Nutrition & Dietetics: Student Scholarship

The purpose of this study was to compare mindful eating practices and food security status of public versus private college students. Food insecurity, the lack of access to healthy foods, is a real issue facing the college-aged population. Mindful eating behaviors could be effective in improving health and creating interventions for students who are food insecure. In this study, data on mindful eating behaviors and food insecurity status was collected via an online survey which included the validated Mindful Eating Questionnaire (MEQ) and Food Insecurity Screening tool. Mindful eating was assessed based on scores across 5 MEQ subscales (awareness, distraction, disinhibition, emotional, external). Higher MEQ scores indicate higher mindful eating behavior. Eighty-two college students participated in the survey, of which 59.8% attend private schools and 40.2% attend public schools. The prevalence of food insecurity was 21.6% overall, with a higher incidence of food insecurity in public schools (24.2%) versus private schools (20.4%). Results showed males and females had different total MEQ scores with females having a significantly higher score (p=0.022). There were no significant differences found between undergraduate and graduate, food insecure and food secure, or private and public school students with regards to mindful eating behaviors. Results suggest more education is needed to promote mindful eating behaviors in all student populations, especially the male population.

Protein is a macronutrient used for building and repairing tissues in the body. The purpose of this study was to analyze protein intake of Division I collegiate baseball players during the fall off-season. Twenty-one Lipscomb University baseball players (19.7±1.4 yrs; 183.9±7.6 cm; 19.7±6.2 % BF; 87.9±8.6 kg) completed 3 dietary recalls on 2 weekdays and 1 weekend day. Participants received education on determining portion sizes along with an informational handout and dietary intake form instructions. Dietary intake forms were collected, reviewed, and clarified for credibility and accuracy. Protein intake was determined by averaging consumption of the 3 days collected, and analyzed with the nutrition database, Nutritionix. Protein requirements were defined at 2 g/kg/d based on recommendations from the Academy of Nutrition and Dietetics. Data analysis revealed athletes consumed 2.0±0.6 g/kg/d protein on average. Further analysis revealed that 10 out of 21 (47.6%) athletes did not meet the recommended 2 g/ kg/d of protein, and 6 of 21 (28.6%) did not meet 1.8 g/kg/d. It appears that Lipscomb University baseball players are not consuming adequate dietary protein for muscle growth considering the rigorous weight-lifting and training programs mandated. This study emphasizes the need for sports dietitians in optimizing muscle protein synthesis for athletes. Future research can investigate if baseball players meeting protein needs execute better in various performance measures.

The macrobiotic diet has gained traction within the holistic nutrition community for its possible healing effects as an anti-inflammatory diet for chronic diseases such as cancer. The macrobiotic diet includes food groups such as whole grains and local, inseason produce while purportedly avoiding the “toxins” that come from dairy products, meats, and animal-based fat sources. The macrobiotic diet is not currently recognized as a therapeutic diet by the Academy of Nutrition and Dietetics. The purpose of this research study was to evaluate dietetic professionals’ (e.g. registered dietitians, dietetic technicians, dietetic interns and students) current knowledge of the macrobiotic diet as well as their level of interest in learning more about it. Data was collected via a 12-question online survey available from November 2019 to January 2020 (N = 55). Results indicate that of the participants responding 41.51% were familiar with the macrobiotic diet, and 72.72% reported that their knowledge level on the diet was average or good. Only 3 respondents answered “yes” to the question which asked if they’ve had patients or clients inquire about wanting to try the macrobiotic diet; however, the majority of respondents (n = 48) indicated they were interested in learning more about the diet. Overall, study results suggest that practicing and future dietitians or technicians could benefit from further education on the various components of the macrobiotic diet.

The increasing popularity of plant-based diets (e.g. vegetarian and vegan) may stem in part from research connecting those eating patterns to health benefits such as a reduced risk of heart disease, diabetes, and certain cancers. A vegetarian diet is defined as a diet excluding meat, poultry, or seafood whereas a vegan diet excludes all animalderived products including dairy, eggs, and honey. The purpose of this study was to determine the knowledge and perception of vegetarian and vegan diets among current health professional students. Data was collected via an online survey from students enrolled in allied health professional programs (Nursing, Dietetic Undergrad and Interns, Physician Assistant, Pharmacy, Exercise Physiology, and Mental Health Counseling) at Lipscomb University (N=34). Results show that 32% (n=11) and 38% (n=13) of respondents incorrectly identified components of a vegetarian and vegan diet, respectively. Furthermore, 23.5% (n=8) of respondents perceived a balanced vegetarian diet as inappropriate for the general public. Almost half (47%) of the respondents reported having not participated in a nutrition course within the past 5 years. Thirtytwo percent of subjects (n=11) indicated being somewhat uncomfortable consulting with a patient who follows a plant-based diet and 6% (n=2) indicated being very uncomfortable. Based on these study results, continued nutrition education regarding plant-based diets is needed for students in health professional fields.

Total parenteral nutrition (TPN) is a mode of feeding that bypasses the gastrointestinal tract and administers nutrients into a vein. The purpose of this study was to evaluate factors contributing to uncontrolled glucose levels (above 180 mg/dL) in hospitalized TPN patients. Charts of hospitalized patients (N=38) from October to December 2019 were reviewed and 17 clinical variables were recorded for each patient (e.g. gender, age, race, BMI, steroid usage, insulin prescription, etc.). Upon TPN initiation, 34.2% of patients were prescribed steroids and 15.8% had a diabetes diagnosis which is consistent with clinical expectations of elevated glucose levels under those circumstances. Overall, 31.6% of patients were found to have uncontrolled glucose levels and of those, 33.3% of patients received insulin initially with their TPN while 41.6% had insulin added after TPN initiation, and 25.1% never had insulin added. Chi-square analysis indicates that males and females (X2=4.656, df=1, N=38, p=0.031) differ significantly in whether or not they experience uncontrolled glucose levels while receiving TPN. Not surprisingly, patients with or without a diabetes diagnosis are significantly different in whether or not they experience uncontrolled glucose levels (X2=8.833, df=1, N=38, p=0.008) while receiving TPN. Additional research is needed to explore how early administration of insulin to TPN patients can better manage blood glucose levels and ultimately improve clinical outcomes.

Food insecurity, defined by USDA, is a reduced access by households to enough food for an active, healthy life. Poverty, unemployment and inconsistent access to adequate healthy food can lead a household towards food insecurity, which affected 11.1% of U.S. households in 2018. The Emergency Food Box (EFB) program is one initiative that addresses food insecurity through the distribution of typically pre-made food boxes (e.g. peanut butter, canned goods, bread, etc.) to those enrolled. The aim of this study was to assess Middle Tennessee Second Harvest Food Bank EFB program participants’ perspectives of the emergency food boxes they receive. Five Nashville-area EFB distribution sites were visited during October and November 2019. A 10-question survey collected participant data (N=45) including frequency of receiving a food box, how much food is typically eaten from the box and how long the food lasts the household. Results indicate that 49% of clients (n=22) receive an EFB 3-5 times per year, 31% of clients (n=14) report an EFB lasts 2-3 days, and 49% of clients (n=22) indicate they consume all the food provided by the program. Study results appear consistent with Second Harvest Emergency Food Box standards for a household receiving 3-5 boxes per year that lasts them 2-3 days, and from which they eat all the food. More research is warranted to evaluate additional client feedback on food boxes from other EFB sites in Middle Tennessee.

The body’s main source of dietary energy comes from carbohydrates (CHO); thus adequate CHO intake is particularly important for physical activity. The aim of this research project was to observe the relationship between exercise performance and CHO in the previous 24 hours. Six resistance-trained male volunteers (24.4±4.1 years; 1.74±10.9m; 90.1±11.9kg), with at least 1 year of resistance training experience participated in this study. Following an overnight fast, participants performed a lower-body acute resistance exercise bout consisting of 4 sets of the leg press and leg extension exercises (up to 10 repetitions at 75% of 1-repetition maximum for each set). Participant 24-hour dietary recalls were collected to identify CHO gram (g) consumed per kilogram (kg) of body weight (g/kg) during the previous day. Macronutrient analyses were performed using MyFitnessPal. Exercise performance was indicated by percent of repetitions completed per set for each exercise. Spearman correlation coefficient analysis identified weak correlations between CHO g/kg consumed and repetitions completed for both leg press (rs = 0.0304; p = 0.9545) and leg extension exercises (rs = 0.0870; p = 0.8699). No significant relationships were identified. These data suggest that CHO intake over the previous 24 hours is not related to resistance exercise performance in males; however, the application of these findings is likely limited due to the small sample size.

Nutrition Focused Physical Examination (NFPE) is a tool used by Registered Dietitians (RDs) to evaluate the nutritional status of patients at risk of malnutrition. Clinical markers of malnutrition can range from edema, wasting of muscle mass or subcutaneous fat, to signs of micronutrient deficiencies. Performing NFPEs on patients allows RDs to diagnose patients with malnutrition, which can be predictive of clinical outcomes and mortality. The purpose of this study was to determine whether RDs with 10 years of experience. Data was collected via an online survey shared on social media. Survey results reveal that participants (N=45) practice in a variety of facilities (e.g. community hospitals, long-term acute care, outpatient clinics) ranging from 23 to 800 beds. Data was divided based on the number of years as a practicing RD as it was supposed that RDs with >10 years of experience did not perform NFPEs as frequently in comparison to RDs with 10 years of experience are not significantly different in their frequency of performing NFPEs. Future research is needed to further examine variations between generations of RDs and their frequency in usage of NFPEs as well as identifying barriers to routinely performing NFPEs.

The purpose of this study was to evaluate the effectiveness of the sports nutrition resources available to collegiate student athletes by assessing change in nutrition knowledge according to the frequency of interactions with the Sports Nutrition Department (SND) (e.g. Registered Dietitians, Dietetic Interns, and Graduate Assistants). Data was collected from 4 athletic teams (N=32) using the validated 49-item Sports Nutrition Knowledge Instrument (49-SNKI) during two survey periods: baseline (week 0) and mid-year (week 23). Researchers maintained documentation of all nutrition-related interactions in which nutrition knowledge was shared by the SND with study participants. The number of interactions was then used to group the 4 athletic teams into low (25-49 interactions), medium (50-74 interactions) and high (75-100 interactions) SND interaction categories. A dependent t-test revealed statistically significant (p<0.05) improvements in mean 49- SNKI scores in each of the interaction groups, with the greatest mean improvement shown in the high interaction group (M = 12.16, SD = 2.14, t = 5.65). The results of this study suggest increased athlete utilization of sports nutrition resources results in significant increases in nutrition knowledge. Future research should further examine the interaction type, duration of interactions, and personalized interaction between the athlete and SND staff in relation to changes in overall nutrition knowledge.

Consumers are increasingly interested in discovering recipe modifications which add nutritional value, decrease food waste, or accommodate allergy and/or plant-based dietary patterns. One potential recipe modification ingredient is aquafaba. Aquafaba, the liquid portion of canned chickpeas, is low in protein but can be used as an egg substitute for those who are vegan, have allergies, or need to limit dietary protein. The aim of this research was to test the acceptability of aquafaba as a substitute for eggs in a brownie recipe. Data was collected through a blind taste test of 2 brownies by employees at 2 middle Tennessee healthcare sites (N=70). A standardized brownie recipe was prepared 2 ways: 1 with eggs and 1 with aquafaba in place of eggs. Participants were asked to taste both brownie samples and evaluate (1=worst to 5=best) 4 acceptability categories: taste, texture, appearance, and overall satisfaction. Results show that when comparing Brownies A (aquafaba) and B (egg) a larger mean score difference was found for appearance (.43) while taste (.26) and texture (.1) had smaller mean score differences. The overall satisfaction mean score for Brownie A (M=3.56, SD=1.12, N=70) was smaller than Brownie B (M=3.81, SD=0.68, N=70). Using a two-sample t-test, t(130) = -1.61, p=0.11, results suggest that the brownie samples may be similar in overall satisfaction. Future research is needed to further explore potential uses for aquafaba as an economical and functional ingredient.

Relative Energy Deficiency in Sport (RED-S) refers to a combination of physiological symptoms indicating an athlete's balance between dietary intake and energy expenditure. Low energy availability can cause decreased bone mineral density, which places athletes at an increased risk for injuries and fractures. If RED-S is identified early, a registered dietitian can help the athlete restore optimal health status through proper nutrition interventions prior to bone loss, and reduce the risk of a bone-related injury. The risk of RED-S was determined for male and female (N = 30) D1 collegiate cross country runners at Lipscomb University using scores from the Low Energy Availability in Females Questionnaire (LEAF-Q) screening tool and bone density from DXA scans. Bone density measurements were standardized with Z-scores. | Results show a weak negative correlation between Z-score and LEAF-Q score for females (r = -0.349). The correlation for males (r = -0.150) was weaker. The results suggest that the higher the LEAF-Q score, the lower the z-score, indicating that athletes with low energy available are more likely to have lower bone density. The lack of a gender-neutral screening tool may have resulted in a blunted affect for the males. This study indicates the need for screening protocols in collegiate athletic departments to identify at-risk athletes, and the need for registered dietitians to develop nutrition intervention for athletes at high risk for RED-S. It is also suggested that a gender-neutral screening tool for low energy availability should be developed to better assess the nutritional status of male athletes.

As we continue to learn more about human metabolism and the pathophysiology of various disease states, health professionals are able to provide more specific therapeutic approaches for disease management. The study of nutrigenomics demonstrates a novel approach to disease prevention and management through dietary inter-individual variability. Initial research in this area has focused on a particular type of genetic variation called a single nucleotide polymorphism (SNP). Numerous polymorphisms have been identified as significant influencers in the differing response to identical dietary intake. The purpose of this research was to review current literature on the development of personalized nutrition and nutrigenomics particularly for the management of metabolic syndrome. Literature searches were conducted in PubMed utilizing the keywords 'nutrigenetics' and metabolic syndrome'. Clinical trials were then reviewed to meet the following inclusion criteria: sample size of n > 50, subject diagnosis of metabolic syndrome, and genetic variation as a measured outcome. While there were no common SNP's identified between different studies, several demonstrated potential utility for the management of metabolic syndrome. Individuals with the PPARA Leu162Val x PPARG Pro12Ala genotype observed significantly lower plasma LDL cholesterol (p = 0.0002) following a 24-week intervention on a high monounsaturated fat diet. In a separate study, individuals carrying the A allele of the FTO-rs9939609 polymorphism saw a significant decrease in serum triglyceride levels (p = < 0.05) with a 12-week treatment of artichoke leaf extract. Additional research is warranted to develop a framework for the implementation of personalized nutrition on a larger scale.

In recent years grocery stores have seen market shares for store food brand foods steadily growing. With the price gap widening between name brands and store brands, consumers have begun to purchase more store brand food products. The purpose of this study is to explore cost differences between conventional and specialty grocery store foods and assess consumers perceptions of product differences. A food item price comparison from three grocery store chains (Kroger, Publix, and Whole Foods) was performed on ten staple household items in four cities across Tennessee (Nashville, Knoxville, Chattanooga, and Memphis). Additionally, a 10-question, online survey was provided to shoppers in those same Tennessee cities in order to assess the decisions which differentiate shopping at a conventional grocery store versus a specialty store. Seventy-five shoppers, 74% being female (n = 54), participated in the survey. Results of the food product cost comparisons suggest that the Nashville region Kroger had the overall lowest store brand cost. Whole Foods in all regions had the highest overall store brand cost. A large percentage (80.8%) of shoppers believed the Whole Foods '365 Everyday Value' store brand would be more expensive than competing store brand items at conventional grocery locations. Sixty-four percent of shoppers say they choose a specialty store for higher quality items, brand specific products, and diet specific needs. Conventional grocery stores were chosen mainly for convenience factors, reduced prices, and staple food items. Dietitians can utilize these results to assist clients in grocery shopping advice depending on their financial standing.

Herbal and dietary supplement use continues to increase among U.S. adults. The purpose of this research is to compare previous National Health and Nutrition Examination Survey | (NHANES) research of herbal and dietary supplement users to current users. A validated online, 36-question survey was posted through social media. In this research study (N = 157), seven of the adults 65 years and older (50%), 27 adults 40-64 years old (75%), and 66 adults 20-39 years old (64%) reported they currently use dietary supplements. When compared to previous NHANES findings there was a 21% and 24% increase in supplement use in adults 40-64 and 20-39 years of age respectively, yet a 22% decreased supplement intake among adults 65 years and older. Of the 100 study participants who indicate taking dietary supplements, 91% report that it helps them, 53% are taking supplements due to single or multiple health conditions, 43% are taking supplements along with medications, and 77% of supplements were not prescribed by a doctor. When examining the knowledge of herbal and dietary supplements, most participants report they had a general understanding of product safety issues, labeling and regulation laws. This research indicates a growing trend and acceptance of dietary supplement use among adults younger than 65 years old with a large percentage taking supplements through self-prescription. Dietitians can use this research to increase awareness on herbal and dietary supplement use as well as highlight the importance of asking clients about supplements they take in order to evaluate any potential dietary contraindications.

Recovery from bouts of exertion is critical for overall health and performance of athletes. Student-athletes are a special population because of their demanding schedules which may limit time for physical recovery after sport. This research evaluated 30 male athletes on the Lipscomb varsity baseball team ages 18 to 24 years. The testing period took place during the fall of 2018. Participants completed a 6-question recovery tracking tool weekly for eight weeks. The tool addressed aspects of sleep, nutrition, hydration, physical regeneration, work-life balance, against workout intensity. After eight weeks of off-season training and use of the recovery tracking tool, the participants took a survey assessing their level of perceived health, along with self-reported incidence of illness and injury. Results from this 10-question survey showed that 46.7% of participants reported no illness during the research period, while 53.3% of participants reported illness one to five times. Additionally, 53.3% of participants did not report any incidence of a new injury, yet 46.7% reported between one to five new injuries. On a Likert-scale from 1-10, the tabulated results of the survey revealed the participants' mean score of 7.6. This means that the participants reported above average health during their time using this recovery tracking tool. A recovery tracking tool might be useful to monitor the overall health and recovery of student athletes. More research is needed to develop a validated recovery tracking tool, as well as its usages for monitoring student-athlete recovery.

Fitness tracking devices are a growing industry in wearable health and fitness technology. These devices provide wearers with real-time data to track exercise, heart rate and calories burned. The purpose of this research study is to evaluate the accuracy of fitness tracker calorie estimates compared to an energy expenditure standard, the Mifflin-St. Jeor (MSJ) equation. Data was obtained via a 21-question online survey which included beliefs about tracker accuracy and how participants use tracker data in their daily lives. Participants (N = 78) also reported their wearable device brand (e.g. Apple, Fitbit, other), anthropometric data, activity level, and tracker calories from three consecutive fitness days. Self-reported age, height, weight, gender and activity level data was used to calculate the MSJ equation and then compare that to the trackers reported caloric expenditure. Results indicate the average Apple Watch calorie estimates were 85.5% of the MSJ equation while Fitbit and Garmin were 100.5% and 82.8%, respectively. Additionally, 62% of participants stated they believe their tracker device data is accurate while only 11% base their calorie consumption off the data provided by their device. Overall, 50% of participants said they use tracker data to set and achieve fitness or weight goals, while 61% indicated they use their device as an accountability tool for fitness goals. This study can improve the knowledge of dietitians and healthcare professionals on the accuracy of fitness tracking devices compared to typical calorie estimation methods, and how utilizing the tracker data can assist clients with weight and fitness goals.

Relative energy deficiency in sport (RED-S) is a syndrome related to low energy availability in athletes that compromises physiological functioning such as metabolic rate, bone health, immunity and endocrine function. RED-S can be particularly damaging to young athletes who could see their physical development stunted, affecting future growth potential. Through screening, athletic staff are in ideal positions to recognize and intervene in cases of collegiate athletes RED-S. The aim of this research was to evaluate the self-efficacy of athletic staff (e.g. Registered Dietitians (RDs), Athletic Trainers, Strength Coaches, Team Coaches) in recognizing and managing RED-S. A 22-question, online survey was developed and distributed to assess familiarity, process, and confidence of athletic staff when managing RED-S. Nine subject matter experts (SEMs) evaluated face and content validity ratio (CVR) of the survey. Results of the CVR analysis were 0.60 which does not meet the content validity threshold of 0.75, yet all SEMs confirmed face validity. Twenty-four participants accessed the survey with 75% (n = 18) meeting survey completion criteria. All eighteen survey participants were RDs, had a mean age of 33.9 years, and were mostly female (n = 17). Survey results revealed that 94.4% of RDs had heard of RED-S and 58.8% (n = 10) used a screening tool. Of those screening for RED-S, 80% (n = 4) indicated they felt confident in diagnosing RED-S. Recognizing and treating RED-S among collegiate athletes is imperative for ensuring their long-term health. Further research into the self-efficacy of RED-S screening with athletic staff is needed.

Mindful eating is a non-diet approach which has been effectively utilized to improve one's relationship with food. Mindful eating focuses on internal hunger cues, fullness and satiety. The aim of this research study was to determine if mindful eating techniques were more prevalent in males versus females, while exploring which mindful eating subscale factor (awareness, distraction, disinhibition, emotion, and external) was most prevalent among males and females. This study consisted of 109 participants (92 females and 17 males) who completed a validated, online mindful eating survey containing 31 questions. The mean age of the participants was 39 years old (36 for males and 40 for females). Each participant's mindful eating category was tabulated and the sum of the subscale score was divided by the number of questions in that category, giving the summary score for that factor. Results show that males and females both scored the highest overall for the emotional eating factor, indicating that negative emotional states (e.g. sadness, anger, jealousy, etc.) do affect mindful eating habits. Females scored lowest on the area of awareness, indicating that females are less mindful when they have certain perceptions, thoughts and feelings toward food. Males scored the lowest on the external factor, indicating that males are less mindful in certain environments (e.g. social settings with friends). In practice, dietetic professionals can utilize mindful eating questionnaires as a tool to further explore mindful eating factors with their clients and work to encourage a healthy relationship with food.

Anywhere from 40 to 60% of adults have tried to lose weight at least once. Unfortunately, many individuals who have tried often never reach their weight loss goal. According to the Centers for Disease Control and Prevention, adult obesity rates in the United States have climbed to nearly 40% of the population. The purpose of this study was to identify factors contributing to or barriers against successful weight loss. Individuals 18 years or older were invited to complete an 11-question online survey over their weight loss experiences. Seventy-two (N = 72) participants, of whom 92.3% were female and 58.3% were between the ages of 18 to 28 years old, agreed to complete the survey. Results indicate that 95% of participants wanted to lose weight, with 46.5% wanting to lose between 0 and 15 pounds. For 35% of the participants, it took between six months to one year to achieve their desired weight loss goal. Over half (55%) of the participants reported maintaining their weight loss. The most common factors identified in successful weight loss were exercise, portion control or diet restriction, and self-education. The most influential barriers to weight loss were not having enough time, being too hard/too much work, and lack of support. Only 2.8% of the participants sought any weight loss assistance from a Registered Dietitian. As Registered Dietitians we can use this research to help clients target successful weight loss tactics and continue to promote our profession as a valuable resource for those seeking a healthy weight.

The purpose of this research study was to compare compensation data for Registered Dietitian-Nutritionists (RDNs) in the metropolitan areas of Nashville, Memphis, and Knoxville to similarly sized metropolitan areas across the country. Data was collected from a salary survey conducted by the Academy of Nutrition and Dietetics which included 30,000 respondents. Salary comparison cities included 50th percentile data for both hourly and annual compensation in addition to having a population size within 10% of the populations of Nashville, Memphis, or Knoxville using data from the U.S. Census Bureau. Data was divided into groups depending upon city population size: large cities (LC, n = 11, including Nashville and Memphis) and small cities (SC, n = 4, including Knoxville). The LC group had a variation of $9.79/hour between the highest and lowest 50th percentile hourly compensation rate. The SC group had a variation of $11.05/hour between the highest and lowest 50th percentile hourly compensation rate. The LC group had a variation of $28,600 between the highest and lowest 50th percentile annual salary. The SC group had a variation of $21,100 between the highest and lowest 50th percentile annual salary. All three Tennessee cities ranked in the bottom half of their data groups for both hourly compensation and annual salary. Results indicate the possibility that RDNs receive less compensation in the three major Tennessee cities than in similar-sized cities across the United States. Future research may reveal that Tennessee RDNs receive more compensation in other forms, including diverse employment benefit packages.

Longstanding research has proven that vitamin D is critical to the prevention of bone disease. Research also suggests that vitamin D enhances cognitive and immune function and decreases the risk of some autoimmune diseases, certain cancers, heart disease, and depression. At this point, there is limited research that compares vitamin D status of those living in the southern parts of the United States to that of those living in the northern parts of the United States. An anonymous, electronic survey was sent to undergraduate students at Lipscomb University in Tennessee and The College of St. Benedict/St. John’s University in Minnesota to obtain data regarding dietary intake of vitamin D and direct sunlight exposure among college students exposed to different climate conditions. Most of the vitamin D that is synthesized in the body is derived from sunlight and not from the diet. Daily vitamin D recommendations range from 600 IU to 2,000 IU and should be obtained from a combination of diet, sunlight, and supplementation. Results of this study indicate that college students do not obtain adequate vitamin D intake from the diet. Furthermore, a significant percentage of students from each school wear sunscreen outside. Even a small amount of a low-grade sunscreen can reduce the body’s ability to synthesize vitamin D by up to 95%. Therefore, these young adults should consume a vitamin D3 supplement or vitamin D-containing multivitamin with 1,000-2,000 IU daily to prevent and/or treat vitamin D deficiency. There was no funding source for this research.

Flavonoids are group of bioactive compounds that are found in a wide range of different foods. Adequate consumption of flavonoids is correlated with reduced risk of chronic diseases, such as cancer and cardiovascular disorders. The reported daily consumption of flavonoids by an American adult is 344.83 mg. The purpose of this research is to examine the pattern of flavonoid consumption among nutrition professionals. A food frequency questionnaire containing selected flavonoid-rich food was sent electronically to 140 Registered Dietitians in Middle Tennessee in order to examine the frequency and the pattern of consumption per different time intervals and serving sizes. Thirty-seven participants completed the survey. The survey included 7 vegetables, 15 fruits, 6 beverages, 2 herbs and 4 miscellaneous food items. More than half of flavonoid intake was from beverages and the consumption of fruits was triple the consumption of vegetables. The most common food source of flavonoids was black tea. Peppers, apples, black tea, and dark chocolate are the most popular sources of flavonoids among different food groups. Red cabbage, blackberries, dark chocolate and black teas constitute the highest sources in vegetables, fruits, miscellaneous and beverage items, respectively. The average daily consumption of flavonoids for the registered dietitians in is 241.78 mg/day, as compared to the 344.83 mg/day consumed by the general population. In conclusion, it was notable that beverages were the main source of flavonoids. Compared to the national estimated mean of flavonoid intake by US adults, RDs consumed less than the average consumption by the general population.

Chefs play an integral role in preparing and serving healthful food. The rise in the number of meals eaten away from home coupled with the increasing incidence of chronic diseases has directed more focus to nutrition in the culinary industry. The purpose of this study was to assess the general nutrition knowledge and nutrition-related attitudes of culinary students. The survey instrument was distributed by convenience sample to the culinary students associated with The Art Institutes of Tennessee. The 2-part survey contained a total of 32 questions. Demographic information was requested, including nutrition education experience. Section 1 of the questionnaire was developed to measure students' food science knowledge by multiple choice and true/false questions. Section 2 measured students' attitudes toward nutrition utilizing a 5-point Likert scale with a higher mean response on the scale correlating to positive attitudes toward general nutrition. The statistical analysis assessed the frequency and means of participant responses. Student chefs found nutrition knowledge to be an important aspect for their future career as far as recipe modification and how it applies to healthful cooking practice with 71% strongly agreeing. Student chefs had the lowest interest in the nutrition for their own diet with 47% being neutral regarding importance of their own nutrition. It is important for chefs to have an interest in their own nutrition, as they are responsible for creating the food of our generation. This presents an opportunity for dietitians to become educators within the food service and culinary industry.

If 10% of adults in the United States walked regularly, an estimated $5.6 billion in healthcare costs could be saved. 10,000 steps/day are recommended and many activity trackers are available for consumers. Factors influencing activity tracker selection include accuracy, cost, applications, and ease of use. This study measured the variability among four accelerometers through a small field study including five females. Each participant wore 4 devices (Moov1, Fitbit Zip, Misfit Link, and Polar Loop) for a period of 7 days each while completing their daily tasks, except for water activities/showering. Participants recorded data at the close of each day on a log sheet, including steps/active minutes, distance, and calories burned. The Moov1 doesn’t track steps, which the website didn’t make clear, and active minutes were recorded instead for this device. The Fitbit Zip and Misfit Link were clip-ons, while the Moov1 and the Polar Loop were worn as wristbands. Greater variance was seen between the wrist worn and clip on versions, regardless of cost or brand. Participants felt the step count was more accurate in the clip on versions versus an overestimation of steps with wrist worn devices/ arm movement. As dietitians encourage physical activity, it is important to recognize cost as a barrier for some clients in choosing to use activity trackers. This field study proves that cheaper versions such as the Misfit Link, are just as effective as the more expensive versions and despite the variance in steps or distance, calories burned were similar across all 4 devices.

Excessive weight gain during the first year in college, commonly termed the “Freshman 15,” is a major concern due to the rising obesity rates in the United States. There are many changes a young adult goes through during this transition period that contribute to weight gain. Poor nutritional choices, social pressures, and a lack of nutrition knowledge can lead to weight changes affecting the perception a young adult has of himself/herself. While research has shown how these factors affect female students, evidence is lacking in the comparison of male and female first-year students. The purpose of this study was to examine the knowledge, beliefs, and frequency of weight gain between male and female first-year university students. Data was collected from 97 freshman college students at Lipscomb University in Nashville, Tennessee using a web-based survey application. The survey was composed of questions identifying the participant’s background, as well as his/her thoughts regarding weight gain, eating habits, and previous nutrition education. The results of this study reveal that the majority of individuals surveyed, both male and female, are conscious about their weight. However, male and female responses differed in how they perceive and feel about their current weight, how often they think about their weight, and what factors contribute to weight gain in college. Further research is necessary to focus specifically on male college students eating habits at multiple universities, both private and state institutions. A greater pool of male participants is necessary to represent a wider range of opinions and beliefs.

Breast milk is known to be the perfect food for most babies. It naturally contains all a baby needs to thrive. Human milk has essential nutrients, of course, but the role of prebiotics and innate live bacteria are only beginning to be fully understood. The goal of this research is to raise awareness of this little understood area of breastfeeding, in order to inform and inspire parents and caregivers. Endogenous bacteria train baby's immune systems. Infants depend on microorganisms for proper immune system development. Breast milk is an excellent source for the infant from the mother of endogenous and probiotic bacteria. In breast milk, there is a huge network of life. This study will determine whether or not potential probiotic bacteria in breast milk is delivered from mothers who consume the same yogurt as opposed to the mothers who do not eat yogurt. The null hypothesis is that there is no relationship between consuming yogurt and of the transferring of those same beneficial bacterial strands from mother to baby via breast milk. The alternative hypothesis is that consuming yogurt while breastfeeding will enhance mother’s milk with the same strains of live active cultures.

Nutrition plays an integral role in the management of gastrointestinal (GI) diseases, but the extent to which patients with GI diseases are receiving nutrition therapy is unknown. The purpose of this self-funded study is to determine if services of registered dietitians (RDs) are being utilized by adult patients diagnosed with GI diseases, why GI patients decide not to consult RDs, and if the patients who consulted RDs felt that information provided to them was useful. One hundred copies of a flier containing a web link to a 12-question survey were available at an office of a GI specialist in Nashville, TN. While eighty-five fliers were handed out, only six participants completed the survey. Of the six, three utilized the services of an RD. All three respondents agreed that the information provided to them was useful, easy to follow, and helped them to manage their GI condition. The three respondents who had not sought the services of a RD reported not being able to afford out-of-pocket costs to see an RD, personal knowledge of nutrition management for their condition, physicians provided nutrition advice, and ?other? as reasons for not seeking services of an RD. This research, despite low responses, provides baseline knowledge for dietitians regarding perceptions of GI patients in the Nashville, TN area. This information may be helpful in future efforts of RDs regarding marketing themselves to this population, the need for partnerships with GI physicians’ offices, as well as demonstration of their value in the management of GI diseases.

Halal describes any product that follows specific Islamic Laws. This word is becoming more common in the United States (U.S.) with increasing diversity of the population. As a result of this diversity, there is an increased demand for Halal products to meet the needs of Muslim patients. The purpose of this research is to assess Halal status of nutritional supplements for adult patients in the U.S. based on the Nutrition Care Manual Database formulary. Supplements were evaluated using the manufacturers’ website information or direct communication via email. After excluding pediatric, non U.S. and discontinued supplements of the 535 products, a sample of 462 from 10 companies resulted. Only 10.8% (n=50) were considered Halal. These Halal supplements were further categorized based on administration methods of oral, tube fed or dualpurpose with a distribution of 54%, 20%, and 26%, respectively. The study results indicate a disproportionate number of Halal supplements available in the U.S. compared to non-Halal products. In addition, this study concludes that only three out of the ten companies represented in the sample of 462 supplemental products seek assistance and certification for Halal using Islamic agencies. This study should bring awareness of the limited resources available to U.S. dietitians for appropriate supplemental products to best serve Muslim patients following Islamic Law and a greater need for manufacturers of these products to consider ingredients and production process for Halal certification. Further research is needed to examine the availability of disease specific Halal supplements in the U.S. market.

Brazilian Jiu Jitsu (BJJ) fighters engage in intense bouts of physical activity, but there is little research examining their nutritional habits pre- and post-competition to sustain optimal performance. The goal of this self-funded study is to determine trends of Nashville-based BJJ fighters regarding the prevalence, timing, and composition of pre- and post-competition meals/snacks. The hypothesis is that the pre- and post-competition food consumption of these athletes would correlate to the general recommendations of the International Society of Sports Nutrition’s Position Stand: Nutrient Timing. The prediction being that high carbohydrate meals/snacks would be consumed prior to competition, and that high protein meals with substantial carbohydrate portions would be consumed post-competition. Two Nashville-based BJJ training schools distributed a paper survey to eighty students over the age of eighteen for voluntary and anonymous completion. The Likert-type scaled survey, with a description of the food items consumed, evaluated the prevalence, timing and nutrient profile of pre- and postcompetition meals/snacks. Thirteen completed surveys were considered usable. General macronutrient content of the foods chosen for both pre- and post-competition consumption were analyzed through Microsoft Excel using descriptive statistics. The results indicate a well- balanced nutritional profile of the foods frequently chosen, as well as proper timing for sport competition, confirming the initial hypothesis. However, because of the low participation rate and the unusable responses of some of the participants, a follow-up study would provide a better understanding of the specific nutrition habits of these athletes.

Nutritional deficiencies are common in the world, and are a leading cause of preventable health related problems in the poverty stricken communities of Africa. Healing Hands International is a Nashville based organization specializing in helping local and global communities to establish and grow a 50 x 3 raised bed-garden with drip-irrigation, to provide a sustainable food source. By combining Healing Hands International’s mission purpose with nutritional counsel, this project has developed a raised-bed garden plan for the region of Africa in efforts to potentially reduce nutritional deficiencies common to this area. Literature review from the World Health Organization (WHO) identifies the most common nutritional deficiencies in Africa to be vitamin A, iron, and protein. Following identification of foods high in these nutrients, which could also be grown in a raised-bed garden with the resources available to the African community, the layout of the garden space was determined. Factors in planning the garden layout included food yield per plant, mature plant dimensions, plant spacing, and germination timeframes. The developed garden design also considered the African soil, culturally accepted foods, and limited resources for construction needs. Foods identified for the garden include African eggplant, bambara bean, teff, amaranth, cowpea, maize, cassava, egusi, African potato, and yam. By establishing a region-specific garden plan, organizations such as Healing Hands International can assist Africans to build a sustainable food source that may reduce their incidence of nutritional deficiency related diseases such as, blindness, infections, iron deficiency anemia, protein-energy malnutrition, and even premature death.

Everyone is born with a sweet tooth. Research has shown that Americans on average consume 22 teaspoons of sugar a day. The food industry has accommodated for the public’s cravings for sweets by developing alternative sweeteners in liquid, powder, and granulated forms. In the south, where sweet tea, banana pudding, and pecan pie are often a part of daily diets, sugar continues to be a staple. As sugar substitutes are increasingly more available for the consumer, personal preference in choosing a sweetener is often based on taste, calories, research, health gains, weight goals, or habit. Artificial sweeteners are a topic of constant debate and controversy in the literature and the media because use may not resolve health issues, can cause side effects and aftertaste, as well as consumers questioning the source or safety of the product. This research explores the acceptance, opinions, and concerns that many southerners have on the subject of sugar and sugar substitutes. Data was obtained for this self-funded project through a survey created on www.surveymonkey.com for 18 year old and above persons currently living in the states of Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, or Tennessee or who grew up in these states and are now living elsewhere. The survey was completed anonymously and voluntarily. The significance of these findings is important for dietitians to know concerning the public’s opinions on sugar and sugar substitutes. Dietitians also should be informed on the latest research to be a voice of reason, while counseling patients.

Hen ownership is increasing in popularity across the country, not only in rural settings but also in densely populated urban areas. The rise of interest in backyard poultry is due to several factors including a movement toward getting closer to ones food, environmental concerns, the desire for increased food quality, and creating a family fun hobby. Metro Nashville passed an ordinance on January 18, 2012 allowing most zones in the Metro Nashville area to own backyard hen flocks. Understanding the law pertaining to raising poultry can be tricky and often times difficult to decipher and filter through. Poultry keeping laws vary county-to-county and city-to-city, and can be superseded by individual subdivision restrictions. There are several choices to make once you decide to start a flock. Choosing a chicken breed can be based on several factors including egg size, egg color, and amount of eggs produced, chicken temperament and temperature hardiness of the bird, or based purely on the chicken’s physical appearance. Data was obtained for this self funded project through several mediums including extensive research, personal interviews with chicken owners, and a survey created through www.surveymonkey.com that was sent to Nashville area registered dietitians to access the knowledge and interest regarding urban flocks. The benefits of starting a backyard flock by far exceed the necessary effort; take surprisingly less time, money, and labor than one would envision, and can be a very rewarding process.

The NCP is a methodology used by RDs to provide a uniform framework when delivering care to clients. The Academy of Nutrition and Dietetics encourages the implementation of the NCP in all areas of dietetics. Current literature addresses better ways to implement the NCP, but is limited in the actual use of the NCP in the field. The purpose of this study is to assess the use of the NCP among Tennessee RDs, assess the need for further education, and identify barriers to its application. Data was collected using a web-based survey created by interns of the Lipscomb University Dietetic Internship. The survey was anonymous and voluntary. The survey questions focused on background information and use of the NCP. Data for individuals were combined and analyzed using frequencies. Of the 36 RDs who completed the survey, 90% aged 20-29 use the NCP. Less than 60%, aged 30 and older, use the NCP. Of the participants, 100% in clinical management, 75% in clinical nutrition, 80% in sports nutrition/wellness, 67% in research/education, 50% in private practice, 25% in foodservice, and 0% in community/public health use the NCP. 89% have received NCP education/training and 71.4% feel they would benefit from additional education/training. Barriers to using the NCP include increased paperwork, absence of electronic medical records, and knowledge deficit. The results reveal that as age increases, NCP use decreases. There is a need for education/training across all disciplines of dietetics. Incorporating the NCP into computerized charting could increase the use of the NCP.

The purpose of this study was to assess teenage athletes’ baseline nutrition knowledge and determine the influence of the Academy of Nutrition and Dietetics’ Kids Eat Right (KER) Healthy Snacking in a Nutshell toolkit on the nutrition knowledge of teenage athletes. Teenage athletes (n=125) from Jackson Christian School in Jackson, TN voluntarily completed an anonymous six question survey before and after a KER Healthy Snacking in a Nutshell nutrition education workshop to establish baseline nutrition knowledge and to assess whether the workshop increased athletes’ nutrition knowledge. Results were analyzed using a dependent t test to compare the differences between means of the pre- and post-workshop overall survey scores. The results indicated that the athletes studied had a significantly higher mean score on the survey after the nutrition education workshop than on the pre-workshop survey, (5.8 ± 5.5 vs 3.9 ± 1.2; p<0.001). Only 8.8% (n=11) of the athletes surveyed answered all questions correctly before the nutrition education workshop, while 53.6% (n=67) answered all questions correctly after the workshop. Sixty-seven percent (n=84) of the athletes had an increase in nutrition knowledge after the workshop. These findings suggest that teenage athletes are lacking in nutrition knowledge, and the KER Healthy Snacking in a Nutshell toolkit is effective in increasing the athletes’ nutrition knowledge. This study emphasizes the need for nutrition professionals to be integrated into the middle and high school setting to improve the nutrition knowledge in teenage athletes.

The purpose of this study was to determine if online media, an e-newsletter created by the current dietetic interns, was an effective and efficient marketing tool to positively impact perceptions of current preceptors and reach potential preceptors through sharing of program activities, accomplishments and current nutrition-related topics. A significant challenge exists among dietetic internships associated with universities to partner with healthcare facilities and registered dietitians for preceptorships. Determining effective methods of marketing to preceptors is critical to future growth. The first edition of the E-newsletter was released in December to all current preceptors and the district presidents for distribution to members of the Tennessee Academy of Nutrition and Dietetics. Following distribution via email, a ten-question survey was created through www.SurveyMonkey.com and emailed to assess perceptions of the newsletter and internship program pre- and post-viewing. 32 surveys were completed with 21 having read the newsletter prior to survey completion. 87.5 % of the 21 readers found the information to be accurate and relevant. 18.2% of readers had an increased awareness of the internship program, including comments such as, “Great level of diversity in their experience that mirror the real world experience…” and “I am impressed with the interns and their involvement …” 92.3% of respondents prefer receiving the newsletter via email versus print. Two more editions will be distributed this program year. Although the study may have provided more robust results had the survey measured perception following multiple newsletters, it is obvious that online media was effective as a marketing tool.

This self-funded research outlines similarities and differences between the health systems of the United States and the metropolitan city of Lima, Peru. The goal of the research is to learn new ways to collaborate among diverse cultures and within individual cultures in order to share ideas and improve patient care. Information was obtained during two six-day trips to Lima with an Indianapolis-based university professor who travels to Lima annually to teach Peruvian doctors in a healthcare management class. The trips included visits to local private hospitals and discussions and interviews with Peruvian healthcare professionals. The results of the interviews and discussions were the realization that there are similarities to how U.S. facilities provide care in the public vs. private sector, but significant differences in interdisciplinary team interactions in healthcare centers in Lima than what is typical in the U.S. The Peruvian healthcare providers are much more focused on each individual provider focusing solely on his or her specialty than on working in teams to provide care. Because of the current emphasis on effective interdisciplinary teams in the U.S. healthcare system, it is important to understand multicultural viewpoints on such teams before attempting to apply the method in other cultures. The Indianapolis professor hopes to train the Peruvian doctors to work as a part of interdisciplinary teams at their respective hospitals and care facilities, and these results will be helpful for her training programs as well as those of other educators involved in teaching a multicultural student base.

According to the Accreditation Council for Education in Nutrition and Dietetics (ACEND), participation in “legislative and public policy processes as they affect food, food security, nutrition, and health care” is a core competency for the supervised practice component of entry level dietitian education programs. Dietitians at any experience level should be knowledgeable in the area of nutrition public policy. The emphasis of most Dietetic Internships (DI) on Medical Nutrition Therapy often overshadows attention on community nutrition experiences. Consequently, questions on the Registration Examination for Dietitians pertaining to public policy processes are frequently answered incorrectly. This study seeks to assess the need for specific training regarding public policy and to examine the effectiveness of such training. An online module entitled Public Policy for the RD was created specifically for this research http://nutripolicy.wordpress.com/public-policy-for-the-rd/). The module was designed to assess participants’ knowledge before and after completing the unit using pre- and post-tests powered by www.SurveyMonkey.com. All participants (n=24) were enrolled in DIs within the state of Tennessee during their involvement. Interest in future involvement in public policy increased from 2.75/5 to 3.59/5. When asked what a piece of legislation starts as, 29.17% correctly answered “an idea” on the pre-test and 90.91% on the post-test. A basic familiarity with components of the Farm Bill went from 50% to 90.91%. Knowledge of the number of locations a restaurant must have to be covered under menu labeling legislation went from 33.33% to 90.91%. There was a clear increase in interest and understanding on all but one question.

There are many reasons companies and/or individuals choose to write a grant. Grants are typically written for additional income to support ideas and projects. However, it’s not all about the money. Receiving grant money for a project can lead to critical improvements in the community and the acquirement of new resources to accomplish goals important to the implementation and operation of the proposed project. With billions of dollars allotted each year to fund grants, it’s smart to be equipped with the knowledge and tools necessary to tap into this segment of resources. The main objective of this poster is to educate the audience on how to write a successful grant application, one that will grab the attention of the grantor and reap the most benefits for the grantee. The following steps will ensure grant writing success: developing a unique idea, finding mentors/collaborators willing to provide knowledge and guidance, searching for the appropriate grant for the idea proposed, creating a realistic timeline, confirming that the idea and/or project will align with the mission and goals of the funder’s organization, and finally, writing a skilled application and proposal. This poster introduces a “mock” organization entitled “Fun Factory: Fresh & Fit,” a community-based health and activity center for at-risk youth. The daunting task of obtaining funds and resources to support a program will be addressed by walking the reader through the creation of “Fun Factory: Fresh & Fit,” the detailed application process, and the staffing and budgeting processes.

Lactase is an enzyme catalyzing lactose hydrolysis. Individuals with impaired lactase production, or lactose intolerance, endure symptoms such as bloating, cramps, excessive gas and diarrhea when digesting products containing lactose. The most notable products containing lactose include bovine milk, cheese, yogurt, butter and ice cream. However, breakfast cereals, baked goods, soups, sauces and processed meals also contain traces of lactose. With more than 70% of the world's population suffering from this digestive disorder, the market lacks suitable lactose-free replacements. Milk alternatives, such as soy and nut milks, attempt to fill this gap but do so unsuccessfully because they lack the nutrient density unique to bovine milk. Without access to dairy products, lactose intolerant individuals are at a greater risk for osteoporosis, impaired exercise recovery and high blood pressure. The purpose of this experiment is to improve and expand food availability in the lactose-free market. Specifically, researchers detail the efficiency of lactase tablets in types of bovine milk and how to use its products to make a lactose-free milk chocolate in a standard American kitchen. Samples of chocolate made from whole milk, evaporated milk, reconstituted milk powder, and reconstituted milk powder-based evaporated milk were compared for texture and flavor.

Nonalcoholic fatty liver disease (NAFLD) entails a spectrum of pathologies that range from hepatic steatosis to nonalcoholic steatohepatitis (NASH). NAFLD can ultimately progress to irreversible cirrhosis of the liver or hepatocellular carcinoma. Over the years, correlations have been drawn suggesting high fructose consumption is a major contributor to the increase in NAFLD. The activation of hepatic stellate cells (HSCs) is a significant event in the development of NASH and cirrhosis. HSCs are responsible for collagen deposits in the liver. However, it remains unknown how these cells respond to high concentrations of fructose. Our lab has previously shown that high concentrations of sugar in media induce activation of mouse primary HSCs. Based on these findings, we hypothesized that high fructose concentrations and fructose in combination with glucose increase HSC activation and proliferation. To test this hypothesis, we isolated primary HSCs from mice and cultured the cells with 5mM glucose, 35mM glucose, 35mM fructose, and 35mM glucose and fructose concentrations for 6 days. The cells were then analyzed by immunofluorescence, measuring the protein expression of a fibrotic intermediate filament protein which is expressed in activated HSCs, alpha smooth muscle actin (a-SMA), and ki67 as an indicator of cell proliferation. The number of activated HSCs were quantified using ImageXpress. In addition, we explored the gene expression of fibrotic markers in LX-1 cells, a human HSC cell line, cultured in the absence and presence of fructose using real-time polymerase chain reaction..

Researchers have found that aging is associated with loss of muscle mass, atrophy of type II fibers, and/or a decline in muscle force production. Long-term resistance and sprint training may preserve certain muscle characteristics. The purpose of this study was to determine if muscle thickness is correlated with peak power during an anaerobic sprint test. Sixteen males (age = 33.6±19.25 yrs; ht = 177±16 cm; wt = 78.25±18.75 kg) and 14 females (age = 26.6±7.61 yrs; ht = 167±10 cm; wt = 66.5±15.5 kg) volunteered to participate. Muscle thickness of the rectus femoris and vastus lateralis in the right leg was measured via ultrasonography (GE NextGen LOGIQ ℮). Participants completed a 20-second sprint on a mechanically braked cycle ergometer (Monark 894 E) against a resistance that corresponded with 7.5% body mass. Pearson correlation was used to determine relationship between muscle thickness and peak power. There were significant positive correlations between peak anaerobic power and muscle thickness of both the rectus femoris (r = 0.6453, p = 0.0001) and vastus lateralis (r = 0.7351, p = 0.0001). Strong positive correlations between anaerobic power and muscle thickness of quadriceps muscles existed despite age and gender differences, suggesting that anaerobic-specific exercise is characteristic of muscle mass preservation.