Health, Nutrition & Exercise Science

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Research from the Department of Health, Nutrition & Exercise Science. The department website may be found at https://www.ndsu.edu/hnes/

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    The Acute Effects of L-Arginine Supplementation on Flow-Mediated Dilation after Resistance Training to Fatigue
    (North Dakota State University, 2017) Streeter, Daniel
    The purpose of this study was to determine the effects of acute L-arginine supplementation on the endothelial health in healthy adults by assessing flow-mediated dilation (FMD) and cardiovascular indicators both before and after resistance exercise to fatigue. Thirty (15 male, 15 female) physically active healthy participants (mean ± SD: age 20.4 ± 1.8 years, height 176.9 ± 10.2 cm, body mass 76.0 ± 12.2 kg) volunteered for a randomized, cross-over, double-blind, placebo controlled clinical trial. Participants completed five sets of isokinetic elbow extension/flexion exercise after consumption of either placebo or 3 g L-arginine one hour prior. Baseline brachial artery diameter significantly increased post FMD (p<0.001), post-exercise (p<0.001), post-exercise FMD (p<0.001). There was no significant supplement effect on FMD (p=0.179). The increase in brachial diameter due to fatiguing exercise was not enhanced by acute supplementation with L-arginine nor did supplementation alter FMD responses after exercise.
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    Acute Exercise Response of Caffeine and Nitric Oxide Stimulating Pre-Workout Supplement among Healthy Male Recreational Athletes
    (North Dakota State University, 2017) Blake, Michael Scott
    The effect of cocktail or “pre-workout” supplements containing L-arginine nitrate and caffeine are equivocal with anaerobic performance. The purpose of this study was to compare anaerobic performance and blood flow of pre-workout supplement containing L-arginine-nitrate and caffeine-to-caffeine and placebo. In a randomized, double-blind study, 12 resistance-trained males (caffeine users) completed three trials. Biodex concentric-concentric elbow-flexion and extension (5-sets, 10-repetitions). Ultrasound measured brachial blood flow (M-Vel, V- r2 and V-C). Statistical analyses revealed a significant difference in total dynamic work PRE-PLA (P<0.0001) and CAF-to-PLA (P<0.0001) but not PRE-to-CAF (P=0.9581). Furthermore, a significant difference V- r2 PRE-to-CAF (P=0.0391) and PLA-to-CAF (P=0.0070) and M-Vel PRE-to-CAF (P=0.0281). Conclusion, PRE did not differ CAF in strength measures other than a difference in M-Vel. PRE compared to PLA were not statically different in blood flow. The study illustrated no improvement beyond individual ingredient. This research may be useful for future cocktail supplement and Nitric Oxide research.
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    Ad Libitum Fluid Intake and Plasma Responses Following Pickle Juice, Hypertonic Saline, and Deionized Water Ingestion
    (North Dakota State University, 2012) Allen, Scott Thomas
    Some clinicians warn against pickle juice (PJ) ingestion due to its sodium. PJ drinking guidelines have been developed but never tested. The purpose of this study was to determine if drinking PJ, hypertonic saline (HS), or deionized water (DIW) affected ad libitum DIW ingestion, plasma variables, or perceptions of thirst, fullness, or nausea (perceptual indicators). On three days, subjects were dehydrated (~2%), given one of three treatment drinks, rated its palatability, and rehydrated with DIW ad libitum. Over 60 minutes of rehydration blood samples and perceptual indicators were collected. Subjects consumed more DIW ad libitum following HS and PJ than DIW. Plasma variables and perceptions of thirst, fullness and nausea didn’t differ between treatment drinks. The rationale behind PJ drinking guidelines is questionable. Subjects drink more, not less, after PJ ingestion. Plasma variables and perceptual indicators didn’t differ between PJ and DIW. Athletes should schedule their drinking to fully rehydrate.
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    Altering Cardiopulmonary Resuscitation (CPR) Education for Allied Health Care Providers Based on Self-Reported Experiences with Recertification
    (North Dakota State University, 2021) Landin, Kassiann Deen
    Health care providers (nurses, athletic trainers, and emergency medical services [EMS] personnel) are expected to perform high-quality cardiopulmonary resuscitation (CPR) regardless of their confidence. Also, regardless the design of CPR recertification courses, it is expected that health care providers perform high-quality CPR. The first goal of the study pertained to self-efficacy. This research investigated health care professionals reports of self-efficacy of CPR performance with the current CPR guidelines for a specific amount of time as well as over athletic equipment. Secondly, this research explored differences in recertification expectations and educational approaches between professions. Ninety-nine health care professionals (36 nurses, 36 athletic trainers, and 27 EMS personnel) completed a self-efficacy questionnaire and a CPR recertification questionnaire. For investigation one, raw data and, a 3X2 ANOVA model was estimated to test for differences between the professional groups and for the condition of athletic equipment in place. For investigation two, descriptive statistics, means, standard deviations, and frequencies were utilized to analyze the differences between professions in CPR recertification components. Health care providers claimed to have high levels of self-efficacy for CPR performance over an extended period of time, but a low level of self-efficacy when asked about performing CPR for an extended period of time over athletic equipment (40.09% of health care providers agreed/strongly agreed they could perform CPR for an extended period of time over athletic equipment). Nurses reported a lower total score for self-efficacy for CPR performance over protective athletic equipment when compared to athletic trainers and EMS personnel. Six percent of surveyed health care providers reported they trained on high-fidelity equipment in their most recent certification. Ninety-seven percent indicated that feedback directly from a manikin enhanced their ability to perform high-quality CPR. Only 41% of reported participation in booster sessions with 38% of nurses reporting participation every 3 months and 45% of athletic trainers never participated in booster session. The relationship between confidence and CPR quality must be explored further to ensure CPR education is revised. Also, because results provide baseline data clarifying differences between specific health care professions, deliberate practice specific to professionals for CPR education can occur.
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    Analysis of Availability, Quality, and Price of Food Options in Denver, CO Grocery Stores
    (North Dakota State University, 2016) Lunsford, Jesse Adam
    In certain areas in the United States low-income, non-white populations have less access to healthy foods. This lack of access can manifest itself with higher costs, lower quality, or less availability of healthy food options. Research has shown a correlation between health status and ethnic and/or income status, which is related to negative correlations in health disparities and dietary intake. This study examined the Denver area grocery stores to identify if any populations had significant differences in food cost, food availability, or food quality. Thirty stores were randomly selected from Denver and analyzed using Nutritional Environmental Measure Survey for Supermarkets (NEMS-S). Results showed no significant relationships between cost, availability, or quality and socioeconomic status or minority status. Large supermarkets had better prices of healthier food options, and of higher quality than small, ethnic markets. Further research should assess behavioral decisions by consumers in Denver.
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    An Analysis of Certified Athletic Trainers’ Ability to Provide High-Quality Cardiopulmonary Resuscitation (CPR) over Hockey Shoulder Pads
    (North Dakota State University, 2018) Estabrooks, Adam Gregory
    Certified Athletic Trainers (ATCs) are expected to perform CPR for athletes regardless of whether the athlete is wearing protective equipment. The goal of this research was to determine /if ATCs were able to/ deliver high-quality CPR over hockey shoulder pads. Fifty ATCs completed CPR according to 2015 AHA guidelines on a medium-fidelity manikin, which had been fitted with hockey shoulder pads. CPR quality was measured with the Resusci Anne Wireless SkillReporter. CPR data included the following dimensions of compressions: overall score, mean rate, chest compression fraction, mean depth, % chest recoil, and % compressions with appropriate depth. Data were analyzed to compare differences of CPR performance between covariates. Overall score separated by gender was significant with men outperforming women. 56% of ATCs did not compress at the recommended depth. Therefore, the removal of hockey shoulder pads is recommended to ensure high-quality CPR performance as administered by ATCs.
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    An Analysis of CPR Performance, Self-Efficacy, and Deliberate Feedback
    (North Dakota State University, 2022) Martinez, Caroline
    During sudden cardiac arrest (SCA), prompt initiation of cardiopulmonary resuscitation (CPR) by a healthcare provider or layperson is critical to a patient’s odds of survival.4 The absence of health care providers in athletic settings often leaves coaches as the primary responder in competitive or recreational athletics. The goal of this study was to determine if coaches could provide high-quality CPR. Twenty coaches completed confidence and deliberate feedback questionnaires before and after two sessions of 5 minute compression-only CPR. Data were analyzed to compare confidence pre and post CPR assessment, as well as to determine the relationship between CPR performance, self-efficacy, and deliberate feedback. After receiving feedback on the initial five minutes of compression-only CPR as well as completion of a one-minute bout of CPR with deliberate feedback, a strong, positive relationship between self-efficacy and quality of CPR performance was observed.
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    An Analysis of Kinesio® Tape on Mitigation of Dynamic Knee Valgum
    (North Dakota State University, 2022) Smedley, Katelynn
    Kinesio® Tape has potential to be an intervention to mitigate dynamic knee valgum. This research project investigated the effect of Kinesio® Tape has on dynamic knee valgum through three-dimensional (3D) motion analysis in females with a history or current participation in competitive basketball or volleyball. Thirty volunteers preformed a Y-Balance test and drop jump landing (DJL) test with three different taping conditions. No tape, Kinesio® Performance Plus Tape for the facilitative gluteus medius application, and Kinesio® Tex Classic Tape for the spiral technique (ST). Results observed a statistically significant decrease in knee abduction valgum angle during 100 ms after initial contact on a DJL with application of the Kinesio® spiral technique. No significant results were observed between all three conditions during Y-Balance testing. Based off these findings we can conclude that applying the Kinesio® spiral technique mitigates dynamic knee valgum, therefore possibly decreasing the risk for ACL injury in females.
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    An Analysis of Kinesio® Tape on Myofascial Pain Syndrome of the Iliotibial Band
    (North Dakota State University, 2021) Riegel, Hannah Nicole
    This study analyzed the effects of Kinesio® Tape on pain pressure threshold (PPT) of trigger points (TrPs) within the iliotibial band (ITB). Fifty participants were evaluated for TrPs in the ITB. An algometer was used to measure pre-intervention PPT followed by a Visual Analogue Scale (VAS) score for pain. A sham or fascial taping technique was applied. After 10 minutes, a post-intervention PPT was obtained. After 48 hours, participants returned where post-intervention PPT and VAS was obtained with the tape on and PPT again 10 minutes following tape removal. Participants reported a decrease in pain. There was a slight increase in PPT from pre-tape to 10-minutes post tape. An ANOVA model incorporating all four measurements was statistically significant. There is sufficient evidence to suggest the fascial taping technique is effective at manipulating PPT of TrPs. Overall, more pressure was needed to elicit pain and the TrPs became less symptomatic.
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    An Analysis of Muscle Activity During Load Carriage, ACFT Scores, and Back Pain in Army ROTC Cadets
    (North Dakota State University, 2021) Longo, Jennifer Ann
    Context: Low back pain (LBP) is a leading musculoskeletal complaint among the military population. Load carriage tasks are a frequently reported mechanism of injury for low back pain (LBP) in the Army. Furthermore, researchers have demonstrated a clear association between physical fitness and injury incidence. Objectives: 1) to analyze changes in muscle activity during load carriage and how LBP relates to changes in muscle activation; and 2) to analyze a possible relationship between performance on the Army Combat Fitness Test (ACFT) and LBP, muscle activity, and kinesiophobia in Army Reserve Officer Training Corps (ROTC) cadets. Methods: 30 Army ROTC cadets (age 21±1.82) completed a 5-kilometer walk with and without a 35-pound load. Electromyography (EMG) data were obtained of the rectus femoris (RF), rectus abdominis (RA), gluteus medius (GM), gluteus maximus (GMx), erector spinae (ES), and biceps femoris (BF), and a questionnaire was used to assess LBP. Twenty-one cadets from the initial sample completed the six-event ACFT, the Tampa Scale of Kinesiophobia (TSK), and visual analog scales (VAS). ANOVA models were estimated for each muscle with time and load as independent factors. Correlations were used to assess relationships between pain and muscle activity. Regression was used to model the ability of muscle activity, MMBQ, TSK, and VAS scores to predict performance on each component of the ACFT. Results: Muscle activation for all muscles declined significantly over time (p<.001). Amplitude of RF (p=.014), GM (p<.001), and GMx (p=.007) significantly increased in the LC condition. Cadets who reported pain had greater average muscle activation; however, only the RF showed a significant association (p=.01). Significant regression equations were found for the Sprint-Drag-Carry (p=.009) and two-mile run (p=.004). Conclusion: Due to the associations between LBP and increased muscle activation with added loads, cadets displaying muscle activity at greater percentages of their MVC should consider adopting a core strengthening program prior to embarking on foot marches with load carriage. Additionally, cadets with poor performance on the SDC and 2MR should require a fitness program focused on improving these measures, as they are significantly associated with LBP.
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    Anterior Cruciate Ligament Neuromuscular Training Protocol of the Core and Hip Musculature: Effects On Female Athletes' Landing Mechanics
    (North Dakota State University, 2013) Young, Charley John
    Landing is a dynamic activity and considered one of the leading causes of noncontact ACL injuries. Poor biomechanics during dynamic activity resulting from neuromuscular imbalances may contribute to ACL injury. The purpose of this study was to determine if a trunk and hip neuromuscular training program for female high school athletes facilitates neuromuscular changes during landing mechanics. Participants were assessed using the Landing Error Scoring System (LESS) after a drop box jump, pre-test, mid-test, and post-test. A high LESS score indicates poor landing mechanics. Additionally, participants filled out a survey regarding their perceptions of neuromuscular changes and their landing mechanics. LESS scores decreased significantly between pre to post testing. Participants believed their landing mechanics improved, they became stronger, and they become more aware of their body. Results showed that an eight week hip and trunk neuromuscular program improved landing mechanics and may help decrease noncontact ACL injuries in this population.
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    Appraising Anterior Cruciate Ligament Injury Risk: Single-Legged Jump-Landing Dynamic Postural Stability
    (North Dakota State University, 2022) Bond, Colin
    Appraising anterior cruciate ligament (ACL) injury risk is of great interest to the orthopedic and sports medicine professional. Due to the high prevalence of non-contact ACL injuries, professionals have sought to identify intrinsic and modifiable neuromuscular and biomechanical risk factors to aid in the design of injury risk screens that have the discriminatory capacity to stratify ACL injury risk and the efficiency to be implemented at-scale. Prospective studies have revealed that poor dynamic postural stability (DPS), quantified as time to stabilization (TTS), following a backwards single-legged jump-landing (BSLJL) and poor hip external rotation and abduction strength relative to body weight, quantified using a handheld dynamometer, are two risk factors for ACL injury. The purposes of this study were to assess the effects of repeated BSLJL on within-session motor learning as quantified by DPS, evaluate the reliability of DPS, and determine the relation between DPS, hip strength, and fatigue. Twenty-seven recreationally active college-aged adults (24.0 ± 2.8 y, 1.73 ± 0.08 m, 75. ± 14.0 kg) were enrolled in this semi-randomized, cross-over study. During visit one, subjects completed 10 BSLJL trials per leg without familiarization and had their hip external rotation and abduction strength measured. During visits two through four, subjects complete two fatigue sessions and one control session in a randomized order. During these sessions, subjects completed two sets of three BSLJL trials per leg separate by either a seated rest in a chair (control) or a short-term functional fatigue protocol (fatigue). DPS was quantified as TTS and the dynamic postural stability index (DPSI). To appropriately familiarize a subject to the BSLJL, results suggest that a minimum of six familiarization trials per leg are required to sufficiently reduce the motor learning effect. Results also indicate that TTS reliability is poor after 10 trials per leg whereas DPSI reliability is good after just two trials per leg and excellent after just six trials per leg. Finally, results indicate that following completion of a fatigue protocol, there are decrements in TTS, but not in DPSI. Further, greater hip abduction strength is associated with better DPSI when rested and fatigued, but not TTS.
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    Asking Why, Instead of What: Investigating a Picky Eating Spectrum
    (North Dakota State University, 2021) Jellison, Savanna Elizabeth Jean Westrom
    There is currently no universal definition for picky eating. Picky eating is also currently viewed as a binary decision. The purpose of the current study was to develop a spectrum of picky eating. The researchers used a why instead of what approach to identifying 23 picky eating categories and themes among individuals. Exploratory Factor Analysis was utilized on pilot data (N = 412) and items loaded on three factors. The first factor consisted of 7 items (α = .76) and accounted for 24.56% of the variance in the data. Factor two consisted of 10 items (α = .79) accounting for 9.87% of variance and factor three consisted of 5 items (α = .66) and accounted for 6.85% of the variance. Our results indicate that the picky eating spectrum identifies various behaviors of picky eating that could lead to targeted interventions and potentially reduce parental frustration and picky eating.
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    Assessing Critical Thinking Skills of Athletic Training Professional and Post-Professional Students
    (North Dakota State University, 2014) Adamietz, Daniel James
    Critical thinking (CT) can be described as using resources, identifying assumptions, asking questions, comparing alternatives, and finally coming to a conclusion. Critical thinking can be used in daily life, general work, or in specialty situations and is a valuable skill in health professions. Athletic training integrates CT into evaluations, treatments, rehabilitation programs, and other activities. Critical thinking is needed in the profession of athletic training to increase accuracy of diagnosis and evaluation and to improve patient outcomes. The purpose of this study was to establish CT baseline scores for athletic training professional and post-professional students. Results revealed that the post-professional students in this sample scored higher on the Health Science Reasoning Test than professional students.
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    Assessing the Reliability of Two Orthopedic Special Tests to Determine Hip Flexor Contracture with the Assessment of Pelvic Tilt Angle during a Back Squat
    (North Dakota State University, 2018) Grieshaber, Derrick
    Orthopedic specialists use Special Tests to determine a pathology’s presence. Hip flexor contracture is linked to injury predisposition and postural anomalies. This research examined reliability for the Modified Thomas and Ely’s Special Tests when evaluating hip flexor contracture, and its effect on dynamic exercise. Twenty adults were randomized in a study and analyzed for hip flexor contracture. Dartfish Motion Analysis measured hip and knee flexion angles. Participants performed isometric squats to determine their maximal voluntary isometric contraction, which was later used to calculate exercise prescription for the eight-repetition dynamic back squat. Inter-rater reliability was slight to fair for iliopsoas contracture during the Modified Thomas Test. Overall analysis of pre-/post-test pelvic tilt and dynamic pelvic tilt between repetitions was not statistically significant (p<.05). Hip flexion between repetitions was statistically significant (p=.016). Clinicians should exert caution when defining pathology utilizing Special Tests and the effect of hip flexor contracture on dynamic movement.
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    Assessment of Protein Intake and Social Support among Bariatric Surgery Patients
    (North Dakota State University, 2017) Gehl, Ashley Marie
    People who have bariatric surgery often fall short of their desired weight loss. The purpose of this study was to assess adherence to protein recommendations of the post-bariatric surgery patients. Results of 59 participants indicated that over half did not meet protein recommendations. Over half used protein supplements to help meet the recommendations. Another purpose of this study was to determine individuals whom post bariatric surgery patients identified as important in their social support network. The use of social support bariatric groups was also assessed. Results showed bariatric support groups were an important form of social support to aid in weight loss. Both studies will aid healthcare professionals deepen their understanding of the long journey of weight loss in post-bariatric surgery patients. Bariatric surgery is an effective solution for individuals with obesity because it results in long-term weight loss; therefore, learning the characteristics of successful bariatric surgery patients is priority.
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    The Association Among Social Support, Binge Eating, and Binge Drinking in NDSU College Students
    (North Dakota State University, 2009) Zaruba, Julie Irene
    The purpose of this thesis was to determine the association between bingeing behaviors and social support in college students. Participants were 216 male (57%) and female students, between 18-25 years, who were enrolled in a university required Wellness course. Participants volunteered to complete an online survey. The survey contained questions related to binge eating (BE), binge drinking (BD), social support, and basic demographic data. Groups were constructed based on the participants' gender or age and reported bingeing behaviors (binge eating (BE), binge drinking (BD), binge eating and binge drinking (BE/BD), and no bingeing behavior (NB)). Further, the social support data were broken down into low, moderate, and high categories for S- and N- Scores. S-scores represent the level of perceived social support an individual reports and an N-Score represents the number of individuals in a social network. Paper 1 (Social Support and Bingeing Behaviors in College Students) examined descriptive data on bingeing behaviors and social support to assess if any associations occur between these variables. Paper 1 also assessed the prevalence of bingeing behaviors among college students and identified gender/age differences among individuals who reported bingeing behaviors. Findings from the study indicate no significant associations between bingeing behaviors and social support (S-Score: p=.778 (BE); .362 (BD); .748 (BE/BD); .144 (NB)) (N-Score: p=.853 (BE); .362 (BD); .602 (BE/BD). Findings from the study also indicate no significant correlation between bingeing behaviors and social support (S-Score: r =.006,p=.573 (BE); r =.047,p=.502 (BD); r =.080,p=.246 (BE/BD)) (N- Score: r =.074,p=.284 (BE); r =.006, p=.936 (BD); r =.036, p=.601 (BE/BD)). The prevalence ofbingeing behaviors was similar to the rest of the nation as 40.3% report BE, and 49.5% report BD. Related to age/gender differences males reported higher levels of bingeing behaviors and males reported significantly higher binge drinking severity level l(males = 64.04% vs. females= 35.96 %, p= .008). Reported binge drinking behaviors were divided into three levels. The three severity levels are; level 0= individuals who drink alcohol, yet have not binged in the past 30 days; level 1 =individuals who binge drank only once in the past 30 days; and level 2= individuals who frequently binge drink (2 or more binge drinking episodes in the past 30 days). Differences in binge drinking severity level 0, 1, and 2 also occurred between age category 18-20 and 21-25 (p=.007, .000, .000, respectively). Implications of this dissertation suggest that, within a collegiate population, social support may not have as much of a positive influence as previously thought. Another implication is the significant differences that exist between age, gender, and bingeing behaviors suggest any attempt to modify binge behaviors within a collegiate population should be gender and age specific.
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    The Association Between Workplace Lactation Accommodations and Corporate Lactation Programs and Breastfeeding Duration in Working Women
    (North Dakota State University, 2017) Hilliard, Elizabeth
    Breastfeeding support has increased over the past 2 decades, especially in the workplace. The Patient Protection and Affordable Care Act of 2010 provided several protections for working, breastfeeding women. Prior to the passage of this legislation, the North Dakota State Legislature amended SB 2344 to create an Infant Friendly business designation available to any business or organization in the state providing specified lactation accommodations for their employees. While this amendment has been in effect since 2009, and the first cohort of businesses was designated in 2011, there has been no evaluation of this designation to determine effectiveness. The purpose of this research is to examine the difference in breastfeeding continuation rates between women working for Infant Friendly and non-designated businesses, and to identify how intention, self-efficacy, and other worksite factors influence breastfeeding duration. An 85 item online questionnaire was developed and distributed using various sampling methods to working women across the state of North Dakota. T-tests, Analysis of Variance, and forward step-wise regression were used to analyze results. While there was no statistically significant difference in breastfeeding duration between designated and non - designated businesses, there was a 3-month difference in duration between continually designated businesses and those letting their designation lapse. Participants disagreed that breastfeeding education was available from their employers. With regard to intention, women who intended to exclusively breastfeed did so with a four month longer duration than those with other feeding intentions, although the results were not statistically significant. Women who perceived only minor challenges with combining breastfeeding and working, and those with greater self-efficacy for breastfeeding had longer breastfeeding durations as well. While the designation is a starting point for worksite breastfeeding support, it could be more comprehensive. Adding a policy promotion and breastfeeding education component to the designation may improve awareness and use of accommodations, making the designation more impactful. These additions may also aid in increasing breastfeeding intention and self-efficacy among working women, and decrease the perception of barriers.
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    Associations between Physical Activity and Quality of Life: Implications for Primary Care
    (North Dakota State University, 2018) Meyer, Stefanie Marie
    It is increasingly well-known that chronic diseases are placing a burden on the United States, including the healthcare system. Considering chronic disease risk and quality of life (QOL) measures, improving lifestyle behaviors such as physical activity (PA) should be further explored. In particular, using a place-based approach such as the healthcare system to improve lifestyle behaviors is a strategy to explore. Lifestyle Medicine (LM) is an approach that uses behavior as therapy to treat conditions and is suggested as an approach for primary care. The purpose of study 1 was to explore potential differences in QOL of patients who were referred to LM and are categorized into one of three groups 1) did not engaged in LM 2) engaged in up to two sessions of LM 3) engaged in three or more sessions of LM. The purpose of study 2 was to explore the relationship among provider QOL, PA level, and referral practices to LM. Participants completed demographic and lifestyle referral practices questionnaire, RAND-36 item health questionnaire, and Physical Activity Vital Sign questions. Results from study 1 include no significant differences between LM groups, QOL, and PA. Additionally, a significant difference was found for patient general health QOL score for those who met PA guidelines (M = 68.16, SD = 23.346) versus those who did not meet PA guidelines (M = 54.67, SD = 16.23); t (48) = 2.41, p = .02. Results for study 2 include no significant differences between provider PA minutes and LM referral as well as provider general health QOL and LM referral. A significant difference was found for provider general health QOL score for those who met PA guidelines (M = 85.833, SD = 10.68) versus those who did not meet PA guidelines (M = 67, SD = 9.08); t (9) = 3.109, p = .013. This dissertation will further inform the healthcare community (health system and health professionals) about the importance of PA to overall QOL for patients and providers. Moving from sick care to preventive care using LM approaches must be further explored and studied for both improved health outcomes and financial sustainability.
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    ASSOCIATIONS OF ANTIOXIDANT CONSUMPTION FROM FOOD AND SUPPLEMENT SOURCES ON COGNITIVE FUNCTION IN OLDER ADULTS
    (North Dakota State University, 2024) Knoll, Kelly
    Oxidative stress, the imbalance of prooxidants and antioxidants, has been recognized as a possible risk factor for cognitive impairment. We postulate that increased dietary antioxidant consumption could help preserve cognitive function during aging. Dietary intake and cognitive function of 50 adults aged ≥65-years (66% women; aged 71.5±5.1 years) was assessed using Cronometer, an electronic nutrition analysis application, and the Saint Louis University Mental Status examination. The fisher’s exact test (p < 0.01) identified a significantly lower percentage of cognitive dysfunction (31.6%; 6 of 19 participants) among participants that met the Recommended Daily Allowances (RDAs) for the antioxidants, vitamin C, vitamin E, selenium, and manganese, and a higher percentage of cognitive dysfunction among those that did not meet the antioxidant RDAs (74.2%; 23 of 31 participants). However, mean cognitive scores differed insignificantly between those meeting RDAs (26.2 ±4.2 points) and those that did not (24.9 ±2.9 points; p = 0.07).