Nutrition education has become a topic of significant concern in today’s society. An area prominent in the interest of nutrition is the battle against food security. Programs like the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) is helping to improve its participants’ food security by providing nutrition education. Kentucky SNAP-Ed participants were asked to complete a survey and a 24-hour food recall to evaluate their knowledge in the following areas: Healthy Eating Index (HEI) scores, food resource management and nutrition practices. Each participant completed an average of 7-12 nutrition education lessons throughout the year. To graduate from the program participants were required to complete the same survey and food recall, applying knowledge gained from the program. Responses from 2,868 participants were analyzed to assess the impact of the SNAP-Ed program. Results demonstrated an improvement of average post-mean responses in all three areas (p-value < 0.001). In conclusion, this research supports that those who participated in the 2012 – 2013 SNAP-Ed program graduated with an overall positive change in nutrition behavior, promoting enhanced food security in low-income families.

Background: Obesity is a complex health issue, which results from the interaction between many determinants: genetics, physical environments, society, economy, and culture. Data indicate that about 19% of American children (2 to 19 years) have obesity, a condition that considerably affects physical and mental health and that usually continues into adulthood. Aside from its direct physical and mental effects, there is strong evidence that childhood obesity is strongly associated with early onset and adult cardiovascular diseases and diabetes. Family and parental factors, which have both genetics and environmental components, have long been implicated in previous research as major forces in the development of childhood obesity. This study delved deeper into the relationship between family and parental factors and childhood obesity. Methods: Data examined in this study is from the Centers for Disease Control and Prevention (CDC) National Survey for Child Health collected during 2013-2015. In total, 42,121 subjects were included in this representative sample. Multiple logistic regression models were run to determine association between family and parental factors (access to the children’s health insurance programs (CHIP), low birth weight (LBW), poverty, family size, and location of residence) with obesity (defined as a body mass index at or above the 95th percentile for the same age and sex). The model was adjusted for possible confounders such as demographics (age, sex and race) and emotional status. SAS v 9.4 was used for analysis. Results: After adjusting for all covariates, there was a significant association determined between childhood obesity and CHIP, poverty, LBW, the number of children in a family and family location. The odds of being obese decreased significantly with an increase in the number of children in each family (Odds Ratio (95% confidence interval) (OR): 0.877 (0.875-0.879), P Conclusion: Family and parental factors such as access to CHIP, family poverty, family size, LBW and location heavily affect the prevalence of childhood obesity in America. Further studies are needed to understand how family structure, dynamics, and parental influences impact rates of obesity in children.

Mental health disorders are rising in children and being referred to as an epidemic. Numerous studies have shown micronutrient deficiencies and poor diet quality are suspected of playing a contributory role in the escalation of certain disorders. However, there is no research in young children focusing specifically on social emotional disorders and possible links to nutrition. Conventional treatment for social emotional disorders in children typically involves medication. Parents are increasingly turning to complementary and alternative medicine to treat their children with a method that is individualized and holistic. The biopsychosocial model provided the theoretical framework for this correlational study that investigated the association between nutrient intake and social emotional functioning. Multiple regression analyses were conducted to determine if diet/health indicators were significant predictors of any of the subscale scores on the Behavior Assessment System for Children - Second Edition (BASC-2), Parent Rating Scale -Preschool social emotional variables. Intake of food categories was measured by the amount reported by a sample of 119 parents over a three-day period. Higher levels of processed food consumption significantly predicted higher scores of atypicality. Additionally, reporting a family history of mental illness was associated with lower levels of hyperactivity and depression. The relationships between the other diet quality/health indicators and social emotional functioning in children were non-significant. The results of this study offer an alternative or supplemental treatment modality to psychotropic drugs. With the increasing health and economic burden of mental health disorders in children, the investigation of risk factors such as nutrient intake, is an essential and pressing research initiative.

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which they describe how the experiences of educators and learners affect the way information is perceived, formed the conceptual framework for this study. An illustrative case study paradigm was used to identify the perceptions of licensed health care practitioners regarding the current adult teaching methods for modifying dietary carbohydrate and excess weight. Using a purposeful sample, data were collected in 2 phases with 5 licensed health care practitioners: Phase 1 entailed an open-ended electronic questionnaire and semistructured telephone interviews with open-ended questions during phase 2. Data were analyzed through coding and aggregation by NVivo and Tosmana software, respectively. The findings indicated that the American Diabetes Association (ADA) plate method was the most effective teaching model for controlling weight and carbohydrate intake. Consequently, the ADA plate method was used to create a professional development program to teach health care educators about nutrition instruction methods for adults. The study contributes to positive social change by enhancing preventive health measures for the local adult population through diet therapy education.

Poor diet quality is a source of morbidity and mortality within the United States. Previous researchers have examined psychosocial influences on diet; however, the relationship between life chaos, a psychosocial measure, and diet quality was not known. The purpose of this cross-sectional survey study was to use the Life Chaos Scale and the Healthy Eating Index-2010 to collect data on life chaos and diet quality, consistent with the biopsychosocial model of health, from a sample of 103 U.S. adults. Regression analysis was used to construct a predictive model. According to the study results, life chaos was not a significant predictor of diet quality (p = .699), although household income, when added to the model, was a predictor of diet quality (p = .011). Although there was no relationship between life chaos and diet quality, life chaos could be found universally throughout household income levels. Additionally, diet quality had a negative correlation with household income. Life chaos was not a significant predictor of diet quality, while confirming the role of income in diet quality. As inequalities of health and nutrition continue to be better understood through studies such as this, social change efforts can be targeted in an evidence-based way to bring the health benefits of a high quality diet to more Americans starting with greater outreach to low-income individuals.

Development of an Educational Program to Obtain and Maintain Healthy Weights Among 4th and 5th Grade Students By Stephanie D. Black MSN, University of Phoenix, 2008 BSN, Southwest Baptist University, 2006 ASN, Southwest Baptist University, 2003 Capstone Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University October 2017 Obesity is prevalent in schoolchildren and increases risk of chronic diseases throughout the lifespan. Strategies are needed to address this growing health problem. Education in elementary schools targeting the topics of nutritional choices and prevention of obesity, particularly in 4th-5th grade population, is one strategy researchers have identified as effective. This quality improvement project designed an educational toolkit to provide students educational knowledge and assist them to develop and explore how to incorporate healthy habits and choices into their daily lives. The purpose of this project was to develop an educational program for use in a southwestern elementary school to improve and/or maintain the weights of 4th and 5th grade students. The educational tool kit was developed for the school to implement to fill a gap their curriculum identified by school board members and educators. Orem's self-care deficit theory informed the development of this program, the educational toolkit, and all associated supplementary materials. An interdisciplinary project team of community and institutional stakeholders led by the Doctor of Nursing Practice student worked together to review peer-reviewed evidence, consider contextual challenges, and develop a curriculum suitable for the population. Plans for program implementation and evaluation were also developed to provide the school with a turnkey solution to the problem of child obesity. This initiative has great potential to promote positive social change through improving the health of local elementary school students and other elementary schools in the area may use it as a model for their own curriculum to improve knowledge, habits, and practices of elementary students relevant to positive nutritional choices.

The aim of the present study was to determine if a nutrition and yoga intervention will improve quality of life (QoL) in breast cancer survivors (BCS). Using the Transactional Model of Stress and Coping as a guide to lead the intervention, the intervention assessed potential barriers, self-efficacy, diet quality, and physical activity as it relates to quality of life. Twenty-seven women were enrolled in the study and randomly assigned to the control or intervention group. The intervention consisted of 6-weeks of yoga classes and 6-weeks of online nutrition education. The control group received a nutrition consultation and nutrition guidelines from the American Cancer Society. Measurement of variables was conducted at baseline, post-intervention (6 weeks), and follow-up (12 weeks). One-way repeated measures ANOVA, paired samples t-test, and post hoc analysis with Bonferroni adjustment was used to analyze the data. Mediation analysis with regression was performed to demonstrate the effect the intervention had on quality of life. The intervention elicited a statistically significant difference in the Total Outcome Index quality of life score from baseline to post-intervention (P < .005) and from baseline to follow-up (P < .005) in the intervention group. The frequency of how often fruits and vegetables were consumed was significant between time points, (P < .05), but not between the control and intervention group, P = .538. The amount of fruit and vegetables consumed each time was statistically significant for the intervention group from baseline to post-intervention (P < .05) however there was no significant difference from baseline to follow-up (P = .067). There was no difference between the control and intervention group, (P = .216). There was a statistically significant difference for physical activity for time (P P = .166) however the intervention group has a statistically significant difference between baseline and post-intervention (PP = .082). We cannot confidently predict that participant’s quality of life scores are determined by group with the help of mediators after conducting a mediation analysis with regression. A six-week nutrition and yoga intervention in BCS elicited significant changes in QoL in BCS. Even though the results did not show significant changes between the control and intervention group there were significant changes within the intervention group from baseline to post-intervention and baseline to follow-up which may indicate a 6-week online nutrition education program coupled with a 6-week yoga intervention an effective tool to improve QoL in BCS.

The prevalence of cardiovascular disease is a major public health concern worldwide. It has been theorized that diets rich in fruits and vegetables may be protective against the development of cardiovascular disease mainly through their high content of flavonoids. Flavonoids were thought to influence traditional risk factors of cardiovascular disease such as blood pressure, lipid profile, and systemic inflammation. Recent clinical studies have shown that this may not be the case. The production of trimethylamine oxide (TMAO) by the gut microbiota from dietary sources of choline has been associated with an increased risk of cardiovascular events. The objectives of this study were to determine the effects of a high flavonoid diet on gut microbiota composition and plasma trimethylamine oxide concentrations. Potential benefits of this research include the determination of a potential correlation between diet and markers of traditional and non-traditional risk factors for cardiovascular disease. Also, the effects that a high flavonoid diet has on the composition of the gut microbiota and plasma trimethylamine oxide concentrations may provide insight into possible dietary interventions to prevent cardiovascular disease.

Carbohydrates are a major energy source for the human body and particularly glucose is the only energy source for the brain. Thus glucose metabolism is important to maintain normal brain function. Evidence showed insulin resistance and diabetes are associated with cognitive decline and a large amount of highly processed carbohydrate intake; in other words, a high glycemic load diet, which increases blood glucose faster and insulin demand, is associated with increased risk of insulin resistance and diabetes. Based on this premise, the hypothesis that a high glycemic load (GL) diet increases the risk of incident Alzheimer’s disease (AD) was examined among Cache County elderly people in Northern Utah. At the baseline survey, 3,831 participants 65 years of age or older completed a food frequency questionnaire (FFQ) and cognitive screening. Observation time to collect the data for incident AD was approximately 10 years. Incident AD was determined by final consensus conference after multi-steps of screening. GL was calculated as the product of carbohydrate intake and glycemic index (GI) and adjusted for energy intake. FFQs from diabetics were considered to be invalid to assess dietary carbohydrates intake and excluded. The analysis was examined separately by gender. The Cox proportional hazard regression model in survival analysis was used to relate GL to incident AD using a time variable with age of AD onset. There was no association in men but a negative association in women in the unadjusted model. Evidence of confounding by total kcal was apparent in women, particularly in the lowest GL group, which had the highest total kcal mean intake. Finally no association between GL and AD was found after adjustment for education, myocardial infarction (MI), stroke, Body Mass Index (BMI), physical activity, smoking, alcohol use, APOE ε-4 alleles, multi-vitamins use, total kcal, and controlling interaction between GL and total kcal. The low GL group had unique characteristics in lifestyle factors, macro-nutrients intake, and pattern of food use. The inverse relationship between GL and total kcal may partly be explained by lifestyle factors, particularly alcohol intake. The characteristics of low GL group, current smokers, alcohol users, and their relationship and interaction between total kcal and risk of AD should be explored further.

This study compared the effect of packaging method (0.4% carbon monoxide, 80% oxygen or vacuum), storage time (7, 14 and 21 days) and internal cooking temperature 49, 57, 66, 71 and 79°C) on color and thiobarbituric acid (TBA) values of top sirloin steaks and ground beef patties. Ground beef was obtained from 3 different sources (chuck, loin and trim). All samples were stored at 2°C for 7, 14 and 21 days. All raw ground beef samples stored in 0.4% carbon monoxide remained bright red throughout the 21-day storage period. The phenomenon of premature browning (appearance of cooked color at lower than normal cooking temperatures) was observed in samples stored in high oxygen. TBA values were highest for the samples stored in 80% oxygen. Internal a* redness values were lowest for samples stored in 80% oxygen. Percent myogobin denaturation (PMD) increased with increase in internal cooking temperature and was highest for the ground beef samples stored in 80% oxygen. The a* redness values were highest for raw steaks stored in 0.4% CO. Steaks stored in vacuum had a uniform purple color, but some browning was noticed on the surface of the samples by day 14. PMD and TBA values of cooked top sirloin steaks were highest for the samples stored in 80% oxygen This study confirms that high oxygen packaging promotes rancidity in ground beef and top sirloin steaks. Packaging in 0.4% carbon monoxide helps maintain a bright cherry red color in ground beef and top sirloin steaks for up to 21 days.