Introduction: A diet high in fermented, oligio-, di-, monosaccharide, and polyols

(FODMAP) has been shown to exacerbate symptoms of irritable bowel syndrome

(IBS). Previous literature has shown significant improvement in IBS symptoms after

adherence to a low FODMAP diet (LFD). However, dietary adherence to the LFD is

difficult with patients stating that information provided by healthcare providers

(HCPs) is generalized and nonspecific requiring them to search for supplementary

information to fit their needs. Notably, studies that have used a combination of

online and in-person methods for treatment have shown improved adherence to the

LFD. Objective: To determine whether a novel artificial intelligence (AI) dietary

mobile application will improve adherence to the LFD compared to a standard online

dietary intervention (CON) in populations with IBS or IBS-like symptoms over a 4-

week period. Methods: Participants were randomized into two groups: APP or CON.

The intervention group was provided access to an AI mobile application, a dietary

resource verified by registered dietitians which uses artificial intelligence to

individualize dietary guidance in real-time with the ability to scan menus and

barcodes and provide individuals with food scores based on their dietary preferences.

Primary measures included mobile app engagement, dietary adherence, and

manifestation of IBS-like symptoms. Baseline Results: A total of 58 participants

were randomized to groups. This is an ongoing study and this thesis details the

methodology and baseline characteristics of the participants at baseline and

intervention start. Validation of the application could improve the range of offerings

for lifestyle diseases treatable through dietary modification.

Obesity is currently a prevalent health concern in the United States. Essential to combating it are accurate methods of assessing individual dietary intake under ad libitum conditions. The acoustical monitoring system (AMS), consisting of a throat microphone and jaw strain sensor, has been proposed as a non-invasive method for tracking free-living eating events. This study assessed the accuracy of eating events tracked by the AMS, compared to the validated vending machine system used by the NIDDK in Phoenix. Application of AMS data toward estimation of mass and calories consumed was also considered. In this study, 10 participants wore the AMS in a clinical setting for 24 hours while all food intake was recorded by the vending machine. Results indicated a correlation of 0.76 between number of eating events by the AMS and the vending machine (p = 0.019). A dependent T-test yielded a p-value of 0.799, illustrating a lack of significant difference between these methods of tracking intake. Finally, number of seconds identified as eating by the AMS had a 0.91 correlation with mass of intake (p = 0.001) and a 0.70 correlation with calories of intake (p = 0.034). These results indicate that the AMS is a valid method of objectively recording eating events under ad libitum conditions. Additional research is required to validate this device under free-living conditions.

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).

This study explores how newspapers framed the weight-loss drugs Xenical®(orlistat) and Alli® (over-the-counter orlistat) during the time period of three months prior to their approvals by the U.S. Food and Drug Administration until one year after each became available on the market. As of June 2011, orlistat is the only weight-loss drug available for long-term use in the U.S. Newspapers are influential sources of information about health issues. Agenda-setting, framing, and priming in news articles can have a powerful effect on public perceptions and behaviors. To conduct the content analysis, researchers first developed a codebook containing variables that described the sources of attribution and the features of each drug. They tested the codebook in a series of pilot tests to ensure inter-rater reliability. The sample of texts for the content analysis, drawn from LexisNexis Academic, contained 183 newspaper articles composed of 85 Xenical articles and 98 Alli articles. The overlap was 25% for inter-rater reliability as well as intra-rater reliability. Frequencies were tabulated using Predictive Analytics SoftWare, version 18.0.3. Results demonstrated that Xenical and Alli were framed differently in some critical ways. For example, there were twice as many quotes from the manufacturer for Alli than for Xenical. Researchers concluded that the reporting on Alli was heavily influenced by the manufacturer's multi-media public relations campaign in the months prior to the market-release date.

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.

ABSTRACT Epidemiological studies have suggested a link between nut consumption and weight. The possible effects of regular nut consumption as a method of weight loss has shown minimal results with 2-3 servings of nut products per day. This 8 week study sought to investigate the effect of more modest nut consumption (1 oz./day, 5 days/week) on dietary compensation in healthy overweight individuals. Overweight and obese participants (n = 28) were recruited from the local community and were randomly assigned to either almond (NUT) or control (CON) group in this randomized, parallel-arm study. Subjects were instructed to eat their respective foods 30 minutes before the dinner meal. 24 hour diet recalls were completed pre-trial and at study weeks 1, 4 and 8. Self-reported satiety data were completed at study weeks 1, 4, and 8. Attrition was unexpectedly high, with 13 participants completing 24 dietary recall data through study week 8. High attrition limited statistical analyses. Results suggested a lack of effect for time or interaction for satiety data (within groups p = 0.997, between groups p = 0.367). Homogeneity of of inter-correlations could not be tested for 24-hour recall data as there were fewer than 2 nonsingular cell covariance matrices. In conclusion, this study was unable to prove or disprove the effectiveness of almonds to induce dietary compensation.