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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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ABSTRACT Epidemiological studies have suggested a link between nut consumption and weight. The possible effects of regular nut consumption as a method of weight loss has shown minimal results with 2-3 servings of nut products per day. This 8 week study sought to investigate the effect of more modest nut

ABSTRACT Epidemiological studies have suggested a link between nut consumption and weight. The possible effects of regular nut consumption as a method of weight loss has shown minimal results with 2-3 servings of nut products per day. This 8 week study sought to investigate the effect of more modest nut consumption (1 oz./day, 5 days/week) on dietary compensation in healthy overweight individuals. Overweight and obese participants (n = 28) were recruited from the local community and were randomly assigned to either almond (NUT) or control (CON) group in this randomized, parallel-arm study. Subjects were instructed to eat their respective foods 30 minutes before the dinner meal. 24 hour diet recalls were completed pre-trial and at study weeks 1, 4 and 8. Self-reported satiety data were completed at study weeks 1, 4, and 8. Attrition was unexpectedly high, with 13 participants completing 24 dietary recall data through study week 8. High attrition limited statistical analyses. Results suggested a lack of effect for time or interaction for satiety data (within groups p = 0.997, between groups p = 0.367). Homogeneity of of inter-correlations could not be tested for 24-hour recall data as there were fewer than 2 nonsingular cell covariance matrices. In conclusion, this study was unable to prove or disprove the effectiveness of almonds to induce dietary compensation.
ContributorsJahns, Marshall (Author) / Johnston, Carol (Thesis advisor) / Hall, Richard (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2011
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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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There are several visual dimensions of food that can affect food intake, example portion size, color, and variety. This dissertation elucidates the effect of number of pieces of food on preference and amount of food consumed in humans and motivation for food in animals. Chapter 2 Experiment 1 showed that

There are several visual dimensions of food that can affect food intake, example portion size, color, and variety. This dissertation elucidates the effect of number of pieces of food on preference and amount of food consumed in humans and motivation for food in animals. Chapter 2 Experiment 1 showed that rats preferred and also ran faster for multiple pieces (30, 10 mg pellets) than an equicaloric, single piece of food (300 mg) showing that multiple pieces of food are more rewarding than a single piece. Chapter 2 Experiment 2 showed that rats preferred a 30-pellet food portion clustered together rather than scattered. Preference and motivation for clustered food pieces may be interpreted based on the optimal foraging theory that animals prefer foods that can maximize energy gain and minimize the risk of predation. Chapter 3 Experiment 1 showed that college students preferred and ate less of a multiple-piece than a single-piece portion and also ate less in a test meal following the multiple-piece than single-piece portion. Chapter 3 Experiment 2 replicated the results in Experiment 1 and used a bagel instead of chicken. Chapter 4 showed that college students given a five-piece chicken portion scattered on a plate ate less in a meal and in a subsequent test meal than those given the same portion clustered together. This is consistent with the hypothesis that multiple pieces of food may appear like more food because they take up a larger surface area than a single-piece portion. All together, these studies show that number and surface area occupied by food pieces are important visual cues determining food choice in animals and both food choice and intake in humans.
ContributorsBajaj, Devina (Author) / Phillips, Elizabeth D. (Thesis advisor) / Cohen, Adam (Committee member) / Johnston, Carol (Committee member) / Bimonte-Nelson, Heather A. (Committee member) / Arizona State University (Publisher)
Created2013
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Background: Previous research suggests a healthy eater schema (i.e., identifying yourself as a healthy eater) may be a useful concept to target in interventions. A "stealth" intervention that discussed the moral issues related to food worked better at promoting healthful eating than an intervention focused on the health benefits. No

Background: Previous research suggests a healthy eater schema (i.e., identifying yourself as a healthy eater) may be a useful concept to target in interventions. A "stealth" intervention that discussed the moral issues related to food worked better at promoting healthful eating than an intervention focused on the health benefits. No research has explored the relationship between moral foundations, a theoretical model focused on delineating core "foundations" for making a moral decision, and healthy eater self-identity or self-efficacy. Purpose: We explored the relationship between moral foundations (i.e., harm/care, fairness/reciprocity, in-group/loyalty, authority/respect, & purity/sanctity) and health eater self-identity and fruit and vegetable self-efficacy (FVSE). Methods: 542 participants completed an online cross-sectional survey, which included moral foundations (i.e., MFQ), political views, healthy eater self-identity (i.e., HESS), and FVSE measures. Logistic regression was used to assess the relationship between moral foundations between healthy eater self-identity after controlling for age, gender, major, BMI, and political beliefs. OLS regression was used to explore the relationship between self-efficacy and the moral foundations after controlling for the covariates. Results: 75.6% of the sample were college students, with a mean age of 25.27 (SD=8.61). 25.1% of students were nutrition majors. Harm/care, authority/respect, and ingroup/loyalty were significantly associated with healthy eater schema, (i.e., OR=1.7, p<.001, OR=1.5, p=.009, and OR=1.4, p=.027, respectively). Ingroup/loyalty, authority/respect, and purity/sanctity were related to FVSE (p=.006, p=.002, p=.04, respectively). Conclusion: Among college students, harm/care and authority/respect were associated with a healthy eater schema. Future research should explore possible uses of these moral foundations in interventions (e.g., a plant-based diet based on reduced harm to animals or eating fewer processed views based on "traditional" values).
ContributorsKiser, Sarah (Author) / Hekler, Eric B. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Health knowledge alone does not appear to lead to sustained healthy behavior, suggesting the need for alternative methods for improving diet. Recent research shows a possible role of moral contexts of food production on diet related behaviors; however no studies have been conducted to specifically explore the relationship between moral

Health knowledge alone does not appear to lead to sustained healthy behavior, suggesting the need for alternative methods for improving diet. Recent research shows a possible role of moral contexts of food production on diet related behaviors; however no studies have been conducted to specifically explore the relationship between moral constructs and food consumption. This study examined the relationship between fast food consumption and two measures of morality, Moral Foundations Questionnaire (MFQ), specifically harm/care and purity/sanctity foundations, and the Ethical Concern in food choice (EC) questionnaire, which includes animal welfare, environment protection, political values, and religion subscales. The study also examined the association between the measures of morality. 739 participants, primarily female (71.4%) and non-Hispanic Whites (76.5%), completed an online survey that included the MFQ, the EC questionnaire, and a brief fast food screener. Participant's morality scores in relation to their fast food consumption were examined first using bivariate ANOVA analysis and then using logistic regression to control for covariates. The MFQ foundations were compared with the EC subscales using Pearson correlation coefficient. Significant bivariate relationships were seen between fast food consumption and the MFQ's purity/sanctity foundation and EC's religion subscales (p<0.05). However these significant bivariate relationships did not hold after controlling for gender, race, university education, and religion in the logistic regression analysis. The foundations of the MFQ were positively correlated with the subscales for the EC questionnaire (r values ranging from .233-.613 (p<0.01). MFQ's purity/sanctity foundation and EC's religion subscale were the two most highly correlated (r=.613, p<0.01) showing that moral intuitions may be associated with eating decision making. The study did not find significant associations between MFQ or EC scores and fast food consumption.
ContributorsMartinelli, Sarah (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Hekler, Eric B. (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
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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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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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The evaluation of nutritional status by dietary intake assessment is fundamental to nutrition research. Accurate assessment allows for health professional-moderated diet adjustment in order to promote disease prevention and management. However, dietary intake can be extremely challenging to measure properly as reliability and accuracy are essential. As technology use has

The evaluation of nutritional status by dietary intake assessment is fundamental to nutrition research. Accurate assessment allows for health professional-moderated diet adjustment in order to promote disease prevention and management. However, dietary intake can be extremely challenging to measure properly as reliability and accuracy are essential. As technology use has become more prevalent in recent years, an assortment of online, web-based diet analysis methods have begun to emerge. Are these modern methods as accurate as the traditional methods? The aim of this study was to compare and contrast diet analyses from a feeding trial in which both subject-coded (using the Automated Self Administered 24 hour recall, or the ASA24) and investigator-coded (using the Food Processor diet analysis program) diet records were available. Sixty-four overweight (body mass index >27-40 kg/m2) members of a campus community between the ages of 20-45 were recruited for an 8-week parallel arm, randomized controlled trial to evaluate the impact of two different pre-dinner meal snacks on satiety, calories consumed, and contribution to modest weight loss. As part of the study requirements, participants completed 3-day food logs at four different times during the trial: pre-trial, and week 1, 4, and 8. Participants also entered their dietary information into the ASA24 website the day after the intake was recorded by hand. Nutrient intake values were compared between the ASA24 records and the handwritten food logs. All statistical analyses were performed using SPSS Statistical Analysis version 19.0; bivariate analyses and Spearman correlation analyses were utilized. Energy, macronutrient, and micronutrient intakes did correlate significantly between the two methodologies, though both under-reporting and over-reporting were found to exist. Carbohydrate and fiber intakes were under-reported by subjects; retinol, beta-carotene, and vitamin C amounts were over-reported. These results are consistent with previous findings in reporting differences and suggest that the ASA24 is a comparably accurate dietary tracking tool to the traditional diet record method.
ContributorsSchohl, Brooke (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Urinary tract infections (UTIs) disrupt military women’s service obligations and health. Females are more susceptible to UTIs due to their unique anatomical features and hormone fluctuations affecting vaginal flora. During phase 1 of the menstrual cycle (onset of bleeding, menstrual cycle days 1-5), estrogen levels significantly decrease and inhibit the

Urinary tract infections (UTIs) disrupt military women’s service obligations and health. Females are more susceptible to UTIs due to their unique anatomical features and hormone fluctuations affecting vaginal flora. During phase 1 of the menstrual cycle (onset of bleeding, menstrual cycle days 1-5), estrogen levels significantly decrease and inhibit the growth of lactobacilli, good bacteria that are essential in warding off harmful bacteria and infections, particularly pathogens of UTIs. To reduce UTI onset, it is recommended to frequently urinate with sufficient urine void volume to facilitate washing out harmful bacteria from the bladder and urethra. While menstruating, increased fluid consumption to support urination frequency and void volume may be critical, as the urethra and urinary tract are more predisposed to pathogenic bacteria found. Yet, there is a lack of research investigating the impact of hydration on urinary tract health during menstruation. The study sought to examine the effects of increased water fluid intake on the uropathogenic bacterial activity of underhydrated menstruating premenopausal females. Thirteen females underwent a 2x2 randomized crossover trial to evaluate the effectiveness of a) additional 1.89 L of water fluid intake and b) maintain habitual fluid intake on two subsequent phase 1 menses. At each phase 1 menses, fluid intake was gathered on days 2 and 5 to determine the fluid amount consumed. First-morning urinations on days 3 and 6 assessed urogenital bacterial activity. Combining data collection days 2 and 5 per intervention (INT) and control (CON), the mean±SD for total fluid intake was INT 2.99±1.05 and CON 1.85±0.89, resulting in a 62% increase, p< 0.001, η2= 0.459. For days 2 and 5, a 48% and 80% increase in total fluid in from CON to INT was found, ps< 0.01. However, only four cultures detected uropathogenic bacteria from four participants, with no patterns between conditions or days, making it difficult to determine the effectiveness of the intervention. Though the intervention results were undetermined, military women’s hydration, menstruation, and urinary tract health remain prominent health concerns. Efforts to assess their fluid consumption and urination behaviors during menstruation and UTI risks are warranted.
ContributorsVento, Kaila Ann (Author) / Wardenaar, Floris C (Thesis advisor) / Johnston, Carol (Committee member) / Kavouras, Stavros (Committee member) / Koskan, Alexis (Committee member) / Lynch, Heidi (Committee member) / Arizona State University (Publisher)
Created2022