Medicine and Health Sciences Commons^™

Discovery Of Genetic Pleiotropy For Obesity And Inflammation And Mediation In Identified Variants Through Obesity-Related Pathways, Yiqian Wenren

Public Health Theses

Genetic data suggest that obesity and inflammation shared a portion of their genetic architectures. Meanwhile, epidemiologic data suggest a causal link between obesity and inflammation. Therefore, we hypothesized that there are variants in the human genome that display pleiotropy for obesity and inflammation and that the effects of at least some of those variants could be mediated by obesity-related pathways. To test these hypotheses, we conducted univariate genome-wide association analyses of obesity-related traits (BMI and WHRadjBMI) and inflammation (CRP) in the UK Biobank (n= 291,396 Caucasian subjects), searched for overlapping signals, fine-mapped the regions to identify putative causal SNPs, and …

United States Long-Term Trends In Adult Bmi From 1959 To 2018 By Income, Education, And Race/Ethnicity, Julia Banas

Public Health Theses

Obesity prevalence has increased dramatically since the 1950s. While cross-sectional comparisons across racial, ethnic, and socioeconomic groups are abundant, there is less work on long-term trends. We assessed trends in average adult body mass index (BMI) in the United States by income, education, and racial/ethnic groups from 1959 to 2018 using the National Health and Nutrition Examination Survey, which assesses repeated cross-sectional, representative samples of the United States population. Height, weight, income, education, and race variables were extracted from raw data files; income data was converted to constant dollars prior to analysis. BMI was calculated from height and weight measurements. …

Acute And Chronic Liver Disease: Lessons Learned From Retrospective Cohort Studies, Ysabel C. Ilagan-Ying

Yale Medicine Thesis Digital Library

Current trends in liver disease are changing due to increased access to pharmacotherapies and the worsening burden of obesity. Large, observational cohort studies are a common tool in clinical and epidemiological research to determine risk for patients that may have experienced an exposure of interest. Past studies have largely examined risk factors for liver disease in patients with cirrhosis or fatty liver disease. We utilized retrospective cohort studies in a disease-agnostic approach and aimed to characterize risk for two increasingly prevalent populations: patients with severe acute liver injury and those with liver fibrosis progressing to hepatocellular carcinoma (HCC).

First, we …

So You Think You Can Exercise: The Gap Between Exercise Confidence And Physical Activity Among Samoan Adults, Diksha Brahmbhatt

Public Health Theses

Samoa is experiencing one of the highest prevalence of overweight and obesity in the world, placing its population at increased risk of developing several noncommunicable diseases including type 2 diabetes and cardiovascular disease. The role of physical activity in reducing the burden of these diseases and overweight is well-established. Exercise self-efficacy or confidence is a predictor, if not determinant, of recreational physical activity. The purpose of this study, therefore, is to assess the relationship between exercise confidence and levels of recreational physical activity among Samoan adults. We confirm that exercise confidence is correlated with time spent exercising. However, despite considerable …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Exploring The Role Of Dopamine Circuits In Eating Behavior, Kara Elizabeth Furman

Yale Medicine Thesis Digital Library

In its simplest terms, obesity is a disease of exaggerated food intake. While current treatment of obesity focuses on changing behavior, few successful models of behavior modification have been developed. Even those treatments that are successful in the short-term, have failed to demonstrate lasting effect. The problem of over-eating, then, needs to be studied in terms of basic motivational programs that are encoded by the brain’s reward system. Understanding the way in which reward system activity directs eating behavior will allow more sophisticated and efficacious treatment options in the future. Several studies have focused on the nucleus accumbens (NAc) as …

Thinking Beyond Health To Motivate Dietary Change: Piloting A Vegan Healthy Eating Program For Obesity Management, Mark Alan Berman

Yale Medicine Thesis Digital Library

This pilot study assessed the feasibility, acceptability and efficacy of a novel approach to facilitating dietary change and weight loss in obese adults by presenting vegan environmental, health and farm animal treatment information in a 6 week, group-based, educational nutrition program (called a vegan healthy eating program). Twenty-nine (29) medically stable, obese adults were recruited from 3 ambulatory care clinics at UCSF and enrolled using partial randomization into one of two serially occurring intervention groups (Group 1 n=14, followed by Group 2 n=15). A delayed intervention control group (n=9) was used, consisting of participants enrolled in Group 2 who were …