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Dietary self-monitoring has been shown to be a predictor of weight loss success and is a prevalent part of behavioral weight control programs. As more weight loss applications have become available on smartphones, this feasibility study investigated whether the use of a smartphone application, or a smartphone memo feature would

Dietary self-monitoring has been shown to be a predictor of weight loss success and is a prevalent part of behavioral weight control programs. As more weight loss applications have become available on smartphones, this feasibility study investigated whether the use of a smartphone application, or a smartphone memo feature would improve dietary self-monitoring over the traditional paper-and-pencil method. The study also looked at whether the difference in methods would affect weight loss. Forty-seven adults (BMI 25 to 40 kg/m2) completed an 8-week study focused on tracking the difference in adherence to a self-monitoring protocol and subsequent weight loss. Participants owning iPhones (n=17) used the 'Lose It' application (AP) for diet and exercise tracking and were compared to smartphone participants who recorded dietary intake using a memo (ME) feature (n=15) on their phone and participants using the traditional paper-and-pencil (PA) method (n=15). There was no significant difference in completion rates between groups with an overall completion rate of 85.5%. The overall mean adherence to self-monitoring for the 8-week period was better in the AP group than the PA group (p = .024). No significant difference was found between the AP group and ME group (p = .148), or the ME group and the PA group (p = .457). Weight loss for the 8 week study was significant for all groups (p = .028). There was no significant difference in weight loss between groups. Number of days recorded regardless of group assignment showed a weak correlation to weight loss success (p = .068). Smartphone owners seeking to lose weight should be encouraged by the potential success associated with dietary tracking using a smartphone app as opposed to the traditional paper-and-pencil method.
ContributorsCunningham, Barbara (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Johnston, Carol (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2012
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Description
ABSTRACT This study evaluated the LoseIt Smart Phone app by Fit Now Inc. for nutritional quality among users during an 8 week behavioral modification weight loss protocol. All participants owned smart phones and were cluster randomized to either a control group using paper and pencil record keeping, a memo grou

ABSTRACT This study evaluated the LoseIt Smart Phone app by Fit Now Inc. for nutritional quality among users during an 8 week behavioral modification weight loss protocol. All participants owned smart phones and were cluster randomized to either a control group using paper and pencil record keeping, a memo group using a memo function on their smart phones, or the LoseIt app group which was composed of the participants who owned iPhones. Thirty one participants completed the study protocol: 10 participants from the LoseIt app group, 10 participants from the memo group, and 11 participants from the paper and pencil group. Food records were analyzed using Food Processor by ESHA and the nutritional quality was scored using the Healthy Eating Index - 2005 (HEI-2005). Scores were compared using One-Way ANOVA with no significant changes in any category across all groups. Non-parametric statistics were then used to determine changes between combined memo and paper and pencil groups and the LoseIt app group as the memo and paper and pencil group received live counseling at biweekly intervals and the LoseIt group did not. No significant difference was found in HEI scores across all categories, however a trend was noted for total HEI score with higher scores among the memo and paper and pencil group participants p=0.091. Conclusion, no significant difference was detected between users of the smart phone app LoseIt and memo and paper and pencil groups. More research is needed to determine the impact of in-person counseling versus user feedback provided with the LoseIt smart phone app.
ContributorsCowan, David Kevin (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Dietary counseling from a registered dietitian has been shown in previous studies to aid in weight loss for those receiving counseling. With the increasing use of smartphone diet/weight loss applications (app), this study sought to investigate if an iPhone diet app providing feedback from a registered dietitian improved weight loss

Dietary counseling from a registered dietitian has been shown in previous studies to aid in weight loss for those receiving counseling. With the increasing use of smartphone diet/weight loss applications (app), this study sought to investigate if an iPhone diet app providing feedback from a registered dietitian improved weight loss and bio-markers of health. Twenty-four healthy adults who owned iPhones (BMI > 24 kg/m2) completed this trial. Participants were randomly assigned to one of three app groups: the MyDietitian app with daily feedback from a registered dietitian (n=7), the MyDietitian app without feedback (n=7), and the MyPlate feedback control app (n=10). Participants used their respective diet apps daily for 8-weeks while their weight loss, adherence to self-monitoring, blood bio-markers of health, and physical activity were monitored. All of the groups had a significant reduction in waist and hip circumference (p<0.001), a reduction in A1c (p=0.002), an increase in HDL cholesterol levels (p=0.012), and a reduction in calories consumed (p=0.022) over the duration of the trial. Adherence to diet monitoring via the apps did not differ between groups during the study. Body weight did not change during the study for any groups. However, when the participants were divided into low (<50% of days) or high adherence (>50% of days) groups, irrespective of study group, the high adherence group had a significant reduction in weight when compared to the low adherence group (p=0.046). These data suggest that diet apps may be useful tools for self-monitoring and even weight loss, but that the value appears to be the self-monitoring process and not the app specifically.
ContributorsThompson-Felty, Claudia (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Levinson, Simin (Committee member) / Arizona State University (Publisher)
Created2014
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Description
The purpose of this study was to gather qualitative data on different and novel methods used to self-monitor diet and exercise during a weight loss study. Participants who used either a traditional paper and pencil method or a smart phone weight loss app for diet and exercise tracking were recruited

The purpose of this study was to gather qualitative data on different and novel methods used to self-monitor diet and exercise during a weight loss study. Participants who used either a traditional paper and pencil method or a smart phone weight loss app for diet and exercise tracking were recruited for focus groups. Focus group discussions centered on the liked and disliked aspects of recording, perceived behavior changes, and suggestions for improved self-monitoring. Focus groups were organized based on the method of self-monitoring. The app group tracked calorie intake and expenditure via the "Lose It" app on their smart phones. The paper & pencil group recorded exercise and food intake in a journal and self-regulated diet based on recommended servings from each food group (or exchange lists). Focus group sessions were audio-recorded, transcribed and coded by the researcher and an independent coder. Results indicated that app participants liked the convenience, affordability, and user-friendly features, but wanted more nutrition advice. App participants liked self-managing their diet, not restricting certain foods or food groups and allowing for indulgences by balancing calories and exercise. Also, they desired an accurate estimation of energy expenditure from an app, based on individual characteristics (i.e., gender and age). Participants who recorded on paper liked the size for a visual layout of food entries, but desired a technology-enhanced method with an auto-calculation of calorie intake and expenditure. They also suggested increased accountability and opportunities for social support would enhance self-monitoring. Overall, an ideal technology-assisted self-monitoring app or program would be free and include an auto-calculation of calorie intake, a gender- and age- specific estimation of calories expended, easy entry of foods from a large database, the ability to enter whole recipes, nutrition information and recommendations, and be available via phone, tablet or computer (based on personal preference).
ContributorsSterner, Danielle (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Johnston, Carol (Committee member) / Hall, Richard (Committee member) / Arizona State University (Publisher)
Created2012
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Description
The aim of this study was to compare the effects of an intervention involving physical practice combined with motor imagery and physical practice alone on swimming performance for fifty-yard freestyle. Forty-five male and female high school swimmers were participants on two different high school teams. One team was the treatment

The aim of this study was to compare the effects of an intervention involving physical practice combined with motor imagery and physical practice alone on swimming performance for fifty-yard freestyle. Forty-five male and female high school swimmers were participants on two different high school teams. One team was the treatment group, which included the participants partaking in both motor imagery and physical practice. The other team served as the age matched control group, and the swimmers participated in physical practice only. The combined practice group performed motor imagery three times per week and physical practice five times per week. The physical practice only group performed physical practice five times per week. Each group performed their respective tasks for 9-weeks. Pre-, half-point, and post-tests consisted of a timed fifty-yard freestyle. The treatment group produced significantly faster times on the percent change in swim time scores in comparison to the control group for the half-time to post-time and pre-time to post-time score (p=.000). The treatment group also produced better performances on the pre-time to half-time scores, however, the results were not statistically significant (p = .009). Findings, therefore, support the effectiveness of motor imagery in enhancing swim performance, when combined with physical practice.
ContributorsSears, Mychaela Leduc (Author) / Hoffner, Kristin (Thesis director) / Broman, Tannah (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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Description
Gastrointestinal (GI) complaints are prevalent among athletes. Fermented foods with pre-or probiotic features may relieve GI symptoms by improving gut health. This study aimed is to examine the impact of a nutritional supplement containing fermented whey protein with Galacto-oligosaccharide (GOS) fiber on GI distress among well-trained athletes over time by

Gastrointestinal (GI) complaints are prevalent among athletes. Fermented foods with pre-or probiotic features may relieve GI symptoms by improving gut health. This study aimed is to examine the impact of a nutritional supplement containing fermented whey protein with Galacto-oligosaccharide (GOS) fiber on GI distress among well-trained athletes over time by analyzing self-reported GI complaints without a control group. This quasi-experimental clinical trial consisted of a 3-week baseline period, reflected by two baseline measurements on Day 1 and Day 22, which was followed by a 3-week intervention period, reflected by a post-intervention measurement on Day 43, in which athletes added 15g of a fermented whey protein product to their diet. The primary outcome was based on the self-reported gastrointestinal symptom rating scale (GSRS), and the secondary outcome was based on a daily questionnaire, in which daily GI complaints and exercise occurrences were reported. Tertiary outcomes included a 24-hour diet recall (ASA24) and self-reported diet quality (REAP). Outcomes obtained during baseline (Day 1 and Day 22 average) were compared to those post-intervention (Day 43). Statistical significance was set at P<0.05. A total of n=50 athletes (24.7±4.5 years) with GI issues were included in the study. Five individual items of the GSRS including abdominal pain, acid reflux, bloating, burping, and loose stools reflected significantly lower scores on Day 43 in comparison to baseline (P≤0.028). A total of 78% reported GI complaints at baseline, and 61% of the participants reported lower GI complaints on Day 43 after supplementation in comparison to baseline (P=0.004). Further research is needed to explore the potential benefits of a hydrolyzed and fermented whey protein with prebiotics in a more controlled setting among athletic populations.
ContributorsClear, Anna Marie Grace (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Committee member) / Arizona State University (Publisher)
Created2023
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Description
Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors

Exposure to sun radiation (SUR) with ambient temperature may be an influencer on athletes’ sweat loss in different environments, but the results are not currently known. The purpose of this study was to determine the effects of SUR on fluid balance (FB) and hydration status (HS) in athletes exercising indoors and outdoors.

Initial FB and HS were assessed in NCAA-DI female soccer athletes (n=10) of a single team in temperate, dry conditions (55-68°F, 18-48% humidity) who were monitored during 3 practices of equal estimated energy expenditure (EE): two outdoors in direct SUR (cold/moderate temperatures) and one indoors without SUR (moderate temperatures). Humidity, temperature, and wet bulb globe temperature (WBGT – a measurement partly based on SUR, including ambient temperature/relative humidity) were recorded using Heat Stress Meters placed in the direct sun or in the shade. Each athlete’s semi-nude dry body weight was recorded before and after exercise. Urine samples were taken before, after, and the morning after. Urine specific gravity (USG) was tested to assess HS. Athletes wore combined heart rate and activity monitors to estimate EE and were provided ad libitum water and/or a zero-calorie sports drink. Their total intake included weights of consumed food and drink. Sweat rate was calculated using body weight change and intakes of liquids minus urine losses/hour.

Two-way repeated measures ANOVA analyzed group-level differences. No significance was found in total FB (1.01±0.32 L/hr) or EE/hr (444±97.1 kcal/hr) across all days (p>0.05). In analyzing individual athlete results, 40% had consistent USG >1.025 (p=0.001) suggesting potential dehydration. These 4 athletes selected water as their beverage, of which is known that consuming only water does not stimulate drinking behavior as does electrolyte drinks. The remaining 60% were overall not dehydrated (USG <1.025) but must be aware of incidental dehydration in hotter temperatures.

The conclusion is that in low-moderate temperatures, athletes self-regulate drinking habits and achieve fluid balance during exercise with or without sun radiation. However, athletes with average USG >1.025 are likely to remain dehydrated in moderate temperatures. The findings suggest that more education would benefit these athletes by ensuring hydration in any environment.
ContributorsOlzinski, Stephanie (Author) / Wardenaar, Floris (Thesis advisor) / Johnston, Carol (Committee member) / Yudell, Amber (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Nutrition instruction has become more accessible; it is no longer relegated to the doctor’s office, dietitian briefing, outpatient clinic, or hospital. Now it is available in people’s hands, pockets, and purses via their smartphone. Since nutrition instruction has become more accessible, health professionals and members of the general public are

Nutrition instruction has become more accessible; it is no longer relegated to the doctor’s office, dietitian briefing, outpatient clinic, or hospital. Now it is available in people’s hands, pockets, and purses via their smartphone. Since nutrition instruction has become more accessible, health professionals and members of the general public are increasingly interested in using smartphone apps to assist with health-related dietary changes. With more and more of the population required to follow certain dietary recommendations and/or monitor specific nutrient intake, commercially available apps may be a useful and cost-effective resource for the public. The purpose of this four-week intervention was to determine if the popular calorie counter app, MyFitnessPal, can be used to reduce sodium intake to ≤ 2,300 mg/day compared to the traditional paper-and-pencil method. This four-week randomized parallel trial enrolled 30 generally healthy adults who were 18 to 80 years of age. Participants were randomly assigned to the MyFitnessPal (“APP”) group or to the paper (“PAP”) group and required to meet three times with the researcher for screening, baseline (start), and completion of the study. There was a significant difference in the mean urinary sodium change between the APP group and the PAP group from the start of the intervention to the completion (-24.0±32.6 and 8.5±41.9 mmol/g creatinine respectively, p = 0.027). Other positive trends that resulted from the intervention included a decline in dietary sodium in both groups and a higher adherence in the APP group compared to the PAP group regarding recording method. The MyFitnessPal app proved to be a useful tool in reducing and/or monitoring sodium intake. Thus, this trial reinforces the potential of this app to be used for monitoring other nutrients, but further research needs to be conducted.
ContributorsIpjian, Michelle (Author) / Johnston, Carol (Thesis advisor) / Shepard, Christina (Committee member) / Johnson, Melinda (Committee member) / Arizona State University (Publisher)
Created2016
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It is widely documented and accepted that athletes have difficulty maintaining adequate hydration status and that dehydration is a key risk factor for the heat-related illnesses commonly observed among athletes. Research has also suggested that hydration status can influence cognitive performance. Educational interventions focused on rehydration strategies have had

It is widely documented and accepted that athletes have difficulty maintaining adequate hydration status and that dehydration is a key risk factor for the heat-related illnesses commonly observed among athletes. Research has also suggested that hydration status can influence cognitive performance. Educational interventions focused on rehydration strategies have had minimal success reducing dehydration rates; hence, alternative interventions promoting adequate hydration status in athletes should be explored. This trial examined the efficacy of a commercial hydration mobile application (app) for reducing dehydration rates in campus athletes. Fifty-eight college students aged 18-40 y, who participated in club-level collegiate athletics were recruited from a large Southwestern university and randomized by team to one of two study arms, the Standard of Care – Education (EDU) or the hydration mobile app (APP), to determine if app technology improved hydration status as compared to traditional education messaging. Twenty-three (79%) in the EDU group and twenty (69%) in the APP group were mildly-dehydrated at baseline based on the three-day averages of hydration assessment (USG 1.010). Moreover, 31% (n=9) and 28% (n=8) of the EDU and APP groups, respectively, were dehydrated (USG 1.020). No significant differences were found between the EDU and APP groups following the intervention. Three-day average post-intervention USG testing showed 76% (n=22) and 72% (n=21) of the EDU and APP groups respectively were at best mildly-dehydrated. Additionally, 28% (n=8) and 17% (n=5) were considered dehydrated. Neither intervention improved hydration status after four weeks of treatment. Further analyses of cognitive measures were conducted by hydration assessment groups at baseline and post-intervention: hydrated (HYD) (USG < 1.020) or dehydrated (DEH) (USG 1.020). No significant differences between hydration status were found between intervention groups. Additionally, no significant improvements were seen for either group, which indicates there is still a need for a novel way to improve hydration status in this population. Multi-dimensional interventions and individualized interventions to improve hydration status in this at-risk population may be more effective. Additional research should be conducted to determine if there is any cognitive performance enhancement associated with dehydration or mild-dehydration by reassessing previous data and conducting future trials.
ContributorsZemek, Kate A (Author) / Johnston, Carol (Thesis advisor) / Hekler, Eric (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Ransdell, Lynda (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2017
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Vegetarian diets can provide an abundance of nutrients when planned with care. However, research suggests that vegetarian diets may have lower protein quality than omnivore diets. Current protein recommendations assume that vegetarians obtain a majority of their protein from animal products, like dairy and eggs. Studies have shown that this

Vegetarian diets can provide an abundance of nutrients when planned with care. However, research suggests that vegetarian diets may have lower protein quality than omnivore diets. Current protein recommendations assume that vegetarians obtain a majority of their protein from animal products, like dairy and eggs. Studies have shown that this assumption may not be valid. The recommended dietary allowance (RDA) may not be adequate in vegetarian populations with high protein requirements. The purpose of this study is to analyze dietary protein quality using the DIAAS (Digestible Indispensable Amino Acid Score) method in both vegetarian and omnivore endurance athletes. 38 omnivores and 22 vegetarians submitted 7-day food records which were assessed using nutrition analysis software (Food Processor, ESHA Research, Salem, OR, USA). Dietary intake data was used to calculate DIAAS and determine the amount of available dietary protein in subject diets. Dietary data was compared with the subjects’ lean body mass (obtained using DEXA scan technology), and strength (quantified using peak torque of leg extension and flexion using an isokinetic dynamometer). Statistical analyses revealed significantly higher available protein intake in the omnivore athletes (p<.001). There were significant correlations between available protein intake and strength (p=.016) and available protein intake and lean body mass (p<.001). Omnivore subjects had higher lean body mass than vegetarian subjects (p=.011). These results suggest that vegetarian athletes may benefit from higher overall protein intakes to make up for lower dietary protein quality.
ContributorsZuelke, Corinne (Author) / Johnston, Carol (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2017