Nutrition & Diet

The objective of this project is to develop a dietary intervention to improve self-management of bowel dysfunction in patients with ostomies or anastomosis. This project received funding from the National Cancer Institute. 

The purpose of this grant was to advance understanding of the chronic burden of foodborne illness, help the Food and Drug Administration (FDA) better estimate the true overall burden of foodborne illness, and act appropriately on food safety priorities. The main objectives were (1) to develop a questionnaire for use with healthcare providers to estimate incidence, duration and severity of post-infectious functional bowel disorders and reactive arthropathies in patients with evidence of prior infection with foodborne pathogens and (2) evaluate the available literature and secondary data sources to better characterize and quantify the association between specific acute foodborne infections and chronic sequelae, including functional bowel disorders and reactive joint diseases (arthropathies). This grant was supported by the FDA.  Other faculty/staff/students: Alexandra Armstrong, PhD, and McKenzie Schaefer, undergraduate student.

The objective of this pilot study was to assess the feasibility and acceptability of a randomized, controlled beverage intervention in 50 obese Hispanic adults ages 18–64 over 8-weeks. Eligible participants were classified as obese, between the ages 18–64, self-identified as Hispanic, and were able to speak, read, and write in either English and/or Spanish. Study recruitment was completed August 2017. Upon the completion of baseline assessments, participants were randomized to either Mediterranean lemonade, Green Tea, or flavored water control. After completing a 2-week washout period, participants were asked to consume 32 oz. per day of study beverage for 6-weeks while avoiding all other sources of tea, lemonade, citrus, juice, and other sweetened beverages. Water was permissible. Primary outcomes were recruitment, retention, and acceptability of the intervention strategies. Our study also evaluated participant-reported tolerance and as an exploratory aim, assessed safety/toxicity-related to renal and/or liver function. Fasting blood samples were collected at baseline and 8-week intervals to assess the primary efficacy outcomes: total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Secondary outcomes include fasting glucose, hemoglobin A1c (HbA1c), and high-sensitivity C-reactive protein (hs-CRP). This project was sponsored by the University of Arizona Foundation Diabetes Development Fund.   

Although Benin has been making progress in reducing malnutrition problem, yet it still exists at a proportion of public health significance. Access to food and especially to high quality foods is limited in the region. Food insecurity is high and particularly related to a high incidence of poverty and food availability unevenly distributed across the country in the context of recurring rising prices of staple foods. In addition, food production is very dependent on erratic rainfalls, which often lead to precarious food harvests and chronic strain on national financial stability. On the back of this situation, in 2007, the Solar Electric Light Fund (SELF) began a pilot test of commercial-scale solar-powered drip irrigation (PVDI) systems in the Kalalé district of northern Benin. The Solar Market Garden (SMG) systems were installed in conjunction with local women's agricultural groups. Over the first two years of operation, these gardens were found to have a significant impact on the food security and economic well-being of the farmers and their households (Burney et. al 2010). However, there is no evidence base on their health and nutrition impacts in sub-Saharan Africa. Increased consumption, along with increased income, could all contribute to improvements in maternal and child health and nutrition outcomes. In addition, to date there has been limited understanding as to how these types of program can be optimized to maximize impacts on child health and nutrition outcomes. The goal of the present study is therefore to evaluate the impact of the SMG on child and women’s nutritional status, child and mother anemia status and measured indicators of women’s empowerment. The study was conducted in 16 villages in the Kalalé district of northern Benin at the same period (January –March) in 2014 and 2015. The study enrolled 774 households. Socio demographic information, household food insecurity, child and women’s anthropometry measurement, and information pertaining to women’ empowerment were obtained.  Jennifer Burney and Roz Naylor were contributors for this project. 

Access to healthy food is a fundamental building block for a productive life. While federal food assistance benefits are critical to enabling low-income families to buy food, the lack of access to healthy, fresh food contributes to poor health outcomes and increases the risk of diet-related chronic illness. Community Food Bank of Southern Arizona’s (CFBSA) Double Up SNAP program (DUSP) uses existing infrastructure — farmers’ markets and the EBT card — to improve access to and affordability of fresh fruits and vegetables for low-income family; grow the local economy by supporting purchases from local farmers, and to shift public policy so that future federal nutrition assistance programs can simultaneously address health, hunger, and nutrition and support a more sustainable food system. The primary objectives of the DUSP evaluation are to: determine the effectiveness of monetary incentives to promote healthier food choices (as evidenced by food purchasing behavior) for SNAP customers; determine the impact of the DUSP project on the participating markets, vendors and the local food economy; determine the implications of the evaluation findings in relation to policy change and best practices for replicating the model. Kara Jones and Abigail Plano were contributors for this project. 

In the U.S., Hispanic males have the highest rate of overweight and obesity when compared to males of other racial/ethnic groups. Obesity contributes to the risk for certain cancers in Hispanics. For example, obesity is associated with non-alcoholic fatty liver disease (NAFLD), which is 1.4 and 1.9 times more common in Hispanics than in Non-Hispanic Whites (NHW) and African Americans, respectively. While not all individuals with NAFLD develop liver complications, nearly 30% will develop nonalcoholic steatohepatitis (NASH) and be at risk for hepatocellular carcinoma, the most common form of liver cancer in adults. Consequently, Hispanic males have the highest rates of liver cancer incidence in the U.S., twice those of NHW men. Weight loss is considered the first line of prevention for NAFLD progression. Yet, current research is lacking to inform best practices to engage Hispanic males in weight loss and/or to promote a successful weight loss trajectory. Without this information, the health disparities associated with obesity related cancer will continue to increase. Using existing practice guidelines and evidence from our qualitative assessments in overweight/obese Hispanic males, we will test a novel intervention approach to address this knowledge gap. We propose to 1) assess the feasibility, acceptability and preliminary efficacy of a gender- and culturally-sensitive weight loss intervention in 20 overweight/obese Hispanic males ages 18-64 over 24 weeks; and 2) examine pathologic changes in the liver (NAFLD, NASH, fibrosis, or cirrhosis) in 20 overweight/obese Hispanic males ages 18-64 over 24 weeks using a non-invasive Magnetic Resonance Imaging (MRI) of the liver. This project will be the first gender and culturally-sensitive weight loss intervention of which we are aware to explicitly target Hispanic males with an emphasis on reducing body weight. In addition, the intervention will provide highly impactful formative research on the effects of a weight loss lifestyle intervention on liver histology. Given the Hispanic population is the fastest growing in the U.S., efforts to identify strategies to promote weight control among Hispanic males has potential to significantly impact obesity-related cancer health disparities.

The purpose of the study is to shed light on how obesity develops by examining daily behaviors and sleep in people who have involuntarily lost their job. If findings show that disturbances in daily routine and sleep precede weight gain, then there is solid backing for the development of a behavioral sleep prevention program targeting unemployed individuals. Since unemployment, chronic sleep restriction, and obesity are such prevalent social and public health issues, the results of this study are highly relevant to a large segment of the U.S. population. Funding for this study came from the National Heart, Lung, and Blood Institute. 

Ovarian cancer accounts for over 18,000 deaths each year in the U.S. with disease progression rates estimated at 60-70% after 4 years. The efficacy of a physical activity + dietary intervention to increase progression-free survival (PFS) in this vulnerable population is currently being tested in a hypothesis-driven, randomized, attention-control study of 1070 women with prior invasive disease [(Gynecological Oncology Group (GOG) 0225 study (Lifestyle Intervention for oVarian cancer Enhanced Survival- (LIVES) Trial]. Here, we propose to take advantage of the trial infrastructure and capacity to collect repeat blood samples to evaluate the mechanistic underpinnings that might explain any changes in health indices by treatment arm over time. The overarching hypothesis is that change in metabolic and inflammatory status of participants, that is expected to demonstrate a reduction in inflammation and metabolic deregulation in the intervention group participants more so than the attention-control group, will be associated with increased PFS. A secondary focus of the proposed work will be the interaction with central adiposity. The Specific Aims include: To determine if the LIVES intervention alters biomarkers of metabolic deregulation in women previously treated for stage II-IV ovarian cancer; Aim 2: To determine if any effect of the intervention on biomarkers is mediated by change in central adiposity; and Aim 3: To determine if any effect of the intervention on biomarkers is modified by baseline central adiposity including exploration of central adiposity using Computerized Tomography (CT) scans. Our longer term goal is to determine whether change in central adiposity, insulin/lipid metabolism or inflammation is associated with progression free survival.

Abstract not available. 

This trial includes the evaluation of daily grapefruit consumption over 6 weeks and its role in weight control and cardiometabolic risk factor modification. Additionally, the study includes an evaluation of the effects of added grapefruit on post-prandial inflammatory and oxidant stress response to a high-fat diet. This study received funding from the National Cancer Institute of the National Institutes of Health. 

Description:  This randomized, controlled dietary intervention trial is being conducted among lactating women in order to test the hypothesis that adoption of a Mediterranean diet rich in walnuts and citrus during lactation will be associated with a significant decrease in estradiol-17-beta and SHBG as compared to usual diet and a secondary hypothesis that adherence to a Mediterranean diet rich in walnuts and citrus will decrease the oxidative stress biomarkers 8-OHdG and 8-iso-PGF2alpha.  Impact:  The results of this trial may have implications for dietary recommendations/practices during lactation to promote improved health in both mother and child. The recruitment manuscript was published in Contemporary Clinical Trials  Stendell-Hollis NR, Laudermilk MJ, West JL,Thompson PA, Thomson CA. Recruitment of lactating women into a randomized dietary intervention: successful strategies and factors promoting enrollment and retention. Contemp Clin Trials. 32(4):505-511, 2011. [PMID: 21382511].

The study started in 1993 to evaluate health outcomes in aging postmenopausal women and to identify factors associated with healthy aging. Between 1993 and 1998, more than 161,000 women between 50 and 79 years of age joined the WHI. Beginning in October 2004, participants were consented for sequential 5-year WHI Extension Studies (ES). The research team continues to collect self-reported as well as medical record adjudicated health and mortality data. A team of junior investigators are engaged with data analysis in an effort to advance the dissemination of WHI research findings. Arizona research team members have published over 45 manuscripts in the past 8 years using this well-characterized and robust phenotypic information.

This study completed this year. I am working on manuscripts. One was submitted and is currently under review. 

This project was an evaluation subcontract for part of a $16 million CDC-funded cooperative agreement awarded to Pima County Health Dept. to focus on policy and environmental strategies to prevent obesity. Evaluation teams included the following roles: Co-PI, Sr. Research Specialist, Sr. Program Coordinator, Research Specialist, 2 GRAs, and data input specialist. Maia Ingram served as the Co-PI for this subcontract, and co-lead team in primary and secondary data collection activities. She also served as Youth Risk Behavior Survey Coordinator for the project. This project successfully obtained weighted YRBS data for Pima County by surveying over 1300 students in 21 high schools. 

This project was designed to investigate the role of vitamin D and genetic differences in the Vitamin D pathway on the develop of the precursor to colon cancer. The research team is using combined approaches from epidemiology and molecular biology to study functional changes and the pathway and their effects on colorectal carcinogenesis. Project funding came from the National Cancer Institute. 

The goals of this study are to utilize existing and archived population-based questionnaire and biological data that describe food and water consumption histories and exposures to construct predictive models for urinary arsenic biomarkers that can be used as indicators of arsenic exposure and health effect outcomes. Five publications were published in relation to this study. This was an EPA funded study.