Master of Science / Department of Hotel, Restaurant, Institution Management and Dietetics / Carol W. Shanklin / The purposes of this study were to explore factors associated with residents’ dining experience in assisted living facilities and to investigate the influence that these factors had on perceived quality and residents’ satisfaction with their dining experience. Food quality, service quality, mealtime customization, and dining room environment were the four constructs explored. Focus groups were conducted with residents of three assisted living facilities to determine attributes of the constructs that were important to them. A total of 22 residents participated in the three focus groups. A questionnaire developed by Huang was revised to include measurement items identified in the focus groups. The questionnaire was distributed to residents of 16 randomly selected assisted living facilities within a 110 mile radius of the research institution. Of the 492 residents in 16 facilities, 246 completed the questionnaire for a response rate of 50%. Residents evaluated the attributes on a 5-point likert scale (1-strongly disagree; 5-strongly agree). Service quality (4.03) and dining room environment (3.97) attributes were rated significantly higher than food quality (3.64) and customization attributes (3.42). Resident satisfaction also was evaluated on a 5-point scale (1-very dissatisfied; 5-very satisfied). Residents were satisfied with the overall dining experience (3.94) and the overall facility (3.97). Residents were less satisfied with food served (3.67) or the amount of choices they had at meals (3.58). Residents were satisfied with services (3.95) and the dining room atmosphere (3.98). Satisfaction with services and the dining room atmosphere were significantly higher than food served and amount of choices at mealtimes. Residents’ perceptions of food quality, service quality, level of customization, and dining room environment had a positive influence on their satisfaction with the overall dining experience. Residents’ perceptions of food quality had a positive influence on satisfaction with the food served, service quality impacted satisfaction with services, level of customization effected satisfaction with the amount of choices, and dining room environment influenced satisfaction with the dining room atmosphere. Administrators, foodservice directors, and dietitians employed in assisted living facilities can use the results to improve the dining experience for residents and ultimately improve residents’ quality of life.

Master of Science / Department of Human Nutrition / Valentina Remig / The use of computer-based and personal assistive technology is projected to increase as the boomer generation continues to age. Technology is infiltrating and improving the lives of older adults, including their education. This study determined older adults’ preferences toward the use of technology to learn about nutrition and health. The sample included 132 volunteer subjects, mostly female, white non-Hispanic, ranging in age from 65−92 years, recruited from local organizations, senior centers, churches, and senior apartments. All participants completed a newly developed, 32-item pilot tested questionnaire that included demographic and self-rated health characteristics, current use of technology, factors that motivate and/or influence attitudes and interest toward use of technology, and preferred formats and topics of interest for nutrition and health education information. The results indicated that, overall, these older adults self-rated their health as either excellent or good, and that those who were younger and among the higher income brackets and education levels were more likely to use computers than those who were older, with less income, and education levels. Findings also indicated that older adults were interested and willing to learn about technology, had positive attitudes toward it and showed a high demand for user-friendly programs and training. Finally, results show that although newsletters, magazines and television were mostly preferred by older adults, computers were also considered very helpful and were used to learn about nutrition and health information.

Master of Science / Department of Grain Science and Industry / Charles E. Walker / Potassium bromate is a well-known strong chemical oxidant. It was once widely used by the baking industry all over the world, especially for making frozen doughs. Since potassium bromate has been banned in many countries, many researchers have studied in this area to find a replacement. Ascorbic acid was often combined with potassium bromate in frozen dough making as an oxidant dough additive. In addition, ascorbic acid has different chemical oxidant activity, and its function in yeast leavened dough is not as strong as is potassium bromate. More dough additives have been found, such as enzymes. Enzymes play key roles in bread making. In recent years, enzyme usage in bread making has been increasing, especially for shelf-life extension. Based on the results from this research, potassium bromate use can be replaced by a combination of ascorbic acid and hemicellulase/endoxylanase. However, using hemicellulase/endoxylanase alone cannot benefit frozen dough quality such as finer crumb cell or increasing final bread volume. These experimental results also show that using a combination of ascorbic acid and hemicellulase/endoxylanase can delay the development of bread firmness (staling) after baking. As frozen storage time increased, the firmness of frozen dough bread increased, and the bread tended to have a coarser texture. Hence, larger and uneven grain cells reflect a gray or dark crumb color.

Master of Public Health / Public Health Interdepartmental Program / Tandalayo Kidd / Heart disease, cancer, stroke, and diabetes are the leading causes of death in the United States. In addition, the prevalence of obesity has significantly increased since the 1970s. In Kansas, 37% of adults are overweight and 24% are obese. These chronic diseases and conditions tend to be prevented by and/or managed with both adequate physical activity and a healthy diet rich in fruits, vegetables, and whole grains. In Kansas 48.5% of adults meet the current recommendations for physical activity set by the American Heart Association, while 20% of adults consume the recommended amounts of fruits and vegetables. Public health officials need to work together to encourage Kansas adults to increase their participation in physical activity and consumption of fruits and vegetables to help prevent future health problems or manage current chronic diseases. To help address these health issues in Kansas, Kansas State University Research and Extension developed the 8-week Kansans Move into Health nutrition and physical activity program, building its framework around the Theory of Planned Behavior (TPB). Using TPB, participants address attitudes and perceived norms as well as perform specific behaviors associated with healthy eating and physical activity. The purpose of this study was to evaluate the effectiveness of condensing the 8-week nutrition and physical activity program into four one-hour classes using a pre- and post-survey. Nineteen participants from the Johnson County community signed up to participate with 63% (n=12) completing the program. Results indicated that participants changed their belief that nutritious foods are more expensive (p≤0.05). Furthermore, participants gained knowledge in how to prepare healthy snacks that are quick and easy. All other measures did not change (n=19; p>0.05). Future research evaluating longer program interventions could better assess attitudes and perceived norms associated with healthy behaviors and determine whether the increase in knowledge leads to behavior change.

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / Consumption of fruits and vegetables (FV) contributes to healthy growth and development among youth. For effective intervention development, an understanding of the underlying casual influences on consumption is needed. The current dissertation is intended to identify whether influences on youth fruit and vegetable consumption (FVC) vary by age, gender, ethnicity and socioeconomic status (SES). The series of four chapters focus on self-efficacy for FVC and proxy efficacy to influence other adults to provide supportive FV environments. Chapter One reviews studies examining the influences on youth FVC. Consistently across studies, FV preferences and FV availability influenced youth FVC. Chapter Two and Chapter Three report studies documenting that children's confidence (proxy efficacy) to influence parents to make FV available and to influence other adults (after-school staff) to make FV available are independent but related constructs to self-efficacy to eat fruits and self-efficacy to eat vegetables. Differences were found in these constructs according to school demographic variables and youth demographic variables. Chapter Two reports that youth attending elementary schools with lower concentrations of racial/ethnic diversity and higher concentrations of high SES were more confident in influencing their parents to make FV available than youth attending schools with higher concentrations of racial/ethnic diversity and higher concentrations of low SES. Although analyses of cross sectional data collected on elementary-aged youth presented in Chapter 3 showed no demographic differences at the school level, Chapter Four examined longitudinal data across sixth-, seventh- and eighth-grade and found demographic differences using youth level variables. Across the middle school years, youth declined in proxy efficacy and racial/ethnic minority youth declined at a significantly faster rate than white youth. Each year, male and lower SES youth were significantly lower in proxy efficacy than females and higher SES youth, respectively. Thus, school or youth demographic differences in self-efficacy and proxy efficacy may contribute to the understanding of why males and lower SES youth eat less FV than females and higher SES youth.

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / The prevalence of obesity within the U.S. has risen dramatically in the past thirty years. Recent changes in food and physical activity environments may contribute to increased obesity prevalence, suggesting that disparities in these environments may be linked to the increased risk of obesity observed in low-income, and racial/ethnic minority women. This dissertation characterizes the local food environment experienced by low-income women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Kansas, evaluates whether characteristics of the local food environment contribute to obesity risk, and examines how these relationships vary across the urban-rural continuum. Chapter One reviews the relevant literature examining the association between obesity and local food environments, and identifies three testable hypotheses that serve as the framework for later chapters. Chapter Two characterizes the local food environment and examines geographic, racial, ethnic, and socioeconomic disparities in the availability of small grocery stores and supermarkets. Chapter Three examines the association between store availability and obesity risk at an individual level among participants in the WIC Program, while Chapter Four utilizes multi-level modeling to examine the relationships between tract deprivation, tract store availability and body mass index (BMI). Significant geographic disparities were observed in the availability of small grocery and supermarkets. Racial and ethnic disparities observed within tracts were not observed when examining store availability in a 1-mile radius around the residence of WIC mothers. The majority of women participating in the WIC program resided within a 1-mile radius of a small grocery store, and micropolitan and metropolitan WIC mothers had a multiplicity of food stores available within a 3-mile radius of residence. Food store availability was associated with increased obesity risk only in micropolitan areas. The availability of food stores did not mediate the association between tract deprivation and BMI, which varied across the urban-rural continuum. Overall, these results suggest that the relationship between local food environments and eating behaviors is complex, that limited store availability does not contribute to increased obesity risk in vulnerable populations, and that the association between local food environments and obesity risk varies across the urban-rural continuum.

Doctor of Philosophy / Department of Human Nutrition / Craig A. Harms / The overall aim of this dissertation was to ascertain the influences of lifestyle factors on airway health in children and young adults. In Study 1 (Chapter 2) the effect of a high-fat meal on airway inflammation and hyper-responsiveness was examined. Results revealed a post-prandial increase (p<0.05) in total cholesterol (~4%), triglycerides (~93%), and exhaled nitric oxide (a marker of airway inflammation, ~19%) two-hours following a high-fat meal (74.2±4.1g fat). These novel findings suggest that a high-fat meal may contribute to impaired airway function. In study 2 (Chapter 3) we assessed the role of body fat and physical activity (PA) on airway health in prepubescent children. This study revealed that children with higher-body-fat levels (>21%), who were not meeting current PA recommendations, experienced greater (p<0.05) amounts of post-exercise airway narrowing (FEV1, forced expiratory volume in 1-second, ~11%), as compared to children with lower-body-fat (<21%), who were meeting PA guidelines. These findings suggest that elevated adiposity and low PA levels may place children at risk for development of asthma and asthma-like symptoms. In study 3 (Chapter 4), based on study 2 results, we assessed the impact of 8 weeks of high-intensity interval training on airway health in children who were not meeting PA guidelines. We determined that high-intensity training significantly increased V02max (~24%), and decreased total cholesterol (~11%) and LDL cholesterol (~35%). Additionally, we found improvements (p<0.05) in ∆FEV1 both post-exercise (pre: -7.6±2.2%, post: -1.3±1.8%) and post-eucapnic voluntary hyperventilation (pre: -6.7±2.2%, post: -1.4±1.5%) with training. Further, Lower-body-fat and higher V02max subjects experienced significantly greater improvement in ∆FEV1 following training than higher-body-fat and lower V02max subjects (r=-0.80, r=0.73, respectively). These results suggest that in children, high-intensity training can ameliorate the negative health consequences of inactivity. However, increased body fat, and low V02max levels may constrain these improvements. This series of studies underscores the importance of dietary habits, body composition, and PA for airway health in children and young adults. These findings may be useful in determining policies and practices impacting children’s health, and could facilitate protocol development for prevention of asthma-like symptoms.

Master of Public Health / Department of Human Nutrition / Sandra B. Procter / HIV/AIDS is one of the most devastating health concerns of the developing world, especially in sub-Saharan Africa (SSA). To address individual food insecurity and malnutrition, numerous small-scale nutrition and agriculture interventions have been implemented. This study compared the CTC Community Garden Project in Maai Mahiu, Kenya (n=15) and the HelpMercy Nutrition and Food Security Project (seed distribution) in Macha, Zambia (n=64), after one year. Study objectives included assessing food security in Maai Mahiu, determining beneficiaries' perceived usefulness of the interventions, comparing and evaluating the interventions, determining the importance of education in the interventions, and making recommendations for improvement. A survey in Maai Mahiu used a modified FAST tool to determine food security for beneficiaries (n=15) and non-participants (n=50). The majority of respondents were determined food insecure (without hunger), indicating a need for improved access to food/land. To determine outcomes and make comparisons, intervention outcome and beneficiary 'perceived usefulness' were measured using two verbally administered surveys, two focus groups, and two interviews with translation. Qualitative and quantitative results demonstrated differences between beneficiary perceptions of the interventions. No association was observed between perceived usefulness of the two studies (χ2). A backward elimination logistic regression model of the HelpMercy intervention showed that attendance at community-based nutrition and agriculture education sessions (CBES), household size, and number of seed types planted were predictors of perceived usefulness. Households who attended at least one CBES were more likely to perceive the intervention as useful (χ2 for trend, p=0.007), and there was a linear relationship between number of CBES attended and perceived usefulness (Mann-Whitney, p=0.008). Results may support research that agriculture interventions are more effective when combined with nutrition education. Perceived barriers and benefits differed significantly between the two programs. 60.3% of HelpMercy beneficiaries and 40.0% of CTC beneficiaries perceived the interventions as useful. Program improvements are possible, and further research is needed to better understand the impact and potential benefits of small-scale nutrition and agriculture interventions for HIV-affected populations in SSA.

Master of Science / Department of Grain Science and Industry / Sajid Alavi / Extrusion processing and frying are the two most commonly used methods to produce savory snacks. These snacks are mostly starch based and also contain high amounts of fat. Snacking percentage has increased drastically over the past few decades causing many health problems like obesity, hypertension and cardiovascular diseases. The overall objective of this study was to develop novel soy based savory snack that are high in protein and has less fat using both extrusion processing and frying. In the first part of this study both defatted soy (25-75%), wheat flour, monoglycerides (0.375 & 0.75%) and sodium bicarbonate (0 and 0.5%) were used to produce dense extrudates, which mimic the shape of lentils using pilot scale twin screw extruder. The extrudates were soaked in water and fried in corn oil to produced savory snacks. Soy influenced the water absorption during soaking and oil uptake during frying. The water uptake and % fat decreased with increase in soy and the amount of water uptake influenced the % fat absorption in the product. No significant differences were observed in overall acceptability and to summarize the increased protein and dense structure of the products challenge the texture of the products. In the second part of this research, dynamics of water and oil uptake were studied to see the role of texture modifiers like soy protein isolate (4, 8, & 12%), calcium bicarbonate (0.2, 0.4 & 0.6%) and pregelatinized wheat starch (4, 8, & 12%) on texture, water and oil uptake. Descriptive sensory analysis was conducted to study the sensory attributes of the products. Water holding capacity is influenced by the level of % starch addition and the degree of starch degradation during processing. Oil uptakes correlates to that of WHC and is also affected by the degree of gelatinization and crust formation. Degree of starch gelatinization, oil uptake and oil and starch matrix interactions had an impact on hardness. Among SPI, CaCO3 and PGWS, PGWS lowered the product hardness followed by SPI and CaCO3. Descriptive sensory results are similar to experimental results with PGWS samples having lower initial or substantial hardness and more oxidized or heated oil aroma and flavor.

Doctor of Philosophy / Department of Human Nutrition / Richard C. Baybutt / Weiqun George Wang / Although omega-3 fatty acids have been a hot issue in nutrition for years, there remains a paucity of research on the topic of omega-3 fatty acid and pulmonary fibrosis and the mechanism is still unclear. The purpose of this research is to investigate the preventive effects of flaxseed oil for bleomycin-induced pulmonary fibrosis in rats and to find the possible underlying mechanisms. There are two experiments demonstrated in this dissertation, one is with various doses of flaxseed oil in the diet (0, 2.5, 5, 7.5, 10, 12.5, and 15 % (w/w)), and the other is with different times of sacrificing animals after oropharyngeal bleomycin treatment (days 7 and 21). In the first study, three proteins including transforming growth factor-[beta] (TGF-[beta]), interleukin-1 (IL-1), and [alpha]-smooth muscle actin ([alpha]-SMA), commonly associated with fibrotic inflammation in the lung, were examined by Western blot and fatty acids composition of the diets and tissues were analyzed by gas chromatography (GC). Fifteen percent of flaxseed oil group significantly reduced septal and vascular thickness and fibrosis in the lung, and significant cardiac fibrosis in the heart. The amount of IL-1 and [alpha]-SMA decreased significantly as the amount of omega-3 fatty acids increased, whereas TGF-[beta] did not change significantly. The next study further reported the time-course effect and potential underlying mechanisms. Both interleukin-6 (IL-6), a protein associated with fibrotic inflammation in the lung, and renin, an enzyme related to renin-angiotensin system, were examined by Western blot. The time-dependent increase of IL-6 in response to bleomycin treatment was reversed by flaxseed oil diet. Although renin was not significantly different in the kidney, it suggested that the renin-angiotensin system may be involved locally. In addition, the profiles of fatty acids in both liver and kidney tissues as measured by lipidomics demonstrated a significant increase of omega-3: omega-6 ratio in the flaxseed oil-fed groups. Overall, these results indicated for the first time that the omega-3 fatty acids rich in flaxseed oil inhibited the formation of pulmonary fibrosis in a dose-dependent manner - however the moderate dose of flaxseed oil was most effective - via anti-inflammatory mechanisms, which appears associated with the modulated fatty acid composition in the tissues.