M.S. - Nutritional Sciences
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Item The role of astaxanthin in adipocyte biology(2025) Toncan, Fiorenzo; Lee, Mi-Jeong MJ; NutritionItem A QUALITATIVE EXAMINATION OF MOTHER’S OPINIONS REGARDING POTENTIAL INTERVENTION STRATEGIES FOR HEALTHY COMPLEMENTARY FEEDING PRACTICES AMONG NATIVE HAWAIIAN INFANTS RESIDING IN HAWAI‘I.(2023) Dentinger, Amanda Paige; Fialkowski Revilla, Marie K.; Nutritional SciencesItem Systematic Review On The Relationship Between Social Media Content, Body Dissatisfaction, And Disordered Eating Behaviors In US Adolescents(University of Hawaii at Manoa, 2022) Garrido, Samantha; Esquivel, Monica K.; Nutritional SciencesAdolescence demonstrates the onset of puberty with both physical and emotional changes in girls and boys. Physical changes during puberty (i.e., changes in lean body mass and adipose tissue) can negatively impact body image. In addition, peer influence and the desire to look and be the same as others can lead to negative body image and body dissatisfaction. Both negative body image and body dissatisfaction can lead to the development of disordered eating patterns and eventually clinically diagnosed eating disorders. The addition of social media into this dynamic can further influence negative body image and disordered eating behaviors. Social media use among adolescents is growing exponentially with the development of several social media platforms that target children and teenagers. Recently, studies conducted by Facebook and others have found associations between social media use and negative health variables such as body dissatisfaction, disordered eating behaviors, and eating disorders. However, little published research is available on the type of content, social media platforms, and other contextual factors related to these observed association between social media, body dissatisfaction, disordered eating behaviors and eating disorders. To bridge this gap in knowledge, a systematic review was conducted to review all available literature on the relationship between social media use and the prevalence of body dissatisfaction, disordered eating behaviors and eating disorders among adolescents in the United States. Five databases (CINAHL, PsychINFO, Psychological & Behavioral Sciences Collection, PubMed Medline, & Web of Science) were searched using a search strategy informed by University of Hawaiʻi at Mānoa library liaisons. The search resulted in 1,291 articles. Articles were reviewed for duplicates, and 766 articles were included in the abstract review after removing duplicates and exclusion criteria set by this systematic review. After completing the abstract review, 23 articles were identified for full-text review, which resulted in the inclusion of 7 articles1-7 being included in this systematic review. Of the 7 articles identified, 52-6 demonstrated a statistically significant relationship between social media and negative health variables that included disordered eating behaviors and/or body dissatisfaction. Two articles1,7 did not find a statistically significant relationship between social media use and negative health variables, stating inadequate measurement tools such as self-reported questionnaires and non-diagnostic criteria for diagnosing an eating disorder. A quality assessment for each article was also conducted using the Joan Brigg Institute (JBI) Checklist for quality of cross-sectional studies, with a score of 2 or less on this checklist indicated an acceptable range for quality of evidence presented. Only 2 articles3,7 had a score of 2 or less, which indicates a lack of high quality evidence among a majority of studies identified in this review. This systematic review identified 5 articles2-6 that found a statistically significant relationship between social media and negative health variables such as disordered eating behaviors and body dissatisfaction, however only 2 of these articles3,7 were considered high quality. While statistically significant associations could be found between social media and negative health variables, the evidence of these articles supporting this relationship is of low quality, indicating a need for further research in this topic to understand the true influence of social media on disordered eating, body dissatisfaction, and eating disorders in adolescents in the United States.Item Impact of TGFβ signaling on adipose tissue biology(University of Hawaii at Manoa, 2022) Lofquist, Sydney; Lee, Mi-Jeong; Nutritional SciencesThe dysfunction of adipose tissue is a hallmark step in the development of metabolic diseases in obese individuals. Transforming growth factor-beta (TGFβ) ligands are higher in the serum and adipose tissue in obesity and activated TGFβ signaling is known to contribute to adipose tissue dysfunctions. However, the molecular pathways through which TGFβ regulate proliferation and myofibroblast differentiation of human adipose stem cells (hASCs) as well as metabolic and endocrine functions of human adipocytes has not been elucidated. Using a siRNA-mediated knockdown of SMAD2 and SMAD3, two downstream effector molecules, we analyzed their roles in mediating TGFβ signaling on proliferation and myofibroblast-like cell differentiation in hASCs. We also assessed the impact of TGFβ signaling on the adipokine and metabolic profile of human adipocytes using chemical inhibitors SB431542 and SIS3. Our results showed that both SMAD2 and SMAD3 significantly increased the proliferation of hASCs (p<0.001) without impacting alpha-smooth muscle actin expression, a marker of myofibroblasts. Inhibition of endogenous TGFβ signaling improved the adipokine profile of adipocytes by increasing adiponectin (p<0.001) while decreasing leptin (p<0.05) and interleukin-6 (p<0.05) secretion. Addition of TGFβ1 promoted a proinflammatory profile by increasing leptin (p<0.01) and interleukin-6 (p<0.01) secretion and inhibiting adiponectin secretion (p<0.01). Inhibition of TGFβ signaling decreased lipolysis (p<0.01) and tended to decrease lipid droplet size while enhancing mitochondrial intensity without significantly affecting OXPHOS expression in adipocytes. Our data indicates that proliferation of hASCs is not differentially regulated by SMAD2 and SMAD3 and that high TGFβ signaling contributes to adipose tissue dysfunction by increasing proliferation of adipose progenitors as well as inducing pathogenic endocrine and metabolic profiles.Item Dietary Patterns Among East Asian Children Living in the US Affiliated Pacific Region(University of Hawaii at Manoa, 2021) Mau, Geneva Chi Ching; Revilla, Marie K. F.; Nutritional SciencesBackground: Childhood obesity is an increasingly global epidemic that has become a public health concern. The three largest groups of Asian Americans are of East Asian descent (Chinese, Korean, and Japanese) which will be the population of focus in this study. East Asian children may be prone to being overweight or obese due to nutrition transition and acculturation. The 2020-2025 Dietary Guidelines for Americans (DGA) identified that a healthy dietary pattern is higher in fruits, vegetables, whole grains, low- and nonfat dairy seafood, legumes, and nuts. A traditional East Asian dietary pattern includes rice, noodles, seafood or animal protein and vegetables. Limited research suggests that the dietary patterns of Asian American children have changed consuming more refined grains, fast food, sugar sweetened beverages, dairy, and meat. However, there has been less research examining the dietary patterns of East Asian children. Objective: The purpose of this study was to examine dietary patterns in East Asian children ages 2-8 living in the United States Affiliated Pacific (USAP) Region. Methods: A secondary analysis was conducted using data from the Children’s Healthy Living Program. Reduced rank regression was conducted to determine foods that were being consumed by East Asian children. The food variables that were analyzed included added sugars, cheese, milk, total milk, yogurt, citrus fruits, melons, and berries, other fruits, fruits, non-whole grains, total grain, whole grain, eggs, fish and shellfish, frankfurters, sausage, and luncheon meats, meat, total meat, nuts and seeds, poultry, soybean products, orange vegetables, dark green vegetables, dry beans and peas, other vegetables, white potatoes, other starchy vegetables, tomatoes, total vegetables, and discretionary solid fat weighted for weekday/weekend days. Only factor loadings above |0.2| were considered. Binary logistic regression was used to analyze the relationship between dietary patterns and overweight/obesity (OWOB) and waist-to-height ratio (WHtR). All models were adjusted for sex and age. Results: The reduced rank regression did not reveal foods that depict a traditional East Asian diet. Dietary pattern 1 loaded on added sugars, milk products, non-whole refined grains, whole grains, meat, and discretionary solid fat. Dietary pattern 2 loaded positively on added sugars and negatively loaded on milk and milk products, nuts and seeds, and solid fat. Dietary pattern 3 positively loaded on nuts and seeds and negatively loaded on other fruits, total fruits, non-whole refined grain, total grain, whole grain, dark green vegetables, and nuts and seeds. The logistic regression showed no significant association between all three dietary patterns and OWOB. The same was also true when examining the results of the logistic regression between all three dietary patterns and WHtR. Conclusion: A traditional dietary pattern was not identified in East Asian children living in the USAP. Westernized foods were consumed by East Asian children, which aligns with previous research. Findings indicate that nutrition transition and acculturation may be happening with East Asian children living in the USAP.Item Effect Of A Short Message Service Intervention On Excessive Gestational Weight Gain In A Low-income Population(University of Hawaii at Manoa, 2020) Holmes, Hannah; Banna, Jinan; Nutritional SciencesSocioeconomic disparities exist in many health conditions. Behavioral interventions may promote healthy behaviors and lead to decreased risk of diseases, both communicable and noncommunicable. These interventions may be unable to reach low-income individuals, who may be lacking in time and resources. This thesis consists of two chapters investigating the use of technology for lifestyle interventions in low-income populations. The first chapter, a literature review to be submitted for publication, is entitled “Novel technologies for nutrition interventions in low-income populations” and systematically reviews the literature to characterize such interventions. The second chapter, “Effect of a short message service intervention on gestational weight gain in a low-income population: a randomized, controlled trial”, reports the results an eighteen-week nutrition and physical activity intervention, delivered via short message service (SMS, or text message), on gestational weight gain (GWG) in a sample of participants of the Special Supplemental Program for Women, Infants, and Children (WIC) in Hawaiʻi. The author of this thesis was responsible for drafting the manuscript included as Chapter 2. The author was also responsible for background research, synthesis of the developmental methods of the intervention, organization of results, creation of tables and figures, analysis of study strengths and limitations, and suggestions for future research to fill gaps in the literature. The appendix includes accompanying tables and figures for both chapters. The results reported in this thesis support the need for additional research in nutrition interventions using novel technology methods to reach low-income populations.Item Examining the Relationship Between Protein Intake and Source and Acanthosis Nigricans Among Young Children in the Children's Healthy Living Program in the United States Affiliated Pacific(University of Hawaii at Manoa, 2019) Calabrese, Allison; Revilla, Marie K. F.; Nutritional SciencesBACKGROUND: Acanthosis Nigricans (acanthosis) is a dermatological condition that is characterized by a symmetrical, velvety, light brown to black pigmentation of the skin. Acanthosis has been reported to be linked to obesity and is a physical marker on the skin for insulin resistance. Previous research has focused on the relationship of high carbohydrate and fat diets with insulin resistance. However, there are no studies to date analyzing the relationship between protein intake and food sources to acanthosis in children. OBJECTIVE: The purpose of this study was to examine if the presence of acanthosis is related to dietary protein consumption and protein source among children in the United States Affiliated Pacific. METHODS: A secondary analysis was conducted on data collected from 3468, 2 to 8-year-old children in 11 jurisdictions from the Children’s Healthy Living Program. One way ANOVA was conducted to determine the relationship between acanthosis and total energy intake (kcal), mean protein (g), fat (g) and dairy (servings) intake of the two days weighted for weekday/weekend, mean meat (oz) intake and lean meat equivalents from egg (oz), poultry (oz), franks and luncheon meats (oz), fish and seafood (oz), beef, pork and lamb (oz), nuts and seeds (oz), soy (oz), and dry beans and peas (oz) weighted for weekday/weekend days and adjusted for within person variance, and age (yrs). Binary logistic regression was used to analyze the protein sources and whether children consuming protein intake within the age appropriate US Dietary Guidelines and Dietary Reference Intakes were less likely to screen positive for acanthosis. All models were adjusted for age, sex, overweight/obesity, energy intake (kcal) and mean total fat intake (oz). RESULTS: There were 191 (5.5%) children that screened positively for acanthosis. The prevalence of acanthosis was higher in overweight and obese children than in healthy weight children (63.4% vs 35.6%). The total intake for protein was not significantly associated with acanthosis. However, for every 1 oz increase in intake of meat per day, the risk of acanthosis significantly increased by 16% (p= 0.009). Lean meat from meat, poultry, and fish (oz) was significantly associated with acanthosis (p= 0.000). Poultry and meat intake were no longer significantly associated with acanthosis in logistic regression models after controlling for confounding variables. However, for every 1 oz increase in fish and seafood intake the risk of acanthosis significantly increased by 22% (p=0.001). Mean total dairy intake had a protective effect against the risk of acanthosis, where for every ½ serving increase in dairy, the risk decreased by 40% (p<0.001). There was no significant difference in acanthosis risk between children who consumed protein within the age appropriate Dietary Guidelines and Dietary Reference Intakes as compared to those who did not. CONCLUSION: Total protein intake did not affect the likelihood of screening positive for acanthosis in young children from the United States Affiliated Pacific. However, meat intake, specifically from fish and seafood did increase the risk for having acanthosis while dairy consumption was shown to have a protective effect. Further study analyzing the different nutrient components of protein sources such as fish, seafood, and dairy sources are warranted.Item Plate Waste In School Lunch: Barriers, Motivators And Perspectives Of Early Adolescents In The United States(University of Hawaii at Manoa, 2019) Zhao, Chenchen; Banna, Jinan; Nutritional SciencesABSTRACT Objective: The aim of this project was to determine barriers, motivators, and perspectives about plate waste of early adolescents in the National School Lunch Program (NSLP) in Hawai'i, Montana and Virginia. Design: A semi-structured interview guide was developed and pilot tested with three participants. Trained interviewers conducted audio-recorded individual interviews with adolescents (n=47) from Hawai‘i, Montana, and Virginia. Interviews were transcribed verbatim. A codebook was devised using existing literature on barriers, motivators, and perspectives on reducing school lunch plate waste in the US. Two researchers coded three transcripts individually using NVivo software to determine interrater reliability and calculated an average Cohen's Kappa coefficient. With an average Cohen's Kappa coefficient of 0.68, the two coders then coded all transcripts independently. New codes were added to the codebook on the basis of emerging themes. Key themes were evaluated by the two coders separately. In discussion, the two agreed on final themes and collectively summarized the results. Setting: Elementary schools implementing National School Lunch Program (NSLP) in Hawai'i, Montana, and Virginia. Participants: Early adolescents (n=47, 9-13 years) from families receiving or eligible to receive the Supplemental Nutrition Assistance Program (SNAP) benefits were recruited to participate. Phenomenon of Interest: Factors influencing plate waste among adolescents and potential plate waste reduction strategies. Analysis: Coders analyzed content and thematic data to identify code categories and themes. Results: The main barriers to the reduction of school lunch plate waste were unsupportive school policy, undesirable food quality, satiation, and social influences. The key motivators to help reduce school lunch plate waste were supportive school policy, including allowing students to share food with peers and save food to eat later; and social influences. Perspectives on the reduction of school lunch waste were: participants found it acceptable to throw away disliked food, unacceptable to throw away wanted food, perceived their peers did not care if food was thrown away, and their parents disliked wasting food. Conclusion and Implications: Results suggest several factors might allow for minimization of school lunch plate waste in the NSLP, including improvements in food quality, food policy and social influences. Under these key themes, strategies to employ may include improving food preparation, food taste, allocating more time for students to finish their lunches, allowing students to self-select food lunch items, and to share and save their leftover foods.Item Nutrient Composition of Avocados Grown in Hawai‘i and Cameroon(University of Hawaii at Manoa, 2017-08) Kai, Jessie S. M. P.; Nutritional SciencesAvocados (Persea americana) are a source of monounsaturated fatty acids, dietary fiber, and beneficial phytochemicals. Despite the health benefits of avocados, there is limited nutritional research on Hawaii and Cameroon-grown avocados. The health benefits of the fruit are primarily based on research involving the Hass cultivar. In Hawaii and Cameroon, many other avocado cultivars besides Hass are consumed. The objective of this research is to illustrate the nutrient content variability among the common varieties of Hawaii and Cameroon avocados. In doing so, the data will help consumers make informative decisions when purchasing the fruit. The data will also help decrease the deficiency of nutritional information which may restrict the growth of the local avocado industry in Hawaii and Cameroon. If consumers know the nutrient profile of avocados, they might be more apt to buy locally grown fruits rather than imported fruits. The nutritional quantities of six Hawaii-grown cultivars and four Cameroon-grown cultivars were analyzed. The Hawaii cultivars were Linda, Beshore, Serpa, Nishikawa, Ohata and Murashige. The Cameroon cultivars were Peteson, Pollock, Fuer Florida and Booth VIII. Fatty acids (FA) were extracted via Soxhlet, then hydrolyzed and quantified via LCMS. Total protein content was determined via Kjeldahl digestion, mineral profile via ICP, and carotenoid content via HPLC. Nutritional profiles varied among the cultivars. The genetic background appeared to have a stronger influence than the environmental and growing factors as cultivars form the same farms differed from each other. This data will provide information on the most suitable cultivars in a nutritive and commercial perspective. Furthermore, the public in Hawaii and Cameroon will benefit from the nutritional information on avocados grown in their local region. This will also help improve understanding the health benefits of the fruit which are related to their chemical composition.Item Nutritional Management of Individuals with Chronic Disease and Vulnerable Populations Following a Disaster(University of Hawaii at Manoa, 2016-05) Wilcox, MistyChronic diseases and related conditions (CDRCs), such as diabetes, renal disease, and cardiovascular disease affect a large proportion of the population in developed nations. Following a large scale disaster, when food, water, and medical supplies are limited, CDRCs increase the risk of adverse health outcomes in displaced populations and require nutrition intervention. Other vulnerable populations, including the elderly, breastfeeding moms, and infants are also at high risk for adverse nutrition related health outcomes following a disaster. This thesis is comprised of two research studies, which examine: a) the prevalence of CDRCs in non-institutionalized U.S. adults, b) the effect of chronic disease status, mental or emotional health status, and disability status on disaster preparedness behaviors, and c) nutritional management of vulnerable populations include those with CDRCs. Preparation for disasters by both individuals and communities is an important part of critical infrastructure needed to be able to respond, and recover from disasters.