Recipient Organization
OKLAHOMA STATE UNIVERSITY
(N/A)
STILLWATER,OK 74078
Performing Department
(N/A)
Non Technical Summary
The eating patterns of U.S. adults are characterized by increased ultra-processed foods (UPF) and few raw agricultural commodities (i.e., minimally processed foods), which can encourage excessive energy intake, increasing the risk of diet-related chronic diseases. What is currently unknown is the extent to which adults can maintain consumption of a low UPF diet in free living conditions after receiving education, and if successfully doing so would improve eating patterns, eating behavior, and health. The objective of this project is to characterize if and how individuals are able to minimize UPF consumption in free-living conditions, and to use these data to develop an educational phone application ("app") to support individuals in decreasing UPF consumption, improving eating patterns, and improving biomarkers of disease risk. The central hypothesis is that individuals will achieve decreases in their UPF consumption in response to intervention, but will report challenges in doing so related to social and environmental influences. The specific research objectives are to determine the impact of attempted consumption of a minimally processed diet on adherence to the U.S. Dietary Guidelines, eating behavior, energy balance, health outcomes, and tendency toward obesity over time; evaluate and understand facilitators and barriers central to avoiding UPF; and develop and test an app to assist individuals in minimizing UPF consumption.
Animal Health Component
75%
Research Effort Categories
Basic
0%
Applied
75%
Developmental
25%
Goals / Objectives
The overall goalof this project is to characterize if and how individuals are able to minimize their consumption of ultra-processed foods (UPF) in free-living conditions, and to use these data to develop an empirically-driven educational phone application ("app") to support individuals in decreasing UPF consumption and improving overall eating patterns and biomarkers of chronic disease risk. The central hypothesis informing this work is that individuals will achieve decreases in their consumption of UPF in response to intervention, but will report challenges in doing so related to social and environmental influences. The following objectives will test this hypothesis:Objective 1. Determine the impact of attempted consumption of a minimally processed diet on adherence to the United States Dietary Guidelines for Americans (i.e., HEI), eating behavior, energy balance, downstream health outcomes, and tendency toward obesity over time. Objective 2. Conduct a mixed methods evaluation to understand facilitators and barriers central to successfully or unsuccessfully adopting a minimally processed diet among rural, underserved, and/or food insecure adults.Objective 3. Develop and conduct a user-centered evaluation of a consumer-friendly resource/instructional tool to facilitate the consumption of a minimally processed diet.
Project Methods
Objective 1. Determine the impact of attempted consumption of a minimally processed diet on adherence to the United States Dietary Guidelines for Americans (i.e., HEI), eating behavior, energy balance, downstream healthoutcomes,and tendency toward obesity over time.Experimental Design. We will conduct a 1-year study assessing impacts of attempted consumption of a minimally processed diet. After a baseline observation period, participants will be randomized to consume either their normal diet (control group) or a minimally processed diet (intervention group). The control group will be instructed to continue consuming their normal diet for the next 12 months. The intervention group will be instructed to consume a diet that is as low in ultra-processed foods (UPF) as possible for next 6 months. Participants in the intervention group will receive regular guidance and support from research personnel with regard to consuming a minimally processed diet. After 6 months, intervention group participants will be passively followed for an additional 6 months to observe potential dietary changes relative to baseline and the control group. A 3-day food record will be completed by all participants at baseline, 1 month, 3 months, 6 months, 9 months, and 12 months. Body composition, resting metabolic rate, physical activity, metabolic markers, and gut microbiome outcomes will be measured at baseline, 6 months, and 12 months.Diet intervention and measurement. After completion of a baseline 3-day food record, participants will be randomized to either the control (normal diet) or intervention (minimally processed diet) group. Both groups will complete 3-day diet records at 1, 3, 6, 9, and 12 months. The control group will be instructed to continue their regular diet. The intervention group will be instructed to consume a diet that is as low in processed and UPF as possible - that is, to the extent possible, consume no processed or UPF (i.e., NOVA categories 3 and 4).Prior to initiating the diet, a member of the research team (specifically, a registered dietitian) will explain in detail the premise of consuming a minimally processed diet. Participants will be provided a handout, as well as a QR code to an online list of foods and their NOVA category.Energy balance, metabolism, and physical activity. Free living physical activity energy expenditure will be estimated using accelerometers (Actigraph wGT3X-BT) for 3 days. Resting metabolic rate will be assessed using indirect calorimetry with a canopy hood system (Parvo Medics TrueOne 2400). These measurements will be used to estimate total energy expenditure. Energy intake will be estimated using a 3-day diet record. These measurements of energy expenditure and intake will allow crude assessment of propensity toward energy balance or imbalance (i.e., energy surplus or energy deficit) in the diet trials.Health outcomes. We will assess body composition with a Hologic Horizon A dual-energy X ray absorptiometry (DEXA) scanner. This measurement allows the determination of bone mineral density, lean mass and fat mass, including visceral adipose tissue. Whole blood samples obtained via single venipuncture will be used to measure metabolic markers via the Piccolo Xpress clinical chemistry analyzer (Abbott) with Lipid Panel Plus reagent discs. We will measure fasting triglycerides, glucose, HDL, total cholesterol, ALT and AST, as well as calculate LDL and VLDL. Fecal samples will be collected with the ALPCO Easy Sampler stool collection kit. Samples will be processed and stored at -80 Cº. When data collection is complete, samples will be shipped to Zymo Research for 16S rRNA sequencing. This service includes bioinformatics analysis and support, such as clustering analysis, within-sample α-diversity analysis, between-sample β-diversity analysis, principal component plots, and distance analysis.Statistical analyses. Data will be checked for normality prior to analysis. Non-normal data will be transformed. A two-way repeated measures analysis of variance will be used to determine group- and time-based differences, as well as interactions, in key outcomes: diet quality, energy intake, metabolic health markers, body composition parameters, and gut health outcomes. If significant interactions and/or main effects are detected, a Tukey's post hoc analysis will be conducted to determine pairwise differences.Objective 2. Conduct a mixed methods evaluation to understand facilitators and barriers central to successfully or unsuccessfully adopting a minimally processed diet among rural, underserved, and/or food insecure adults.Experimental Design. We will conduct qualitative semi-structured interviews (SSI) to explain and contextualize our quantitative findings, yielding a mixed methods study design. At the cessation of the 6-month intervention (Objective 1), intervention participants will be invited to complete a SSI with research personnel conducted via phone call or Zoom. Questioning routes will be tailored according to response to intervention. Specifically, individual consumption of UPF will be quantified according to percent of calories consumed from UPF, and individuals split into quartiles. Further, we will identify whether individuals decreased, increased, or had no change in consumption of UPF. Questions will assess overall experiences and relative success in modifying UPF consumption (e.g., "How were you able to successfully lower your UPF consumption in the past 6 months?") or challenges (e.g., "What was it like trying to decrease how much UPF you ate?") per the quantitative data.Statistical analysis. The theoretical framework informing our analysis is an adaptation of the Theory of Planned Behavior which incorporates the role of hedonics (e.g., taste and pleasure) in driving food choices.For analysis, interviews will be transcribed verbatim and two members of the research team will independently review a subset of interviews using deductive content analysis to establish a preliminary codebook and optimal percent agreement (i.e., 80%) in assigning codes using this codebook. Emergent themes inconsistent with this framework will also be captured. Coding of transcripts will occur iteratively until 80% agreement is achieved, after which one member of the research team will finish coding all transcripts and enter the data into NVivo. Findings will be consolidated to demonstrate frequency of codes, and themes will be compiled into coding matrices to match to complementary intervention strategies which can be integrated in to the app platform in Objective 3.Objective 3. Develop and conduct a user-centered evaluation of a consumer-friendly resource/instructional tool to facilitate the consumption of a minimally processed diet.App design process. After obtaining the qualitative feedback in Objective 2, we will first develop a sitemap for the mobile application which will list all the pages anticipated in the mobile app in its hierarchical fashion. After the sitemap is completed, wireframe of each page of the mobile application will be developed. The wireframe contains the page layout of the application content, including interface elements and navigational systems. The key features in the app will dictate how the page is defined in the wireframe. User Interface (UI) and User Experience (UX) design will be performed next for each of the wireframed pages. Each of the pages will be designed with iconography, fonts, and other visual objects to create a cohesive mobile app experience to produce the desired outcome.