The energy drink market increased 240% between the years 2004 and 2008 and is expected to continue to grow. Growth of this market is concerning because energy drink consumption has been associated with a variety of health risk behaviors including increased marijuana use, sexual risk-taking, fighting, alcohol consumption, but little research has explored the relationship between energy drinks and dietary behaviors of emerging adults. Therefore, the purpose of this study was to explore the relationship between energy drink consumption and diet among a sample of emerging adults. Participants included 585 undergraduate students from a large, public US university (m age=18.7; 47% non-Hispanic White, 20.9% Hispanic, 25.5% Asian, 2.7% non-Hispanic Black, and 4.4% other; 56% Female). Using an online survey, students self-reported energy drink consumption and dietary behaviors. Past week and past month energy drink consumption was measured with single items asking the number of times and the number of days the student consumed an energy drink, respectively. Dietary behaviors measured included soda, diet soda, milk, sweet snacks, salty snacks, fruits, vegetables, breakfast, frozen food meals, fast food meals, and restaurant meals consumption in a usual week. Summing responses to items including weekly consumption of milk, fruits, vegetables, and breakfast created a healthy eating index. Similarly, summing responses on items including weekly consumption of soda, diet soda, sweet snacks, salty snacks, frozen food, fast food, and restaurant food created an unhealthy eating index. Linear regression analyses were run to determine the associations between energy drink consumption and the individual dietary behaviors as well as the healthy and unhealthy eating indices. All analyses controlled for gender, race/ethnicity, and body mass index (BMI). Additional models were run with gender as a moderator to determine if the associations between energy drink consumption and dietary behaviors differed by gender. Overall, 17.5% of students consumed energy drinks at least one time in the past week (12.6% male, 5.0% female), and 38.1% consumed energy drinks on at least one day in the past month (22.7% male, 15.4% female). Increased past month energy drink consumption was associated with a higher score on the unhealthy eating scale (B=0.25 (SE =0.13), p=0.001), soda consumption (B=0.11 (SE =0.05), p=<0.001), and diet soda consumption (B=0.07 (SE =0.04), p=0.007), and a lower score on the healthy eating scale (B=-0.27 (SE=0.17), p<0.05). Increased past week energy drink consumption was associated with a higher score on the unhealthy eating score (B=0.80 (SE =0.28), p=<0.001), soda (B=0.25 (SE =0.10), p=0.003), diet soda (B=0.20 (SE =0.09), p=0.003), pre-packaged salty snacks (B=0.16 (SE =0.09), p=0.04), and frozen meal consumption (B=0.16 (SE =0.05), p=<0.002). No moderation effect was found by gender. Results suggest that those students who consume more energy drinks also consume more unhealthy foods and beverages. Given these associations, it is important that interventions aimed at addressing diet quality, overweight, or obesity rates within this population also consider the implications of energy drink consumption as a risk factor. / text

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Objective: Measure the association between School Health Index (SHI) scores and student health outcomes related to physical activity (PA) and nutrition. Design: Cross-sectional design utilized to collect SHI scores and administer questionnaires regarding nutrition and PA behaviors, knowledge and the home environment in 5 counties of southwest Virginia. Participants: Staff, administrators and students (grades 4, 7, 10; n = 1094) in 27 schools in 5 school divisions. Main Outcome Measures: SHI scores were obtained from school surveys while LWP score, student BMI percentile and fitness (mile run, PACER) measures were obtained from school data. The School Physical Activity and Nutrition questionnaire was used to measure student nutrition, PA behaviors and knowledge, and the home food environment was measured through a validated questionnaire. Analysis: Two-sided Pearson's correlation (p<0.05) measuring associations between SHI score and student health outcomes of BMI percentile, one mile/PACER, nutrition and PA behaviors and health knowledge and beliefs. Results: SHI was negatively correlated with BMI percentile for 4th grade students (-0.472, p<0.001) and positively correlated with BMI percentile for 8th grade students (0.679, p<0.001). SHI was positively correlated with 4th grade mile run (0.412, p<0.001), 8th grade mile run (0.218, p<0.001) and 4thgrade PACER (0.414, p<0.001). Conclusion: Behavioral influences are multifactorial and factors outside the school environment may affect the correlations between these variables. Application: Data concerning the influence of the school health environment can be used towards making evidence-based changes to school health programs. / Master of Science

High rates of obesity are seen across the country with rural areas disproportionately affected. Based on the socio-ecological model, policy, system, and environmental approaches targeted at the population level have the potential to create more sustainable health behavior change than individual level approaches. Historically, the Cooperative Extension Service (CES) has provided direct education related to healthy eating and active living in response to high obesity rates. Utilizing the resources and infrastructure of the CES, the Centers for Disease Control challenged CESs across the country to implement PSE strategies in counties with obesity rates greater than 40% through the CDC 1416 High Obesity Project. This qualitative study examined the experiences of Family and Consumer Science (FCS) Cooperative Extension Agents in conducting PSE strategies in addition to their direct education roles within their rural counties in an effort to reduce the high prevalence of obesity. Semi-structured, in-depth interviews with ten FCS Extension agents from Kentucky and Tennessee were conducted upon completion of the project and were analyzed thematically. These FCS agents encountered several barriers while implementing PSE strategies including inadequate training and poor communication regarding responsibilities and available resources. In addition, FCS agents found PSE work to be overwhelming and time consuming. Agents felt that support from project staff and their community partners allowed them to be successful. Findings from this study will be used to better prepare FCS agents in other rural counties across the country to conduct PSE work in an effort to reduce obesity prevalence in their communities.

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This study examined the association between different socio-demographic factors and food insecurity in the Central Florida Communities of Maitland, Winter Park, and Eatonville. Data from the Institute for Social and Behavioral Sciences at the University of Central Florida were utilized to analyze 3 main questions: In which community is food insecurity more prevalent? To what extent are food consumption, transportation, poverty, and unemployment associated with food insecurity? Does the association between food consumption, transportation, poverty, unemployment, and food insecurity remain when controlling for self-reported overall health, education, marital status, and race. The results revealed differences in predictors of food insecurities. Particularly, there was a positive relationship between food consumption and the knowledge of recommended number of servings of fruits and vegetables suggesting that those who have nutritional knowledge practice healthy dietary behaviors. Furthermore, structural dysfunctions and affordability pose food consumption limitations on the communities studied (mainly Eatonville).

abstract: Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated with healthier dietary behaviors among age-ineligible children (5-18-years-old) in WIC households. Consumption frequency of fruits, vegetables, 100% juice, sugar-sweetened beverages (SSBs), and energy-dense snacks (sweet and salty snacks) among children from WIC and income-qualifying non-WIC households were compared. Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females. Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02). Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households, / Dissertation/Thesis / Masters Thesis Nutrition 2019

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Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the MTM (initiation) constructs on actual salt/sodium intake was evaluated to validate self-reported behavior. A convenience sample of 149 consenting Nigerian adults with hypertension and of ages 20 to 60 years, self -administered the valid and reliable 39-item MTM instrument. The findings of confirmatory factor analysis showed construct validity of subscales for the initiation and sustenance model. All items loading for the two models were significant, p < 0.001. Multivariate regression analysis revealed 40.6% of the variance in initiating the consumption of low salt diets explained by advantages outweighing disadvantages, behavioral confidence, and changes in physical environment. About 41.8 % of the variance to sustain the intake of low salt diet was explained by emotional transformation, practice for change, and changes in social environment. The results justified the predictive role of MTM and adequacy of its utility to build evidence-based health education programs and interventions to address the health need of people with hypertension and contribute to social change in the country.