Bite Sized Biomarkers: Promoting Health Behavior Change Through Objective Dietary Monitoring

A critical research gap of FIM is objective, non-invasive measures of dietary intake for rigorously evaluating interventions, such as produce prescription programs. The Veggie Meter® is a research-grade tool strongly correlated with plasma carotenoid levels that utilizes pressure-mediated reflection spectroscopy to rapidly detect carotenoids in the skin, correcting for melanin concentration across skin tones, to estimate V/F intake over 30 days. Carotenoids are fat-soluble compounds found ubiquitously in V/F, detectable in the diet, plasma, and body tissues and may contain bioactive properties that have been demonstrated to slow the progression of chronic disease development. Carotenoid status may serve as a comprehensive, objective, and non-invasive measures of dietary intake that has yet to be implemented in the evaluation of FIM. In addition to being ideally suited for evaluating the effectiveness of FIM, the Veggie Meter® may serve as a promising tool to incorporate into primary care for better assessing dietary intake for prevention and treatment of diet-related chronic diseases. With dietary intake and behavioral lifestyle modifications at the core of chronic disease management, understanding the role of nutritional monitoring in primary care on initiating and sustaining patient health-related behavior change is essential to reduce disease prevalence and severity.

The specific aims of the project are:

Aim 1: Evaluate whether participants in a FIM intervention have higher skin carotenoid scores compared to those not in a FIM intervention over 6 months.

Aim 2: Determine whether informing participants of their skin carotenoid scores at baseline is effective for increasing diet quality at 6 months compared to not receiving skin carotenoid scores. Participants and controls (n=150) will be randomized to receive skin carotenoid scores and their clinical lab values (HbA1c, lipids, BP, anthropometrics) or to only receive their clinical lab values.

Aim 3: Examine barriers and facilitators of integrating objective, non-invasive nutritional monitoring into primary care using a convergent mixed methods design.