Detecting Body Mass Index from a Facial Photograph in Lifestyle Intervention

This study aimed to identify whether a research participant’s body-mass index (BMI) can be correctly identified from their facial image (photograph) in order to improve data capturing in dissemination and implementation research. Facial BMI (fBMI) was measured using an algorithm formulated to identify points on each enrolled participant’s face from a photograph. Once facial landmarks were detected, distances and ratios between them were computed to characterize facial fatness. A regression function was then used to represent the relationship between facial measures and BMI values to then calculate fBMI from each photo image. Simultaneously, BMI was physically measured (mBMI) by trained researchers, calculated as weight in kilograms divided by height in meters squared (adult BMI). Correlation analysis of fBMI to mBMI (n = 1210) showed significant correlation between fBMI and BMIs in normal and overweight categories (p \u3c 0.0001). Further analysis indicated fBMI to be less accurate in underweight and obese participants. Matched pair data for each individual indicated that fBMI identified participant BMI an average of 0.4212 less than mBMI (p \u3c 0.0007). Contingency table analysis found 109 participants in the ‘obese’ category of mBMI were positioned into a lower category for fBMI. Facial imagery is a viable measure for dissemination of human research; however, further testing to sensitize fBMI measures for underweight and obese individuals are necessary

Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression

Background Most effective treatment for morbid obesity and its comorbidities is bariatric surgery. However, research is limited on weight loss and associated outcomes among patients in Appalachia. The objective of this study was to examine demographic and comorbidity influence on surgical outcomes of this population including age, sex, race, state of residence, education, marital status, body mass index (BMI kg/m2), excess body weight (EBW), percent excess weight loss (%EWL), blood pressure, diagnosed depression, diagnosed type 2 diabetes (T2D), Beck Depression Inventory-II (BDI-II), and laboratory values (i.e., hemoglobin A1c). Methods A retrospective electronic medical record (EMR) data extraction was performed on N = 582 patients receiving bariatric surgery (laparoscopic Roux-en-Y gastric bypass [RYGB] and laparoscopic sleeve gastrectomy [SG]) between 10/2013 and 2/2017. Results Patient population was 92.5% Caucasian, 79.3% female, 62.8% married, 45 ± 11.1 years, 75.8% received RYGB, and 24.2% received SG. Average %EWL from baseline to 1-year follow-up was 68.5 ± 18.4% (n = 224). In final descriptive models, surgery type, diagnosed T2D, HbA1c, and depressive symptoms were significant covariates associated with lower %EWL. Conclusions Findings suggest patients completing surgery within an Appalachian region have successful surgical outcomes at 1-year post-surgery, as indicated by significant reductions of \u3e 50% EWL, regardless of other covariates. Results suggest that bariatric programs should consider paying special consideration to patients with T2D or depressive symptoms to improve outcomes. Results have potential to inform future prospective studies and aid in guiding specific interventions tailored to address needs of this unique population

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n=228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P=.042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes

Strategy for Expanding Nutrition Professionals’ Competency: A Pilot Case Study in Dissemination and Implementation Science Training

Dissemination and Implementation (D&I) science trainings are essential to build knowledge among a variety of current and future health professionals. The objective of this study was to pilot-test and assess implementation of a nutrition-specific D&I science training. Participants (students enrolled in nutrition and public health programs) completed pre/post surveys and exit interviews. Descriptive statistics and a qualitative thematic analysis used deductive coding; in which coding and theme development are directed by existing concepts. Initial coding was completed by one researcher and validated by an additional researcher to describe and provide examples of the categories the Kirkpatrick Model and Implementation Outcomes Framework. The evaluation of the training was positively supported through the Kirkpatrick Scale results (mean scores between 6.94 ± 1.7 (Learning) and 7.35 ± 1.9 (Reaction)) and qualitative findings (increased confidence in D&I science and positive feedback on active learning strategies (application-based learning, mentorship, and discussions). Participants (n=8) described the learning activities (case studies, discussions, projects), the structure of the course (flipped classroom, content, learning strategies), the setting (hybrid, online), and mentorship (continuous feedback on assignments) as enabling effective implementation, which reflects with positive Implementation Outcome findings (3.59 ± 1.26, appropriateness score 3.94 ± 0.85, and feasibility score of 4.09 ± 0.67). These findings support positive implementation feasibility and program evaluation. Future studies need to compare changes in knowledge, attitudes, and beliefs among current or future nutrition professionals before and after completing this training

Prevalence and Predictors of Household Food Insecurity among Adult/Youth Dyads at the Initiation of the iCook 4-H Two-Year Obesity Prevention Study

Objective: Determine food insecurity prevalence and predictors among adult/youth dyads enrolled in a childhood obesity prevention study (iCook 4-H).Methods: The iCook 4-H intervention was designed for youth (9-10 years old) and their adult main meals preparer to cook, eat, and play together. Although not an inclusion criteria, diverse, low income, and/or rural families were the target during recruitment. At baseline, adults completed surveys on food insecurity, socioeconomic and demographic characteristics and youth anthropometrics were collected with body mass index (BMI) calculated. Descriptive statistics were computed and chi-square analysis was conducted to test differences between potential predictors and food insecurity. Binomial logistic regression was used to assess the relationship between food insecurity and its predictors.Results: Thirty-four percent of households (n=71 of 206) were food insecure. Youth were primarily white (69.9%) and normal weight (58.3%). Adults were also primarily white (74.8%), overweight or obese (67.9%), married (68.9%), not participating in government assistance programs (57.8%), and held no college degree (55.3%). Based on the logistic regression model, households with a non-white youth (OR=13.53; 95% CI=3.33, 55.05), an adult without a college degree (OR=5.62; 95% CI=2.01, 15.73), and government assistance program participation (OR=5.63; 95% CI=2.63, 12.07) were significantly associated with household food insecurity. However, there was no significant association with BMI found (youth p=0.167; adult p=0.179).Conclusion: Consistent with previous findings, household food insecurity status was associated with youth race, adult education, and government assistance program participation. In contrast, no relationship between BMI and food insecurity status was observed in this study, which warrants further investigation

Efficacy of nutritional interventions to lower circulating ceramides in young adults: FRUVEDomic pilot study

The 2010 USDA Dietary Guidelines for Americans (DGA) recommends a diet largely composed of fruit and vegetables. Consuming a diet high in fruit and vegetables and low in refined carbohydrates and saturated fat may reduce an individual’s risk for type 2 diabetes, nonalcoholic fatty liver disease, low-grade chronic inflammation, and metabolic syndrome (MetS). Several recent studies have implicated the bioactive sphingolipid ceramide as an associative and causative biomarker for the development of these conditions. Considering that the intake of fruit and vegetables is frequently inadequate in young adults, we performed a pilot investigation to assess the efficacy of a free-living fruit and vegetable intervention on overall metabolic health, circulating ceramide supply, and inflammatory status in young adults. We discovered that adoption of the recommended DGA for fruit and vegetable intake for 8 weeks decreased waist circumference, systolic blood pressure, and circulating cholesterol. Lipidomics analysis revealed that nutritional intervention can lower circulating ceramides, including C24:0 ceramide, a known inhibitor of insulin signaling. Unexpectedly, we observed an increase in C16:0 ceramide, suggesting that this form of ceramide in circulation is not associated with metabolic disease in humans. We also observed an improved inflammatory status with enhanced fruit and vegetable intake that was correlated with ceramide concentrations. These data suggest that adopting the recommended DGA is associated with a reduction of many, but not all, ceramide species and may help to prevent or mitigate MetS. Future research needs to assess whether the ceramide-lowering ability of nutritional intervention is associated with reduced risk of developing metabolic disease

Using Ripple Effects Maps to Identify Story Threads: A Framework to Link Private to Public Value

Extension professionals must demonstrate organizational value to garner public awareness and support. Measuring and communicating outcomes that have public value can be challenging. In this study, Ripple Effects Mapping incorporating the Community Capitals Framework was used to evaluate a childhood obesity prevention study, iCook 4-H, of youth-adult pairs in Maine. The objective was to describe the process of generating impact statements through story threads about program benefits to the participants and the potential benefits to nonparticipants, such as family members, friends, and other community members. Extension professionals can use storylines, or story threads, as a qualitative research technique to generate stories about private and public value from participants’ actions, experiences, and emotions following community programs. The story threads process can be used across disciplines to leverage community program data into public value messaging

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n = 228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results : Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P = .042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes

Health Behaviors of Student Community Research Partners When Designing and Implementing a Healthy Lifestyle Intervention on College Campuses

Few studies work with college students as equal partners in all aspects of Community-Based Participatory Research (CBPR) and even less evaluate behaviors of those college partners. The current study aimed to examine health behaviors of students by designing and implementing a peer-led, social marketing campaign (Get Fruved) to promote healthier lifestyles on their campuses. Enrolled students (n = 376) were trained to either design and implement a health promotion intervention (Social Marketing and Environmental Interventionists; SMEI, n = 78), be peer mentors (PM; n = 205), or serve as control participants (n = 93). Students’ behaviors (dietary, activity, and stress) and anthropometrics were assessed at baseline, 6 months, and 12 months. The population was predominately Caucasian, female, and between 19 and 20 years old. On average, fruit and vegetable consumption slightly decreased across all time points for each group with control at a larger decline. Students International Physical Activity Questionnaire (IPAQ) scores showed students met recommended amounts of activity throughout the intervention, with males reporting higher activity levels. Cohen’s Perceived Stress Scale (PSS) analyses indicated 19 year olds had higher stress along with females had higher than males. Students involved in a CBPR approach to be trained, design, and implement a lifestyle intervention can achieve maintenance of health behaviors throughout a college year when compared to control students

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n=228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P=.042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes