Graduation Date

Fall 12-20-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Ann Anderson-Berry

Abstract

Background: Social Health Programming (SHP) is a holistic intervention that can empower communities to address modifiable risk factors for poor cardiovascular health, including suboptimal nutrition or psychosocial stressors. SHP participation has been shown to increase dietary intake of fruits and vegetables, decrease perceived stress, and improve cardiovascular endurance. However, it is unknown how SHP participation during adolescence affects carotenoid serum levels, hair cortisol concentrations (biological marker of chronic stress), or vascular reactivity index (VRI; measure of subclinical cardiovascular health).

Methods: Adolescent girls and young adult women (12–29-year-old) were enrolled in this observational cohort study. Serum, hair, and saliva samples were collected from current/previous participants of a nationally recognized SHP (Girls Inc., Omaha; n=28) and study participants with no SHP exposure (n=60). Serum carotenoids were analyzed using HPLC and salivary/hair cortisol concentrations were analyzed using ELISA. The Endothelix VENDYS II® was used to measure VRI, blood pressure, and heart rate. Participant questionnaires collected information on dietary intake, resiliency, physical activity, demographics, and socioeconomic status. Mann-Whitney U or Chi-Squared tests were used as appropriate to determine whether SHP participation was associated with carotenoid nutritional status, resiliency and cortisol levels, and VRI. Linear regressions were used to adjust for age and race/ethnicity.

Results: SHP participants had significantly higher serum concentrations of multiple carotenoids including lycopene, lutein+zeaxanthin, and β-cryptoxanthin compared to the control group. However, dietary intake of carotenoids was similar between groups. There was no significant difference in resiliency or salivary cortisol concentrations between groups, but hair cortisol concentration was significantly higher among SHP participants. There was no significant difference in VRI, blood pressure, or resting heart rate between groups.

Conclusion: Participation in Girls Inc., Omaha was associated with improved carotenoid nutritional status and stable resiliency scores despite significantly higher hair cortisol concentrations. These findings support the need for further investment in SHP to mitigate risk factors for poor cardiovascular health. Future studies should explore the longitudinal impact of SHP participation on nutrition, resiliency, and cardiovascular health in a national cohort of adolescents and young adult women.

Comments

2024 Copyright, the authors

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