caloric expenditure, has increased in the last 30 years. Although the prevalence of obesity has stabilized in recent years, it remains a top public health concern in the United States, especially in urban centers. The purpose of this study was to examine the associations between diet, physical activity, and the built environment in relation to the mean body mass index (BMI) of adolescents aged 12 to 17 years living in South Los Angeles, California. The research design, methods, and data analysis were based on the California Health Interview Survey 2007-2013 dataset. This database was mined for the independent variables: physical security, food insecurity, parental education and income, and availability of recreational facilities necessary for a healthy lifestyle; the dependent variable was BMI. Descriptive statistics and multiple regression analysis were used in analyzing for the association between the dependent variable and the independent variables. The outcomes of this study showed no associations between neighborhood physical security, recreational facilities, adolescent's physical activity, parents' education level, parents' income level, and BMI. However, the results did show a significant correlation between adolescent's dietary intake, food security, and BMI. This study will contribute to positive social change by informing public health officials and policy makers of the benefits of food security to healthier eating habits and BMI among the adolescents studied. Resulting actions could result in collaborative efforts toward reduction and prevention of childhood obesity.

This study was conducted to determine the impact of nutrition edu cation on participants of the Supplemental Food Program for Women, Infants and Children (WIC) and the Expanded Food and Nutrition Education Program (EFNEP). The specific objectives were to: 1) determine the impact of participation in EFNEP on iron status as assessed by hematocrit (hct) and ferritin levels; 2) determine the effect of nutrition knowledge on hct and ferritin values; and 3) determine the effect dietary behavior has on hct and ferritin levels for both WIC and EFNEP participants. Each study participant completed a 24-hour dietary recall record plus food frequency record, medical history, validated nutrition knowledge test, and finger stick blood sample prior to program enrollment or nutrition education, and again six months later. There were 42 WIC, 26 EFNEP, 23 WIC-control, and 23 EFNEP-control participants. Paired t-tests were used to find differences between preprogram and postprogram evaluation scores for the variables of nutrition knowledge score, hematocrit level, ferritin level, and levels of several nutrients. Nutrition knowledge test scores increased significantly from preprogram to postprogram for both WIC and EFNEP participants (14.2 ± 3.27 to 15.5 ± 2.89 for WIC, 14.2 ± 3.77 to 15.6 ± 2.79 for EFNEP). EFNEP participants also increased significantly in hct levels (38.5% ± 3.78 to 40.7% ± 2.13). Hematocrit levels did not change significantly for the WIC or control groups and nutrition knowledge did not increase for the control group between preprogram and postprogram evaluations. Mean intakes of vitamin A, vitamin c, calcium, and protein were above the RDA at preprogram and postprogram evaluations, yet the percentage of individual participants who consumed less than 67% of the RDA in this study was higher than in the continuing survey of Food Intake of Individuals - 1985. Improvement in nutrient intake at postprogram evaluations was encouraging. Regression analysis indicated that nutrition education classes in college, income level, and level of formal education each had a positive effect on nutrient intake and nutrition knowledge.