Medicine and Health Sciences Commons^™

Increased Risk For Vitamin D Deficiency In Obese Children With Both Celiac Disease And Type 1 Diabetes, Nithya Setty-Shah, Louise S. Maranda, Benjamin U. Nwosu

Benjamin U. Nwosu

Background. It is unknown whether the coexistence of type 1 diabetes (T1D) and celiac disease (CD) increases the risk for vitamin D deficiency.

Aims. To determine the vitamin D status and the risk for vitamin D deficiency in prepubertal children with both T1D and CD compared to controls, TID, and CD.

Subjects and Methods. Characteristics of 62 prepubertal children of age 2–13 y with either CD + T1D (� = 22, 9.9 ± 3.1 y), CD only (� = 18, 8.9 ± 3.3 y), or T1D only (� = 22, 10.1 ± 2.8 y) were compared to 49 controls of …

Locus Of Control And Obesity, Florence Neymotin, Louis R. Nemzer

Chemistry and Physics Faculty Articles

In the developed world, the hazards associated with obesity have largely outstripped the risk of starvation. Obesity remains a difficult public health issue to address, due in large part to the many disciplines involved. A full understanding requires knowledge in the fields of genetics, endocrinology, psychology, sociology, economics, and public policy - among others. In this short review, which serves as an introduction to the Frontiers in Endocrinology research topic,we address one cross-disciplinary relationship: the interaction between the hunger/satiation neural circuitry, an individual's perceived locus of control, and the risk for obesity. Mammals have evolved a complex system for modulating …

A Potential Role For Adjunctive Vitamin D Therapy In The Management Of Weight Gain And Metabolic Side Effects Of Second-Generation Antipsychotics, Benjamin U. Nwosu, Bruce Meltzer, Louise Maranda, Carol A. Ciccarelli, Daniel Reynolds, Laura A. Curtis, Jean A. King, Jean A. Frazier, Mary M. Lee

Mary M. Lee

Second-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a five-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their financial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best …

Preliminary Efficacy Of Group Medical Nutrition Therapy And Motivational Interviewing Among Obese African American Women With Type 2 Diabetes: A Pilot Study, Stephania T. Miller, Veronica J. Oates, Malinda A. Brooks, Ayumi Shintani, Tebeb Gebretsadik, Darlene M. Jenkins

Human Sciences Faculty Research

Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT) intervention, using motivational interviewing (MI). Research Design & Method. African American (AA) women with type 2 diabetes (T2D) participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24) were …

Osteopontin: A Novel Regulator At The Cross Roads Of Inflammation, Obesity And Diabetes, Florian Kahles, Hannes M. Findeisen, Dennis Bruemmer

Gill Heart & Vascular Institute Faculty Publications

Since its first description more than 20 years ago osteopontin has emerged as an active player in many physiological and pathological processes, including biomineralization, tissue remodeling and inflammation. As an extracellular matrix protein and proinflammatory cytokine osteopontin is thought to facilitate the recruitment of monocytes/macrophages and to mediate cytokine secretion in leukocytes. Modulation of immune cell response by osteopontin has been associated with various inflammatory diseases and may play a pivotal role in the development of adipose tissue inflammation and insulin resistance. Here we summarize recent findings on the role of osteopontin in metabolic disorders, particularly focusing on diabetes and …

Obesity And Diabetes Cause Cognitive Dysfunction In The Absence Of Accelerated Β-Amyloid Deposition In A Novel Murine Model Of Mixed Or Vascular Dementia, Dana M. Niedowicz, Valerie L. Reeves, Thomas L. Platt, Katharina Kohler, Tina L. Beckett, David K. Powell, Tiffany L. Lee, Travis R. Sexton, Eun Suk Song, Lawrence D. Brewer, Caitlin S. Latimer, Susan D. Kraner, Kara L. Larson, Sabire Özcan, Christopher M. Norris, Louis B. Hersh, Nada M. Porter, Donna M. Wilcock, Michael Paul Murphy

Sanders-Brown Center on Aging Faculty Publications

Mid-life obesity and type 2 diabetes mellitus (T2DM) confer a modest, increased risk for Alzheimer's disease (AD), though the underlying mechanisms are unknown. We have created a novel mouse model that recapitulates features of T2DM and AD by crossing morbidly obese and diabetic db/db mice with APP^ΔNL/ΔNLx PS1^P264L/P264L knock-in mice. These mice (db/AD) retain many features of the parental lines (e.g. extreme obesity, diabetes, and parenchymal deposition of β-amyloid (Aβ)). The combination of the two diseases led to additional pathologies-perhaps most striking of which was the presence of severe cerebrovascular pathology, including aneurysms and small …

Resveratrol And Cancer: Focus On In Vivo Evidence, Lindsay G. Carter, John A. D'Orazio, Kevin J. Pearson

Graduate Center for Nutritional Sciences Faculty Publications

Resveratrol is a naturally occurring polyphenol that provides a number of anti-aging health benefits including improved metabolism, cardioprotection, and cancer prevention. Much of the work on resveratrol and cancer comes from in vitro studies looking at resveratrol actions on cancer cells and pathways. There are, however, comparatively fewer studies that have investigated resveratrol treatment and cancer outcomes in vivo, perhaps limited by its poor bioavailability when taken orally. Although research in cell culture has shown promising and positive effects of resveratrol, evidence from rodents and humans is inconsistent. This review highlights the in vivo effects of resveratrol treatment on breast, …

Lean Body Mass May Explain Apparent Racial Differences In Carotid Intima-Media Thickness In Obese Children., Shahryar M. Chowdhury, Melissa H. Henshaw, Brad Friedman, J Philip Saul, Girish S. Shirali, Janet Carter, Bryana M. Levitan, Tom Hulsey

Manuscripts, Articles, Book Chapters and Other Papers

Background: Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.

Methods: Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.

Results: A total of 120 subjects (46 white, 74 …

Fact Sheet #2: How Do Mainecare Providers Perform On Childhood Screening And Prevention?, Jean A. Talbot Phd, Mary Lindsey Smith Phd, Msw, Kimberley S. Fox Mpa

Population Health & Health Policy

The annual Survey of Children Served by MaineCare, which collects a wealth of data on the experiences of MaineCare families, examines the extent to which MaineCare providers follow Bright Futures guidelines during well-child visits. This fact sheet presents findings on Bright Futures adherence from the 2013 survey.

Treatment Of Adult Obesity With Bariatric Surgery, Robin Schroeder, Jordan Garrison, Mark Johnson

Robin S. Schroeder MD

Bariatric surgery procedures, including laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, and Roux-en-Y gastric bypass, result in an average weight loss of 50 percent of excess body weight. Remission of diabetes mellitus occurs in approximately 80 percent of patients after Roux-en-Y gastric bypass. Other obesity-related comorbidities are greatly reduced, and health-related quality of life improves. The Obesity Surgery Mortality Risk Score can help identify patients with increased mortality risk from bariatric surgery. Complications and adverse effects are lowest with laparoscopic surgery, and vary by procedure and presurgical risk. The Roux-en-Y procedure carries an increased risk of malabsorption sequelae, which can …

The Relationship Between Subnormal Peak-Stimulated Growth Hormone Levels And Auxological Characteristics In Obese Children, Jefferson Barrett, Louise S. Maranda, Benjamin U. Nwosu

Benjamin U. Nwosu

Context: The hypothesis that obese children are overdiagnosed with growth hormone deficiency (GHD) has not been adequately investigated in the context of adiposity-related differences in auxology.

Aim: To investigate the differences in auxological parameters between short, prepubertal, obese children, and normal-weight peers who underwent growth hormone stimulation testing (GHST).

Hypothesis: Over-weight/obese children with GHD [peak growth hormone (GH) < 10 μg/L] will have higher values for growth velocity (GV) standard deviation score (SDS), bone age minus chronological age (BA − CA), and child height SDS minus mid-parental height (MPTH) SDS when compared to normal-weight GHD peers.

Subjects and Methods: A retrospective review of anthropometric and provocative GHST data of 67 prepubertal, GH-naïve children of age 10.21 ± 2.56 years (male n = 45, age 10.8 ± 2.60 years; female n = 22, age 8.94 ± 2.10). Inclusion …

Effect Of The Planet Health Intervention On Eating Disorder Symptoms In Massachusetts Middle Schools, 2005-2008, S. Bryn Austin, Jennifer L. Spadano-Gasbarro, Mary L. Greaney, Emily A. Blood, Anne T. Hunt, Tracy K. Richmond, Monica L. Wang, Solomon Mezgebu, Stavroula K. Osganian, Karen E. Peterson

Monica L. Wang

INTRODUCTION: The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. METHODS: Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous …

Low Birth Weight Male Guinea Pig Offspring Display Increased Visceral Adiposity In Early Adulthood., Ousseynou Sarr, Jennifer A Thompson, Lin Zhao, Ting-Yim Lee, Timothy Regnault

Paediatrics Publications

Uteroplacental insufficiency (UPI)-induced intrauterine growth restriction (IUGR) predisposes individuals to adult visceral obesity. We postulated that low birth weight (LBW) offspring, from UPI-induced IUGR pregnancies, would display a visceral adipose lipogenic molecular signature involving altered gene expression, phosphorylation status of proteins of the lipid synthesis pathway and microRNA (miR) expression profile, occurring in association with increased visceral adiposity. Normal birth weight (NBW) and LBW (obtained by uterine artery ablation) male guinea pig pups were fed a control diet from weaning to 145 days and sacrificed. Despite being lighter at birth, LBW pups displayed body weights similar to NBW offspring at …

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …

Creating Patient Instructions For Community Health Resources, Kevin Saiki

Family Medicine Clerkship Student Projects

In the US, more than a third of adults are obese as well as 17% of children. A recent report estimates the annual cost of obesity in Maine amounts to approximately 452 million dollars. Additional reports estimate the cost of obesity to the entire country lies somewhere between 10-30 billion annually.

Encouraging patients to have healthy diet rich with whole grains, fruits, and vegetables, and to maintain regular exercise (150 minutes a week) are effective ways to combat higher BMIs and to stave off associated hypertension, coronary artery disease, type II diabetes, and dyslipidemia.

Ethical Dilemmas Posed In The Care Of Obese Patients In The Emergency Department, Arvind Venkat, Gregory Luke Larkin

Journal of Health Ethics

The rising prevalence of obesity represents a health care crisis. As the gateway to the health care system, the emergency department is the clinical setting where the difficulties posed by the care of obese patients are heightened. These difficulties include the increasing burden of obesity-related illnesses, the challenges posed in diagnostic evaluation and treatment and the known barriers to access to care seen in this patient population. The limitations posed by obesity on care in the emergency department, the one guaranteed access point for medical treatment, creates a series of ethical dilemmas for emergency physicians and the facilities in which …

Food For Thought: Nutrition Education And Nutrient Delivery At Two Local Elementary Schools, Jenna Bodmer

Family Medicine Clerkship Student Projects

I designed a 20 minute powerpoint presentation and delivered it to healthcare providers in the area.
- Discussed the growing problem of obesity, and new federal regulations designed to curb it - Summarized data gathered in interviews at both schools
- Compared schools to each other
- Suggested changes that each school could make in the future
- Offered suggestions for changes in office practices and office collaboration with schools, for PCP's in the area

Summer Physical Activity Log And Reward System For Children In Colchester, Vermont, Bryce Edwards

Family Medicine Clerkship Student Projects

- Childhood obesity has doubled in children and quadrupled in adolescents in the past 30 years.
- As of 2012, over 1/3 of children and adolescents in the United States are overweight or obese.
- A study from the CDC estimates that 1 in 3 children born In the year 2000 will develop diabetes in their lifetime.
- Obese children are at an increased risk for developing cardiovascular disease, diabetes and pre-diabetes, joint problems, sleep apnea, as well as social and psychological problems stemming from stigmatization and poor self-esteem. Overweight and obesity are also risk factors for multiple types of …

Community Resources For Elevated Bmi In Downeast, Me, Nicolas Monte

Family Medicine Clerkship Student Projects

The US is currently mired in a decades-long battle against an epidemic of obesity. ­According to the CDC 69.2% of the US population over the age of 20 is either overweight or obese. As primary care clinics move towards becoming “Patient-Centered Medical Homes” the need exists to provide adequate and specific educational materials.­While a great wealth of educational resources exist to inform patients about the nature and pathogenesis of individual diseases, access to specific local treatment tools is lacking. Although nearly all clinicians screen patients for elevated BMI and provide general information about general healthy habits, this is often the …

Using Local Resources To Build Strong, Healthy Families, Cornelia Willis

Family Medicine Clerkship Student Projects

Although obesity rates across all demographics continue to climb annually, when separated into income levels, the prevalence of obesity in poor adults and children are rising at a greater rate than middle class individuals. A recent publication by the Food Research and Action Center (FRAC) compiled a list of data points that indicated that, while the trend is gradually slowing, rates of severe obesity are about 1.7 times greater in children coming from families whose incomes fell below the poverty line than equal counterparts in the middle class income bracket. High fat, high carb foods are often the staple of …

“A Little On The Heavy Side”: A Qualitative Analysis Of Parents' And Grandparents' Perceptions Of Preschoolers' Body Weights, Karin Eli, Kyndal Howell, Philip Fisher, Paulina Nowicka

Karin Eli

Objectives: Parents’ difficulties in perceiving children's weight status accurately pose a barrier for family-based obesity interventions; however, the factors underlying weight misinterpretation still need to be identified. This study's objective was to examine parents and grandparents’ perceptions of preschoolers’ body sizes. Interview questions also explored perceptions of parental responsibility for childhood obesity and appropriate contexts in which to discuss preschoolers’ weights. Design: Semistructured interviews, which were videotaped, transcribed and analysed qualitatively. Setting: Eugene and the Springfield metropolitan area, Oregon, USA Participants: Families of children aged 3–5 years were recruited in February—May 2011 through advertisements about the study, published in the …