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- All Subjects: Intermittent Fasting
- All Subjects: Smartphones
- Creators: Johnston, Carol
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 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
Description
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
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 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
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 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
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 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
Description
Background: Smartphone diet tracking applications (apps) are increasing in popularity but may not adequately address the important concerns of proper intake and of diet quality. Two novel weight loss apps were designed based on the popular dietary frameworks: MyPlate and FoodLists. MyPlate, the dietary guidelines put forth by the U.S. government, encourages a balanced diet from five primary food groups, but does not specify intake limits. The Food Lists set upper intake limits on all food groups except vegetables, and these guidelines extend to include fats, sweets, and alcohol.
Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.
Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.
Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.
Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.
Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.
Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).
Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.
Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.
Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.
Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.
Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.
Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.
Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).
Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.
ContributorsScholtz, Cameron (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2016
Description
Circadian misalignments in terms of eat and sleep cycles, common occurrences among college students, are linked to adverse health outcomes. Time-restricted feeding, a form of intermittent fasting, may offer an exciting, non-pharmacologic approach to improve the health of this population by restricting eating to feeding windows that align with circadian biology. This study aims to fill a gap in the literature regarding the effect of early time-restricted feeding (eTRF) on college students, particularly in regard to diet quality, diet self-efficacy, and sleep quality. To test the hypothesis that eTRF would lead to an increase in all three variables, a 4-wk randomized-controlled, parallel arm trial was conducted. Thirty-five healthy college students were randomly assigned to one of two groups: the intervention group (TRF) was instructed to adhere to an 8-h feeding window aligned with the light cycle (9 am to 5 pm), and the control group (CON) was instructed to adhere to a 12-h feeding window typical of college students (10 am to 10pm). The eTRF diet was consumed ad libitum, and the participants were not instructed to avoid compensatory hyperphagia. The results showed a strong, reverse effect of eTRF on diet quality: fasting had a highly significant association with decreased diet quality. The results suggest that, under free-living conditions, college students practicing eTRF are more likely to compensate for prolonged fasting with unhealthy eating and snacking.
ContributorsGonzalez, Valeria Isabel (Author) / Johnston, Carol (Thesis director) / Hundley, Amanda (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Mood disorders are prevalent within the college student population, increasing the potential for poor academic performance among those students. Intermittent fasting, particularly time-restricted feeding (TRF) regimens, have shown promising results associated with improvements in health outcomes related to weight loss, cardiovascular health, glucose and insulin regulation, and breast cancer; however, very limited research exits for the impact on mood states. The objective of this eight-week randomized, controlled trial was to examine the effects of a daily fasting regimen of 18 hours (six hour feeding window), compared to a daily fasting regimen of eight hours (16 hour feeding window), on the mood state of healthy college students attending Arizona State University or University of Arizona. Twenty nine students were recruited and randomized into the TRF group (n = 16) following a 16-hour fast or the control (CON) group (n = 13) following an eight-hour fast. Participants in each group were instructed to consume their first meal within an hour of waking, which would then begin their assigned feeding window. Participants were also allowed one ‘cheat day’ per week in which they were not required to follow their assigned fasting protocol, otherwise no additional dietary instructions were given; participants were permitted to consume food and beverages ad libitum throughout their feeding window. Mood state was assessed at baseline, week four, and week eight using the Profile of Mood States questionnaire and the GAD-7, specific to generalized anxiety. Of the initial 29 participants recruited, 18 completed the trial (TRF group n = 8; CON group n = 10). Data were reported through week four only, due to inconsistencies with week eight data as a result of the COVID-19 pandemic. The mood state measures did not show any statistically significant changes after four weeks. The results of this study suggest that a TRF regimen of 18 hours does not significantly impact overall or individual mood states among college students.
ContributorsChondropoulos, Kelly Nicole (Author) / Johnston, Carol (Thesis advisor) / Shepard, Tina (Committee member) / Alexon, Christy (Committee member) / Arizona State University (Publisher)
Created2021
Description
Background: College students face a particularly high prevalence of body dissatisfaction and weight instability increasing the risk of being unhappy and having a poor quality of life. Time-restricted feeding, a type of intermittent fasting, has gained popularity recently for sustainable weight loss without the characteristic dietary restrictions of most fad diets. A limited number of randomized control trials have looked at the effects of time-restricted feeding in humans, but none have looked at how this dietary regimen impacts happiness and quality of life. Objective: The goal was to examine the effects of an 18-hour daily fasting regimen compared to an 8-hour daily fasting regimen on happiness and quality of life in college students in Arizona.
Methods: Participants included 29 healthy, non-smoking, non-vaping students attending college in Arizona between October 2020 to March 2021. Of the 16 participants allocated to the time-restricted feeding intervention, 8 completed the trial. Of the 13 participants allocated to the control group, 10 completed the trial. The eating window began within one hour of waking up with a 6-hour eating window for the intervention group and 16-hour window for the control group. They could do one cheat day per week. No dietary restrictions were enforced. Participants completed the Oxford Happiness Questionnaire and the WHOQOL-BREF quality of life questionnaire at baseline, week 4, and week 8. Week 8 data were not reported due to data collection changes and cancellations related to the new safety protocols for the COVID-19 pandemic.
Results: Quality of life related to social relationships improved significantly in the intervention group (p=0.026). There was a trend favoring the intervention group as well showing a possible improvement in happiness related to perceived energy levels (p=0.088). No other significant data were reported.
Conclusion: Adherence to an 18-hour time-restricted feeding regimen for 8 weeks may improve quality of life related to social relationships in college students in Arizona. The results of this trial do not suggest a significant impact on overall quality of life or happiness in this population.
ContributorsDe León, Anateresa (Author) / Johnston, Carol (Thesis advisor) / Shepard, Christina (Committee member) / Grant, Shauna (Committee member) / Arizona State University (Publisher)
Created2021
Description
ABSTRACT
Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.
Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting morning blood pressure, biomarkers of glucose regulation, biomarkers of lipid metabolism, and anthropometric measures.
Methods. Eighteen healthy college students (age = 23 ± 4 years; BMI = 23.2 ± 2.3 kg/m2; MET = 58.8 ± 32.9 min/wk) completed this study. Participants were randomized to a daily 18-hour fasting protocol (Intervention; n = 8) or a daily 8-hour fasting protocol (Control; n = 10) for eight weeks. One ‘cheat’ day was permitted each week. Outcomes were measured at weeks 0 (baseline), 4, and 8. A non-parametric Mann Whitney U test was used to compare the week 4 change from baseline between groups. Statistical significance was set at p≤0.05.
Results. Diet quality (p = 0.030) and body weight (p = 0.016) improved from baseline to week 4 for the INV group in comparison to the CON group. The data suggest these improvements may be related to reductions in snacking frequency and increased breakfast consumption. Fasting blood glucose and hip circumference tended to improve for the INV group in comparison to the CON group (p = 0.091 and p = 0.100). However, saturated fat intake tended to increase in the INV group in comparison to the CON group (p = 0.064). Finally, there were no treatment differences between groups (p>0.05) for the 4-week change in total calories, dietary vitamin C, added sugars, resting systolic blood pressure, resting diastolic blood pressure, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, waist circumference, or MET.
Conclusion. These data, although preliminary, suggest that the 18-hour fasting protocol was effective for improving diet quality and reducing weight in comparison to the 8-hour fasting protocol in healthy college students. Future intervention trials will need to confirm these findings and determine the long-term relevance of these improvements for health outcomes.
Background. College students’ modifiable health behaviors, including unhealthful eating patterns, predispose them to risk for future cardiometabolic conditions.
Purpose. This novel 8-week randomized control parallel-arm study compared the effects of a daily 18-hour Time-Restricted Feeding protocol vs. an 8-hour fast on diet quality in college students. Secondary outcomes were resting morning blood pressure, biomarkers of glucose regulation, biomarkers of lipid metabolism, and anthropometric measures.
Methods. Eighteen healthy college students (age = 23 ± 4 years; BMI = 23.2 ± 2.3 kg/m2; MET = 58.8 ± 32.9 min/wk) completed this study. Participants were randomized to a daily 18-hour fasting protocol (Intervention; n = 8) or a daily 8-hour fasting protocol (Control; n = 10) for eight weeks. One ‘cheat’ day was permitted each week. Outcomes were measured at weeks 0 (baseline), 4, and 8. A non-parametric Mann Whitney U test was used to compare the week 4 change from baseline between groups. Statistical significance was set at p≤0.05.
Results. Diet quality (p = 0.030) and body weight (p = 0.016) improved from baseline to week 4 for the INV group in comparison to the CON group. The data suggest these improvements may be related to reductions in snacking frequency and increased breakfast consumption. Fasting blood glucose and hip circumference tended to improve for the INV group in comparison to the CON group (p = 0.091 and p = 0.100). However, saturated fat intake tended to increase in the INV group in comparison to the CON group (p = 0.064). Finally, there were no treatment differences between groups (p>0.05) for the 4-week change in total calories, dietary vitamin C, added sugars, resting systolic blood pressure, resting diastolic blood pressure, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, waist circumference, or MET.
Conclusion. These data, although preliminary, suggest that the 18-hour fasting protocol was effective for improving diet quality and reducing weight in comparison to the 8-hour fasting protocol in healthy college students. Future intervention trials will need to confirm these findings and determine the long-term relevance of these improvements for health outcomes.
ContributorsMayra, Selicia (Author) / Johnston, Carol (Thesis advisor) / Sears, Dorothy (Committee member) / Swan, Pamela (Committee member) / Sweazea, Karen (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2020