Abstract: Alzheimer’s Disease (AD) is a complex neurodegenerative disease that requires interprofessional collaboration. Pharmacological options are currently ineffective, increasing the need for preventative strategies to combat the rise of AD. Considerations of gut-targeted interventions have increased as a key component in the prevention of AD, based on the understanding that the state of the gut microbiome can impact cognitive function through the pathway known as the gut-brain axis. Methods: This scoping review explored information on the gut-brain axis in persons with AD. A comprehensive search was conducted in November 2023. Forty reviews and 13 human studies were analyzed. Results: There is an abundance of information supporting the role of the gut-brain axis in the development and prevention of AD. This information is complex and may deter healthcare professionals outside of neuroscience, medicine, and nutrition from engaging in the literature. Further research is needed from within the SLP’s scope of practice.

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21â??70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed using SPSS. Also, independent t test, and Levene's test were used for ad hoc analysis to assess variation of food choice decisions over 30 days. Of the sample, 5% had low and 95% very low food secure status. Food security status did not predict coping strategies (p = .724); however, food security status and type of coping strategy had a moderate relationship (p < 0.01; r =.60). Food choices of 11 food categories changed over a 30-day cycle with greatest variation for Week 1, compared to Weeks 2â??4 (p < .005). Use of coping strategies to minimize hunger was limited. Very low food security associated with certain coping strategies disrupted eating patterns. Disrupted eating patterns affect food variation over time, increasing the intake of non-nutrient-dense foods and the risk of obesity and Type 2 diabetes. The implications for positive social change include the potential to change SNAP's benefit allotments, make nutrition education mandatory, and create a nutrition package, thereby lowering food insecurity and the risk of Type 2 diabetes.

Establishing healthy eating behaviors is vital in the early years to help combat the development of obesity and other chronic diseases. Mothers play an invaluable role in shaping their children's eating habits through controlling what and when children eat as well as the overall food environment, which is why a better understanding of what influences mothers’ decisions about these behaviors is important. The purpose of the dissertation was to gain a better understanding of what impacts maternal feeding decisions regarding toddler nutrition behaviors. This was a two-phased mixed methods study. The aim of the initial study was to explore, using a Theory of Planned Behavior (TPB) framework, the influences on mothers’ toddler feeding decisions. These included attitude, subjective norms, and perceived behavioral control. These constructs were derived from discussions about what sources of nutrition information mothers use and trust. The aim of the subsequent study was to use the TPB to assess factors affecting a mother’s behavioral intention to provide their toddler with a healthy diet and to see if the addition of the parental role construction variable strengthened the TPB’s ability to significantly predict the mother’s behavioral intention. The first study used a qualitative approach to gather data from three focus groups that consisted of mothers of toddlers (N = 15). Qualitative thematic analysis was used to define prominent themes. Four major themes emerged from the data analysis: (1) attitudes (subthemes: positive towards maternal role of feeding and negative towards the maternal role of feeding); (2) subjective norms positively accepted (subthemes: social media, pediatricians, and registered dietitians); (3) subjective norms negatively accepted (subthemes: pediatricians and registered dietitians); (4) perceived behavioral control (subthemes: acceptance, scarcity of time and outside influences). An online survey was created using data gathered from the focus groups and a previously validated survey that fit the theoretical basis of the study. The survey utilized the TPB to assess the connections between the constructs and the mothers’ behavioral intentions surrounding toddler feeding. The final sample consisted of 148 mothers. The mean age was 32.83 (SD = 6.16) years. The majority of participants were married (87.2%), had earned a college degree or higher (79.7%), held part-time or fulltime employment, (60.8%), and were White (90.3%). The TPB model predicted 53% of the variance in mother’s behavioral intention surrounding the behavior of providing meals that include a wide variety of the five food groups in appropriate amounts. The addition of the parental role construction variable added 6% more predictive power to the model. The most salient predictors included attitude, perceived behavioral control, and parental role construction. Mothers positively and negatively receive information from a variety of sources, they have many strong emotions associated with feeding that are deeply rooted in their roles as mothers, and their feeding decisions were strongly influenced by the TPB constructs. Health promotion efforts should aim to increase the mother’s sense of behavioral control and parental responsibility rather than focusing on the benefits of healthy eating. Programs should provide tangible ways to help mothers overcome perceived barriers and, in turn, increase mothers’ beliefs in their ability to provide toddlers with a balanced diet.

Rural Appalachian populations have greater rates of obesity and chronic diseases attributed to lesser consumption of fruits and vegetables (F/V) and physical inactivity. Barriers to F/V consumption and physical activity include poor access and affordability. To help overcome these barriers, a community-initiated walking and farmers market F/V voucher program was implemented. Participants were encouraged to walk (1.2 miles roundtrip) to the local farmers market to redeem a $10 voucher which could only be spent on F/V. The 16-week program (June – Sept) included 121 participants. Data was analyzed by creating two groups, low-engagers and high-engagers that differed significantly in the number of times walked to the market and redeemed vouchers, p ≤ 0.0001. Among all participants’ significant decreases were seen in total cholesterol, LDL, ratio of total cholesterol/HDL cholesterol, 10-year risk of heart disease or stroke score, and hemoglobin A1c (p ≤ 0.05). Significant increases were seen in HDL, quantity and variety of F/V consumption among all participants and the high-engagers group. There were improvements in knowledge pertaining to participants’ awareness of the term “phytonutrient” with correctly identifying plant-based foods as the source (p=0.01). Results demonstrate that a community-based walking and farmers market F/V voucher program can improve health in a Rural Appalachian population.

Childhood obesity is associated with significant morbidity and mortality and poses a health care burden. Child care facilities serve at the forefront in fighting childhood obesity among preschoolers. Since 2009, a significant shift has occurred in studying child care settings among children aged 3-5 in North Carolina and South Carolina in response to the rising rates of obesity in this population. Some of the hypothesized determinants of childhood obesity among preschoolers in North Carolina and South Carolina are outdoor activity, staff behavior, center's size and location. The purpose of this study was to investigate if significant relationships exist between childhood obesity and each one of these variables. This study was conducted within the framework of social cognitive theory within the contexts of the process of self-efficacy for realizing goals. A quantitative correlational design was used, while data were collected through Survey Monkey administering a closed end survey. Multiple linear regression was used to examine the associations between childhood obesity and center size, location, outdoor activity and staff behavior. The Power analysis determined total of 110 participants (N=100) who worked in North and South Carolina Head Start facilities of preschool children aged 3-5. The multiple regression indicated significant contributions of the center size (â = .32, p = .001), the location (â = -.28, p = .002), the outdoor activity (â = -.25, p = .005), and staff behavior (â = .27, p = .008). Therefore, the overall null hypotheses were rejected. This study may help to effect positive social change through identifying the important barriers to minimizing the risk of obesity among preschool children, which in turn would help to inform policy for developing and implementing strategies to reduce risks of preschoolers' obesity.

Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful sampling took part in the study. Data were largely collected through interviews utilizing open-ended semi-structured questions, which were used as the level-1 priori codes for data analysis. Inductive codes were developed from additional information provided by subjects during interviews. Sublevels were developed as needed. Codes with 2 or more responses from subjects were utilized in the analysis. Findings were based on the data and solely on the experiences and information shared by the subjects. The findings revealed that, among this sample of women, breastfeeding figured prominently in the African American culture. Most participants indicated they would breastfeed regardless of any support. Barriers to breastfeeding included the stigma that only the poor breastfeed, perceived inconsistency in information and assistance provided by health care personnel to African Americans as compared to other groups, and mothers not being aware of available resources. These results can be used to enhance social change initiatives, laws, and policies on breastfeeding for African Americans.

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.

Eating disorders and disordered eating habits and behaviors were measured using the Eating Disorders Inventory-3 Referral Form (EDI-3 RF). The sample consisted of 159 elite, collegiate student athletes, males and females, aged 18 to 22. Five sports were represented, including basketball, gymnastics, soccer, swimming & diving, and volleyball. Overall, findings support the position that athletes, as a distinct population, and specifically female athletes and those that participate in lean sports, are at an increased risk for disordered eating behaviors and diagnosable eating disorders. Of the 159 total athletes that completed the questionnaire, 33% (n=53) of the athletes sampled met one or more referral criteria based on reported behavior in the 3 months prior. A total of 37 athletes were referred to professional healthcare providers for meeting criteria of disordered eating behavior according the the Eating Disorder Inventory-3 Referral Form.

Serum vitamin D deficiency/insufficiency, Chronic Kidney Disease (CKD) and elevated blood pressure are important health concerns especially among minorities with type 2 diabetes. The effect of vitamin D3 supplementation (cholecalciferol) at 6,000 IU/day (d) vs. 4,000 IU/d on kidney function and cardiovascular disease markers among Hispanics and African Americans with type 2 diabetes and hypovitaminosis D (/ml) was evaluated. Subjects (n=63) were recruited from two clinics in Miami-Dade County, FL. Fasting venous blood and fresh, single-voided first morning urine samples were collected from each participant by a certified phlebotomist and analyzed by Solstas Lab Partners, Davie, FL. Linear mixed models were used to compare the interaction between time and intervention. Least Significant Difference (LSD) comparisons were used to detect significant differences within and between 4,000 IU/d and 6,000 IU/d groups from baseline, 3 and 6 months. In the 4,000 IU/d and 6,000 IU/d groups, a significant increase in serum 25-hydroxy vitamin D [25(OH)D] levels were observed from baseline [(19.9±1.1 ng/mL) and (21.4±1.3 ng/mL)] to 3 months [(36.1±2.2 ng/mL, p3 longer than 6 months may be needed to determine sustained long term effects in kidney and cardiovascular disease markers. Further research could provide more information for translation of these findings into recommendations for individuals with CKD, hypertension and type 2 diabetes. The efficacy of vitamin D3 supplementation as complementary therapy for CKD and blood pressure in minority and other ethnic groups needs further investigation in larger and longer duration randomized controlled trials.

Obesity has reached an epidemic level in the United States. A number of epidemiological studies have established obesity as a critical risk factor for postmenopausal breast cancer (post-BC), whereas a reverse association holds prior to menopause. A significant scientific gap exists in understanding the mechanism(s) underpinning this epidemiological phenomenon, particularly the reverse association between obesity and premenopausal breast cancer (pre-BC). This study aimed to understand how folate metabolism and DNA methylation informs the association between obesity and pre-BC. Fifty normal breast tissue samples were collected from premenopausal women who underwent reduction mammoplasty. We developed and measured the breast tissue folate by a Lactobacillus Casei microbiological assay, and the DNA methylation of LINE-1, a biomarker of genome-wide methylation, and the promoter methylation and gene expression of SFRP1, a tumor suppressor, were measured by pyrosequencing and real-time PCR. We found a high BMI is associated with increased folate level in the mammary tissue, with an increase of 2.65 ng/g of folate per every 5-unit increase of BMI (p < 0.05). The LINE-1 DNA methylation was significantly associated with BMI (p < 0.05), and marginally associated with folate concentration (p = 0.087). For the 8 CpG sites analyzed in the promoter region of the SFRP1 gene, no associations were observed for either BMI or tissue folate (p > 0.05), although a high expression of SFRP1 was observed in subjects with high BMI or high folate (p < 0.05). This study demonstrated that, in premenopausal women, obesity is associated with an increased mammary folate status, genome-wide DNA methylation and SFRP1 gene expression, indicating that the improved folate and epigenetic status is potentially responsible for the reverse association between obesity and pre-BC. More studies are warranted to further understand how obesity mediates pre-BC via altering folate metabolism and DNA methylation.