This study evaluates the effects of feeding modes on the infant gut microbiome, especially focusing on the unique microbial composition provided by human milk. It analyzed the gut microbiome of 51 mother-infant dyads and identified significant differences in microbial diversity related to feeding practices. Alpha diversity results, measured using the Shannon diversity index (H = 38.134, p = 1.05e^-7) and Faith's Phylogenetic Diversity (H = 45.999, p = 2.45e^-9), showed that breastfeeding, in any form, supports microbial alpha diversity comparable to exclusive breastfeeding that was lower in infants receiving breast milk compared to formula and cow’s milk. In contrast, formula or cow's milk led to a distinctly different microbiome. This study utilized both unweighted and weighted UniFrac metrics to assess the impact of feeding modes on microbial community structure or beta diversity. Using these metrics, and PERMANOVA testing, significant differences were observed between several feeding modes. Cow’s milk and formula did not differ for gut microbiome community structure but all modes of feeding that included breastmilk were significantly different from both cow’s milk and formula (q < 0.005). Additionally, breastmilk fed at breast resulted in a significantly different community structure than in infants fed breastmilk at breast and pumped for bottle feeding. Multivariate models of beta diversity metrics, including both subject ID and time, suggested that individual differences accounted for 48% of the variance, while feeding mode accounted for 2%. Despite the smaller explained variance of feeding mode, the association between feeding mode and unweighted UniFrac was statistically significant (p = 0.01). Interestingly, while feeding mode was a significant factor in microbial community diversity, it did not significantly associate with the abundance of Bifidobacterium (p = 0.31) or Lactobacillus (p = 0.21). Covariate inclusion in models revealed that subject ID (individual baby) was the only substantial contributor (p < 0.0001) to the variance in Bifidobacterium abundance. These findings emphasize breast milk's critical role in the development of a healthy gut microbiome and highlight the complex interplay between diet, genetics, and microbial colonization. These insights suggest that while individual genetics are a driving force, breast milk consumption contributes significantly to the gut microbiome diversity and community composition, particularly when compared to formula or cow’s milk consumption. Further research into the mechanisms driving the establishment and maintenance of the infant gut microbiome are warranted.

Studies show that having greater weight-for-length in infancy and obesity in childhood can lead to obesity in adolescence and adulthood. Reducing obesity risk factors may decrease one’s chance of developing obesity. This longitudinal observational study’s objective was to investigate longitudinal associations of infant nighttime sleep proportion with gut microbiome diversity and taxa abundance (n=30). Fecal samples, sleep diaries and sleep actigraphy were taken at 3 and 8 weeks, and 3, 6, 9, and 12 months during infancy. Diversity analysis was completed in Quantitative Insights Into Microbial Ecology 2 (QIIME 2.0) in conjunction with PERMANOVA tests for group comparisons. QIIME2 diversity plug-ins were used to calculate alpha diversity (Shannon index) and beta diversity (Unweighted UniFrac distance) metrics. Percent abundance values for bifidobacteria and lactobacillus were exported at the genus level for subsequent analyses. Mixed linear models (MLM) and Adonis multiple regression analyses were used to test for significant (alpha = 0.05) effects of nighttime sleep fraction on alpha and beta diversity metrics and abundance of specific microbial taxa. All statistical models accounted for individual effects (baby/subject ID), time, and a time*sleep fraction interaction. For aim 1, the regression model was: Shannon = baby + time + sleep fraction + time*sleep fraction. The overall regression was statistically significant (R2 = 0.518, F = 3.9576, p < 0.0001). Nighttime sleep proportion did not significantly predict gut microbiome richness in infants (β = 0.281, p = 0.8603). For aim 2, when adjusting for covariates in a multiple regression model, sleep fraction was insignificant. The R2= 0.005106, F= 0.810996, p=0.619). For aim 3, the fitted regression models were Bifidobacteria/Lactobacillus= baby + time + sleep fraction + time*sleep fraction. The overall regression for Bifidobacteria was statistically significant (R2 = 0.371944, F = 2.6286, p = 0.0008) but nighttime sleep proportion did not significantly predict Bifidobacteria abundance in infants (β = -54.40518, p = 0.2723). The overall regression for Lactobacillus was statistically significant (R2 = 0.236381, F = 1.8687, p = 0.0208) but sleep fraction was not associated with taxa abundance. Further research is needed to describe associations between sleep, gut microbiome, and the distal outcome of obesity.

The prevalence of cardiovascular diseases, closely associated with elevated cholesterol levels, remains a significant public health concern worldwide. Dietary interventions, particularly the consumption of whole grains, have been advocated for their potential in reducing cholesterol levels and mitigating cardiovascular risk. However, the specific impact of corn flour, a staple in many diets, on cholesterol modulation remains underexplored. This thesis aims to address this gap by exploring how three varieties of corn flour (refined, whole grain, and excellent fiber mixture) provided by the North American Millers Association Corn Division (NAMA) affect both LDL cholesterol levels and triglycerides. This study was conducted using a randomized-single blinded crossover design. There were three treatment periods that were each 4-weeks long, each treatment period consisting of a different flour treatment. There was a 2-week washout period in between each treatment making the study a total of 16 weeks. During each treatment period, blood samples were collected from each participant to analyze LDL and triglyceride levels. At the beginning and end of each treatment period, two blood samples were taken to account for day-to-day variability. Pre-intervention LDL cholesterol levels were compared to post-intervention LDL cholesterol levels using a general linear model. This study found that LDL cholesterol levels were significantly reduced by the excellent fiber mixture by ~10 mg/dL. Whole grains and refined grains, however, had no significant effect on LDL cholesterol levels. None of the corn flour treatments had a significant effect on triglyceride levels. The overall results of the study indicated that implementing the excellent fiber mixture into the diet could be effective in reducing risk for cardiovascular disease.

Postpartum depression affects approximately 15% of the childbearing population in the United States and has been linked to a number of negative maternal and infant outcomes. Mothers who rate low in areas of confidence and self-efficacy tend to have lower satisfaction and view their infants as having more negative temperaments. Infants of depressed mothers have been found to have delays in social and emotional growth which can impair their health and future developmental outcomes. The purpose of this study was to determine if there is any evidence to support the hypothesis that maternal depression is associated with infant social and emotional development and maternal role satisfaction among low-income women in rural Arizona. This study employed a repeated measures correlational descriptive prospective longitudinal design using chart reviews analyzing existing clinical data. Purposive sampling was used to select charts of women who participated in the Verde Valley Medical Center branch of the Arizona Healthy Families program. Chart reviews were used to identify charts that met the inclusion criteria of mothers and their infants who completed at least 18 months of the Arizona Healthy Families Program. Findings of this study indicated evidence of a relationship between depression, infant social and emotional development, and maternal role satisfaction. Mothers who had infants that scored higher, with higher being indicative of concern, on the Ages & Stages Questionnaire: Social-Emotional Edition 2 (ASQ:SE 2) had lower role satisfaction scores on the Healthy Families Parenting Inventory (HFPI) and mothers who indicated dissatisfaction at 6 months postpartum were more likely to continue to indicate lower maternal satisfaction at 12 and 18 months postpartum when infant ASQ:SE 2 scores were higher. Investigating the role of the visiting service providers, such as Healthy Families, and their impact on young families for risk identification and resource support will provide information to policy and lawmakers to aid in decisions for funding and help support young families with the goal of growing strong, healthy families in healthcare deserts like rural Arizona. Keywords: Postpartum depression, maternal depression, infant social and emotional development, maternal role, maternal role satisfaction

This study aimed to investigate the association between active physical comforting strategies during bedtime and autonomy strategies with the relative abundances of Veillonella, Corynebacteria, Prevotella, and Faecalibacterium genera in the gut microbiota of three-month-old infants. We also assessed the impact of mode of delivery (vaginal delivery vs. cesarean section), feeding mode (breastfeeding vs. formula feeding), and sleep patterns on the relative abundances of prespecified bacterial genera. The study also aimed to explore how different nighttime parental interventions influenced gut microbiota composition and identify potential interventions to improve health outcomes in infant growth development and sleep.

This study explored the impact of delivery mode on the diversity of the infant gut microbiome. Four delivery groups were studied: vaginally delivered (VD), planned cesarean section (CSD), emergency cesarean section (ECSD), and vaginally born after previous cesarean (VBAC). The alpha and beta diversity of each delivery group was quantified and compared. Baby ID (uniqueness of each infant) and time (change in microbiome over time) covariates were also included to discover if delivery mode had an impact on the infant microbiome regardless of these covariates. Many significant group-wise and pairwise differences in alpha and beta diversity were found amongst the delivery groups.

The microorganisms that form the gut microbiome begin colonizing the gut at birth. The microorganisms will establish a symbiotic relationship with the host when in a state of eubiosis. However, when there is an imbalance or lack of diversity in the microorganisms present in the gut microbiome, it will shift to a state of dysbiosis, which increases the risk of inflammatory bowel and neurodegenerative diseases. There are known factors that affect the infant intestinal microbiome: mode of delivery, gestational age, and exposures, such as the use of antibiotics and feeding methods. Studies have shown that maternal lifestyle, particularly stress levels and diet, has an association with the infant microbiome diversity. However, there is limited literature that examines how postpartum maternal sleep influences the intestinal microbiome diversity in infants. We hypothesized that sleep efficiency below 85%, total sleep time and nocturnal sleep time below 7 hours, and later nocturnal sleep onset would be associated with decreased gut microbiome diversity within the sample and between samples. 27 Mother-infant pairings were used for this sub-analysis. Postpartum maternal sleep data was obtained via actigraphs and sleep diaries while infant intestinal microbiome data was obtained through fecal samples swabbed from soiled diapers. Actigraphs recorded time, movement, temperature, and light for five 24-hour periods, and sleep diaries were used to supplement the actigraphy and ease the scoring of sleep. DNA samples were extracted and sequenced using next-generation sequences, and QIIME2 was used to analyze these sequences. Alpha- and beta-diversity results following sequencing revealed good postpartum maternal sleep efficiency is associated with increased infant gut microbiome diversity within and between samples. There was a trend for nocturnal sleep onset being associated with beta-diversity measurements which were driven by phylogenetic differences and abundance of bacteria. Nocturnal total sleep time and 24-hour total sleep time were not associated with alpha- and beta-diversity. Our findings as well as the scarcity of the literature illustrate the need for further investigations on the mechanics of maternal sleep efficiency association with infant gut microbiome. Future research is needed to further evaluate the trending nocturnal sleep onset influences on the infant gut microbiome beta-diversity with a larger and more diverse sample.

Grains are a major dietary staple in many cultures and countries. Corn can be consumed as either a fruit, vegetable, or grain. In the case of the Corn and Heart Health Study (CHS), the effect of corn flour was examined. The study used three varieties of corn flour (whole grain, refined, and a refined plus bran blend), provided by the North American Millers Association (NAMA), to examine the effectiveness of corn flour on lowering low-density lipoprotein (LDL) cholesterol as well as its effects on the diversity of the gut microbiome. The objective of this analysis was to determine the magnitude of change between pre- and post- intervention serum blood samples and the changes in alpha (within-sample) diversity in the gut microbiome. The study utilized a randomized-single blinded, crossover model. The study was 16 weeks long, with three 4-week long treatment periods with two-week washout periods in between. During each treatment period blood samples, stool samples, a diet record, and questionnaires were collected from participants. Two blood samples were collected at the beginning and end of each treatment period to account for potential day to day changes on LDL cholesterol. For the purpose of this study, the results of blood and fecal analysis were used to determine the effectiveness of the intervention. Fecal analysis using the Shannon Index showed that there was no significant difference in the within-sample microbiome diversity by corn flour type (H=2.86, p=0.72). Pre-treatment plasma LDL levels were subtracted from post-treatment levels and analyzed using a general linear model that controlled for sequence, period and a nested (ID[sequence]) variable to account for the within-person crossover design. This showed that the bran-enriched flour had the highest mean reduction in LDL cholesterol while the refined and whole grain flour resulted in increases in LDL cholesterol. The change in LDL cholesterol for bran-enriched flour was significantly different from the refined flour (Mean Difference of -14.97 mg/dL; P=.041). The results of this study indicate that refined corn flour enriched with bran could be a recommended addition to the diet to prevent cardiovascular disease and reduce LDL cholesterol in individuals who are at low risk.

Background: Studies have examined student fruit/vegetable (FV) consumption, selection, and waste related to lunch duration and found that longer duration at lunch was associated with greater consumption, selection, and reduced waste. However, few studies have investigated the relationship between time to eat and FVs. The aim of this research is to analyze the relationship between objective time to students took to eat (“time to eat”) as it relates to their fruit and vegetable consumption, selection, and plate waste.in elementary, middle, and high schools. Methods: A secondary analysis of cross-sectional study of 37 Arizona schools to discover the differences in the selection, consumption, and waste of FVs from students (Full N = 2226, Elementary N = 630, Middle School N = 699, High School N = 897) using objective time to eat measures. Zero-inflated negative binomial regressions examined differences in FV grams selected, consumed, and wasted adjusted for sociodemographics including race, ethnicity, eligibility for free or reduced lunch, academic year, and sex and clustering for students within schools. Results are presented across school level (elementary, middle, and high school). Results: The average time taken to eat ranged from 10-12 minutes for all students. The association of time to eat and lunch duration were not closely related (r=0.03, p = 0.172). In the count model for every additional minute spent, there was a 0.5% greater likelihood of selecting FVs for elementary kids among those who took any FVs. In the zero-inflated model, it was found that there was a statistically significant relationship between time spent eating and the selection of fruits and vegetables. For the total sample and high schoolers, a minute more of eating time was associated with a 4.3% and 8.8% greater odds of selecting FV. This means that longer eating time increased the likelihood of choosing fruits and vegetables. The results indicated that the longer students took to eat, the higher the likelihood of consuming more of FVs. Each 10 more minutes spent eating (i.e., time to eat) is associated with a 5% increase in grams of FV selected relative to mean (for those that chose FV) over 1 week this equates to 32 g increase of FV selected. However, for middle schoolers, the time to eat was not found to be significant in relation to the grams of fruits and vegetables consumed. There was some significance in the sociodemographic factors such as gender (all) and other (middle school). There was a relationship between time taken to eat and waste as a proportion for fruits and vegetables. For example, among those among the students who wasted something (as a proportion of selection), each additional 10 minutes of eating time was associated with a .6% decrease in waste relative to the mean (for those who chose fruits and vegetables) over a week, resulting in a decrease in waste percentage of 16.5%. Among high schoolers, males had a slightly higher odds of wasting a proportion of fruits and vegetables. Conclusions: This study aimed to examine the association between the time students take to eat during lunch and their fruit and vegetable (FV) consumption, selection, and plate waste. The findings revealed that the time to eat was related to FV consumption, depending on the school level. However, it was not significantly associated with FV selection or waste. The study emphasized the need for further research on time to eat, distinguishing it from the duration of lunch. Longer lunch periods and adequate time could influence better food choices, increased FV consumption, and reduced waste. The study highlighted the importance of interventions and school policies promoting healthier food choices and providing sufficient time for students to eat. Future research should validate these findings and explore the impact of socialization opportunities on promoting healthier eating habits. Understanding the relationship between lunch duration, time to eat, and students' dietary behaviors can contribute to improved health outcomes and inform effective strategies in school settings.

Food insecurity affects more than 10 million households in the United States and has been shown to impact what and how a child is fed. Additionally, there is some evidence to suggest that food insecurity may affect how an infant is soothed (either with food or another mechanism), but no study has examined the possible relationship between soothing techniques and the incidence of food insecurity. To evaluate whether food security status and nighttime soothing techniques have a relationship, surveys were administered to a sample of mothers from various racial and socioeconomic backgrounds at 3-weeks, 8-weeks, and 3-months postpartum. Of the 69 participants sampled, 61 had data that could contribute to evaluations of food security status and soothing techniques used at night. A chi-square model was utilized to determine what, if any, relationship existed between the two variables. The chi-square model did not yield statistically significant results (Pearson Chi-Square= .506, p=.477) and descriptive statistics showed that just six of the 61 participants sampled did not use food to soothe at the time their baby was 3-weeks-old. Further examination of descriptive statistics revealed that, between breastfeeding and bottle-feeding as a means to soothe an infant, breastfeeding was used twice as much as bottle-feeding. For participants enrolled in the Special Supplemental Nutrition Program for Women, Infants, Children (WIC), the use of food to soothe increased at each of the three time points. Among participants found to be food-insecure, the use of breastfeeding and bottle-feeding as means to soothe varied from time point to time point. The physical and mental toll of the postpartum period may contribute to the high use of food-to-soothe among mothers seen in this study. Future research efforts in this area should examine whether the observations reported in this study are similar among larger samples, and if more mental health support for mothers has any effect on whether food is used to soothe.