Digital Commons Network^™

Missed Opportunities: Documentation And Referral Rates Among Children And Adults With Obesity, Heidi Walls, Christina Holt, Amy Haskins Phd, Williams Dexter

Journal of Maine Medical Center

Introduction: Our study reports rates of obesity documentation on the problem list (PL) and numbers of referrals to obesity medicine specialists and dietitians among pediatric and adult patients with obesity.

Methods: All pediatric and adult patients with obesity seen at 14 primary care clinics between 7/1/2017 and 6/30/2019 were evaluated for inclusion of obesity on the PL and referrals to obesity medicine specialists or dietitians.

Results: For children with BMI >95% for age, obesity was documented in 31.2%, and 12.5% received a referral. For adults with BMI >30, obesity was documented in 54.2%, and 8.4% received a referral. Significantly more …

The Influence Of Tas2r38 Bitter Taste Gene Polymorphisms On Obesity Risk In Three Racially Diverse Groups, Chaowanee Chupeerach, Pradtana Tapanee, Nattira On-Nom, Piya Temviriyanukul, Boonrat Chantong, Nicole Reeder, Grace A. Adegoye, Terezie Tolar-Peterson

BioMedicine

Objectives: Bitter taste perception affects food preference, eating behavior, and nutrient intake. The purpose of this study was to investigate the contribution of bitter taste gene polymorphisms to body fatness as measured by percentage of body fat.

Method: Three common single nucleotide polymorphisms (SNPs) of the TAS2R38 gene which result in amino acid changes in the protein (A49P, V262A, and I296V), were studied in three racially diverse groups: European Americans n=313, African Americans n=109, and Asians n=234.

Results: The allele frequencies of the three SNPs were similar to previous studies. The rare haplotypes, AAI and AAV, were found in high …

Racial And Socioeconomic Disparities Influencing Obesity Amongst Middle-Aged Women, Morgan Woods

Master of Science in Integrative Biology Theses

Many studies have examined the effects of racial and socioeconomic differences on health-related disparities involving obesity but, few have examined the mental and physical well-being intersection. Obesity is a disease that affects many Americans and has become an epidemic affecting the American population. Obesity, especially morbid obesity, is a risk factor for many other obesity-related diseases such as diabetes, cardiovascular diseases, hypertension, and more. Using the 2018 Healthcare Avoidance Study, differences were found between two racial groups, Caucasian and African-American women. Race was found as a significant factor for both level of physical activity and ideal body image perception

Dietary Blueberry And Soluble Fiber Improve Serum Antioxidant And Adipokine Biomarkers And Lipid Peroxidation In Pregnant Women With Obesity And At Risk For Gestational Diabetes, Arpita Basu, Jeannette Crew, Jeffrey L. Ebersole, Jefferson W. Kinney, Arnold M. Salazar, Petar Planinic, James M. Alexander

Kinesiology and Nutrition Sciences Faculty Research

Pregnancies affected by obesity are at high risk for developing metabolic complications with oxidative stress and adipocyte dysfunction contributing to the underlying pathologies. Few studies have examined the role of dietary interventions, especially those involving antioxidants including polyphenolic flavonoids found in fruits and vegetables on these pathologies in high-risk pregnant women. We conducted an 18 gestation-week randomized controlled trial to examine the effects of a dietary intervention comprising of whole blueberries and soluble fiber vs. control (standard prenatal care) on biomarkers of oxidative stress/antioxidant status and adipocyte and hormonal functions in pregnant women with obesity (n = 34). Serum samples …

A Sled Dog Model For Positive Health Effects Of Weight Management And Exercise, Laura Kay Falkenstein

Chemistry and Biochemistry

Hypertrophic white adipose tissue found in obesity leads to chronic inflammation and reduced insulin sensitivity, bringing rise to a myriad of diseases and is a significant risk factor for premature death. Obesity can be combatted with physical activity, dietary restrictions, or a combination of the two. However, exercise training regardless of changes in body weight has been shown to improve metabolic health. Expanding on a previous study of changes in metabolic biomarkers upon weight gain and after a period of athletic conditioning, in this project we used a sled dog model to examine biomarker shifts over a course of sedentary …

Perceptions Of Pediatric Obesity In The Rural Community Setting, Kathyrn Smith

Group: Samford University Moffett & Sanders School of Nursing

In the United States, pediatric obesity remains an unresolved epidemic. Locally, children in the rural Mississippi community of Houston suffer from pediatric obesity or being overweight. The Mississippi Kids Count (2019), reports that 13.1% of children ages 10-17 are overweight and 26.1% of children ages 10-17 are obese.

The purpose of this project is to apply Callista Roy's Adaptation Model to improve the overall health and wellness of the pediatric population in the rural church setting over the course of four weeks. The target group will consist of children from the ages of 7-12 in the rural church setting.

Effect Of An Antenatal Lifestyle Intervention On Dietary Inflammatory Index And Its Associations With Maternal And Fetal Outcomes: A Secondary Analysis Of The Pears Trial, Sarah Louise Killen, Catherine M. Phillips, Anna Delahunt, Cara A. Yelverton, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Maria A. Kennelly, Martina Cronin, John Mehegan, Fionnuala M. Mcauliffe

Faculty Publications

We investigated the effect of an antenatal lifestyle intervention of a low-glycaemic index (GI) diet and physical activity on energy-adjusted dietary inflammatory index (E-DIITM) and explored its relationship with maternal and child health in women with overweight and obesity. This was a secondary analysis of 434 mother−child pairs from the Pregnancy Exercise and Nutrition Study (PEARS) trial in Dublin, Ireland. E-DII^TM scores were calculated for early (10–16 weeks) and late (28 weeks) pregnancy. Outcomes included lipids, inflammation markers, insulin resistance, mode of delivery, infant size, pre-eclampsia, and gestational diabetes. T-tests were used to assess changes in E-DII^TM. …

On The Relationship Of Diabetes And Sleep Apnea: Evolution And Epigenetics, Nancy Wilson

Undergraduate Honors Theses

This thesis gives an overview of the relationship between diabetes, sleep apnea, obesity, and heart disease. It then addresses evidence that the traditional understanding of this relationship is incomplete or misleading. In the process, there is a brief discussion of the evolutionary rationale for the development and retention of sleep apnea in light of blood sugar dysregulation, as an adaptive mechanism in response to environmental stressors, followed by a brief overview of the general concepts of epigenetics. Finally, this paper presents the results of a literature search on the epigenetic marks and changes in gene expression found in sleep apnea …

Lived Experience Of Being An Obese Registered Nurse: A Phenomenological Inquiry, Trina Rodgers

Dissertations

Research has shown obesity is a significant problem affecting the general-public and is increasing in prevalence among health care providers. The purpose of this descriptive phenomenological study was to understand the lived experience of being obese as a registered nurse. One-on-one interviews with 15 registered nurses, who had a personal experience with being obese as a registered nurse, were conducted. Data were collected through in-depth interviews, which were taped and transcribed verbatim. The data analysis was conducted manually to gain the true essence of the participant's lived experiences. The responses were analyzed, coded, and themed using Colaizzi's method of data …

Identifying Motivation Toward Healthy Behavior In Overweight And Obese Pregnant Women, Heather Lynn Watson

Dissertations

Excessive weight gain in overweight and obese pregnant women may result in long-term maternal and child health implications. Current interventions reflect minimal effectiveness toward achievement of appropriate weight gain in this population. Although not specific to examination of motivation towards dietary and exercise behaviors in pregnant overweight and obese women, the literature supports that motivation represents a factor impacting diet and exercise health behavior modification. This study examined the predictive value of basic psychological needs (autonomy, competence, relatedness), healthcare climate, attitude toward weight gain, and BMI on motivation towards healthy dietary and exercise behaviors and the mediation effect of healthcare …

Adipose Tissue Hyaluronan Production Improves Systemic Glucose Homeostasis And Primes Adipocytes For Cl 316,243-Stimulated Lipolysis, Yi Zhu, Na Li, Mingyang Huang, Mason Bartels, Sophie Dogné, Shangang Zhao, Xi Chen, Clair Crewe, Leon Straub, Lavanya Vishvanath, Zhuzhen Zhang, Mengle Shao, Yongjie Yang, Christy M Gliniak, Ruth Gordillo, Gordon I Smith, William L Holland, Rana K Gupta, Bingning Dong, Nathalie Caron, Yong Xu, Yucel Akgul, Samuel Klein, Philipp E Scherer

Faculty, Staff and Students Publications

Plasma hyaluronan (HA) increases systemically in type 2 diabetes (T2D) and the HA synthesis inhibitor, 4-Methylumbelliferone, has been proposed to treat the disease. However, HA is also implicated in normal physiology. Therefore, we generated a Hyaluronan Synthase 2 transgenic mouse line, driven by a tet-response element promoter to understand the role of HA in systemic metabolism. To our surprise, adipocyte-specific overproduction of HA leads to smaller adipocytes and protects mice from high-fat-high-sucrose-diet-induced obesity and glucose intolerance. Adipocytes also have more free glycerol that can be released upon beta3 adrenergic stimulation. Improvements in glucose tolerance were not linked to increased plasma …

Family-Based Obesity Prevention Interventions Among Hispanic Children And Families: A Scoping Review, Erica G Soltero, Armando Peña, Veronica Gonzalez, Edith Hernandez, Guisela Mackey, Chishinga Callender, Jayna M Dave, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and …

Bullying Experiences, Body Esteem, Body Dissatisfaction, And The Moderating Role Of Weight Status Among Adolescents, Lauren A. Fowler, Chelsea L. Kracht, Kara D. Denstel, Tiffany M. Stewart, Amanda E. Staiano

Population and Public Health Science Faculty Publications

Introduction: The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status. Methods: Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine …

Exploring The Relationship Between The Distance Of Parks And Rates Of Adult Obesity In El Paso, Texas, Shawna Payan

Open Access Theses & Dissertations

Background: In El Paso, areas of the city do not have access to parks within walking distance. The rates of people suffering from obesity and the comorbidities that come with obesity are rising annually. Physical activity has been shown to increase lifespan and provide positive health outcomes for the individual. Increasing physical activity in adults by using the parks can decrease their risk for heart disease and diabetes. Objectives: The overall aim of the procedure is to determine a relationship between park density and distance from residence to the nearest park, adult population density, and the obesity rate density within …

Development Of Culturally Tailored Prenatal Nutritional Counseling For Hispanic Women, Manola Mccain

Group: Samford University Moffett & Sanders School of Nursing

In Nashville, TN in 2018, the average for Hispanic pregnancies with GDM was approximately 6% (CDC, n.d.). Appropriate diet and physical activity are well documented methods for prevention, and also for managing GDM and its sequela (CDC, 2019). In Nashville, 58% of Hispanic mothers are unmarried, 49% have a high school education or less, and the ages ranged from 17 to 43 with the majority of women being 26 years old at time of delivery (CDC, n.d.). Out of the 1,641 births in Hispanic women between 2016-2018, half of them were enrolled in the Women, Infants, and Children (WIC) Program …

This Or That?: A Study Of Online Supermarket Interventions And Their Ability To Influence Healthy Food Choices, Abby Tobin

Honors Theses - Providence Campus

As obesity rates continue to rise in the United States, there is an increasing need for new ideas and solutions to combat this worrisome epidemic. This study targets the food purchase behavior of consumers by attempting to sway their food choices using various “nudges,” or alterations in choice architecture. Participants were exposed to various interventions that were applied to product images on a fake grocery store website. Participants that fit inclusion criteria of being 18 years or older were recruited through survey-taking groups found on Reddit and Facebook. After randomization into either the control or intervention group, participants took a …

A Comparison Study Among The High School Students In The Us: Obesity And Overweight Rates Among Racial Minorities—Stress, Dietary Behavior, Sports And Physical Activity Participation, Animesh Dali '24, Naima Shifa

Student Research

Background: The Youth Risk Behavior Surveillance System (YRBSS) collects data on American youth primarily for assessing various health risk factors. This study aims to examine the relationship between demographic, and behavioral variables that we have considered as risk factors and obesity in American youth in 2015 and 2019.

Methods: Data pertaining to obesity risk factors and BMI measurements were obtained from the YRBSS. Cross Tables and linear regression models were constructed and subsequent analyses were used to examine the correlation between risk factors and BMI. Two-sample t-tests were used to explore the difference between the 2015 and 2019 datasets.

Results: …

Association Of X-Ray Absorptiometry Body Composition Measurements With Basic Anthropometrics And Mortality Hazard, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999–2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and …

Increasing Obesity Odds Among Foreignborn New Yorkers Are Not Explained By Eating Out, Age At Arrival, Or Duration Of Residence: Results From Nyc Hanes 2004 And 2013/2014, Margrethe F. Horlyck-Romanovsky, Sean J. Haley

Publications and Research

Background: Among the foreign-born in the United States (US) dietary acculturation and eating out may increase obesity risk. Using the 2004 (N = 1952) and 2013/14 (N = 1481) New York City (NYC) Health and Nutrition Examination Surveys, we compared for the foreign-born and US-born by survey year: 1) odds of obesity; 2) association between eating out and obesity and 3) effect of age at arrival and duration of residence among the foreign-born. Weighted logistic regression estimated odds of obesity.

Results: Compared to the US-born, the foreign-born had lower odds of obesity in 2004, (aOR = 0.51 (95%CI 0.37– 0.70), …

Health Disparity And Covid-19—A Retrospective Analysis, Sanjay Sarkar, Archie Taylor, Pratik Dutta, Bidisha Sengupta, Debarshi Roy

Faculty Publications

Background and Aims

According to the World Health Organization (WHO), more than 75.7 million confirmed cases of coronavirus disease 2019 (COVID-19), a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been reported so far. Researchers are working relentlessly to find effective solutions to this catastrophe, using genomic sequence-based investigation, immunological analysis, and more. The role of health disparity has also emerged as an intriguing factor that made a huge impact on the lives of people.

Methods

We analyzed various factors that triggered the health disparity in the United States of America along with the rate of …

Registered Nurses' Perceptions Of Obesity, Elizabeth Pettifor

Dissertations

Obesity has become an epidemic in the United States (U.S.) population. Obesity is a risk factor for many health problems that ultimately lead to death or disability. Nurses in the U.S have a higher-than-average rate of overweight and obesity. The purpose of this exploratory, qualitative case study was to identify and recommend areas for change in the hospital environment to assist bedside nurses in the U.S to have a healthier lifestyle. Social media was used to conduct a purposeful sampling technique and recruit 10 registered nurses working full time at the bedside in the U.S who struggle with obesity. Semi …

Screen Time Parenting Practices And Associations With Preschool Children’S Tv Viewing And Weight-Related Outcomes, Cody D. Neshteruk, Gina L. Tripicchio, Stephanie Lobaugh, Amber E. Vaughn, Courtney T. Luecking, Stephanie Mazzucca, Dianne S. Ward

Dietetics and Human Nutrition Faculty Publications

The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring …

Learning Of Food Preferences: Mechanisms And Implications For Obesity & Metabolic Diseases, Hans-Rudolf Berthoud, Christopher D. Morrison, Karen Ackroff, Anthony Sclafani

Publications and Research

Omnivores, including rodents and humans, compose their diets from a wide variety of potential foods. Beyond the guidance of a few basic orosensory biases such as attraction to sweet and avoidance of bitter, they have limited innate dietary knowledge and must learn to prefer foods based on their flavors and postoral effects. This review focuses on postoral nutrient sensing and signaling as an essential part of the reward system that shapes preferences for the associated flavors of foods. We discuss the extensive array of sensors in the gastrointestinal system and the vagal pathways conveying information about ingested nutrients to the …

Association Of Hiv-1 Infection And Antiretroviral Therapy With Type 2 Diabetes In The Hispanic Population Of The Rio Grande Valley, Texas, Usa, Juan Carlos Lopez Alvarenga, Dora A. Martinez, Alvaro Diaz-Badillo, Liza D. Morales, Rector Arya, Christopher Jenkinson, Joanne E. Curran, John Blangero, Ravi Duggirala, Srinivas Mummidi, Ruben D. Martinez

School of Medicine Publications

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from …

Developmental Origins Of Metabolic Diseases, Daniel J. Hoffman, Theresa L. Powell, Emily S. Barrett, Daniel B. Hardy

Obstetrics & Gynaecology Publications

Almost 2 billion adults in the world are overweight, and more than half of them are classified as obese, while nearly one-third of children globally experience poor growth and development. Given the vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remain as to why the world is now in the midst of a global epidemic of obesity accompanied by the “double burden of malnutrition,” where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy …

Menu Engineering And Dietary Behavior Impact On Young Adults’ Kilocalorie Choice, Christine Bergman, Yuan Tian, Andrew Moreo, Carola Raab

Hospitality Faculty Research

The obesity pandemic is associated with increased consumption of restaurant food. Labeling of menus is an intervention used to provide consumers with kilocalorie (calorie) information in hopes of them making healthier food choices. This study evaluated the relationship between young adults’ calorie choices on restaurant menus and menu design, dietary behaviors, and demographic characteristics. A 3 (fast-casual restaurants) × 4 (menu-designs based on menu engineering theories) between-subjects (n = 480, 18–24-year olds) experimental design was used. The relationship between the participants’ calorie choices (high versus low) and menu design, stage of change, gender, race, educational level and weight status was …

Exercise Is Key To Sustaining Metabolic Gains After Bariatric Surgery, Bruno Gualano, John P. Kirwan, Hamilton Roschel

Division of Basic Science Faculty Publications

The extent to which the benefits of bariatric surgery may be maintained by lifestyle changes after surgery is unclear. Our hypothesis is that exercise may sustain some metabolic benefits and counteract some of the adverse effects of surgery. In this review, we present findings supporting the proposition that exercise is key to improving overall health in patients after bariatric surgery.

Web-Based Applications For Weight Loss And Management: An Integrative Review, Linda Lawton Smith

Doctoral Dissertations and Projects

Obesity is associated with the leading causes of death in the United States and the world. Internationally, 39% of the world’s population was overweight or obese, in 2014, with 9% having diabetes. These causes include diabetes, stroke, certain types of cancer and heart disease. Obesity can lead to poorer mental health outcomes and cause a decrease in the quality of life. This integrative review is to determine if health and dietary smart-phone apps are effective tools to help overweight and obese people lose weight and maintain that loss.

The Relationship Of Structured Environments With Children’S Body Composition And Obesogenic Behaviors, Ethan T. Hunt

Theses and Dissertations

Recent nationally representative data show among children and adolescents aged 2 to 19 years, the prevalence of obesity is 17.0% (95CI= 15.5%-18.6%). Further, rates of obesity are disproportionately high among minoritized youth. The prevalence of children and adolescents with obesity is lower among White children compared to Black children (14.7% vs. 19.5%) or Hispanic children (14.7% vs. 21.9%). Disparities by socioeconomic status exist as well. Prevalence of children with obesity from households with an income that is >350% of the federal poverty threshold (after accounting for household size) is significantly less compared to children from households with an income that …

Reciprocal Control Of Obesity And Anxiety-Depressive Disorder Via A Gaba And Serotonin Neural Circuit, Guobin Xia, Yong Han, Fantao Meng, Yanlin He, Dollada Srisai, Monica Farias, Minghao Dang, Richard D Palmiter, Yong Xu, Qi Wu

Children’s Nutrition Research Center Staff Publications

The high comorbidity between obesity and mental disorders, such as depression and anxiety, often exacerbates metabolic and neurological symptoms significantly. However, neural mechanisms that underlie reciprocal control of feeding and mental states are largely elusive. Here we report that melanocortin 4 receptor (MC4R) neurons located in the dorsal bed nucleus of the stria terminus (dBNST) engage in the regulation of mentally associated weight gain by receiving GABAergic projections from hypothalamic AgRP neurons onto α5-containing GABA