Nutritional supplements (the combination of dietary supplements, sports foods, and performance-enhancing supplements) are used by many athletes for health and/or performance-related reasons. Nutritional supplements may be contaminated with illegal substances, putting the athlete at risk of adverse health outcomes or a positive doping test. Third-party testing programs help mitigate risk by regulating the purity and safety of supplements. However, it is unknown what percentage of high school athletes are familiar with third-party testing programs and how many athletes use such programs. This study was designed to explore high school athletes’ use of nutritional supplements, whether they were third-party tested, and their attitudes and influences toward safe(r) nutritional supplement use. An online questionnaire was developed to distribute among student-athletes from a private high school in the western US, resulting in a representative sample (n=225). Ninety-four percent (n = 211) of the student-athlete population reported using at least one nutritional supplement within the past year, reporting six different supplements on average. Sports foods were used the most (87%), followed by dietary supplements (76%), and then supplements claiming to enhance performance (58%). The most frequently reported nutritional supplements were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), recovery drinks (46%), and multivitamin/mineral supplements (40%). One-fourth of student-athletes reported consistent use of third-party tested supplements. Reasons for supplement use include gaining muscle (48%), improving health (46%), improving performance (44%), and losing or gaining weight (29%). Parents (45%) had the most influence on the athlete’s purchasing of supplements, followed by friends, teammates, or other family members (40%), the physician (30%), head sports coach (26%), strength and conditioning coach (25%), and athletic trainer (24%). The sports dietitian was checked by 8% of students as influential. The biggest gap in knowledge was where to find third-party tested supplements (22% knowledgeable) and where to order third-party tested supplements (25% knowledgeable). Based on the results, high school athletes would likely benefit from increased education regarding third-party testing programs and should increase their knowledge of where to find and purchase third-party tested supplements.

Nutritional supplement use by high school student athletes may pose risks of consuming prohibited or banned substances that can result in suspension of athletic participation. Currently, there is no peer-reviewed published data that exists on the use of supplements and use of third-party tested supplements for this population. When looking at supplement use, the Theory of Planned Behavior (TPB) can be utilized. This model was designed to determine if the intention of completing a behavior is based on three different constructs which include attitude, subjective norm, and perceived behavioral control. A pre- and post- test questionnaire was used to determine the effect of an educational intervention that was designed and developed. A total of 106 high school student athletes, ranging from 14-19 years of age from a private high school in the western US were included in the analysis of the study. The intention to use a good basic diet and intention to use nutritional supplements were both predicted by attitude, subjective norm, and perceived behavioral control and both resulted in a significant regression equation (p < .001). There was 95.3% (n=101) of athletes that reported use of at least one supplement in the last 12 months with reporting on average eight supplements ranging from 0-31 supplements. In conclusion, almost all high school student athletes reported using at least one nutritional supplement in the last 12 months, while roughly one-fourth consistently reported to use third-party tested nutritional supplements. The TPB based supplement education program resulted in the intention to change supplement behavior toward using safe third-party tested supplements more frequently at a group level.

Tools designed to help match people with behaviors they identify as likely to lead to a successful behavioral outcome remain under-researched. This study assessed the effect of a participant-driven behavior-matching intervention on 1) the adoption of a new behavior related to fruit and vegetable (F&V) consumption, 2) study attrition, and 3) changes in F&V consumption. In this two-arm randomized controlled trial, 64 adults who did not meet standard F&V recommendations were allocated to an intervention (n=33) or control group (n=31). Participants in the intervention group ranked 20 F&V-related behaviors according to their perceived likelihood of engagement in the behavior and their perception of the behavior’s efficacy in increasing F&V consumption. Participants in the intervention group were subsequently shown the list of 20 behaviors in order of their provided rankings, with the highest-ranked behaviors at the top, and were asked to choose a behavior they would like to perform daily for 4 weeks. The control group chose from a random-order list of the same 20 behaviors to adopt daily for 4 weeks. During the study period, text messages were sent to all participants 90 minutes before their reported bedtime to collect Yes/No data reflecting successful behavior engagement each day. The binary repeated-measures data collected from the text messages was analyzed using mixed-effects logistic regression, differences in attrition were assessed using log-rank analysis, and change scores in F&V consumption were compared between the two groups using the Man-Whitney U test. P<0.05 indicated significance. The rate of successful behavior adoption did not differ significantly between the two groups (b=0.09, 95%CI= -0.81, 0.98, p=0.85). The log rank test results indicated that there was no significant difference in attrition between the two groups (χ2=2.68, df=1, p=0.10). F&V consumption increased significantly over the 4 weeks in the total sample (Z=-5.86, p<0.001), but no differences in F&V change scores were identified between the control and intervention groups (Z=-0.21, p=0.84). The behavior-matching tool assessed in this study did not significantly improve behavior adoption, study attrition, or F&V intake over 4 weeks.

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food, which may include inadequate finances, transportation, skills, and information. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of hunger, nutritional deficiencies, and chronic disease among vulnerable populations. This dissertation tested a novel food insecurity intervention using informational nudges to promote food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.

Sleep is an essential biological requirement to sustain human life and a critical component for athletes. There has been a rising trend for poor sleep in the general population and the problem persists as well within the athletic population. Research has demonstrated numerous benefits of optimized sleep on athletic performance and athlete wellness. Further investigation of potential dietary strategies to improve self-perceived sleep quality is warranted. This study examined the differences in perceived sleep quality and wellness between a 3-week baseline period and after a 3-week supplementation period, in which participants consumed a dietary supplement containing fermented whey protein + galacto-oligosaccharides (GOS) + casein protein daily. Validated questionnaires, namely, Athens Insomnia Scale (AIS), Physical Health Questionnaire (PHX), Kessler-6 Mental Stress Scale (K6) were used to measure perceived sleep quality and wellness on Day 1, Day 22 and Day 43. Additionally, multiple 24-h dietary recalls (ASA24), and food quality using the validated Rapid Eating Assessments for Participants (REAP) questionnaire, were used to assess dietary patterns throughout the study, while exercise occurrence was tracked through a self-developed daily questionnaire. A total of 54 healthy active adults (age=18-35yrs) experiencing gastro-intestinal (GI) complaints were included in the trial, and 50 participants were included in the final analysis. Significantly lower AIS-8 total scores were found on Day 43 compared to Day 22 while controlled for Day 1 (Day 43: 4.36 ± 3.68 versus Day 22: 5.02 ± 4.11, F=4.379 (1, 50), p=0.042), while no differences were found for wellbeing (p≥ 0.180). Dietary intake, food quality and exercise frequency did not change over time (p≥0.080). These results suggested that a daily protein + GOS supplement was associated with a decrease in AIS-8 total scores suggesting improved perceived sleep quality among athletes after 3 weeks. A controlled research study should confirm these results in the future. More research is required to assess the effects of protein + prebiotic supplementation on sleep parameters among athletes.

The health of the planet and its people face considerable challenges; the climate faces threats of irreversible damage while chronic disease and obesity rates continue to rise. Both issues can be attributed in part to humanity’s poor treatment and attitude towards food. Humans throw away much of the nutritious food available, resulting in unhealthful diets and considerable amounts of food waste, leading to harmful greenhouse gas emissions. The current solutions for improving the separate matters of planetary and human health include tradeoffs between the two, despite their interrelatedness. Paradoxically, current research shows that increased fruit and vegetable intake is associated with increased food waste. Current literature has not emphasized a focus on interventions aimed to improve diet quality and food waste simultaneously.Recent research shows that mindfulness can have impacts on human health, such as in relation to chronic pain, mental wellbeing, and self-awareness. Mindful eating specifically has demonstrated improvements in disordered eating behaviors and relationship with food. Yet, no research has been conducted to explore mindful eating in relation to healthful and efficient relationships with food. Therefore, the present study explores mindfulness as a mechanism to improve diet quality and reduce food waste. The protocol presented in the study, titled Mindful Waste Watchers (MWW), was a 4-week novel virtual program incorporating nutrition education, household food waste reduction education, and mindfulness/mindful eating exercises into each lesson. Entry, exit, and 4-week follow-up surveys, each identical, were distributed to participants to assess diet quality, household food waste habits, mindful eating, mindfulness, and food appreciation, primarily by utilization of validated scales. The two primary outcomes evaluated in the present article were diet quality and household food waste behaviors. It was found that the intervention did not produce significant effects for either parameter, suggesting that the protocol was not feasible. However, a significant positive effect was found for food appreciation, a factor that may show promise in future research. While no significant effects were found for the primary outcomes, the findings of this study can be considered in future research targeted towards discovering effective interventions to improve diet quality and reduce household food waste.

Gastrointestinal (GI) complaints are prevalent among athletes. Fermented foods with pre-or probiotic features may relieve GI symptoms by improving gut health. This study aimed is to examine the impact of a nutritional supplement containing fermented whey protein with Galacto-oligosaccharide (GOS) fiber on GI distress among well-trained athletes over time by analyzing self-reported GI complaints without a control group. This quasi-experimental clinical trial consisted of a 3-week baseline period, reflected by two baseline measurements on Day 1 and Day 22, which was followed by a 3-week intervention period, reflected by a post-intervention measurement on Day 43, in which athletes added 15g of a fermented whey protein product to their diet. The primary outcome was based on the self-reported gastrointestinal symptom rating scale (GSRS), and the secondary outcome was based on a daily questionnaire, in which daily GI complaints and exercise occurrences were reported. Tertiary outcomes included a 24-hour diet recall (ASA24) and self-reported diet quality (REAP). Outcomes obtained during baseline (Day 1 and Day 22 average) were compared to those post-intervention (Day 43). Statistical significance was set at P<0.05. A total of n=50 athletes (24.7±4.5 years) with GI issues were included in the study. Five individual items of the GSRS including abdominal pain, acid reflux, bloating, burping, and loose stools reflected significantly lower scores on Day 43 in comparison to baseline (P≤0.028). A total of 78% reported GI complaints at baseline, and 61% of the participants reported lower GI complaints on Day 43 after supplementation in comparison to baseline (P=0.004). Further research is needed to explore the potential benefits of a hydrolyzed and fermented whey protein with prebiotics in a more controlled setting among athletic populations.

Food waste is gaining considerable attention from researchers in terms of its sources, its causes, and its potential effects on the environment, economy, and population health. To date, few instruments exist that allow researchers to measure food waste at the household level in reliable ways. This study aimed to assess the reliability of a newly developed self-assessment tool to measure household food waste, among participants living in Mexico. The survey tool consisted of 11 items which ask participants (N = 22) to estimate the amount of food per category that generally gets thrown away instead of eaten in the average week. Two tests of reliability were conducted, including Cronbach's Alpha for test-retest reliability, and Intra-class Correlation for internal reliability. Results varied across food categories evaluated by individual items. Items related to fresh fruit and bread products did not show reliability when testing for internal reliability or test-retest reliability. Fresh vegetables, meat and poultry products, meat alternative products, fish and seafood products, leftovers, and shelf stable foods were shown to be reliable when testing Cronbach's alpha and ICC. However, dairy products, eggs and frozen foods were inconclusive when testing for reliability. The study suggests future testing with larger sample sizes should be conducted to demonstrate reliability of the food waste self-assessment tool.

Background: Vegan and vegetarian diets have gained in popularity in recent years. Stated reasons for this include some possible health benefits and concerns of animal welfare. Though considered to be nutritionally adequate, questions remain over whether current protein recommendations of 0.8 g/kg/d are sufficient to maintain body processes and growth. Protein is unique in that it is the only macronutrient that contains nitrogen. Its status can be determined through nitrogen balance analysis of the urine if protein content of the diet is known. Nitrogen balance is considered the gold standard for determining protein intake requirements. A negative balance indicates a catabolic state, whereas a positive nitrogen balance is seen during anabolism. In healthy people, nitrogen equilibrium is desired under normal circumstances. This equilibrium reflects the net synthesis and breakdown of proteins. While nitrogen balance techniques have been used for decades, currently, there are no known studies measuring nitrogen balance and protein intake in strict vegans. Methods: Twenty vegan, inactive, male participants were recruited and received a 5-day eucaloric diet with a known protein content held constant at 0.8 g/kg/d. On day five, 24-hour urine was collected by participants and aliquoted for future analysis. Nitrogen content of the urine was determined through photometric assay and compared to the known nitrogen content of the diet to calculate nitrogen balance status. Results: Mean absolute nitrogen balance (-1.38 ± 1.22 g/d, effect size = -1.13) was significantly lower than zero (equilibrium) (p < .001). Mean relative nitrogen balance (-18.60 ± 16.96 mg/kg/d, effect size = -1.10) was significantly lower than zero (p < .001). There were no correlations seen between nitrogen balance and age, years as vegan, or fat- free mass. Conclusion: Consuming 0.8 g/kg/d of protein is insufficient to produce nitrogen balance in long-term vegans.

A large amount of research associates the lack of fruit and vegetable consumption and the intake of animal-based foods with poor health outcomes. Making shifts towards a plant-focused diet could benefit the health of individuals. Individuals who show the highest long-term adherence to the avoidance of animal-based foods are those who value animal welfare. PURPOSE: The primary purpose of this study is to explore the validity of a novel animal food frequency questionnaire (AFFQ) in relation to dietary animal food intake using 3-day dietary food logs and measuring potential renal acid load (PRAL). PRAL is the amount of acid that is produced by the body after digesting food. Fruits and vegetables produce a lower acid load, which is reflective of positive health outcomes. A secondary aim of this study is to explore the relation between AFFQ scores and measures of empathy. METHODS: Participants complete a 10-minute survey including the AFFQ and the BES-A. The Basic Scale of Empathy for adults will be viewed based on the 2 factor and 3 factor analysis assessing: Affective empathy, Cognitive empathy, Emotional contagion, and Emotional Disconnection. The AFFQ will be scored and correlated with the 3-day food log and PRAL to explore validity of the new AFFQ scale. Secondarily, the AFFQ will be scored and correlated with the BES-A to explore an association. RESULTS: The null hypotheses H01 and H02 were rejected. H01 showed that AFFQ correlates significantly with percentage of dietary protein coming from animal- based products (r=.676, p=.016). H02 showed AFFQ has a significant correlation to PRAL (r=.831, p<.001). PRAL and the percentage of protein in the diet coming from animal-based products have a significant correlation (r=.725, p=.008). The null hypothesis H03 was accepted with AFFQ and BES-A 2 factor and 3 factor’s correlations showing (r= -.412, p=.183) and (r= -.307, p=.332). CONCLUSION: The AFFQ was able to reflect differences in frequency of animal-based food intake among the convenience sample. The AFFQ and individuals’ food choices were not related to their empathy levels.