Medicine and Health Sciences Commons^™

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Effects Of A 12-Week Plant-Based Diet Program On Obese And Overweight Adults In Rural Michigan, Nadine Larcher

Doctor of Nursing Practice Projects

Background

Overweight and obesity among adults are a rising epidemic in the U.S. Obesity is a risk factor for many chronic diseases and impacts morbidity and mortality. Despite our high-tech medical care system in the U.S., we are losing the war on obesity due to not addressing the underlying problems. These include unhealthy lifestyles and an unhealthy diet. A growing body of research studies has shown that adopting a low-fat whole food plant-based diet (WFPBD) regime consisting of whole grains, fruits, vegetables, legumes, and no animal-based products is an effective measure to counteract the rising pandemic of chronic diseases related …

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …

The Fecal Fermentation Profile Of Infants With Different Feeding Modalities, Willow Lewis, Michelle E. Johnson, William A. Clark, Amy Wahlquist

Undergraduate Honors Theses

Introduction/Background

Research indicates nutrition and environment in the first year of a child's life are crucial in their development and growth and can contribute to lower chances of developing obesity and other health concerns. Key factors that can determine these outcomes include the bacteria and resulting short chain fatty acids (SCFAs) present in the gut. This composition may be affected by feeding modality (formula feeding vs breastfeeding), exposure to the mother’s microbiota, weight status of the child, and type of delivery. This research aims to identify the impact of infant feeding modality on toddlers' fecal fermentation profile, and if there …

Investigating The Effects Of Body Weight Fluctuations On Insulin Resistance In Adults: A Nhanes Study, Jessica Claire Burke

All Master's Theses

The aim of this study was to investigate the effects of a history of weight cycling on insulin resistance (IR) utilizing the 2015-2020 NHANES database. A value greater than 3.2 for homeostatic model assessment of insulin resistance (HOMA-IR) was used to define IR. No study to date has examined the weight cycling question since its application in the NHANES 2015-2016 cycle year. RESULTS 53% of the total 4100 participants reported weight cycling at least once and 33% of the total were classified as having IR. Prevalence of IR and obesity were highest amongst those who weight cycled 3 times or …

The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray

Nursing | Senior Theses

Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …

Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson

Evidence-Based Practice Project Reports

The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those …

Fucoxanthin: A Review Of Potential Benefits Relative To Human Health, Michael R. White

Masters Theses, 2020-current

Fucoxanthin is a carotenoid sourced and extracted mainly from dark orange and brown seaweeds found in the pacific ocean, such as the wakame algae. The allenic bonds and unique oxygen groups give fucoxanthin its unique structure and are thought to be part of the reason fucoxanthin has unique physiological functions. Fucoxanthin has potentially numerous effects on the physiology of human health, ranging from skin health to metabolic health, which have been demonstrated in animal model research. The goal of this review is to examine current literature to discuss fucoxanthin’s potential application as a nutraceutical, treatment for obesity, type 2 diabetes, …

Healthy Food Accessibility In Rural Mississippi And Potential For A Corner Store Intervention, Anna Conner

Honors Theses

Some areas of the United States have poorer food environments than others. The Mississippi Delta has limited access to nutritious food, often relying on corner stores for sustenance. The impact of a poor diet can increase chronic disease prevalence, creating additional barriers to health and nutrition for Mississippians. The purpose of this study was to document and explore the rural food environment and discuss urban intervention studies in light of the current state of stores in the Delta. An adapted version of the Baltimore Healthy Kids survey and store impact questionnaire was used to record owner perceptions and food availability. …

Body Mass Index, Waist Circumference, And Hemoglobin A1c In The Lower Income African Americans, Lisa Gabel, Joci Verb, Lauren Windham

Williams Honors College, Honors Research Projects

The Honors project is in conjunction with a larger, state funded, intervention study, the Finding A Better U! (FABU) project, by Carolyn J. Murrock, PhD, RN, Mary Jo MacCracken, PhD, Judi-Juvancic-Heltzel PhD, and Alex Holt. While the larger study focuses on the effects of a weekly exercise and nutrition intervention on cardiovascular disease (CVD) and type 2 diabetes (T2DM) outcomes, the honors project will analyze data to determine preliminary findings, specifically, the relationship between body mass index (BMI), waist circumference, and hemoglobin A1C in the lower income African Americans (AA). The honors students will also assist the FABU team in …

Effectiveness Of Behavior-Based Counseling For Weight Loss Maintenance: A Systematic Literature Review, Jaime V. Stanczyk

All Graduate Theses, Dissertations, and Other Capstone Projects

Obesity is linked to the development of chronic health conditions such as diabetes, hypertension, and atherosclerotic cardiovascular disease (ASCVD) at an annual expense of $147 billion in related healthcare costs. Effective lifestyle modification treatment for long-term WLM remains elusive. Traditional advice from primary care providers regarding dietary modification and increased physical activity has not led to WLM as a long-term outcome. Newer guidelines for the treatment of obesity now recommend high-intensity behavior-based counseling (BBC) programs that deliver traditional weight loss education in tandem with behavior-change strategies. Methods: A database search was conducted for peer reviewed literature published in 2012-2020 on …

Social Consequences Of Obesity: Case Study Of Bariatric Population At Ellis Hospital, Kara Leyden

Honors Theses

Despite the fact that the majority of adults living in the United States are overweight or obese, obesity remains a highly stigmatized physical condition. Society often sees obesity as a physical manifestation of personal faults such as the lack of self-control and laziness. Obese individuals thus experience discrimination in places of employment, have lower educational attainment, are underrepresented in popular culture, and often have difficulty finding and sustaining intimate relationships. For individuals with extreme obesity (BMI greater than 40), bariatric surgery is the most effective strategy to improve health and lose weight. Individuals who have undergone bariatric surgery typically experience …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Compensatory Behaviors During A 12-Week Vigorous Interval Intervention In Post-Bariatric Men And Women, Kristen Byrne

Masters Theses, 2020-current

Strong links have been recognized between sedentary time, higher BMI, and waist circumference among post-operative bariatric surgery patients. The time-efficient aspects of the High Intensity Interval Training show a significant influence in creating a habitual strategic exercise for fighting obesity and controlling compensatory components. Ten post-operative bariatric participants (9 females, 1 male) with BMI of 33.65 ± 2.90 kg/m², undergoing a 12-week Vigorous Intensity Interval Training (VIIT) program, were assessed for the compensatory mechanisms of sedentary behavior and caloric intake. Participants were evaluated through 4-day food intake records and ActivPal accelerometers, assessed using Nutrition Data System for Research …

The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur

Evidence-Based Practice Project Reports

In the US, overweight and obesity are growing concerns, as both can have life altering consequences if not prevented or treated. Since 2000, there has been nearly a 10% increase of adults who are obese, from 30.5% (85.8 million) to 39.8% (93.9 million) in 2016 (CDC, 2017). These conditions are preventable with early intervention and motivation. Obesity statistics are especially of interest during the transition to young adulthood. The purpose of this project was to improve student outcomes by identifying barriers, effective strategies, and healthy choices that would ultimately impact weight, increasing healthy food choices, and decreasing overall BMI in …

The Now Trial: A Pragmatic Randomized Controlled Trial Of Personalized, Genetic-Based Lifestyle Advice, Justine Rochelle Horne

Electronic Thesis and Dissertation Repository

Background: The impact of nutrigenomics and lifestyle genomics interventions on health outcomes and behaviours remains controversial and under-explored.

Objectives: To determine the short-term (3-month), moderate-term (6-month) and long-term (12-month) impact of providing personalized, genetic-based lifestyle information and advice on anthropometric measures, as well as dietary intake and adherence.

Methods: The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pragmatic randomized controlled trial that was incorporated into the Group Lifestyle Balance™ (GLB) program (N=140). Inclusion criteria: overweight or obesity (BMI ≥ 25 kg/m²), ≥ 18 years of age, English-speaking, having access to internet at least …

Energy Compensation With Exercise Is Not Dependent On Dose, H. Michael Hays

Theses and Dissertations--Nutrition and Food Systems

Background: Exercise induced weight loss is often less than expected due to a coordinated set of compensatory mechanisms that serve to maintain energy homeostasis. The extent to which exercise frequency, duration, intensity and exercise energy expenditure (ExEE) influences the compensatory response to an exercise-induced energy deficit (energy compensation) is controversial. Determining how these variables impact energy compensation would help health care providers prescribe exercise with greater probability of creating a sustained negative energy balance and subsequent weight loss.

Methods: 44 Overweight/obese men and women (BMI=25-35kg/m²) aged 18 to 40 years were randomized to perform aerobic exercise 2 or 6 days/week …

Cardiac Effects Of Obesity During Pregnancy In C57bl/6j Mice, Kayla Lynn Dudick

Theses and Dissertations--Nutrition and Food Systems

Objective: Pregnancy requires profound cardiac and metabolic adaptation. Left ventricular (LV) mass is increased in response to pregnancy, but is not associated with cardiac damage. In contrast, obesity-mediated cardiac hypertrophy is pathological. Data from animal studies indicate dietary fatty acid composition may have a protective effect during states of extreme cardiac physiological adaptation. In contrast, aberrant cardiac metabolism is a hallmark of disease. Over a third of reproductive-age women in the United States are obese, but there is a paucity of data describing the effect of obesity on maternal cardiac adaptation to pregnancy. The objective of this study was to …

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Effectiveness Of Nutrition Education And Fitness Tracking In A Large Corporate Healthcare Wellness Program, Jess Tyrrell

All Master's Theses

In the United States, greater than two-thirds of adults are considered overweight or obese – making the treatment and prevention of overweight/obesity a public health priority. In response, employers are recognizing that promoting and maintaining employee health is beneficial, so the implementation of corporate wellness programs is on the rise. The purpose of this study was to determine the effectiveness of a ten-month multicomponent employee corporate wellness program on two health-related outcomes: weight loss and step count. The study was used to determine how active utilization of program components would affect the achievement of health-related outcomes among participants. This retrospective …

Effects Of Mitochondrial Nadp+-Dependent Isocitrate Dehydrogenase Deficiency On Fructose-Induced Obesity In Mice, Allison Michelle Montalbano, Kaleigh Elizabeth Beane

Human Nutrition and Hospitality Management Undergraduate Honors Theses

Obesity prevalence in the United States continues to increase and is associated with health consequences such as type 2 diabetes, hypertension, atherosclerosis, and hyperlipidemia. Among many contributing factors to obesity, fructose may be one of the major reasons as it disrupts the antioxidant system thereby resulting in an accumulation of reactive oxidative species and leading to obese conditions. The enzyme, isocitrate dehydrogenase 2 (IDH2), reduces nicotinamide adenine dinucleotide phosphate from the TCA Cycle, hence might be implicated with not only energy metabolism but also cellular redox homeostasis. Therefore, the hypothesis was that IDH2 deficiency in mice would exacerbate hepatic lipid …

Child Care Teachers’ Knowledge Of Fun Physical Activities And Healthy Food Choices For Pre-School Children, Elizabeth Gwyn

Nursing Theses and Capstone Projects

The focus of this project was to explore child-care teachers’ knowledge of fun physical activities and healthy food choice activities for preschool children. A four-week educational session was implemented in a rural child-care center. The intervention provided education in relationship to the implementation of fun physical activities and healthy food choice activities for child-care teachers during preschoolers structured playtime. The Child Care Teachers’ Knowledge Evaluation (CCTKE) tool developed by the doctoral student was used to collect responses from participants before and after the intervention. The participants’ data was analyzed using a t-test. There were no statistically significant differences between the …

Utilization Of Web‐Based App To Target Obesogenic Factors In Rural Kentucky Counties With High Rates Of Obesity, Erin M. Casey

Theses and Dissertations--Nutrition and Food Systems

Due to socioeconomic disparities and geographic isolation, rural Kentucky residents bear a greater burden of poor health compared to national averages. Specifically, rural Kentucky residents are at greater risk of becoming obese and suffering from comorbidities of obesity such as type 2 diabetes, hypertension and cardiovascular disease. The purpose of the present study was two-fold. First, we the barriers to nutrition and physical activity unique to rural Kentucky counties which high proportions of obese adults (< 40%) were examined and extrapolated. Second, this information was used to develop a health and wellness app tailored to rural Kentucky counties. The objective was met via a formative assessment regarding causes for obesity in three rural Kentucky counties using focus groups. From these discussions, two major themes arose: barriers to good nutrition and physical activity, and desired web‐app features. From this assessment, FitFaceoff was developed and released into the same counties. Usage and user interaction were assessed using GoogleAnalytics™ software. Analysis revealed poor user liking and unsuccessful implementation of FitFaceoff, however further qualitative research is needed to evaluate poor user reception of FitFaceoff and possible future directions.

A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn

DNP Projects

PURPOSE:Obesity costs the U.S. roughly $147 billion in health care spending annually. There has been a call for healthcare providers to initiate all possible weight loss interventions. One treatment strategy not used to its fullest potential is that of prescribing antiobesity medications. The purpose of this project was to examine and evaluate the effectiveness of three common weight loss medications used in the treatment of obesity, including discussion and recommendations.

METHODS: This project was a single-center retrospective study comparing three different groups of patients seen at a rural weight loss clinic. The sample consisted of 84 patients seen between September …

Weight Management Related Factors And Healthy Behaviors In Adults, Sumadhuri Pamarthi

Electronic Theses and Dissertations

Obesity is an ongoing global pandemic that affects more than one in three adults in the United States. Being overweight or obese also increases the risk of chronic health conditions. Weight management does not only center on immediate weight loss but also on the proper maintenance of an appropriate body weight over the years. Methods of weight management include eating a healthy diet and meeting physical activity guidelines. Such weight management practices are important to ensure that the people suffering from obesity can decrease risks of morbidity or even mortality. Nevertheless, unhealthy weight management strategies might lead to unintended health …

Association Of Diet Quality And Body Mass Index With Serum Ceramides In Middle-Aged Adults, Margaret Ann Drazba

Graduate Theses, Dissertations, and Problem Reports

Cardiovascular disease (CVD) is one of the leading causes of death worldwide and identifying CVD risk is important for determining and implementing appropriate intervention strategies. Ceramides are a class of sphingolipids that are implicated in the pathogenesis of obesity and CVD. However, their relationship to diet quality, a modifiable risk factor for CVD, is largely unknown. The purpose of this cross-sectional study was to determine the association of an a priori diet quality index and body mass index (BMI) with circulating ceramides in middle-aged adults (n=96). Dietary intake was assessed using three 24-hour recalls and Nutrition Data System for Research …

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …

The School Food Environment And Its Association With Dietary Intake Among Rural Adolescents, Hannah F. Hickey

Theses and Dissertations--Nutrition and Food Systems

The school food environment has the ability to increase the consumption of fruit and vegetables in rural adolescents. This study used a survey to allow adolescents in seven rural counties to self-report their fruit and vegetable intake as well as utilizing the USDA Mathematica tool and the School Nutrition and Meal Cost Study audits to evaluate what food and beverage products were actually available to adolescents. By using these two measures, associations between fruit and vegetable intake and availability of healthy and unhealthy foods were determined. The availability of healthy snacks and beverages was found to be associated with sugar-sweetened …

Comparing Mindfulness-Enriched Weight Management To Current Standard Practices, Teresa M. Lee

Theses and Dissertations--Nutrition and Food Systems

Mindfulness-based interventions have been shown to be effective for numerous diet-related conditions. Mindfulness skills have been theorized to be helpful in improving eating behaviors, and thereby weight management. The purpose of this study was to compare the effectiveness of a mindfulness-enriched weight management program to a standard weight loss program over the course of a 12-week intervention, and weight maintenance over six months. This was a two-group randomized experimental design. One group received a standard weight loss program, while the other group received the same program with an additional mindfulness component. Follow up assessments were conducted twice at three-month intervals. …

Social Marketing Campaign At Farmers' Markets To Encourage Fruit And Vegetable Purchases In Rural Counties With A High Obesity Prevalence, Emily M. Dewitt

Theses and Dissertations--Nutrition and Food Systems

Farmers’ markets are one food environment venue with the potential to increase fruit and vegetable consumption among rural residents in the United States. This study used the Plate It Up Kentucky Proud social marketing campaign in six rural communities over two years to determine the association between exposure to the campaign and fruit and vegetable purchasing decisions. The availability of recipe cards at the farmers’ market was associated with influencing the purchase of fruits and vegetables (p<0.001); the recipe sample was associated with buying the ingredients for the recipe (p<0.001); taking the PIUKP food sample was associated with a willingness to prepare the food item at home (p<0.001). Utilizing social marketing strategies at farmers’ markets may be an effective way to improve fruit and vegetable intakes in rural communities.