Nutritional sciences

Permanent URI for this collectionhttps://digital.lib.washington.edu/handle/1773/4949

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Toward Achieving Latino Food Equity: Insights from Latino Community Leaders in Central Eastern Washington
(2025-10-02) Grijalva-Martinez, Evelyn Isabel; Chaparro, Pia
Latino Food Equity acknowledges the diverse cultural and socioeconomic factors that influence food access and consumption within the Latino community, promoting more inclusive and effective strategies to achieve food equity. This is a qualitative sub-study of the Food Research and Equity Collaborative (FrEsCo), and it aims to document the perception of community leaders in Central Eastern Washington on the role of their community-based organization in advancing Latino food equity. Twelve key informant, semi-structured interviews were conducted with diverse community leaders and representatives of organizations working towards Latino food equity in the region, and the data were coded following the six steps of thematic analysis. The following four themes were identified: 1) The context in which community leaders and organizations operate, 2) Accessing food and resources for the Latino community is challenging, 3) Enhancing equitable access to food and resources for the Latino community, and 4) Opportunities and strengths of community-based organizations and the Latino community in Central Eastern Washington to advance Latino food equity. The findings reveal that addressing the lack of food access extends beyond food assistance, touching on many more factors including social, economic, legal, and geographical considerations. Community leaders highlighted the necessity for equal opportunities and respect for all Latinos. Overall, this study offers valuable insights into the complexities of addressing Latino food equity which could inform the development of tailored interventions and policies.
Food Policy Entities in Washington State: A Qualitative Exploration of Social Capital
(2025-10-02) Chapman, Haley; Spiker, Marie
Food systems—and the policies and structures that govern them—are complex, and food policy entities (FPEs) are one way that communities navigate this complexity. Efforts are underway to increase coordination among FPEs, and exploring how FPEs describe their structure, activities, and experience with social capital can support these coordination efforts. This thesis aims to characterize local FPE activity in Washington State, as well as to explore the ways in which FPEs engage with social capital. To address this, qualitative interviews and follow-up surveys were conducted with representatives of Washington State food policy entities. The interviews were then analyzed using thematic analysis techniques. Participants viewed social capital, particularly bridging social ties, as core to FPE purpose and function. Participants also spoke about the importance of both time and intention when building relational social capital (i.e., trust between individuals) with internal and external partners alike. Finally, informality emerged as an intentional practice used by FPEs to allow space to promote inclusivity and facilitate collaborative efforts to build relationships and share resources to advance cognitive social capital. Investing in social capital can enable FPEs to increase their impact to further drive food systems change within their communities.
Affordable Nutrient Density of Aquatic Foods in the FAO uFISH Database Assessed Using Nutrient Rich Food (NRF) Indices
(2025-10-02) Johnsson, Emma; Drewnowski, Adam
Background: Fish and shellfish have the potential to improve global public health by alleviating protein-energy malnutrition and closing micronutrient gaps. Objectives: To determine nutrient density of fish and shellfish in the FAO/INFOODS uFISH database using the Nutrient Rich Food (NRF) index and compare their affordability in relation to protein and priority micronutrient content. Methods: Two versions of NRF index were applied to the uFISH database. NRF6.2 was based on 6 priority micronutrients: iron, zinc, calcium, vitamin A, vitamin B12, and folate. NRF9.2, specifically tailored to fish and shellfish, used protein, calcium, iron, potassium, magnesium, selenium, vitamin A, vitamin D, and omega-3 fatty acids. Saturated fat and sodium were the 2 nutrients to limit. The NRF score was the sum of percent daily values (%DVs) for nutrients to encourage minus the sum of %DVs for nutrients to limit, capped at 100%. Food prices were obtained from GlobeFish. Affordability was calculated as protein and nutrients per penny. Results: The NRF6.2 score identified mollusks, and especially bivalves, as the best aquatic source of priority micronutrients. The NRF9.2b identified small pelagic fish as the most nutrient rich, followed by bivalves. Mollusks scored higher compared to finfish and crustaceans. Mackerel, tilapia, squid, and mussels provided the most protein per penny. Mackerel and tilapia provided the most NRF6.2 and NRF9.2b nutrients per penny. Conclusion: Fish and shellfish are an affordable source of protein, omega-3, and priority micronutrients. Disaggregating species within the broad seafood category reveals differences in cost and nutrient density, with mackerel, tilapia, squid, and mussels earning the highest scores.
Sodium Intake Differences and its Relationship to the Gut Microbiome in Female Individuals with Irritable Bowel Syndrome and Healthy Controls
(2025-10-02) Du, Stephanie Tian Xue; Lampe, Johanna
Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and changes in bowel movements. Although IBS pathophysiology is still unclear, research has suggested that IBS may be associated with diet and the gut microbiome. Sodium is a nutrient that may be associated with bloating, gut motility, and gut microbial composition. This study investigated the relationship between sodium intake, symptoms, and the gut microbiome in females with IBS and healthy controls. 113 participants provided 3-day food records as well as 28-day symptom diaries. Participants also provided a stool sample for microbiome analysis where 16S rRNA gene sequencing was used for bacterial genus identification. We compared differences in sodium intake and abundances of Lactobacillus and Bifidobacterium between 67 females with IBS and 46 healthy controls. Results showed no significant differences in sodium intake between females with IBS and healthy controls. There was also no significant correlation between sodium intake and the symptoms of interest: abdominal pain, bloating, and intestinal gas. Sodium density (mg sodium /1000 kcal) did not significantly correlate with Lactobacillus and Bifidobacterium relative abundances, but our analysis showed significant associations in abundance of other genera that were not selected a priori. We also found significant associations between sodium, energy, and macronutrient intake. Because sodium is such an integral component in daily diet, our study indicates the need for further, more focused nutrition studies on how sodium intake is associated with gut microbial composition and IBS.
The Intersection of Culture, Eating Habits and Eating Competence Among U.S.-born vs Immigrant Southeast Asian College Students
(2025-10-02) Suarez-Thai, Miki; Averill, Michelle
Southeast Asian (SEA) countries have a shared culture that is distinct from the vaguely defined "Asian culture," a nuance that is lost in U.S.-based research that reports racial demographic groups as opposed to ethnic ones. SEA cultures share characteristics in their relationship to food and mealtimes, and understanding these cultural influences on eating habits can better inform nutrition interventions and barriers to eating competence (EC) among SEA Americans. EC emphasizes positive attitudes, internal cues, food enjoyment, and meal planning without restrictive rules. This mixed methods analysis examines the association between culture, eating habits, and EC among U.S.-born (n=77) versus immigrant (n=36) SEA undergraduate college students in the U.S. We hypothesized that EC would be higher in the immigrant SEA population due to aspects of traditional food culture that may align with the Satter Eating Competence Model (ecSatter). EC was measured via the Satter Eating Competence Inventory (ecSI 2.0TM) and perceived influence of culture was analyzed through written responses to the question, "How does your culture and/or upbringing inform what and how you eat?". Results showed no statistically significant difference in ecSI 2.0TM scores between the U.S.-born and immigrant SEA groups (p=0.8302). However, qualitative analysis revealed insights into SEA culture and wider "Asian culture" on food. These insights include an emphasis on balanced meals, rice as a staple grain, traditional food as inherently "healthy," and aspects of SEA culture that align with EC. While there may be features of SEA food culture that promote (or hinder) EC, future research is needed to further explore how EC appears in SEA cultures.
Executive Function, Eating Competence, and the Feeding Relationship in Parents of Preschool-Aged Children
(2025-10-02) Evans, Kristen; Harris, Cristen
Importance: The Satter Division of Responsibility in Feeding (sDOR) is a commonly-used feeding framework to establish healthy eating and feeding relationships in preschool-aged children. Eating competence is positively associated with adherence to the sDOR. Both eating competence and adherence to the sDOR require executive functioning skills but little is known about the relationship between executive functioning, eating competence, and adherence to the sDOR. Objective: The primary aim of this study is to test whether parental executive function is related to eating competence and/or adherence to the sDOR. Methods: In this cross-sectional study, 40 participants completed the Barkley Deficits in Executive Functioning Scale (BDEFS), Satter Eating Competence Inventory (ecSI 2.0TM), Satter Division of Responsibility in Feeding Inventory for 2- to 6-year-olds (sDOR.2-6yTM), the 10-Item Perceived Stress Scale (PSS-10), and completed short answer questions about the family meal experience. Correlations between survey totals were calculated using Spearman's rank correlation coefficient. Qualitative themes were compiled from short-answer responses. Results: There was a moderate negative correlation between aggregate BDEFS scores and aggregate ecSI 2.0TM scores (rs = -0.488, p-value = 0.001), a strong correlation between aggregate BDEFS scores and aggregate PSS-10 scores (rs = 0.816, p-value < 0.001), and a moderate negative correlation between aggregate sDOR.2-6yTM scores and aggregate PSS-10 scores (rs = -0.468, p-value = 0.003). Conclusions: While we were able to show a relationship between executive function and eating competence, further research is necessary to ascertain if there is a relationship between executive function and adherence to the sDOR because our sample did not contain enough variety in executive functioning abilities to draw any conclusions about this relationship.
Associations Between Usual Plant & Animal Protein Intake and Select Serum Biomarkers of Chronic Disease Risk
(2025-10-02) Plyler, Kara; Neuhouser, Marian; Lampe, Johanna
Background:The prevalence of lifestyle-related chronic diseases has increased significantly in the U.S. over the last two decades, and nutrition interventions may help reduce disease risk. However, studies linking diet with chronic disease risk factors have yet to confirm optimal proportions and sources of certain dietary components such as protein. The purpose of this analysis was to identify associations between usual intake of plant and animal protein and standard clinical chemistries relevant to chronic disease risk. Methods:This analysis of baseline screening data from an ongoing study within the Seattle Dietary Biomarker Development Consortium included a subset of adult participants screened for the first trial of the study. Screening data included usual diet and fasting blood measures of common clinical chemistries. Using linear regression models, animal- and plant-based protein intake were assessed relative to serum concentrations of select biomarkers, including LDL cholesterol, triglycerides, hematocrit, and albumin. Additionally, mean biomarker concentrations were compared between tertiles of intake of select protein foods using ANOVA and post-hoc Tukey models. Results:Data associated with a total of 33 participants were analyzed. The linear regression revealed a significant inverse relationship between plant-based protein intake as a percent of total calories and hematocrit (p=0.02). A significant positive relationship between animal-based protein intake as a percent of total calories and hematocrit (p=0.004) was also identified after adjustments. ANOVA tests revealed a significant difference in mean triglyceride concentrations between protein intake tertiles in terms of servings per week of poultry (p=0.04) as well as a significant difference in mean hematocrit in terms of servings per week of green beans and peas (p=0.007). Conclusion:These results suggest that the proportions of plant and animal-based protein in the diet may meaningfully influence hematocrit levels and may be important considerations in addressing iron-deficiency anemia or mitigating CVD risk. However, large, randomized controlled trials are needed to confirm these findings.
Nutritional Adequacy of the Planetary Health Diet Improved by More Nutrient-Rich Foods: Analyses of the FAO Food Composition Tables for Western Africa
(2025-10-02) Sanders, Hannah; Drewnowski, Adam
The EAT-Lancet planetary health diet (PHD) was designed to meet nutritional needs while staying within planetary boundaries. This study tested nutrient adequacy of the PHD using the Food and Agriculture Organization Food Composition Tables for Western Africa (WAFCT). WAFCT food items (n=596) were aggregated into PHD categories (n=21). Median energy, protein and micronutrient content were calculated for each category. Protein amounts were corrected using the Protein Digestibility Corrected Amino Acid Score (PDCAAS). Priority micronutrients were iron, zinc, calcium, vitamin A, vitamin B12 and folate. Nutrient density of food categories was assessed by the Nutrient Rich Food Index. Median nutrient values were multiplied by food amounts to estimate PHD's nutritional value. Energy was estimated at 2,516 kcal/day. Total protein was estimated at 87 g/day before and 62 g/day after PDCAAS correction. The proposed amounts of calcium vitamin A and zinc were insufficient based on nutrient reference values. Folate, iron, and vitamin B12 were sufficient. Increasing suggested amounts of nutrient-rich beef and chicken livers, small dried fish, and pulses, while reducing whole grains and tree nuts led to a food plan that achieved reference values.
Knowledge, attitudes, and behaviors on animal agriculture: evaluating the effects of a modified Deliberative Poll
(2025-08-01) Werch, Clair Elizabeth; Otten, Jennifer
This study evaluates the use of a modified Deliberative Poll (DP), a methodology traditionallyused in political science, to assess shifts in college students’ knowledge, attitudes, and behaviors related to animal agriculture. This is the first known use of a DP for the topic of animal agriculture. The modified DP was conducted with 40 self-selected undergraduate participants enrolled in a 10-week course that included lectures, small group discussion, and expert panels related to meat production and sustainability problems and interventions. Surveys administered before and after the DP assessed knowledge, attitudes, and behaviors regarding meat consumption and sustainability and proposed systems interventions. Findings indicated that participants improved their knowledge of animal agriculture, increased their trust in farmers, and moderated their positions on related systems interventions. These results suggest that a DP format can help participants grapple with the tradeoffs inherent in sustainability issues. Overall, this intervention demonstrates promise for advancing sustainability education and could be adapted for use in broader food systems engagement efforts.
Exploring the Future of Sustainable Foods through Nova Classification of Upcycled Certified Products
(2024-10-16) Yoon, Irene; Harris, Cristen
In 2021, the world’s first certification program for upcycled products, called Upcycled Certified, was established to allow consumers to easily identify products developed with ingredients that would otherwise have gone to waste. Current research has sought to understand the potential of upcycled foods to address food loss and nutritional inadequacies while meeting the worldwide increased demand for packaged food. This study adds to this growing body of research, with a focus on understanding the extent to which upcycled foods are consistent with dietary guidelines that emphasize minimal consumption of ultra-processed foods. The Nova classification system was used to assess the degree to which Upcycled Certified products had undergone processing. After eliminating non-food items and products without sufficient nutrition data, the final sample demonstrated that over half of currently Upcycled Certified foods are deemed ultra-processed foods using Nova. Modern ultra-processed foods are increasingly different from those that have been associated with negative health outcomes in the past, and the benefits of upcycled foods extend far beyond planetary health. This study recommends improvements in the Nova classification system to reduce ambiguity and be more aligned with current research and for the Upcycled Certification to consider more holistic approaches to certification.
Determinants of Indigenous Diet Quality and Their Association with Inflammation and Biological Age in the NHLBI Strong Heart Family Study
(2024-10-16) Naide, Jocelyn; Fretts, Amanda
Chronic, systemic, low-grade tissue inflammation is a major etiologic component of metabolic dysfunction that has been positively associated with biological age and chronic noncommunicable disease (NCD) risk. Chronic systemic inflammation, biological age, and NCD risk are influenced by a wide range of factors, including certain modifiable lifestyle factors such as diet quality. We examined whether diet quality, assessed using the 2010 Alternative Healthy Eating Index, was associated with inflammation (serum interleukin-6 and C-reactive protein) and biological age (leukocyte telomere length) in a sample of American Indian adults in the NHLBI Strong Heart Family Study, a population with disproportionately high rates of NCDs. This analysis found that better diet quality at baseline was associated with lower levels of CRP during an 8-year follow-up. This relationship appeared to be driven by increases in whole grain and legume consumption. The analysis also found poor diet quality among study participants overall. This finding was expanded upon in a review of the historical and social determinants of Indigenous diet quality and identified the concept of Indigenous Food Sovereignty as a direction for future community and policy efforts aiming to improve the health and wellbeing of Indigenous populations.
Nutrient Drug Interaction Probability Scale (NDIPS): A Creation and Validation Process
(2024-10-16) Bregni, Paola Maria; Chan, Lingtak-Neander
Background:Drug-nutrient interactions (DNIs) are interactions between drugs and nutrients that can result in clinically relevant physiological alterations. Despite their potential impact, the importance of DNIs is heavily undervalued and overlooked. Evaluation of drug safety mainly focuses on single drugs or drug-drug interactions, while DNIs are not specifically considered during drug development phases. The prevalence of potential DNIs reported in studies ranges widely from 6% to 70%, indicating substantial underreporting. Contributing factors include limited nutritional expertise among clinicians, reliance on outdated anecdotal evidence, and lack of consensus on objectively assessing DNIs. As a result, DNIs often go undetected, leading to preventable adverse events or unnecessary dietary restrictions. Methods: The Nutrient Drug Interaction Probability Scale (NDIPS) was developed by adapting the DIPS questionnaire (Horn, J; Hansten, D; and Chan, L-N) to assess the probability of DNIs. An internal validation process was conducted by testing the NDIPS on published case reports describing DNIs. An external validation to assess consistency in question interpretation involved practicing clinicians who used the NDIPS to assess a selected case report and provided feedback on question clarity. Results: The internal validation trial revealed some unexpected results. While all the case reports described "established" DNIs, not all were assigned a high probability by the NDIPS tool. Analysis showed that certain question responses strongly correlated with the probability result determined by the NDIPS tool. These key determinant questions are generally not considered in current practice when assessing for DNIs, highlighting the importance of shifting the existing thought process when considering the presence of an interaction. The external validation with clinicians showed consistency in interpreting the NDIPS questions, with some suggestions to clarify certain questions and condense the questionnaire for practicality. Conclusion: The NDIPS was designed to serve as a thought process for clinicians to assess the probability of DNIs on a case-by-case basis. By guiding a comprehensive evaluation of the clinical presentation, timeframe, and alternative causes, the NDIPS supports personalized healthcare models and evidence-based management of potential DNIs. Future improvements based on validation feedback could further improve the tool's utility in addressing the underreported yet clinically relevant issue of DNIs in practice.
Animal Welfare and Environmental Stewardship Decision-Making Among U.S. Animal Producers: a Qualitative Analysis
(2024-10-16) Fudge, Mary Jeanne; Collier, Sarah
Animal agriculture remains an integral part of the U.S. food supply; as demand for animal products grows, it is essential to explore avenues for sustainable animal production across societal, environmental, and economic domains. Using Q-methodology and qualitative methods, this study examined the drivers and tradeoffs of priorities regarding animal wellbeing and environmental stewardship among 35 U.S. beef, pork, and broiler producers. The study found that each producer operated under a unique context of influences; key drivers of decision-making included personal, operational viability, consumer, and regulatory. Operational viability and personal drivers influenced tradeoffs to sustainability, however, some producers maximized multiple domains of sustainability by capitalizing on synergistic relationships between priorities. This study captures the subjective experiences of beef, pork, and broiler producers, highlighting the complexity of drivers and tradeoffs within and between domains of sustainability, predicts increased challenges to sustainability as demand for livestock products grows and offers potential leverage points among producers for effective policy interventions.
The Association Between Eating Competence and Daily Hassles and Uplifts of Eating Location in Undergraduate University Students
(2024-10-16) Allen, Aimee Marie; Averill, Michelle
Objectives: The study sought to investigate the association between the daily hassles and uplifts related to eating location and eating competence (EC), and whether socio-demographics impact this association. Methods: Using a cross-sectional study design and a convenience sample of undergraduate university students, the Lifecourse Eating and Feeding Registry was offered to 644 students during May and June of 2023. Daily hassles and uplifts were measured using the Daily Hassles and Uplifts Scale (DHUS), while EC was measured with ecSI 2.0TM. University students completed a survey which collected socio-demographic data and responses to the DHUS and ecSI 2.0TM. Multivariate regression was used to analyze whether DHUS items were associated with EC in three models: a base model, followed by a primary model with age and gender included as additional independent variables, and finally an exploratory model with birth country and food security status included. A second set of multivariate models used the EC subdomain, Contextual Skills (CS), as the dependent variable using the same independent variables as the original three models. Results: 482 students completed the sections of the survey included in the study. Three of the six DHUS items of interest were statistically significant: the hassle of eating at home, the hassle of eating out, and the uplift of eating out. The hassles of eating at home and of eating out were inversely associated with EC, while the uplift of eating out was positively associated with EC. Neither age nor gender was statistically significant in the primary model, and only birth country was statistically significant in the exploratory model: birth country of the United States was inversely associated with EC. In the CS models, three DHUS items were statistically significant in their association with CS: the uplifts of eating at home and of eating out and the hassle of eating at home. Again, only birth country was statistically significant in the subsequent models, with birth country of the US inversely associated with CS. Conclusion: Viewing an eating location as an uplift is positively associated with EC and CS, while viewing an eating location as a hassle is inversely associated with EC and CS. Future qualitative research could illuminate the reasons these associations exist, while in current practice, Registered Dietitian Nutritionists can use nutrition counseling and ecSI 2.0TM results to work with clients to improve the relationship with food and eating.
Accessibility to WIC-authorized ethnic food stores in Washington state: implications for serving the needs of immigrant WIC-eligible populations
(2024-10-16) Ogaki, Kana; Chaparro, M. Pia
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a U.S. nutrition assistance program serving pregnant and postpartum women, and children 0-5 years who live in low-income households. WIC provides participants with supplemental foods that can only be purchased in WIC-authorized stores. At least 20% of WIC participants in Washington state are of immigrant background, but information on how many WIC-authorized stores are considered ethnic stores, where immigrant households could access culturally preferred foods, is unknown. This study’s purpose is to assess the availability and distribution of WIC-authorized ethnic stores in Washington state in relation to the location of immigrant WIC-eligible populations. To do so, information on WIC-authorized stores in Washington state was obtained from the WIC Shopper cellphone app; stores were categorized as ethnic or non-ethnic based on online store information. Sociodemographic data for Washington state census tracts were obtained from the American Community Survey (ACS) 2017-2021. Using ArcGIS Pro, a map displaying the census tract level percentage of 1) foreign-born individuals and 2) WIC-eligible children as well as 3) the location of WIC-authorized stores (ethnic/non-ethnic) was generated. The distribution of, and distance to, WIC-authorized ethnic/non-ethnic stores based on the distribution of foreign-born individuals and WIC-eligible children were analyzed in R (using chi-square tests) and ArcGIS Pro (using the “Generate Origin-Destination Link” function). This study found that 29.1 percent of Washington state census tracts had WIC-authorized stores and only 1.7% had at least one WIC-authorized ethnic store. Census tracts with high proportions of both foreign-born individuals and WIC-eligible children had the highest proportion of WIC-authorized ethnic stores (14.5%) and the shortest distance to the nearest WIC-authorized ethnic store (3.0 km) when compared to census tracts with low proportions of foreign-born individuals and WIC-eligible children (0.5% and 20.3 km, respectively; p<0.001). In conclusion, while census tracts with higher proportions of foreign-born individuals and WIC-eligible children had the greatest accessibility to WIC-authorized ethnic stores, WIC-authorized ethnic stores are rare in Washington state. Future research should focus on investigating the barriers and facilitators for ethnic stores to become WIC-authorized in Washington state, in order to better serve the needs of immigrant WIC-eligible populations.
Exploring the Relationship between Dietary Supplement Use and Serum Biomarkers Among Postmenopausal Women in a Controlled Feeding Study
(2024-09-09) Baillie, Hannah; Lampe, Johanna W; Neuhouser, Marian L
Background: Dietary supplement use is common among older adults; however, there remains limited knowledge on the contribution of dietary supplements to the blood profile of nutrient biomarkers. Prior studies have failed to examine these biomarkers of dietary supplement intake under controlled feeding conditions.Objective: This study aimed to determine whether users of dietary supplements had higher serum concentrations of corresponding biomarkers, and whether those using multiple sources of the nutrient in dietary supplement form had higher serum concentrations compared to nonusers and those using only one source. Methods: Postmenopausal women from the Women’s Health Initiative were enrolled in a 2- week feeding study (n = 153). Participants consumed an individualized menu. Detailed information on dietary supplement use was also collected, and participants continued to consume these dietary supplements during the feeding period. Serum vitamin B12, lutein + zeaxanthin, and phospholipid fatty acids (PLFAs) including eicosapentaenoic acid and docosahexaenoic acid were measured at the beginning and end of the 2-week feeding period. Linear regression of dietary supplement use, along with participant characteristics, on log-transformed serum biomarker was used to evaluate the association between dietary supplement use and corresponding serum biomarker. One way ANOVA was used to determine whether there were significant differences in mean serum biomarker among groups based on number of sources of a nutrient consumed via dietary supplement. Results: Linear regression models without participant characteristics (n = 152) showed a positive association between use of vitamin B12 containing dietary supplements, lutein + zeaxanthin containing dietary supplements, and omega-3 fatty acids and respective serum biomarker (p < 0.0001, p = 0.012, and p < 0.0001, respectively). Once additional covariates were included, the positive association remained for vitamin B12 (p < 0.001) and omega-3 fatty acids (p < 0.0001). Users of two sources of a nutrient from a dietary supplement had higher serum biomarkers than users of only a multivitamin and users of neither (p < 0.0001). Conclusions: These results add to the existing body of research on the use of serum vitamin B12 and serum PLFAs as biomarkers of dietary supplement use in postmenopausal women. The relationship between nutrient and biomarker differs for each nutrient studied, and the unique factors impacting these associations should be considered.
A Qualitative Exploration of Food Tourism as a Lever for Food Systems Transformation
(2024-09-09) Perkins, Lauren; Spiker, Marie
Objective: This research aims to explore stakeholder perspectives on (1) a growing interest amongst the public in food tourism and (2) the intersection of food tourism and food systems with the potential to drive transformation.Methods: Using qualitative research methods, structured interviews were conducted with 11 participants in the US and Europe in 2023. Participants represented key stakeholder perspectives from government agencies, academia, and public and private sector organizations. Results: Participants described the importance of media and social media in shifting consumer values to favor food tourism and experiential travel. Though most participants did not explicitly articulate the potential impacts of food tourism in terms of its ability to influence food systems, many participants described impacts that were related to food systems components, characteristics, and goals, such as the potential for food tourism to contribute to local economies, pride in place, and resilience. Conclusions: It is of high importance that stakeholders from food systems and food tourism recognize their collective power in influencing systems dynamics that impact food system transformation. Moving forward from this research, food tourism and food system entities must expand and invite conversations on the relationship between these two sectors.
A Scoping Review of Consumer Perceptions of Meat Sustainability: A Focus on Animal Welfare and Environmental Impact
(2024-09-09) Msogoya, Cecilia Theodosy; Spiker, Marie
BackgroundRecent increases in meat production have marked the supply of relatively affordable meat, yet it has also heightened consumer scrutiny over environmental sustainability and animal welfare. Although there are a wealth of individual studies examining consumer concerns about the environmental and welfare impacts of meat production, a systematic mapping of the geographic distribution, methodological approaches, and conceptual dimensions of these studies has not been thoroughly conducted across the disciplines contributing to this research. To address this gap, this thesis conducted a scoping review of peer-reviewed literature spanning from 2010 to 2022 to systematically identify and characterize over a decade of research on consumer perceptions of meat sustainability. MethodsThis scoping review followed guidelines from Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Systematic searches were conducted in five databases spanning business and the biomedical, social, environmental, and agricultural sciences. The process included dual and multi-stage screening by two reviewers, a systematic data extraction process, structured content analysis of open-ended data to identify and organize emergent categories, and quantitative characterization of the included studies. ResultsAnalysis of the 512 peer-reviewed articles included in the final set revealed a marked increase in studies on consumer perceptions of meat sustainability between 2010 and 2022. Across all global regions, more studies focused on consumer perceptions of animal welfare than environmental impact with research predominantly concentrated in Europe and Central Asia (n=288), followed by North America (n=87), East Asia, and the Pacific (n=71), and Latin America and the Caribbean (n=31). Studies assessing consumer perceptions of environmental impact commonly addressed broad issues like environmental degradation and general environmental sustainability, with specific environmental challenges such as climate impacts (n=108), pollution (n=46), resource use (n=45), and land use (n=44) more common in the research. In terms of animal welfare, topics such as housing (n=172) animal feed (n=108), mental and psychological well-being (n=106), animal ethics (n=176), as well as ethical slaughter (n=76) received the most attention after publications examining general animal welfare. The review also highlighted that consumer perceptions of meat sustainability have been studied alongside other social and economic sustainability concerns through varied perceptions and study designs including general survey research, preference elicitation methods, qualitative research, and behavior change research. DiscussionThis review highlighted that studies commonly address environmental impacts and animal welfare as part of broader sustainability discussions, with significant geographic variation reflecting regional influences on environmental and animal sustainability discourse. Furthermore, researchers explored consumer perceptions through a spectrum of thoughts, feelings, and behaviors, using diverse methodologies to assess how these elements influence what consumers care about animal welfare and the environmental impacts of meat production. To address these complexities, the review advocates for a nuanced, multidisciplinary approach to refine data collection and enhance the accuracy of consumer insights. On a practical level, these findings guide targeted strategies to improve policy and interventions, stressing the importance of local adaptability within global sustainability efforts. Additionally, the research calls for a cautious interpretation of consumer data to prevent overgeneralization and inefficacy in sustainability practices, emphasizing the urgent need for more comprehensive research in underrepresented regions to develop truly inclusive global strategies.
Using non-linear, machine learning methodology to assess the potential metabolomic-based biomarkers of total fat and percentage fat intake using a controlled feeding study
(2024-02-12) Nondin, Caroline Lea; Neuhouser, Marian
Background: Understanding and identifying objective dietary biomarkers is a crucial component of nutrition research today. By investigating the relationship between biomarker profiles and dietary intake using machine learning methodologies, there could be a way to more objectively assess study participant nutrient profiles and better understand the relationship between nutrient intake and disease. Our aim in this thesis is to assess the utility of non-linear tree-based models in predicting daily intake of total fat and the percent of energy from fat from serum and 24-h urine high dimensional metabolites. Methods: Our analysis used the dataset from a 2-week controlled feeding study mimicking the participants’ habitual diets among 153 post-menopausal women from the Nutrition and Physical Activity Assessment Study Feeding study, conducted in the Women’s Health Initiative (WHI). Fasting serum metabolite profiles, urine metabolites, as well as demographic and Food Frequency Questionnaire (FFQ) data, were used to predict total fat and percent energy from fat using four cross-validated tree-based machine learning models. A LASSO model for regression was used as a way to compare the models to a linear model. Results: The highest cross-validated multiple correlation coefficients (CV-R2) for total fat intake and percent energy intake were 10.2% and 10.4%, respectively. None of the models had a CV-R2 of over 36%. There were no significant differences found between the performance of linear and non-linear models in predicting fat intake. Conclusion: Both linear and non-linear models were shown to be unable to predict total fat and dietary fat intake using serum and urinary metabolites accurately and reliably. Variable importance suggests that tree-based, machine-learning models have the potential to help understand non-linear interactions between biomarkers and dietary intake.
Effect of cocoa extract supplementation on mental health and risk of incident late-life depression: a secondary analysis of the COSMOS trial
(2023-09-27) Beery, Daniel Manalang; Anderson, Garnet; Neuhouser, Marian
Question Can cocoa extract supplementation improve subjective mental health and prevent the onset of incident late-life depression in older adults?Findings In this secondary analysis of 21,442 adults aged 60 or older, cocoa extract supplementation did not result in a statistically significant change in subjective mental health scores compared to placebo. In 16,059 participants without a previous lifetime diagnosis of depression or receiving depression treatment (anti-depressant use or counseling within the past 2 years or regular selective serotonin reuptake inhibitor [SSRI] use), cocoa extract supplementation did not result in a reduction in incident late-life depression compared to placebo. Meaning These findings do not support the use of cocoa extract supplementation in improving subjective mental health in older adults or as a prophylactic treatment for late-life depression. Importance Late-life depression (LLD) has a lower remission rate, a higher recurrence rate, and is less responsive to pharmacological treatment than early-onset depression, warranting novel prophylactic and therapeutic treatments. Objective To test the effects of cocoa extract supplementation on subjective mental health outcomes and the incidence of late-life depression in older adults. Design, Setting, and Participants There were 21,442 men and women aged 60 years or older in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) trial, a randomized clinical trial investigating the effects of cocoa extract supplementation and a multivitamin on the primary prevention of cardiovascular disease and cancer. The intervention phase was from June 2015 to December 2020, and participants were followed for a median duration of 3.6 years. 10,723 participants were randomized to placebo and 10719 participants were randomized to cocoa extract supplementation. There were 16,059 participants at risk for incident depression. Intervention Randomized assignment in a 2 x 2 factorial design to cocoa extract supplementation [2 capsules/d containing 500 mg cocoa flavanols] and multivitamin or placebo. Main Outcomes and Measures The primary outcomes were mean Mental Health Inventory 5 (MHI-5) scores after 1 year and risk of incident late-life depression. Results Cocoa extract supplementation did not result in a significant difference in MHI-5 scores at 1 year in older adults (β = -0.21, 95% CI: -0.50, 0.09). No interactions between cocoa extract and sex, baseline MHI5, or depression treatment were observed. Cocoa extract supplementation did not result in a significant difference in incident depression in older adults (HR = 0.92, 95% CI: 78, 1.09) (Table 3). No interactions between cocoa extract and sex, baseline MHI-5, or time since randomization were observed. Conclusions and Relevance Among adults >60 years who were free of MI, stroke, and recently diagnosed cancer, cocoa extract was not effective in improving MHI-5 scores and reducing the risk of incident depression. The findings do not support the use of cocoa extract in improving subjective mental health outcomes or as prophylactic treatment for late-life depression.

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