Health Equity — Publications

Characterizing cancer patterns in Okinawan vs. mainland Japanese Americans: The Multiethnic Cohort Study

Streicher SA, Guillermo C, Park S, Chiang CWK, Shepherd J, Sheng X, Bogumil D, Park SL, Cheng I, Lim U, Franke AA, Stram DO, Conti DV, Haiman C, Wilkens L, Marchand LL

medRxiv, , (2025)

Prevalence of mammographically dense breasts in Guam

Evangelista RFP, Dulana L, Teria R, Jin SB, Paras G, Grino R, Shepherd J, Badowski G

Cancer Research, 85, 1029 (2025)

Artificial intelligence-enhanced handheld breast ultrasound for screening: A systematic review of diagnostic test accuracy

Bunnell A, Valdez D, Strand F, Glaser Y, Sadowski P, Shepherd J

PLOS Digital Health, 4, e0001019 (2025)

Prediction of mammographic breast density based on clinical breast ultrasound images using deep learning: a retrospective analysis

Bunnell A, Valdez D, Wolfgruber T, Quon BK, Hung K, Hernandez BY, Seto TB, Killeen J, Miyoshi M, Sadowski P, Shepherd J

The Lancet Regional Health - Americas, 46, 101096 (2025)

Race-neutral Pediatric Reference Ranges for Bone Mineral Density Predict Prospective Fractures in Childhood

Zemel BS, Winer KK, Kelly A, Freedman DS, Mitchell JA, Weber DR, McCormack SE, McWilliams T, Lappe JM, Oberfield SE, Shepherd J, Grant SF, Kalkwarf HJ

The Journal of Clinical Endocrinology & Metabolism, 110, 3034-3048 (2025)

Prediction of future visceral adiposity and application to cancer research: The Multiethnic Cohort Study

Wilkens LR, Castelfranco AM, Monroe KR, Kristal BS, Cheng I, Maskarinec G, Hullar MA, Lampe JW, Shepherd J, Franke AA, Ernst T, Marchand LL, Lim U

PLoS ONE, 19, e0306606 (2024)

Circulating Lipids in an Older, Multiethnic Population: Self-Reported Subgroups as a Gateway to Precision Nutrition

Kristal BS, Sniatynski MJ, Belenky M, Struble JS, Lim U, Hullar MA, Lampe JW, Maskarinec G, Shepherd J, Wilkens LR, Marchand LL

Current Developments in Nutrition, 8, 103619 (2024)

Abstract PO5-08-12: Ethnic Admixture Affects Breast Cancer Incidence in Native Hawaiians: The Multiethnic Cohort

Valdez D, Bunnell A, Bogumil D, Maskarinec G, Shepherd J

Cancer Research, 84, PO5-08 (2024)

Abstract 3449: Is AI-enhanced breast ultrasound ready for breast cancer screening in low-resource environments? A systematic review

Bunnell A, Valdez D, Strand F, Glaser Y, Sadowski P, Shepherd J

Cancer Research, 84, 3449 (2024)

Effect of Intermittent vs. Continuous Energy Restriction on Visceral Fat: Protocol for The Healthy Diet and Lifestyle Study 2 (HDLS2)

Lewis MY, Yonemori K, Ross A, Wilkens LR, Shepherd J, Cassel K, Stenger A, Rettenmeier CA, Lim U, Boushey CJ, Marchand LL

Nutrients, 16, 1478 (2024)

Dietary intake and visceral adiposity in older adults: The Multiethnic Cohort Adiposity Phenotype study

Merritt MA, Lim U, Lampe JW, Kaenkumchorn T, Boushey CJ, Wilkens LR, Shepherd J, Ernst T, Marchand LL

Obesity Science & Practice, 10, e734 (2024)

Learning a Clinically-Relevant Concept Bottleneck for Lesion Detection in Breast Ultrasound

Bunnell A, Glaser Y, Valdez D, Wolfgruber T, Altamirano A, González CZ, Hernandez BY, Sadowski P, Shepherd J

Lecture notes in computer science, , 650-659 (2024)

Evaluation of visceral adipose tissue thresholds for elevated metabolic syndrome risk across diverse populations: A systematic review

Bennett JP, Prado CM, Heymsfield SB, Shepherd J

Obesity Reviews, 25, e13767 (2024)

Abstract P3-04-05: Artificial Intelligence Detects, Classifies, and Describes Lesions in Clinical Breast Ultrasound Images

Bunnell A, Valdez D, Wolfgruber T, Altamirano A, Hernandez BY, Sadowski P, Shepherd J

Cancer Research, 83, P3-04 (2023)

The association of a healthy lifestyle index and imaging-based body fat distribution with glycemic status and Type 2 diabetes in the Multi Ethnic Cohort: a cross-sectional analysis

Klapp R, Nimptsch K, Pischon T, Wilkens LR, Lim U, Guillermo C, Setiawan VW, Shepherd J, Marchand LL, Maskarinec G

European Journal of Clinical Nutrition, 78, 236-242 (2023)

Genome-wide association study of abdominal MRI-measured visceral fat: The multiethnic cohort adiposity phenotype study

Streicher SA, Lim U, Park SL, Li Y, Sheng X, Hom V, Xia L, Pooler L, Shepherd J, Loo LWM, Ernst T, Buchthal SD, Franke AA, Tiirikainen M, Wilkens LR, Haiman CA, Stram DO, Cheng I, Marchand LL

PLoS ONE, 18, e0279932 (2023)

Time-specific impact of mono-benzyl phthalate (MBzP) and perfluorooctanoic acid (PFOA) on breast density of a Chilean adolescent Cohort

Kim CE, Binder AM, Corvalán C, Pereira A, Shepherd J, Calafat AM, Botelho JC, Hampton JM, Trentham‐Dietz A, Michels KB

Environment International, 181, 108241 (2023)

Accuracy and Precision of 3-dimensional Optical Imaging for Body Composition by Age, BMI, and Ethnicity

Wong MC, Bennett JP, Quon BK, Leong LT, Tian IY, Liu YE, Kelly NN, McCarthy C, Chow DC, Pujades S, Garber AK, Maskarinec G, Heymsfield SB, Shepherd J

American Journal of Clinical Nutrition, 118, 657-671 (2023)

Abstract P3-01-13: Comparing portable and clinical ultrasound systems using 3D printed breast phantom inserts

Valdez D, Fukui J, Wolfgruber T, Leong LT, Maskarinec G, Shepherd J

Cancer Research, 82, P3-01 (2022)

Technical note: Low clinical efficacy, but good acceptability of a point‐of‐care electronic palpation device for breast cancer screening for a lower middle‐income environment

Valdez D, Cruz T, Rania S, Badowski G, Cassel K, Wolfgruber T, Grosskreutz S, Dulana L, Adonay R, Maskarinec G, Shepherd J

Medical Physics, 49, 2663-2671 (2022)

Prognostic utility of self‐reported sarcopenia (SARC‐F) in the Multiethnic Cohort

Wu AH, Setiawan VW, Lim U, Tseng C, White KK, Shepherd J, Lenz HJ, Cheng I, Stram DO, Haiman CA, Wilkens LR, Marchand LL

Journal of Cachexia Sarcopenia and Muscle, 13, 987-1002 (2022)

Next-generation smart watches to estimate whole-body composition using bioimpedance analysis: accuracy and precision in a diverse, multiethnic sample

Bennett JP, Liu YE, Kelly NN, Quon BK, Wong MC, McCarthy C, Heymsfield SB, Shepherd J

American Journal of Clinical Nutrition, 116, 1418-1429 (2022)

3D Optical Body Composition Accuracy across Subgroups of BMI and Race/Ethnicity

Wong MC, LIU YE, Kennedy S, Kelly NN, Maskarinec G, Garber AK, Wong JM, Ebbeling CB, Ludwig DS, Weiss EJ, Pujades S, Heymsfield SB, Shepherd J

Biomarker-based visceral adiposity score and incident type 2 diabetes in the multiethnic cohort

Maskarinec G, Raquinio PA, Setiawan VW, Ernst T, Franke AA, Buchthal SD, Shepherd J, Wilkens LR, Lim U, Marchand LL

Annals of Epidemiology, 63, 29-34 (2021)

Associations of the Dietary Inflammatory Index With Total Adiposity and Ectopic Fat and the Mediating Effect of the Gut Microbiota

Panizza C, Wilkens LR, Shvetsov YB, Maskarinec G, Park S, Shepherd J, Boushey CJ, Hébert JR, Wirth MD, Ernst T, Randolph TW, Lim U, Lampe JW, Marchand LL, Hullar MA

Current Developments in Nutrition, 5, 1173 (2021)

Diet and Liver Adiposity in Older Adults: The Multiethnic Cohort Adiposity Phenotype Study

Kaenkumchorn T, Merritt MA, Lim U, Marchand LL, Boushey CJ, Shepherd J, Wilkens LR, Ernst T, Lampe JW

Journal of Nutrition, 151, 3579-3587 (2021)

Genome-wide association study of pancreatic fat: The Multiethnic Cohort Adiposity Phenotype Study

Streicher SA, Lim U, Park SL, Li Y, Sheng X, Hom V, Xia L, Pooler L, Shepherd J, Loo LWM, Darst BF, Highland HM, Polfus LM, Bogumil D, Ernst T, Buchthal SD, Franke AA, Setiawan VW, Tiirikainen M, Wilkens LR, Haiman CA, Stram DO, Cheng I, Marchand LL

PLoS ONE, 16, e0249615 (2021)

The potential of using artificial intelligence to improve skin cancer diagnoses in Hawai‘i’s multiethnic population

Willingham ML, Spencer SY, Lum C, Sanchez JMN, Burnett T, Shepherd J, Cassel K

Melanoma Research, 31, 504-514 (2021)

Utility of self-rated adherence for monitoring dietary and physical activity compliance and assessment of participant feedback of the Healthy Diet and Lifestyle Study pilot

O’Reilly H, Panizza C, Lim U, Yonemori K, Wilkens LR, Shvetsov YB, Harvie M, Shepherd J, Zhu F, Marchand LL, Boushey CJ, Cassel K

Pilot and Feasibility Studies, 7, 48 (2021)

Body Fat Distribution, Glucose Metabolism, and Diabetes Status Among Older Adults: The Multiethnic Cohort Adiposity Phenotype Study

Maskarinec G, Raquinio P, Kristal BS, Franke AA, Buchthal SD, Ernst T, Monroe KR, Shepherd J, Shvetsov YB, Marchand LL, Lim U

Journal of Epidemiology, 32, 314-322 (2021)

Metabolic syndrome screening using visceral adipose tissue (VAT) from opportunistic MRI locations in a multi-ethnic population

Villegas‐Valle RC, Lim U, Maskarinec G, Franke AA, Ernst T, Fan B, Álvarez-Hernández G, Candia-Plata MDC, Díaz-Zavala RG, Wilkens LR, Monroe KR, Valencia ME, Marchand LL, Shepherd J

Obesity Research & Clinical Practice, 15, 227-234 (2021)

The Gut Microbiome Is Associated with Circulating Dietary Biomarkers of Fruit and Vegetable Intake in a Multiethnic Cohort

Frankenfeld CL, Hullar MA, Maskarinec G, Monroe KR, Shepherd J, Franke AA, Randolph TW, Wilkens LR, Boushey CJ, Marchand LL, Lim U, Lampe JW

Journal of the Academy of Nutrition and Dietetics, 122, 78-98 (2021)

Associations of the gut microbiome with hepatic adiposity in the Multiethnic Cohort Adiposity Phenotype Study

Hullar MA, Jenkins I, Randolph TW, Curtis KR, Monroe KR, Ernst T, Shepherd J, Stram DO, Cheng I, Kristal BS, Wilkens LR, Franke AA, Marchand LL, Lim U, Lampe JW

Gut Microbes, 13, 1965463 (2021)

Utility of Self-rated Adherence and Assessment of Participant Feedback of the Healthy Diet and Lifestyle Study Pilot.

O’Reilly H, Panizza C, Lim U, Yonemori K, Wilkens LR, Shvetsov YB, Harvie M, Shepherd J, Zhu F, Marchand LL, Boushey CJ, Cassel K

Research Square, , (2020)

Utility of self-rated adherence for monitoring dietary and physical activity compliance and assessment of participant feedback of the Healthy Diet and Lifestyle Study pilot.

O’Reilly H, Panizza C, Lim U, Yonemori K, Wilkens LR, Shvetsov YB, Harvie M, Shepherd J, Zhu F, Marchand LL, Boushey CJ, Cassel K

Research Square, , (2020)

Predictors of liver fat among children and adolescents from five different ethnic groups

Maskarinec G, Garber AK, Wong MC, Kelly NN, Kazemi L, Buchthal SD, Fearnbach N, Heymsfield SB, Shepherd J

Obesity Science & Practice, 7, 53-62 (2020)

Diet Quality and Visceral Adiposity among a Multiethnic Population of Young, Middle, and Older Aged Adults

Panizza C, Wong MC, Kelly NN, Liu YE, Shvetsov YB, Lowe DA, Weiss EJ, Heymsfield SB, Kennedy S, Boushey CJ, Maskarinec G, Shepherd J

Current Developments in Nutrition, 4, nzaa090 (2020)

Differences in the association of diet quality with body fat distribution between men and women

Maskarinec G, Namatame LA, Kang M, Buchthal SD, Ernst T, Monroe KR, Shepherd J, Wilkens LR, Boushey CJ, Marchand LL, Lim U

European Journal of Clinical Nutrition, 74, 1434-1441 (2020)

Genome‐Wide Association Study of Liver Fat: The Multiethnic Cohort Adiposity Phenotype Study

Park S, Li Y, Sheng X, Hom V, Xia L, Zhao K, Pooler L, Setiawan VW, Lim U, Monroe KR, Wilkens LR, Kristal BS, Lampe JW, Hullar MA, Shepherd J, Loo LLM, Ernst T, Franke AA, Tiirikainen M, Haiman CA, Stram DO, Marchand LL, Cheng I

Hepatology Communications, 4, 1112-1123 (2020)

Associations of plasma trimethylamine N-oxide, choline, carnitine, and betaine with inflammatory and cardiometabolic risk biomarkers and the fecal microbiome in the Multiethnic Cohort Adiposity Phenotype Study

Fu BC, Hullar MA, Randolph TW, Franke AA, Monroe KR, Cheng I, Wilkens LR, Shepherd J, Madeleine MM, Marchand LL, Lim U, Lampe JW

American Journal of Clinical Nutrition, 111, 1226-1234 (2020)

Does Intermittent Energy Restriction Plus Mediterranean Diet Reduce Visceral Adipose Tissue and Minimize Adaptive Responses of Energy Restriction? A Randomized Pilot Study (P21-016-19)

Panizza C, Lim U, Yonemori K, Cassel K, Wilkens LR, Shvetsov YB, Harvie M, Marchand LL, Shepherd J, Delp EJ, Boushey CJ

Current Developments in Nutrition, 3, nzz041.P21-016 (2019)

Proton Magnetic Resonance Spectroscopy (1H-MRS)-Based Neurometabolite Levels and Cognitive Function in Relation to Visceral Obesity and Non-Alcoholic Fatty Liver Disease (P14-019-19)

Pilande E, So S, Lim U, Hullar MA, Wilkens LR, Shepherd J, Albright C, Lampe JW, Marchand LL, Ernst T, Chang L

Current Developments in Nutrition, 3, nzz052.P14-019 (2019)

Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study

Panizza C, Lim U, Yonemori K, Cassel K, Wilkens LR, Harvie M, Maskarinec G, Delp EJ, Lampe JW, Shepherd J, Marchand LL, Boushey CJ

Nutrients, 11, 1386 (2019)

Fecal Microbial Diversity and Structure Are Associated with Diet Quality in the Multiethnic Cohort Adiposity Phenotype Study

Maskarinec G, Hullar MA, Monroe KR, Shepherd J, Hunt J, Randolph TW, Wilkens LR, Boushey CJ, Marchand LL, Lim U, Lampe JW

Journal of Nutrition, 149, 1575-1584 (2019)

Abstract 3268: Associations of plasma trimethylamine N-oxide (TMAO), choline, and betaine with the gut microbiome and biomarkers of inflammation and cardiometabolic risk in the Multiethnic Cohort

Fu BC, Hullar MA, Randolph TW, Franke AA, Monroe KR, Cheng I, Wilkens LR, Shepherd J, Marchand LL, Lim U, Lampe JW

Cancer Research, 78, 3268 (2018)

Subcutaneous Fat Fibrosis Links Obesity to Insulin Resistance in Chinese Americans

Alba D, Farooq J, Lin M, Schafer AL, Shepherd J, Koliwad SK

The Journal of Clinical Endocrinology & Metabolism, 103, 3194-3204 (2018)

Transethnic Evaluation Identifies Low-Frequency Loci Associated With 25-Hydroxyvitamin D Concentrations

Hong J, Hatchell KE, Bradfield JP, Bjonnes A, Chesi A, Lai C, Langefeld CD, Lu L, Lu Y, Lutsey PL, Musani SK, Nalls MA, Robinson‐Cohen C, Roizen JD, Saxena R, Tucker KL, Ziegler JT, Arking DE, Bis JC, Boerwinkle E, Böttinger EP, Bowden DW, Gilsanz V, Houston DK, Kalkwarf HJ, Kelly A, Lappe JM, Liu Y, Michos ED, Oberfield SE, Palmer ND, Rotter JI, Sapkota BR, Shepherd J, Wilson JG, Basu S, Boer IHD, Divers J, Freedman BI, Grant SF, Hakanarson H, Harris TB, Kestenbaum B, Kritchevsky SB, Loos RJF, Norris JM, Norwood AF, Ordovás JM, Pankow JS, Psaty BM, Sanghera DK, Wagenknecht LE, Zemel BS, Meigs JB, Dupuis J, Florez JC, Wang TJ, Liu C, Engelman CD, Billings LK

The Journal of Clinical Endocrinology & Metabolism, 103, 1380-1392 (2018)

Propensity for Intra-abdominal and Hepatic Adiposity Varies Among Ethnic Groups

Lim U, Monroe KR, Buchthal S, Fan B, Cheng I, Kristal BS, Lampe JW, Hullar MA, Franke AA, Stram DO, Wilkens LR, Shepherd J, Ernst T, Marchand LL

Gastroenterology, 156, 966-975.e10 (2018)

Body Shape and Fat Distribution From Whole-Body DXA Accurately Predict Metabolic Syndrome Across Sex and Ethnicity Subgroups

Ng BK, Fan B, Lim U, Marchand LL, Wilkens LR, Shepherd J

Journal of Clinical Densitometry, 19, 527 (2016)

Can Racial Differences in Resting Metabolic Rate be Explained by Body Composition?

Avila J, Ng BK, Kotowski L, Hinton B, Shepherd J

Obesity, 24, 1203 (2016)

Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

McCormack SE, Chesi A, Mitchell JA, Roy SM, Cousminer DL, Kalkwarf HJ, Lappe JM, Gilsanz V, Oberfield SE, Shepherd J, Mahboubi S, Winer KK, Kelly A, Grant SF, Zemel BS

Journal of Bone and Mineral Research, 32, 115-124 (2016)

Measuring body composition in low‐resource settings across the life course

Shepherd J, Heymsfield SB, Norris SA, Redman LM, Ward LC, Slater C

Obesity, 24, 985-988 (2016)

US White and Black Women Do Not Represent the Bone Mineral Density of Sub-Saharan Black Women

Mukwasi C, Chibanda LS, Banhwa J, Shepherd J

Journal of Clinical Densitometry, 18, 525-532 (2015)

Reproducibility and Intermethod Reliability of a Calcium Food Frequency Questionnaire for Use in Hispanic, Non-Hispanic Black, and Non-Hispanic White Youth

Ollberding NJ, Gilsanz V, Lappe JM, Oberfield SE, Shepherd J, Winer KK, Zemel BS, Kalkwarf HJ

Journal of the Academy of Nutrition and Dietetics, 115, 519-527.e2 (2015)

BMD Loci Contribute to Ethnic and Developmental Differences in Skeletal Fragility across Populations: Assessment of Evolutionary Selection Pressures

Medina‐Gómez C, Chesi A, Heppe DHM, Zemel BS, Yin J, Kalkwarf HJ, Hofman A, Lappe JM, Kelly A, Kayser M, Oberfield SE, Gilsanz V, Uitterlinden AG, Shepherd J, Jaddoe VWV, Grant SF, Lao Ó, Rivadeneira F

Molecular Biology and Evolution, 32, 2961-2972 (2015)

Sex and Ethnic Differences in the Association of Obesity With Risk of Hepatocellular Carcinoma

Setiawan VW, Lim U, Lipworth L, Lu SC, Shepherd J, Ernst T, Wilkens LR, Henderson BE, Marchand LL

Clinical Gastroenterology and Hepatology, 14, 309-316 (2015)

High mammographic density in women of Ashkenazi Jewish descent

Caswell‐Jin JL, Kerlikowske K, Shepherd J, Cummings SR, Hu D, Huntsman S, Ziv E

Breast Cancer Research, 15, R40 (2013)

Asian Ethnicity is Associated With a Higher Trunk/Peripheral Fat Ratio in Women and Adolescent Girls

Morimoto Y, Maskarinec G, Conroy SM, Lim U, Shepherd J, Novotny R

Journal of Epidemiology, 22, 130-135 (2012)

Racial Disparity in Fracture Risk between White and Nonwhite Children in the United States

Wren TAL, Shepherd J, Kalkwarf HJ, Zemel BS, Lappe JM, Oberfield SE, Dorey FJ, Winer KK, Gilsanz V

The Journal of Pediatrics, 161, 1035-1040.e2 (2012)

Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005-2008.

Looker AC, Borrud LG, Hughes JP, Fan B, Shepherd J, Melton LJ

PubMed, , 1-132 (2012)

Puberty, body fat, and breast density in girls of several ethnic groups

Novotny R, Daida YG, Morimoto Y, Shepherd J, Maskarinec G

American Journal of Human Biology, 23, 359-365 (2011)

Revised Reference Curves for Bone Mineral Content and Areal Bone Mineral Density According to Age and Sex for Black and Non-Black Children: Results of the Bone Mineral Density in Childhood Study

Zemel BS, Kalkwarf HJ, Gilsanz V, Lappe JM, Oberfield SE, Shepherd J, Frederick M, Huang X, Lü M, Mahboubi S, Hangartner TN, Winer KK

The Journal of Clinical Endocrinology & Metabolism, 96, 3160-3169 (2011)

Comparison of breast density measured by dual energy X-ray absorptiometry with mammographic density among adult women in Hawaii

Maskarinec G, Morimoto Y, Daida YG, Laidevant A, Malkov S, Shepherd J, Novotny R

Cancer Epidemiology, 35, 188-193 (2010)

Body composition data for individuals 8 years of age and older: U.S. population, 1999-2004.

Borrud LG, Flegal KM, Looker AC, Everhart JE, Harris TB, Shepherd J

PubMed, , 1-87 (2010)

High adiposity and high body mass index–for-age in US children and adolescents overall and by race-ethnic group

Flegal KM, Ogden CL, Yanovski JA, Freedman DS, Shepherd J, Graubard BI, Borrud LG

American Journal of Clinical Nutrition, 91, 1020-1026 (2010)

Age, gender, and race/ethnic differences in total body and subregional bone density

Looker AC, Melton LJ, Harris T, Borrud LG, Shepherd J, McGowan J

Osteoporosis International, 20, 1141-1149 (2008)