CTAHR Faculty & Researcher Works

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    Frequency of eating alone among adolescents is associated with adolescent dietary intake, perceived food-related parenting practices and weight status: cross-sectional Family Life, Activity, Sun, Health, and Eating (FLASHE) Study results.
    (Cambridge, 2019) Reicks, M. ; Davey, C. ; Anderson, A. ; Cluskey, M. ; Gunther, C. ; Jones, B. ; Richards, R. ; Topham, G. ; Wong, S.
    Objective To examine relationships between frequency of adolescents eating alone (dependent variable) and diet, weight status and perceived food-related parenting practices (independent variables). Design Analyses of publicly available, cross-sectional, web-based survey data from adolescents. Setting Online consumer opinion panel. Subjects A US nationwide sample of adolescents (12–17 years) completed Family Life, Activity, Sun, Health, and Eating (FLASHE) Study surveys to report demographic and family meal characteristics, weight, dietary intake, home food availability and perceptions of parenting practices. Parents provided information about demographic characteristics. Logistic regression analyses were used to test for associations between variables. Results About 20 % of adolescents reported often eating alone ( n 343) v . not often eating alone ( n 1309). Adjusted odds of adolescents often eating alone were significantly higher for non-Hispanic Black compared with non-Hispanic White adolescents (OR=1·7) and for overweight or obese compared with normal- or underweight adolescents (OR=1·6). Adjusted odds of adolescents eating alone were significantly lower for those who reported that fruits and vegetables were often/always available in the home (OR=0·65), for those who perceived that parents had expectations about fruit and vegetable intake (OR=0·71) and for those who agreed with parental authority to make rules about intake of junk food/sugary drinks (OR=0·71). Junk food and sugary drink daily intake frequency was positively associated with often eating alone. Conclusions Often eating alone was related to being overweight/obese, having less healthy dietary intake and perceptions of less supportive food-related parenting practices.
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    Association between cognitive restraint, uncontrolled eating, emotional eating and BMI and the amount of food wasted in early adolescent girls.
    (MDPI, 2018) Banna, J.C. ; Panizza, C.E. ; Boushey, CJ. ; Delp, EJ. ; Lim, E.
    Understanding of behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O'ahu, Hawai'i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record™ (mFR). Weight and height were measured to compute BMI (kg/m 2). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson's correlations were computed to examine the relationship between three factor eating scores and BMI. General linear models were conducted to examine the effect of each of three-factor eating scores on food plated, consumed, leftovers, and food wasted. Cognitive restraint was positively correlated with BMI (r = 0.36, p < 0.001) and with BMI z-score (r = 0.40, p < 0.001). There were no associations between three-factor eating scores and food plated, consumed, leftovers, and food wasted at lunch. However, at dinner, total energy plated, left over, and food wasted increased by 4.24 kcal/day (p = 0.030), 1.67 kcal/day (p = 0.002), and 0.93 kcal/day (p = 0.031), respectively, with a unit increase in uncontrolled eating score. Similarly, total energy plated and energy left over at dinner increased by 3.40 kcal/day (p = 0.045) and 1.51 kcal/day (p = 0.001), respectively, with a unit increase in emotional eating score. Additional research should examine the specific roles of cognitive restraint, uncontrolled eating, emotional eating and food waste in the development of obesity in adolescents.
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    Effect of a short message service intervention on excessive gestational weight gain in a low-income population: a randomized controlled trial
    (MDPI, 2020) Holmes, H. ; Palacios, C. ; Wu, Y. ; Banna, J.C.
    Objectives: The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on excessive gestational weight gain (GWG) in a low-income, predominantly overweight/obese population. Methods: Participants (n = 83) were mostly overweight/obese women recruited at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics on the island of O’ahu, Hawai’i at 15–20 weeks gestational age. The intervention group received SMS on nutrition and physical activity during pregnancy designed to help them meet Institute of Medicine (IOM) guidelines for GWG and American College of Obstetricians and Gynecologists guidelines for exercise, respectively. The control group received SMS about general health topics during pregnancy, excluding nutrition and physical activity. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last self-reported weight taken before delivery and participants’ self-reported weight before pregnancy. Differences between study groups were examined using t-tests and Chi-square tests. Linear regression models were used to examine association of GWG with study group and other factors. Results: GWG was similar (p = 0.58) in the control group (14.1 ± 11.4 kg) and the intervention group (15.5 ± 11.6 kg). The percentage of participants exceeding IOM guidelines for GWG was similar (p = 0.51) in the control group (50.0%, n = 17) and the intervention group (60.5%, n = 23). Conclusions: GWG was not significantly different between intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer intervention durations and varying message frequency as well as personalized or interactive messages may be needed to produce significant improvements.
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    Characterizing early adolescent food waste using the mobile food record.
    (MDPI, 2017) Panizza, C. ; Boushey, C.J. ; Delp, E. ; Kerr, D. ; Lim, E. ; Gandhi, K. ; Banna, J.C.
    This study aimed to assess the amount of plate waste and how plate waste was disposed by early adolescent girls using a mobile food record (mFR). Participants were girls nine to thirteen years residing in O’ahu, Hawai’i (n = 93). Foods selected and leftover were estimated using a three day mFR. Each leftover food was then classified as thrown into the trash, fed to a pet, eaten later, or other (e.g., composted). Repeated measures analyses of variance (ANOVA) were conducted and Tukey’s post-hoc test were used to adjust for multiple comparisons between times (breakfast, lunch, dinner, and snack) on leftover food and leftover food thrown into the trash. The percentage of food leftover and thrown into the trash was highest at lunch. The percentage of protein, grain, vegetables, fruit, and dairy leftover at lunch were unexpectedly low compared to previous studies. The median for percentage of food thrown into the trash at lunch was <5% for all food groups, and was consistently low across the day (<10%). Average energy intake was 436 kcal (±216) at lunch, and 80% of caregivers reported total household income as ≥$70,000. Studies in real-time using technology over full days may better quantify plate waste among adolescents.
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    Amount, preparation and type of formula consumed and its association with weight gain in infants participating in the WIC Program in Hawaii and Puerto Rico.
    (MDPI, 2019) Graulau, R. ; Banna, J.C. ; Campos, M. ; Gibby, C. ; Palacios, C.
    The aim of this study was to assess the association between amount (below or above recommendations), preparation (liquid vs. powder), and type (regular vs. hydrolysate) of infant formula consumed and weight in infants participating in the Women, Infant and Children (WIC) Program in Hawaii (HI) and Puerto Rico (PR). This was a secondary analysis of 162 caregivers with healthy term 0-2-month-old infants. Socio-demographics, infant food frequency questionnaires, and weight and length were assessed at baseline and after four months. Infant feeding practices were associated with weight-for-length z-scores using multivariable logistic regression. In total, 37.7% were exclusively breastfed and 27.2% were exclusively formula-fed. Among formula users, regular (63.6%) and powder (87.0%) formula were the most common; 43.2% consumed formula above recommendations. Most infants had rapid weight gain (61.1%). Infants fed regular formula had higher odds of overweight after four months (adjusted OR = 8.77, 95% CI: 1.81-42.6) and higher odds of rapid weight gain (adjusted OR = 3.10, 95% CI: 1.12, 8.61). Those exclusively formula fed had higher odds of slow weight gain (adjusted OR = 4.07, 95% CI: 1.17-14.2). Formula preparation and amount of formula were not associated with weight. These results could inform the WIC program's nutrition education messages on infant feeding. Studies with longer follow-up are needed to confirm these results.
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    Effect of a text intervention during pregnancy on birth weight in participants of the WIC program in Hawaii.
    ( 2020) Huwaiken, M. ; Palacios, C. ; Banna, J.C.
    ObjectivesThere are limited studies testing the effect of a pregnancy educational intervention on infants’ birth weight. This study investigated the effect of a short message service (SMS), or text message, intervention for promoting adequate gestational weight gain on infants’ birth weight in a sample of pregnant women in Hawai‘i.MethodsA randomized clinical trial was conducted among women participating in the Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) program in Hawai‘i (n = 83). The intervention group (n = 42) received weekly SMS about appropriate energy intake and physical activity and the control group (n = 41) received weekly SMS about general health issues for 4 months during pregnancy. Weight and length at birth were obtained from the participant's chart in WIC and compared between groups. Birthweight was categorized as small (SGA), appropriate (AGA) or large (LGA) for gestational age.ResultsWomen were age 27.7 ± 5.3y on average, 65.5% were Native Hawaiian, Pacific Islander or American Indian, 54.8% had some college or more and 37.8% were employed. Infant birth weight was similar in the intervention (3431 ± 682 g) and control groups (3232 ± 599 g; P > 0.05). Mothers in the control group had higher odds of having a SGA baby (OR: 2.21; 95% CI 0.40, 12.2) but similar risk of having a LGA baby (0.27; 95% CI 0.07, 1.05) compared to the intervention group. After adjusting for mothers’ age, education level and employment status, results were similar for SGA (OR: 2.34; 95% CI 0.43, 14.7) and LGA (OR: 0.35; 95% CI 0.08, 1.49).ConclusionsThere was no significant difference in birth weight between groups in mothers from the WIC program in Hawai‘i. More intensive educational interventions may be needed to observe an impact on birth weight.
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    Breastfeeding discontinuation not associated with maternal pregravid BMI but associated with Native Hawaiian or Other Pacific Islander race in Hawaii and Puerto Rico WIC participants
    (Springer, 2019) Gibby, C. ; Palacios, C. ; Campos, M. ; Lim, E. ; Banna, J.C.
    Objectives This study investigated the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation at 4-6 months postpartum in Hawaii and Puerto Rico participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods A secondary data analysis was conducted from a text message-based intervention in WIC participants in Hawaii and Puerto Rico. The analysis included 87 women from the control group who initiated breastfeeding and whose breastfeeding status was known at the end of the study when infants were 4-6 months old. Pregravid BMI and breastfeeding discontinuation were assessed using questionnaires. Results The association between pregravid BMI and breastfeeding discontinuation was not significant in the unadjusted model or in the adjusted model. Native Hawaiian or Other Pacific Islander (NHOPI) participants showed significantly increased odds of discontinuing breastfeeding (adjusted odds ratio [AOR] 7.12; 95% CI 1.34, 37.97; p = .02) compared to all the other racial/ethnic participants, as did older women ages 32-39 years versus women who were 25-31 years old (AOR 4.21; 95% CI 1.13, 15.72; p = .03). Women who took vitamins while breastfeeding had decreased odds of discontinuing breastfeeding (AOR 0.15; 95% CI 0.05, 0.46; p = .0009). Conclusions for Practice Pregravid BMI was not significantly associated with breastfeeding discontinuation at 4-6 months postpartum in women from Hawaii and Puerto Rico WIC, but NHOPIs and women who were older had higher odds of discontinuing breastfeeding. The results of this study may inform strategies for breastfeeding promotion and childhood obesity prevention but should be further investigated in larger studies. ClinicalTrials.gov Identifier: NCT02903186.
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    A novel tool for measuring food waste: the mobile food record.
    ( 2021) Danible, K. ; Boushey, C. ; Zhu, F. ; Banna, J.C.
    Abstract. The mobile food record™ (mFR™) is a novel app that allows for the tracking of individual food waste and addresses the limitations of current methods to accurately quantify food waste. Extension educators may use data from the mFR™ to create educational initiatives for food waste prevention and education that may be implemented in settings such as schools and universities. The mFR is an innovative application that simplifies the process of collecting food-based data and accurately quantifying food waste for use in Extension.
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    Validation of a collaboration readiness assessment tool for use by Supplemental Nutrition Assistance Program Education (SNAP-Ed) agencies and partners.
    (Elsevier, 2018) Butel, J.C. ; Banna, J.C. ; Novotny, R. ; Franck, K. ; Parker, S. ; Stephenson, L.
    To evaluate content and face validity of a collaboration readiness assessment tool developed to facilitate collaborative efforts to implement policy, systems, and environment changes in Supplemental Nutrition Assistance Program–Education (SNAP-Ed).Evaluation of the validity of the tool involved 2 steps. Step 1 was conducted with 4 subject matter experts to evaluate content validity. Step 2 used an iterative cognitive testing process with 4 rounds and 16 SNAP-Ed staff and community partners to evaluate face validity.Subject matter experts found that survey items appropriately matched the content area indicated and adequately covered collective efficacy, change efficacy, and readiness. Cognitive testing with SNAP-Ed staff and partners informed modifications and resulted in adequate face validity.The ability to measure collaboration readiness will allow agencies and community partners that implement SNAP-Ed to target areas that facilitate collaboration efforts needed for policy, systems, and environment change and collective efficacy. Further cognitive testing of the tool with other populations is needed to ensure its applicability and usefulness. Evaluation of the reliability of the tool with a broad range of SNAP-Ed programs and community agencies is also recommended.
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