EFFECTS OF LIFESTYLE FACTORS ON TRABECULAR BONE SCORE DURING TRANSITION FROM HIGH SCHOOL TO COLLEGE

Julia Lois Burpeau1, Simon Higgins2, Svetlana Nepocatych1. 1Elon University, Elon, NC. 2University of North Carolina, Chapel Hill, NC. BACKGROUND: Optimization of lifestyle factors known to positively influence peak bone mass and strength are important in the reduction of risk of osteoporosis and low bone mass in the adult populations. Literature suggests that substantial trabecular bone loss occurs in young adulthood, in conditions of sex steroid sufficiency. However, it is unknown why trabecular bone loss occurs during this time. Trabecular Bone Score (TBS) is used to assess bone quality and identify those who are at risk for bone fractures. During the transition from high school to college, young adults make many lifestyle choices including diet, exercise, and sleep. Therefore, these lifestyle-related factors may help account for changes in TBS. The purpose of the study is to evaluate the changes in physical activity, diet, and sleep duration and changes in TBS in young adults during the transition from high school to college. METHODS: This is a prospective cohort study that will follow high school seniors (n=75 50% female 50% male), ages 17 to 18, who plan to attend a 4-year college within a year of graduating high school. Participants will not be living with their parents or guardians during their first year of study. Participants will be assessed approximately 15 months apart: during their senior year of high school and first year of college. TBS will be measured via dual-energy X-ray absorptiometry (DXA) imaging and analyzed using TBS iNsightTM software. Physical activity and sleep duration will be measured via 3-axis accelerometer (GXT9 Link, ActiGraph), and sedentary behavior via physical activity monitor (activPALTM, PAL Technologies). Dietary intake will be measured with the automated self-administered 24-hour (ASA24) dietary assessment tool. Linear regression will be used to determine the relationship between activity, diet, sleep duration, and TBS while controlling for relevant confounders. ANTICIPATED RESULTS: We anticipate that changes in physical activity, diet, and sleep duration during the transition will be associated with the changes in TBS. In addition, we anticipate that those who are physically active for at least 30 minutes a day, eat within recommended dietary guidelines, and sleep more than 5 hours a night will have higher TBS than those who do not. FUNDING: Funding for this project will be provided by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R15HL159650

SHORT-TERM SUPPLEMENTATION WITH β-HYDROHYBUTYRATE KETONE SALT SUPPLEMENT DOES NOT ALTER ENERGY INTAKE IN FEMALES

Svetlana Nepocatych, Miranda Thompson. Elon University, ELON, NC. BACKGROUND: Ketogenic diets have been used to treat disease with metabolic components, alter energy metabolism and aid in weight loss. An alternative to ketogenic diets is the use of ketone salt supplements to induce nutritional ketosis (blood ketone level of 0.5-3.0 mmol/L) in a short period of time. Previously, ketone salt consumption showed increased beta-hydroxybutyrate (BHB) levels, suppressed appetite hormone levels and hunger. Therefore, the purpose of the study was to examine the effects of a 10-day supplementation with BHB ketone salts (KS) and placebo (PL) on appetite profile, energy intake, blood glucose and ketone levels. METHODS: Fourteen healthy females (age: 26±6 y, body fat %: 28.5±8.0, Body Mass Index: 26±8.4 kg/m2) were recruited to participate in a single-blind crossover study. Participants were randomly assigned to consume either 0.25g/kg of KS or flavor matched PL for 10 days with a 14-day wash-out period in-between. During each visit participants completed an appetite profile using Visual Analog Scale (VAS; 0-100mm) at pre, 0, 30, 60 and 90 minutes and blood glucose and ketone levels were measured pre, at 0, 45 and 90 minutes post supplement consumption. In addition, energy intake was calculated following an ad libitum breakfast and as a 10-day average. RESULTS: A repeated measure ANOVA was used for analysis with significance accepted at p\u3c0.05. A significant time and supplement effect but not between D1 and D10 was observed for ketone levels (KS D1: 0.2±0.1, 0.3±0.2, 0.6±0.2, 0.4±0.2 mmol/L and PL D1: 0.3±0.3, 0.3±0.4, 0.3±0.4, 0.3±0.2 mmol/L, KS D10: 0.2±0.3, 0.4±0.4, 0.7±0.4, 0.4±0.3 mmol/L, PL D10: 0.2±0.2, 0.3±0.3, 0.2±0.1, 0.2±0.1 mmol/L, p\u3c0.05) at pre, 0, 45 and 90 min, respectively. A significant difference over time (p\u3c0.05) but not between supplements or days (p\u3e0.05) was observed for glucose. There was no significant difference observed in appetite profile (p\u3e0.05) and energy intake at breakfast (KS D1: 212±110, D10: 184±127 kcals and PL D1: 187±131, D10: 191±151 kcals, p\u3e0.5) or over 10-day average (KS: 1263± 259 and PL:1335±200 kcals/day, p=0.4). CONCLUSIONS: Beta-hydroxybutyrate (BHB) ketone salt supplementation caused modest elevation in blood ketone levels, however, did not have an effect on glucose, appetite profile or energy intake

THE EFFECTS OF TART CHERRY JUICE AND WHEY PROTEIN ON EXERCISE INDUCED MUSCLE DAMAGE RECOVERY

Hailey E. Jurgens, Sara Higgins, Takudzwa A. Madzima, Svetlana Nepocatych. Elon University, Elon, NC. BACKGROUND: Nutritional interventions to prevent and reduce the effects of exercise-induced muscle damage (EIMD), including natural anti-inflammatories have been found to decrease inflammation and aid in the recovery of EIMD. PURPOSE: To examine the effects of tart cherry juice and whey protein on measures of recovery following fatiguing forearm exercises. METHODS: 20 recreationally active women (age: 21±0.3yr; BMI: 23.42±2.79 kg/m 2 ) were randomly assigned to either one of two supplemental protocols (S1: 2x8 oz tart cherry juice + 30 g whey protein (WP)/day or S2: 30 g WP/day) for 3 days. Participants completed 3 sets of seven hand, wrist, and forearm exercises until fatigue with 60 s rest in between. Hand-grip strength, wrist circumference (WC), perceived recovery (PRS), fatigue, and muscle soreness (MS) were measured at pre-, 0, 24, 48, and 72h post-exercise. All measurements and exercise sessions were completed virtually over Zoom after all equipment and supplements were shipped to the participant’s home. ANOVAs were used for analyses. Significance was set at p\u3c0.05. RESULTS: No significant time or supplement effect (p\u3e0.05) or interaction was observed for handgrip strength (p=0.70), fatigue (p=0.55), or WC (p=0.64) between S1 and S2 at pre-, 0, 24, 48 or 72h post-exercise, respectively. However, a significant time and supplement interaction was observed in MS (3.1±3.3, 4.0±2.2, 4.0±3.1, 5.0±3.5, 3.6±3.4, and 1.8±2.2, 5.4±2.4, 5.0±3.4, 4.8±3.4, 3.7±3.4, p=0.006) and PRS (7.5±2.7, 4.7±2.4, 7.0±2.6, 7.2±2.2, 7.4±1.8 and 6.8±2.6, 4.8±2.2, 7.2±2.0, 7.0±2.0, 7.1±1.7, p= 0.02) between S1 and S2 at pre-, 0, 24, 48, or 72h post-exercise, respectively. CONCLUSION: Supplementation of tart cherry juice and WP following fatiguing forearm exercise could be used to reduce the perception of recovery and muscle soreness after exercise. However, the addition of tart cherry juice to WP supplementation did not improve handgrip strength, perception of fatigue, or wrist circumference an indirect indicator of inflammation

THE IMPACT OF THE 16-WEEK HEALTHEYOU PROGRAM ON THE MITIGATION OF METABOLIC DISEASE RISK FACTORS

Talya Emily Geller, Svetlana Nepocatych, Elizabeth Bailey. Elon University, Elon, NC. BACKGROUND: Metabolic syndrome (MetS) is a growing concern in the United States and around the world. MetS is a cluster of disease risk factors including hypertension, hyperlipidemia, hyperglycemia, and obesity increasing the risk of cardiometabolic disease development. The purpose of this study was to design, deliver and assess the efficacy of a 16-week physical activity and nutrition education program (HealthEYou) on mediating metabolic risk factors associated with MetS. METHODS: A survey and focus groups were used to assess the needs of the target population to develop the 16-week education program. Twenty-six participants (age: 50.1±9.2 yrs; Body Mass Index (BMI): 31.2±5.3 kg/m2) enrolled in the HealthEYou program. At baseline, 8- and 16-weeks participants completed assessments including blood pressure, body composition via Dual-energy X-ray absorptiometry (DXA) and waist circumference, 6-minute walk test, handgrip strength test, dietary intake via the Automated Self-Administered 24-hour (ASA-24) dietary assessment tool, and quality of life questionnaire. In addition, blood was drawn to assess metabolic disease risk markers (total cholesterol, glucose and hemoglobin A1c (HbA1c)). The education program consisted of 8-weeks in-person weekly interactive group (60 min) and individual goal setting (15 min) sessions and 8-weeks of weekly newsletters and two individual goal setting sessions. RESULTS: Data was analyzed using repeated measures analysis of variance. 41.7% of participants at the baseline met MetS criteria compared to 18.2% (POST-8) and 15.8% (POST-16). A significant decrease in fat mass at POST-8 (35.8±10.5 kg, p=0.005) and POST-16 (34.4±10.47 kg, p=0.003) compared to baseline (36.8±10.5 kg) and in HbA1c at POST-8 (5.14±0.31%, p=0.003) and POST-16 (5.12±0.37%, p=0.001) compared to baseline (5.36±0.40%) was observed. In addition, significant improvements in distance walked, handgrip strength, caloric intake and quality of life (p\u3c0.05) were observed. However, no significant changes (p\u3e0.05) in total cholesterol, fasting blood glucose or systolic and diastolic blood pressure were observed following the program. CONCLUSION: Participants who completed the 16-week program improved a number of metabolic risk factors contributing to MetS. The physiological improvements coincide with improvement in dietary intake and fitness levels, suggesting positive lifestyle changes were made

THE IMPACT OF LIFESTYLE FACTORS ON HEART RATE VARIABILITY DURING THE TRANSITION FROM HIGH SCHOOL TO COLLEGE

Anna Lipsman1, Simon Higgins2, Svetlana Nepocatych1, Mark Weaver1. 1Elon University, Elon, NC. 2University of North Carolina, Chapel Hill, NC. BACKGROUND: The average American spends 6.5 hours sitting per day. College students, specifically, sit for long hours during class and leisure, which allows less time for moderate to vigorous physical activity (MVPA). In addition, the increased stress and changes in dietary habits associated with college adjustment can further contribute to changes in heart rate variability (HRV) and cardiovascular disease development. Although research has identified a positive relationship between sedentary behavior (SB) and disease risk, little is known about how changes in SB and other lifestyle behaviors (e.g., physical activity, diet, stress) as healthy adolescents transition to college influences disease risk development. Therefore, the purpose of this study is to evaluate how the changes in the ratio between SB and MVPA, dietary habits, and stress affect HRV as an indicator of cardiovascular health during the transition from high school to college. METHODS: This longitudinal study will recruit high school seniors (n=75, 50% females) aged 17-18 years old. Baseline assessments will occur during their high-school senior year with a follow up one year later during the second semester of college. HRV will be assessed as the root mean square of successive differences in R-R intervals obtained from a 5-minute standard lead II ECG recording (Biopax ECG 100C, BIOPAC Systems Inc.) following 15 minutes of supine rest. ECG data will be analyzed with Kubios software (v3.4: Kubios Oy, Kupio, Finland). Sedentary behavior and physical activity ratio will be assessed via ActivPal (PAL Technologies Ltd). Dietary habits will be assessed using the Automated Self-Administered 24-hour Dietary Assessment tool (ASA-24-2018). A 10-item Perceived Stress Scale (PSS) and cortisol levels analyzed via ELISA immunoassay will be used to assess stress levels. Relationships between changes in lifestyle behaviors and changes in HRV will be evaluated using a linear regression model. ANTICIPATED RESULTS: We anticipate that SB will increase while MVPA will decrease during the transition from high school to college. Dietary habits will change, and cortisol levels will increase. Each of these changes will be associated with decreased HRV independent of other behavioral changes. FUNDING: Funding for this project will be provided by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R15HL159650

A COMMUNITY NEEDS ASSESSMENT USED TO DEVELOP A WORKPLACE NUTRITION AND PHYSICAL ACTIVITY EDUCATION PROGRAM

Talya E. Geller, Gabrielle Clancy, Elizabeth Bailey, Svetlana Nepocatych. Elon University, Elon, NC. BACKGROUND: Metabolic syndrome (MetS) is a growing concern, and many communities lack the resources to effectively address the contributing behaviors. MetS is a cluster of cardiovascular disease and type 2 diabetes risk factors such as hypertension, hyperlipidemia, hyperglycemia, and obesity. The purpose of this study was to investigate the needs and interests of faculty and staff at a small liberal arts university to design and deliver a workplace education program to decrease the risk factors associated with MetS. The project is a two phase study with phase 1) the community needs assessment and development of a nutrition and physical activity education program, and 2) the 16-week workplace education program and assessment of its effectiveness. METHODS: 53 faculty and staff members (weight: 85±19 kg, height 163±25 cm, and BMI 31±6 kg/m2 ) completed a community needs assessment and intervention program interest survey. The community needs assessment survey included demographics, overall health satisfaction, lifestyle habits, and interest in a nutrition and physical activity education program. After completion of the survey, 16 individuals participated in the Zoom focus groups. Meetings were video recorded and used for data analysis. During these focus groups participants were asked about what topics, skills, and resources they would like to learn in a workplace nutrition and physical activity education program to help support long-term lifestyle behavioral change. RESULTS: 63% of the survey respondents were dissatisfied with their physical activity habits, 47% with their eating habits, 49% with their overall health and 60% said they would be interested in the education program. Information collected from the focus groups resulted in the identification of relevant themes for the education program including: mindful eating, calorie counting, meal planning, grocery shopping, effective physical activity, motivation for exercise, sleep, and physical and mental health self-care. CONCLUSION: The collected information was used to develop an engaging 16-week workplace nutrition and physical activity education program for a target population to encourage lifestyle behavioral change and to reduce the risk of developing MetS risk factors

FAMILY DIETARY CHARACTERISTICS AND EATING HABITS IN HIGH SCHOOL SENIORS

Anna Morton1, Simon Higgins2, Eric Hall, FACSM1, Svetlana Nepocatych1. 1Elon University, Elon, NC. 2University of North Carolina at Chapel Hll, Chapel Hill, NC. BACKGROUND: Literature suggests that weight gain is associated with increased lifetime risk of obesity and heart disease. Characteristics of the family environment, such as how often the family eats per day, whether those meals are home cooked, and family food choices play a significant role in the development of eating habits. Thus, the purpose of the study was to establish the association between characteristics of the family environment, eating habits, and cardiovascular disease risk factors during youth. METHODS: 23 high school seniors (65% females), 17.9±0.4 years of age, height of 174.3±5.9 cm, weight of 76.4±8.9 kg and body mass index (BMI) 25.1±2.6 kg/m2, with no history of eating disorders were recruited for this cross-sectional study. Family dietary environment was assessed using modified Family Eating and Activity Habits Questionnaire (FEAHQ) with lower score indicating better family dietary environment. Dietary intake was assessed using automated self-administered 24-hour (ASA24) dietary assessment tool and Healthy Eating Index (HEI-2015) score was calculated. In addition, levels of glucose, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were assessed. Pearson Correlations were used to evaluate the associations between the variables. RESULTS: The modified FEAHQ score was negatively correlated with HEI score (r = -0.46, p = 0.03), consumption of whole grains (r = -0.46, p = 0.03), non-citrus fruits (r = -0.43, p = 0.04), and legumes (r = -0.49, p = 0.02). In addition, FEAHQ score was positively correlated with total cholesterol (r = 0.45, p=0.03), but not glucose (r = -0.30, p = 0.17), HDL (r = 0.22, p = 0.32), or LDL (r = 0.25, p = 0.26). Lastly, there was no significant correlation between the FEAHQ score to the total calories (r = -0.20, p = 0.37), carbohydrates (r = -0.17, p = 0.44), protein (r = -0.29, p = 0.18), and fats (r = -0.19, p = 0.39). DISCUSSION: In conclusion, family units with a better dietary environment eat better overall, consume more non-citrus fruits, whole grains, legumes, fiber and have lower total cholesterol levels. While more longitudinal research needs to be done, creating a better dietary environment at home may lead to better dietary habits and overall health. FUNDING: Funding for this project was provided by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R15HL159650

THE RELATIONSHIP BETWEEN SLEEP BEHAVIORS AND MENTAL HEALTH IN HIGH SCHOOL SENIORS

Christina Westbrooks1, Simon Higgins2, Eric Hall, FACSM1, Svetlana Nepocatych1. 1Elon University, Burlington, NC. 2University of North Carolina, Chapel Hill, NC. Background: Diagnoses of mental health disorders are rising in high school students. Little is known about the relationship between changes in sleep and the development of mental health issues, or whether other lifestyle factors (e.g., alcohol consumption) impact this relationship. Indeed, underage drinking is a significant public health concern with 57.8% of high school students reporting binge drinking. The purpose of this study is to determine the relationship between sleep, alcohol consumption, and stress as an acute marker of mental health among high school seniors. Methods: This cross-sectional sample includes 23 high school seniors (56% female, 17.9±.4 years, Body Mass Index 25.1±2.6 kg/m2, relative body fat 31.3±8.7%). Characteristics of sleep were measured via the 19-item Pittsburgh Sleep Quality Index (PSQI) and Sleep Hygiene Index (SHI). Stress was assessed using the 10-item perceived stress scale (PSS). The 10-item alcohol use disorders identification test (AUDIT) was used to screen for alcohol consumption. Pearson correlations were used to assess the relationship between sleep behaviors, alcohol consumption, and mental health. Results: Underage alcohol consumption was reported by 30% of participants, putting participants at moderate risk for an alcohol use disorder in the future. A nonsignificant correlation was observed between sleep quality and SHI (r= 0.31, p=0.15), AUDIT score (r=-0.08, p=0.68), and perceived stress (r=0.37, p=0.07). Similarly, nonsignificant correlations were noted between SHI and AUDIT score (r=0.07, p=0.73), and perceived stress (r=0.28, p=0.19). Discussion: Although, no significant relationship between stress, sleep and alcohol consumption was observed at this time, a trend for better sleep quality and mental health could be observed. As this is part of an ongoing longitudinal study, we anticipate this trend to strengthen as sample size increases. Further research is needed to better understand the effects of lifestyle factors on sleep characteristics and mental health. Funding: Funding for this project was provided by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R15HL159650 and the Undergraduate Research Program at Elon University

THE IMPACT OF A WORKPLACE PHYSICAL ACTIVITY AND NUTRITION EDUCATION PROGRAM ON BEHAVIORAL CHANGE

Gabrielle Clancy, Svetlana Nepocatych, Elizabeth Bailey, Talya Geller. Elon University, Elon, NC. BACKGROUND: The risk for diabetes and cardiovascular disease increases in individuals with metabolic syndrome (MetS), which is defined as the clustering of various risk factors of metabolic origin including obesity, dyslipidemia, hypertension, and hyperglycemia. Behaviors widely practiced in the United States do not support effective control of these risk factors, and different variables such as lack of knowledge and resources inhibit the necessary behavioral change. Previous studies have shown that various educational programs designed to address and support the dietary and lifestyle changes required to control metabolic risk factors are efficacious. The purpose of this study is to determine the efficacy of a 16-week nutrition and physical activity education program in changing behaviors that have a negative impact on health outcomes. METHODS: A total of 26 participants were recruited from a local university to participate in a 16-week education program: 8-weeks synchronous in-person program with weekly group and individual sessions; 8-weeks asynchronous program with weekly newsletters and by-weekly individual sessions; 4-weeks with no programming. Group education sessions consist of modules that cover healthy eating, meal planning, physical activity, and stress management, whereas, individual sessions focus on personal goal setting, goal attainment, and quality of life assessment. Assessments were completed before the program and will be repeated at weeks 4, 8, 16, and after 4 weeks of no programming. The Automated Self Administered 24-Hour Dietary Assessment (ASA24®), International Physical Activity Questionnaire (IPAQ), Self-Regulation of Eating Behavior Questionnaire (SREB), Short Form Self Regulation Questionnaire (SSR), and Adult Eating Behavior Questionnaire (AEB) will be used to assess dietary and physical activity behavioral change. Results will be analyzed using repeated measures ANOVA to determine the significance of differences between various time points. ANTICIPATED RESULTS: It is hypothesized that participation in the interactive intervention education program will enable participants to develop long-term behavior changes that will reduce the risk of developing metabolic syndrome