Year of Publication

2018

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Nursing

Department

Nursing

First Advisor

Dr. Gia Mudd-Martin

Abstract

Excessive intake of sodium, sugar, fats, and other unhealthy dietary patterns significantly contribute to cardiovascular disease (CVD) risk and, among those with diagnosed CVD, to deleterious outcomes. Taste perception is one of the most important factors influencing dietary intake and there are many factors that can alter it such as medication and genetic variations. Yet there has been relatively little research on influences of taste perception on self-management of CVD and CVD risk.

The purpose of this dissertation is to examine the association of various factors and taste perception in order to add to our understanding of what may or may not influence dietary consumption behaviors among persons at-risk for or with diagnosed CVD. The specific aims of this dissertation were to 1) examine the association between dietary sodium consumption and antihypertensive medication regimen in patients with heart failure (HF); 2) examine the associations between variants of the TAS2R38 haplotype and dietary intake patterns of salt, sugar, fat, alcohol and vegetables in community dwelling adults in Appalachia Kentucky with 2 or more CVD risk factors; and 3) examine associations between the TAS2R38 haplotype and salt taste sensitivity and sodium consumption in patients with HF and their family caregivers.

Specific aim one was addressed by evaluating whether prescribed diuretic, beta blocker, angiotensin II receptor blockers (ARBs), and angiotensin converting enzyme (ACE) inhibitors predicted sodium consumption as evidenced by sodium density in a sample of patients with HF when controlling for age, gender, ethnicity, smoking status, New York Heart Association (NYHA) class and body mass index (BMI). The results of this study indicate that, among patients with HF, prescribed ACE inhibitor is predictive of higher sodium consumption but not prescribed diuretics, beta blockers and angiotensin receptor blockers. To address specific aim two, a secondary analysis of data of a sample of adults living in rural Appalachia with 2 or more CVD risk factors was conducted. We examined if having one or two PAV haplotypes was predictive of patterns of salt, sugar, fat, alcohol and vegetable consumption, controlling for age, gender, smoking status, BMI, and prescribed ACE and ARB. There were no associations between TAS2R38 haplotype and any of these dietary intake patterns. Specific aim three was addressed in a study to examine the associations between the TAS2R38 haplotype and salt taste sensitivity and sodium consumption as indicated by 24-hour urinary sodium excretion in patients with HF and their family caregivers, controlling for age, gender, ethnicity, smoking status, and fungiform papillae number. Our outcomes indicated that haplotype did not predict salt taste sensitivity but did predict 24-hour urinary sodium excretion, with significantly less levels of urinary sodium excretion among participants who were homozygous for the PAV haplotype compared to those who were heterozygous for the PAV haplotype or homozygous for the AVI haplotype. The results of these studies, separately and in concert, provide greater understanding of influences of taste perception on self-management among people who are at-risk for or who have diagnosed CVD.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2018.436

Funding Information

This research was supported by Sigma Theta Tau, Delta Psi Chapter Dissertation Award.

Funding was provided by the University of Kentucky Clinical and Translational Science Scholars Seed Grant.

Available for download on Sunday, November 29, 2020

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