Medicine and Health Sciences Commons^™

Greenspace Across The United States: Exploring Equity And Associations With Physical Activity, Obesity, And Health-Related Quality Of Life, Ellen W. Stowe

Theses and Dissertations

Neighborhood greenspace is important for health and well-being but may not be equitably present in neighborhoods across the United States. Also, many adults are physically inactive, have obesity, and report poor health-related quality of life. Greenspace has been tied to these health conditions, but with mixed findings. The purpose of this study was to 1) use an environmental justice perspective to examine variations in 11 measures of greenspace by neighborhood race/ethnicity, income, and rurality in block groups across the contiguous United States and 2) examine 11 greenspace measures in connection to physical activity, obesity, and health-related quality of life in …

Effects Of Macronutrients Intake And Physical Activity On Childhood Obesity Of Hispanic Children, Prosanta Barai

Theses and Dissertations

Obesity has become more ubiquitous during the past few decades, and still, its prevalence is increasing. It is in every population in the world and all regions, including rural parts of low and middle-income countries. In the USA, regardless of age, the severity of obesity is no different from the global trend. Although numerous pieces of literature are available, that tried to find answers to some pressing issues like how obesity can be controlled, but there is little to no study focused on younger children, especially the 4-6-year-old Hispanic population. Our study aimed to determine the causal path among literature …

A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading

Theses and Dissertations

Background

Lifestyle intervention is the first line treatment for obesity. Yet, young men are underrepresented in lifestyle interventions, which is posited to be the result of unmet needs and overall low concern for weight management. The aims of this dissertation are to:

Papers 1 and 2: Test the preliminary efficacy, feasibility, and acceptability of a self-guided lifestyle intervention for young men.

Paper 3: Explore the behavioral and physiological factors associated with changes in adiposity among young men and women enrolled in a more intensive lifestyle intervention.

Results

Papers 1 and 2: The self-guided intervention produced modest weight …

The Moderating Effects Of Parenting Factors And Perceived Stress On African American Adolescent Weight Related Outcomes, Colby Kipp

Theses and Dissertations

African American adolescents experience a higher prevalence of obesity than nonminorities with approximately 40% being overweight or obese. Chronic stress, both among parents and adolescents, may be important to consider when assessing the factors that influence adolescent weight status. Baseline data were collected from one hundred forty eight African American adolescents (M_age = 12.93, SD = 1.75; M_BMI% = 96.7, SD = 3.90) and their caregivers (M_age = 44.5, SD = 8.6; M_BMI = 37.63, SD = 8.21) enrolled in the Families Improving Together (FIT) for Weight Loss trial. Adolescents self-reported their perceptions of …

Gestational Infections And Obesity: Implications For Intellectual Disability Risk, Maggie S. J. Mccarter

Theses and Dissertations

Maternal body weight, measured as Body Mass Index (BMI) and infection during pregnancy are established risk factors of multiple adverse birth outcomes that are also associated with intellectual disability (ID) in children, but little is known of the interaction of these two factors. This retrospective cohort study sought to explore whether BMI is an effect modifier in the association between maternal infection during pregnancy and ID of the child, and to make comparisons between categories of gestational infection. The study sample (n= 124,047 after exclusion) was derived from Medicaid administrative data. After preliminary analysis of interaction, stratified logistic regression analysis …

Examining Body Mass Index And Sepsis Mortality At One Year After Sepsis, Jamie D. Robinson

Theses and Dissertations

Introduction: Sepsis is a serious and life-threatening syndrome affecting 1.7 million Americans annually and resulting in approximately 270,000 deaths. An “obesity paradox” where obese individuals have lower sepsis mortality than their non-obese counterparts has been described. The problem is that the longevity of the effect is unknown, and few studies have examined the obesity paradox after 1-2 months post-diagnosis.

Methods: This retrospective cohort study examined clinical, demographic, and biomarker variables thought to affect sepsis mortality at three-time points: 30 days, 180 days, and at one year post-sepsis diagnosis in order to shed light on specific factors that might define …

Obesity Suppresses Pigment Epithelium-Derived Factor And Alters Pro-Tumorigenic Signaling Pathways In Prostate Cancer, Nizar Ahmed Khamjan

Theses and Dissertations

Background: Pigment epithelium-derived factor (PEDF), a multifunctional protein, is a potent tumor suppressor and anti-angiogenic factor. PEDF has been identified as a novel regulator of lipid metabolism via binding and activating adipose triglyceride lipase, which stimulates lipolytic pathways. PEDF-deficient mice develop prostatic hyperplasia that progresses to cancer when these mice are fed a high fat diet (HFD). PEDF expression is decreased in prostate cancer (PCa) patient tissues. Conversely, PEDF treatment inhibits PCa growth in mouse models. Recently, our lab has demonstrated that excess oleic acid (OA) treatment, an in vitro obesity model, suppresses secreted PEDF expression in PCa cell lines …

Macrophages And Associated Inflammation Differentially Impact Obesity, Colorectal Cancer And Obesity-Enhanced Colorectal Cancer, Jackie Bader

Theses and Dissertations

Colorectal Cancer (CRC) is the third-most common malignancy for men or women, with chronic inflammation considered as a primary risk factor. Obesity is also considered a chronic inflammatory disease and is associated with increased CRC incidence. Further, obesity and CRC occur in men and women differently with the highest incidence of either disease found in men, suggesting that female sex hormones may play a protective role in inflammatory diseases. Macrophages can promote inflammation and are a driving force in obesity-associated metabolic dysfunction. Conversely, macrophages also contribute to pro-tumoral responses including, proliferation, angiogenesis and tissue remodeling. This heterogeneity of macrophage behavior …

The Contribution Of Adipose Tissue From Ovariectomized Mice To Colon Cancer, Meredith Smith Carson

Theses and Dissertations

Obesity is considered a major public health concern worldwide due to the increased incidences of metabolic dysfunction and cancer risk. The obese state is, in part, attributable to the overconsumption of calorie-dense foods commonly seen in a standard Western diet, which aids in the progression of chronic, lowgrade inflammation. The role of estrogen varies depending on menopausal status, where estrogen deficiency coupled with increased visceral fat associated with post-menopause leads to increased secretions of pro-inflammatory adipokines and cytokines. However, the presence of estrogen in a premenopausal state has been shown to attenuate the pro-inflammatory response, which has been demonstrated when …

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

Health, Wellness, And The Health Care Experiences Of Female Adolescents Living With Increased Weight, April L. Yerges

Theses and Dissertations

Clinic-based health care encounters (HCEs) remain a beneficial setting for early assessment, identification and treatment of overweight in adolescents. The purpose of this study is to describe how female adolescents who are obese or overweight perceive the health care encounter with a particular focus on obesity. Using a qualitative design, a purposive sample of 28 English speaking female adolescents, 13–19 years of age, who were overweight or obese, participated in in-depth interviews. Five themes emerged from the thematic analysis: Mental and physical wellness, The impact of weight, Cause I’m a teenager, Talking about weight affects me, and Help me instead …

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

Association Between Hispanic Parents' Attitudes And Knowledge Regarding Obesity And Their Children's Body Mass Index: Implications For The Development Of Obesity, Renee Starr

Theses and Dissertations

According to the World Health Organization (WHO, 2017), more than 1.9 billion adults age 18 and older are overweight and over 650 million are obese. Data collected through the Centers for Disease Control indicates the prevalence of U.S. adults who are overweight and obese is estimated at 36.5% and the national childhood obesity rate is more than 12.7 million (17%), with approximately one in six school-aged children reaching the obesity level (Ogden, Carroll, Fryar, & Flegal, 2015). Hispanic children have the highest levels of obesity among all racial/ethnic groups (21.9%) and obesity rates are especially prevalent among impoverished Hispanics residing …

Do Healthcare Professionals With High Weight Biases Provide Different Quality Of Care To Obese Compared To Normal Weight Patients?, Justine Leigh Seymour

Theses and Dissertations

Though weight bias has been acknowledged in the health field, it is less understood if and how weight bias affects quality of care. The purpose of this study was to determine if weight bias exhibited by healthcare professionals (HCPs) impacts quality of healthcare provided to obese individuals. HCPs (n=220; 88% female, 87% nurses) in the Midwest region of the United States were recruited to complete an online survey. Participants completed the Attitude Towards Obese Persons scale (ATOP) to assess weight bias and responded to hypothetical patient scenarios to evaluate quality of care. A median split was calculated for ATOP scores …

Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, Daria M. Mcmahon

Theses and Dissertations

Background: Chronotype, social jetlag, poor sleep, proinflammatory diet, and low physical activity have been associated with increased risk of chronic diseases: obesity, diabetes, cardiovascular disease, depression and cancer. Yet the relationships between these factors have not been extensively investigated in prospective studies.

Methods: Two studies were conducted. The first study followed 390 healthy men and women ages 21-35 for two years. Social jetlag [SJL] and sleep measures (total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO]), sleep efficiency [SE]), were derived from physical activity personal (armband) monitoring. The participants wore the armband for 4-10 …

Obesity And Asthma: Adiponectin Receptor 1 (Adipo R1) And Adiponectin Receptor 2 (Adipo R2) Are Expressed By Normal Human Bronchial Epithelial (Nhbe) Cells At Air-Liquid Interface (Ali) And Expression Changes With Il-13 Stimulation, Jennifer L. Bradley

Theses and Dissertations

Obesity is recognized as an important risk factor for the development of many chronic diseases such as hypertension, Type 2 diabetes mellitus (T2DM) cardiovascular disease, cancer, renal disease, neurologic dysfunction, metabolic syndrome and asthma (3, 4). Circulating serum adiponectin levels in obese asthmatics have been reported to be low. Therefore, we aimed to investigate the role of adiponectin in a mucus hypersecretion model and hypothesized that adiponectin would decrease IL-13 induced MUC5AC expression from differentiated NHBE cells and that increasing concentrations of IL-13 would cause a decrease in Adipo R1 and Adipo R2 expression. MUC5AC expression with exposure to adiponectin …

Influence Of Built Environment On Physical Activity Outcomes Among African Americans In Community-Based Obesity Intervention Studies, Amanda Sue Thomas

Theses and Dissertations

More than sixty-five percent of people in the U.S. are considered overweight or obese. African-Americans in the U.S. have a higher risk of obesity than any other racial group. One way to reduce this statistic is physical activity. Recreational green spaces (parks) can serve as an avenue to complete the 150 min/wk of recommended physical activity for adults by the ACSM. Data from SISTAS and HEALS interventions, that recruited overweight/obese African-Americans from Columbia and Florence, SC, was used to assess the association of recreational green space (parks) around a residence and physical activity. Physical activity measures of RAPA questionnaire (self-report), …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

An Exploration Of Factors Influencing Attrition From A Pediatric Weight Management Intervention, Melissa Ann Kwitowski

Theses and Dissertations

Childhood obesity is a serious health problem in the United States. Numerous weight management programs attempt to address this issue. However, attrition poses significant treatment efficacy challenges. Understanding attendance and attrition from childhood obesity programs is crucial for effective and appropriate resource utilization. NOURISH+ is a community-based treatment program for parents of overweight and obese children (age 5–11 years, BMI ≥ 85th percentile). The current study investigated attrition from NOURISH+ to enhance understanding of pediatric obesity treatment retention factors. NOURISH+ participants (n=70) completed a questionnaire assessing barriers to adherence and general program feedback. Data were analyzed using frequencies, …

Periodontal Microorganisms, Obesity, Chronic Inflammation, And Type 1 Diabetes, Georges Joseph Nahhas

Theses and Dissertations

Periodontal disease is a low-grade chronic inflammation in the tissues surrounding the teeth caused by multiple, mostly gram-negative pathogens. It is associated with diabetes, obesity, and chronic inflammation. The specific roles that periodontal microorganism play in these conditions are not well-studied. Hereby, we explored how periodontal bacteria from sub gingival plaque clustered in youth with and without type 1 diabetes, and how such patterns related to body-mass-index percentile (BMI percentile), C-reactive protein (CRP) and adiponectin. Cross-sectional data were collected from 105 youth with type 1 diabetes and 71 without diabetes. Participants were between 12 and 19 years of age receiving …

Exploring The Association Between Depression And Obesity Among Alzheimer's Patients, Stephanie Clugstone

Theses and Dissertations

Alzheimer’s disease (AD) is a neurological disorder that affects elderly individuals, and is becoming an increasing concern among the aging population of the world. Due to the projected increase in incidence of AD, modifiable risk factors such as depression and obesity should be evaluated, as prevention is the only current option. This study aimed to determine the prevalence of obesity and depression among AD patients, and to evaluate the association between depression and obesity. Patients were chosen from a subset of the South Carolina Alzheimer’s disease registry, which included information about weight status and depression, as well as several other …

The Effect Of Obesity On Il-1Β, Il-1ra, And Leptin Following Acute Mental Stress, Heather Caslin

Theses and Dissertations

Research regarding the development of cardiovascular disease (CVD) is important because CVD is the leading cause of death in the United States (US) and many countries abroad. Risk factors, such as obesity and psychological stress, should be studied in order to understand contributing factors for CVD and the cellular mechanisms which link risk factors with the development of disease. Specifically, the combined influence of multiple risk factors on inflammation is of interest because many individuals have more than one risk factor, which additively increases an individual’s risk for CVD. Obesity is already characterized by disordered inflammation, which suggests that the …

Metformin-Induced Pedf Expression Regulates Cell Proliferation And Lipid Metabolism In Prostate Cancer Cells, Miguel Angel Tolentino

Theses and Dissertations

Prostate cancer (PCa) is one of the most common cancers in American males. A high fat diet and obesity accelerate PCa progression and increase the 1risk of death from disease. Epidemiological studies have indicated that PCa patients with type 2 diabetes have higher mortality rates than PCa patients without diabetes. Type 2 diabetics who are on metformin, a drug to control blood sugar levels, show a delay in PCa progression in comparison with PCa patients with type 2 diabetes who are not on metformin. It has been proposed that metformin inhibits proliferation via activation of AMP-activated protein kinase (AMPK) or …

High Fat Diet Induced Obesity In A Mouse Model For Colorectal Cancer, Kennerly Clinton Patrick

Theses and Dissertations

Obesity is widely correlated with the incidence of colorectal cancer (CRC). The exact mechanisms that link obesity to CRC risk have not yet been fully established, and only a limited number of animal models are available to study pathways involved in obesity-related colon carcinogenesis. The objective of this study was to determine the influence of HFD-induced obesity on AOM/DSS-mediated colorectal tumorigenesis, tumor proliferation, and symptom severity. Male C57BL/6 mice were fed a novel high fat diet, designed to mimic the standard American diet (12 % saturated fat & 28 % unsaturated fat), at 4 weeks of age until 16 weeks …

Linking Obesity To Colorectal Cancer: Recent Insights Into Plausible Biological Mechanisms, Catherine Guffey

Theses and Dissertations

Obesity has emerged as a leading environmental risk factor for the development of CRC. However, the mechanisms underlying this relationship have not yet been fully explained. Recent literature has focused on 1) inflammatory processes, 2) adipokines, and 3) estrogen. Obesity-enhanced inflammation is largely orchestrated by increases in adipose tissue macrophages leading to the secretion of TNF-alpha, MCP-1, and IL-6, all of which are linked to CRC. Adiponectin is decreased with obesity and has been reported to be negatively associated with CRC, while leptin, which is increased, is positively associated with the disease. Estrogen has been shown to influence CRC, although …

Bmi At Diagnosis And Its Association With Markers Of Hiv Disease Progression And Cardiovascular Disease Risk., Kelly Deshon Johnson

Theses and Dissertations

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with …

Text Messaging As Adjunct To Community Based Weight Management Program, Claudia Bouhaidar

Theses and Dissertations

Obesity ascending rates are still a public health priority. The primary aim of the study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pre and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support and physical activity were assessed at baseline and at 12 …

On The Genetic And Environmental Associations Between Body Composition, Depression Symptoms And Smoking Behavior., Roseann Peterson

Theses and Dissertations

Obesity is a serious public health crisis and recent estimates of its incidence are the highest in United States history, with 35% and 17% of American adults and children affected, respectively. The clinical definition of adult obesity is operationalized as a body mass index (BMI) greater than 30 kg/m2. Although the prevalence of common obesity has increased dramatically over the past 30 years–largely thought to be due to changes in the environment, such as high calorie diets and sedentary lifestyles—twin and family studies have shown consistently that relative body weight is under considerable genetic influence in both children and adults, …

Relationship Of Demographic Characteristics And Bmi With Health Literacy In Pacific Islander Care-Giving Adults, Sharla E. Morgan

Theses and Dissertations

Purpose: Health literacy and obesity are major global issues. Vulnerable populations, such as those with low health literacy, have the highest rates of obesity. Native Hawaiian and other Pacific Islander (NHOPI) nations have the highest prevalence of obesity in the world. This study describes the relationship between health literacy and demographic variables in a sample of NHOPI caregiving adults. Methods: We conducted a correlational study of 364 NHOPI adults. Each was a caregiver of at least one NHOPI child. Data were collected at grocery stores and a preschool in two Hawaiian Islands (n=209) and at NHOPI events in Utah (n=155). …

The Relationship Between Select Demographic Characteristics And Body Mass Index Among Native Hawaiian And Other Pacific Islander Caregiving Adults, Katrina Duncan

Theses and Dissertations

Purpose: Native Hawaiian and other Pacific Islanders (NHOPIs) have the highest prevalence of overweight and obesity in the world. This study identified the proportion of our NHOPI sample in each body mass index (BMI) category and explored relationships between demographic characteristics and BMI. Design: This descriptive correlational study included 364 NHOPI caregiver adults in Utah (n=155) and Hawaii (n=209). We gathered demographic information with a questionnaire. Height and weight were measured for BMI calculations. Results: According to the CDC's BMI categories, 84.3% of our sample was overweight (BMI=25.0-29.9) or obese (BMI ≥30). Participants in Utah had significantly higher BMIs than …