Stanford Advisors

All Publications

  • Methods for Assessing Health Outcomes Associated with Food Insecurity in the US College Student Population: A Narrative Review. Advances in nutrition (Bethesda, Md.) Radtke, M. D., Steinberg, F. M., Scherr, R. E. 2023


    In the United States, college students experience disproportionate rates of food insecurity (FI) compared to the national average. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. The aim of this narrative review is to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies at reducing the pervasiveness of FI in the US college student population.

    View details for DOI 10.1016/j.advnut.2023.10.004

    View details for PubMedID 37865221

  • Perspective: Challenges and Future Directions in Clinical Research with Nuts and Berries. Advances in nutrition (Bethesda, Md.) Zuelch, M. L., Radtke, M. D., Holt, R. R., Basu, A., Burton-Freeman, B., Ferruzzi, M. G., Li, Z., Shay, N. F., Shukitt-Hale, B., Keen, C. L., Steinberg, F. M., Hackman, R. M. 2023; 14 (5): 1005-1028


    Consumption of nuts and berries are considered part of a healthy eating pattern. Nuts and berries contain a complex nutrient profile consisting of essential vitamins and minerals, fiber, polyunsaturated fatty acids, and phenolics in quantities that improve physiological outcomes. The spectrum of health outcomes that may be impacted by the consumptions of nuts and berries includes cardiovascular, gut microbiome, and cognitive, among others. Recently, new insights regarding the bioactive compounds found in both nuts and berries have reinforced their role for use in precision nutrition efforts. However, challenges exist that can affect the generalizability of outcomes from clinical studies, including inconsistency in study designs, homogeneity of test populations, variability in test products and control foods, and assessing realistic portion sizes. Future research centered on precision nutrition and multi-omics technologies will yield new insights. These and other topics such as funding streams and perceived risk-of-bias were explored at an international nutrition conference focused on the role of nuts and berries in clinical nutrition. Successes, challenges, and future directions with these foods are presented here.

    View details for DOI 10.1016/j.advnut.2023.07.010

    View details for PubMedID 37536565

    View details for PubMedCentralID PMC10509432

  • Validation of Diet ID™ in Predicting Nutrient Intake Compared to Dietary Recalls, Skin Carotenoid Scores, and Plasma Carotenoids in University Students. Nutrients Radtke, M. D., Chodur, G. M., Bissell, M. C., Kemp, L. C., Medici, V., Steinberg, F. M., Scherr, R. E. 2023; 15 (2)


    Background and Aim: Collecting accurate dietary information in the research setting is challenging due to the inherent biases, duration, and resource-intensive nature of traditional data collection methods. Diet ID™ is a novel, rapid assessment method that uses an image-based algorithm to identify dietary patterns and estimate nutrient intake. The purpose of this analysis was to explore the criterion validity between Diet ID™ and additional measures of dietary intake. Methods: This prospective cohort study (n = 42) collected dietary information using Diet ID™, the Nutrition Data System for Research (NDSR), plasma carotenoid concentrations, and the Veggie Meter® to estimate carotenoid levels in the skin. Results: There were significant correlations between Diet ID™ and NDSR for diet quality, calories, carbohydrates, protein, fiber, and cholesterol. Vitamin A and carotenoid intake were significantly correlated, with the exception of α-carotene and lycopene. Significant correlations were observed for calcium, folate, iron, sodium, potassium, Vitamins B2, B3, B6, C, and E. Skin carotenoid scores and plasma carotenoids were correlated with carotenoid intake from Diet ID™. Conclusions: Diet ID™ may be a useful tool in nutrition research as a less time-intensive and minimally burdensome dietary data collection method for both participants and researchers.

    View details for DOI 10.3390/nu15020409

    View details for PubMedID 36678280

    View details for PubMedCentralID PMC9865232

  • Perspective: Early Life Nutrition Research Supported by the U.S. National Institutes of Health from 2018-2020. Advances in nutrition (Bethesda, Md.) Landry, M. J., Ruiz, L. D., Gibbs, K., Radtke, M. D., Lerman, J., Vargas, A. J. 2022


    The Dietary Guidelines for Americans, 2020-2025 includes guidelines for pregnancy, lactation, and children from birth to age 24-months (B-24) to reflect the growing body of evidence about appropriate nutrition during the earliest stages of life. Guidelines are based on a thorough review of the existing scientific evidence by the 2020 Dietary Guidelines Advisory Committee (DGAC). This study's objective was to enumerate early life (pregnancy, lactation, and B-24) nutrition research needs that are already being addressed by the scientific community and to identify remaining research gaps. The Scientific Report of the 2020 Dietary Guidelines Advisory Committee was reviewed, and 138 research gaps relevant to early life were identified. Research gaps were consolidated into 13 topic areas. A total of 1,632 nutrition and early life focused research projects funded by the National Institutes of Health (NIH) between 2018-2020 were manually coded using title, abstract, and public health relevance statement available on NIH RePORTER. Projects were coded if they addressed a research gap within one of the 13 research gap topic areas. Of reviewed and coded projects, 235 (14.4%) addressed any early life nutrition research gap. Between Fiscal Years 2018 to 2020, total costs of projects addressing any gap represented only 15% of total costs for all projects reviewed. Complementary foods, breastfeeding (never versus ever), and frequency of eating were research gap areas most frequently coded as being addressed by a funded project. Iron supplementation, seafood consumption, and maternal diet food allergens were research gap areas least frequently coded as being potentially addressed by a funded project. This analysis highlights opportunities for changes in the federal government investment in maternal and child nutrition research to support development of effective, evidence-based dietary guidelines for improvement of early life nutrition practices and overall public health.STATEMENT OF SIGNIFICANCE: The National Institutes of Health (NIH) funded 1,632 research projects between 2018-2020 focused on early life nutrition. Of these, less than 15% intended to address any early life related dietary research gap identified by the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Results suggest an opportunity for more strategic investment in maternal and child nutrition research by the NIH to support the development of effective evidence-based dietary guidelines for pregnancy, lactation, and infants and toddlers aged birth to 24-months.

    View details for DOI 10.1093/advances/nmac044

    View details for PubMedID 35438148

  • Recommendations for the Use of the Veggie Meter for Spectroscopy-Based Skin Carotenoid Measurements in the Research Setting. Current developments in nutrition Radtke, M. D., Poe, M., Stookey, J., Jilcott Pitts, S., Moran, N. E., Landry, M. J., Rubin, L. P., Stage, V. C., Scherr, R. E. 2021; 5 (8): nzab104


    Carotenoids are a class of phytochemical compounds found in a variety of fruits and vegetables (F/V) and, therefore, are commonly used as a biomarker for F/V intake. The Veggie Meter is a noninvasive research-grade instrument that detects and quantifies carotenoids in the skin. To determine current practices and examine variability among users, a survey was administered to researchers using the device (n=19, response rate=35.8%) and variation in anatomical site preparation, calibration, number of measurements, measurement site, and documentation was observed. A protocol was developed in partnership with Veggie Meter users to outline the preparation, calibration, and data collection procedures for using this device for research purposes. Although many protocol conditions will benefit from additional validation, this standardized protocol supports the development of a universal data repository to establish usual observed ranges, with the ultimate goal of examining associations between skin carotenoid scores and diet-related health outcomes.

    View details for DOI 10.1093/cdn/nzab104

    View details for PubMedID 34476333

  • Development and Pilot Testing of a Food Literacy Curriculum for High School-Aged Adolescents. Nutrients Ruiz, L. D., Radtke, M. D., Scherr, R. E. 2021; 13 (5)


    Adolescent obesity and poor diet quality are increasingly prevalent and could be mitigated with attainment of food literacy. However, as these programs for adolescents are lacking, the purpose of this project was to develop a food literacy curriculum for high school-aged adolescents. The curriculum was designed in accordance with food literacy attributes and components utilizing Backward Design, Social Cognitive Theory, and Constructivism. After expert committee review, pilot testing was completed in two low-income communities by a trained facilitator and observer. Detailed observations were collected during pilot testing to assess achievement of learning objectives. Modifications were made to lesson procedures as required. The resulting curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, contains 12 modules of experiential lessons and application activities within three topics. Agriculture lessons concentrate on the food supply chain and food environments; nutrition lessons include food groups while focusing on nutrients of concern for underconsumption; and cooking lessons include food safety, budgeting, and preparation. Teens CAN provides a comprehensive and necessary approach to advancing food literacy in adolescents. Future directions include assessing dietary implications after participating in Teens CAN lessons and employment of an innovative two-tiered cross-age teaching model.

    View details for DOI 10.3390/nu13051532

    View details for PubMedID 34062865

    View details for PubMedCentralID PMC8147294

  • Criterion-Related Validity of Spectroscopy-Based Skin Carotenoid Measurements as a Proxy for Fruit and Vegetable Intake: A Systematic Review. Advances in nutrition (Bethesda, Md.) Radtke, M. D., Pitts, S. J., Jahns, L., Firnhaber, G. C., Loofbourrow, B. M., Zeng, A., Scherr, R. E. 2020; 11 (5): 1282-1299


    Carotenoids are a category of health-promoting phytonutrients that are found in a variety of fruits and vegetables and have been used as a biomarker to approximate dietary fruit and vegetable (F/V) intake. Carotenoids are consumed, metabolized, and deposited in blood, skin, and other tissues. Emerging evidence suggests spectroscopy-based skin carotenoid measurement is a noninvasive method to approximate F/V intake. Spectroscopy-based skin carotenoid measurement overcomes bias and error inherent in self-reported dietary recall methods, and the challenges in obtaining, storing, and processing invasive blood samples. The objective of this systematic review was to examine criterion-related validity of spectroscopy-based skin carotenoid measurement as a proxy for F/V intake. The 3 methods examined were resonance Raman spectroscopy (RRS), pressure-mediated reflection spectroscopy (RS), and spectrophotometers. A comprehensive literature search of PubMed, Excerpta Medica Database (Embase), Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed in December 2018, yielding 7931 citations. Studies that examined associations between spectroscopy, blood carotenoids, and/or dietary intake were identified and reviewed independently by ≥2 reviewers to determine eligibility for inclusion. Twenty-nine articles met the inclusion criteria and all 29 studies found significant correlations or associations between spectroscopy-based skin carotenoids and plasma or serum carotenoids and/or dietary F/V intake. A majority of the studies evaluated carotenoid concentration in adults; however, 4 studies were conducted in infants and 6 studies evaluated children. Twenty studies specified the racial/ethnic groups from which the samples were drawn, with 6 including ≥20% of the sample from a minority, nonwhite population. The findings of this systematic review support the use of spectroscopy for estimating F/V intake in diverse human populations, although additional validation is needed, particularly among racially/ethnically diverse populations and populations of varying ages.

    View details for DOI 10.1093/advances/nmaa054

    View details for PubMedID 32407509

    View details for PubMedCentralID PMC7490174