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University of Alabama at Birmingham

Theses/Dissertations

Obesity

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The Association Between Metabolically Healthy Obesity And Coronary Heart Disease Among Regards Study Participants, Kiara N. Aaron Jan 2022

The Association Between Metabolically Healthy Obesity And Coronary Heart Disease Among Regards Study Participants, Kiara N. Aaron

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A major obstacle to the advancement of our understanding of the metabolically healthy obesity (MHO) phenotype is the inconsistent definition of metabolic health and obesity among studies. A harmonized definition of MHO in adults has been proposed based on the diagnosis of obesity (BMI > 30 k/m2) and meeting the cardio-metabolic criteria for triglycerides, high-density lipoprotein (HDL) cholesterol, systolic blood pressure (SBP), diastolic blood pressure (DBP), no antihypertensive treatment, fasting blood glucose, and no drug treatment with glucose-lowering agents. In addition, waist circumference can be associated with increased disease risk when WC is >94 cm in men and >80 cm in …


Associations Between Dietary Fat Intake And Waist Circumference, Phonchit Teng Soukhamneut Jan 2019

Associations Between Dietary Fat Intake And Waist Circumference, Phonchit Teng Soukhamneut

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The objective of this study was to assess: 1) trends in dietary fat intake from 2003-2016 2) the association between type of dietary fat intake and waist circumference (WC), 3) the association between type of dietary fat intake and body shape, and 4) whether these associations vary by sex and race/ethnicity. This secondary data analysis included 27,057 adults aged 19 to 65 from the National Health and Examination Survey (NHANES) 2003-2016. For WC, participants were categorized into high-risk (men: WC ≥ 40 in; women: WC ≥ 35 in) and low-risk (men: WC < 40 in; women: WC < 35 in). Total fat intake was categorized as high (TOTFAT ≥ 35%) and low (TOTFAT< 35%). Saturated fat intake was categorized into high (SATFAT ≥ 10%) and low (SATFAT < 10%). Unsaturated fat intake was categorized into high (UNSATFAT ≥ 25%) and low (UNSATFAT < 25%). Logistic regression was performed to assess the associations between DFI and WC and DFI and body shape, controlling for age, BMI, and total caloric intake. NHW men with high TOTFAT were found to have 1.41 (OR: 1.41, 1.19 – 1.68) times the odds of having a high-risk WC compared to men with a diet low in TOTFAT, controlling for age, BMI, and total caloric intake. NHW men with a diet high in SATFAT were at increased odds of having a high-risk WC compared to men with a diet low in SATFAT, after controlling for covariates (OR: 1.49, 1.21 -1.84). NHW men with a diet high in UNSATFAT were at increased odds of having a high-risk WC compared to men with a diet low in UNSATFAT after controlling for covariates (OR: 1.375, 1.09 – 1.74). There were no significant associations found among NWB and MA men for any type of dietary fat intake. For women, no associations were found between type of dietary fat and WC by race/ethnicity. There were no associations between DFI and body shape by race/ethnicity groups and sex. Future studies are needed to further investigate the body shape cut-off points for increased risk associated with chronic disease.


Reducing Acute Cardiovascular Hospitalizations With A Weight Management Program (Reach), Laura A. Graham Jan 2017

Reducing Acute Cardiovascular Hospitalizations With A Weight Management Program (Reach), Laura A. Graham

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Reducing cardiovascular (CVD) risk factors such as obesity through lifestyle and behavioral interventions like weight management programs should result in better cardiovascular health. However, there is conflicting evidence on the effectiveness of these interventions in reducing long-term CVD outcomes such as acute myocardial infarction or stroke. This reflects an important gap in our understanding about factors affecting recruitment and engagement in these programs and how these factors relate to improvement in long-term cardiovascular health. To address this gap, we will use a retrospective study with up to 11 years of follow up data from the nation’s largest health care system-associated …


Associations Of Food Environment, Mediterranean Diet And Obesity In United States: A Geographic Information System (Gis) Analysis, Meifang Chen Jan 2017

Associations Of Food Environment, Mediterranean Diet And Obesity In United States: A Geographic Information System (Gis) Analysis, Meifang Chen

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Given the growing obesity epidemic in the U.S., modifying current obesogenic food environment, and identifying and promoting an obesity-modifying dietary approach that fits in the food environment context are urgent. Emerging evidence indicates that Mediterranean diet (MD) could be a beneficial dietary pattern to protect against overweight/obesity. However, as a relatively new dietary pattern in the U.S., how the unique food environment influences MD adherence, and whether consuming a MD can mediate the relationship between food environment and obesity among the population remain unknown. This dissertation, applying Geographic Information System (GIS) and path analytical methods using data from the REasons …


Methods For Measuring Individually Experienced Temperature And Food Intake In Controlled Thermal Environments, Molly Bernhard Jan 2016

Methods For Measuring Individually Experienced Temperature And Food Intake In Controlled Thermal Environments, Molly Bernhard

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The three studies to be presented assess individual-level heat exposure in free-living urban and rural environments and assess food intake in randomized controlled trials in a 2-hour exposure, and a 7-hour crossover heat exposure. The first interest was broad: examining heat exposure and its relation to potential health outcomes. To examine whether heat exposure could be measured in free-living organisms, a light and temperature monitoring device was repurposed and used in a pilot study of individual-level heat exposure in urban and rural community members. Differences between the current and most commonly accepted way of estimating heat exposure, weather station datasets, …


An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton Jan 2015

An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton

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Disparities in the neighborhood retail food environment have been hypothesized to be associated with poor diet quality and adverse health outcomes such as obesity. Studies have found that lower income communities often have reduced access to affordable healthy foods. In 2009, the Centers for Disease Control and Prevention proposed direct farm-to-consumer (FTC) retail outlets (i.e. farmers markets, farm/roadside stands, community gardens and community supported agriculture programs) as a potential strategy to alleviate retail food environment disparities in communities with limited resources. Information on the behavioral and health implications of FTC outlet usage by lower income individuals is limited. This research …


Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell Jan 2015

Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell

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Previous epidemiological studies observed the lack of an association between increased body mass index (BMI: kg/m2) and all-cause mortality in US-residing Hispanic adults. The purpose of this dissertation was to examine the validity of three hypothesized explanations for the absence of significant associations. Using data on Hispanic participants from the National Health and Nutrition Examination Survey (NHANES) [1988-1994 and 1999-2004] and the National Health Interview Survey (NHIS), this dissertation examined whether: (1) BMI was associated with cause-specific mortality; (2) measures of body composition was associated with all-cause mortality; and (3) the BMI-all-cause mortality association differed as a function of Hispanic …


Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson Jan 2015

Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson

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African American (AA) women are disproportionately burdened by obesity, an epidemic with implications that reach beyond physiological consequences. Given that perceptions of body image may impact health-promoting behaviors and weight management efforts, we sought to evaluate the presence and magnitude of body image dissatisfaction (BID) and explore its relationship with waist circumference (WC), independent of weight among overweight and obese treatment-seeking rural AA women. Participants referred to images from the Pulvers Figure Rating Scale that included nine body silhouettes to answer: “How I think I look now” (i.e., current body image) and “How I would like to look” (i.e., desired …


Apparent Change In Obesity-Mortality Associations: Methodological Issues In Survival Analyses With Censored Outcomes, Tapan Shirish Mehta Jan 2013

Apparent Change In Obesity-Mortality Associations: Methodological Issues In Survival Analyses With Censored Outcomes, Tapan Shirish Mehta

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Analyses of the National Health and Nutrition Examination Survey (NHANES) have suggested that the mortality rate (MR) associated with obesity has decreased over calendar time. However, there has been conflicting evidence about the apparent change in the obesity-MR over calendar time. This dissertation investigates some of the empirical and methodological issues involved in assessing the longitudinal change in the obesity-mortality associations. In the first manuscript, Obesity and Mortality: Are the Risks Declining? Evidence from Multiple Prospective Studies in the U.S., a multiple longitudinal design is proposed and implemented to evaluate whether the obesity-mortality associations have declined over calendar time after …


Sleep Duration And Obesity: Longitudinal Study Of Adolescents, Herpreet Kaur Thind Jan 2012

Sleep Duration And Obesity: Longitudinal Study Of Adolescents, Herpreet Kaur Thind

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Prevalence of obesity continues to be high in the United States with about one-third adults being overweight or obese. Among adolescents the rates of overweight/obesity have increased by three times in the past two decades. Moreover, the rates of obesity are disproportionately high among the minority population. Recently, sleep duration has emerged as an independent risk factor for obesity. Several cross-sectional and longitudinal studies worldwide have shown an inverse relationship between sleep duration and obesity. However, some studies do not support this association. Majority of the studies in the United States have been conducted on predominantly White populations. African Americans …


Examining The Association Between Body Mass Index And Weight Related Quality Of Life In Black And White Women, Tiffany Lashaun Cox Jan 2010

Examining The Association Between Body Mass Index And Weight Related Quality Of Life In Black And White Women, Tiffany Lashaun Cox

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Obesity not only increases risk for morbidity/mortality, but also impacts the quality of life of obese individuals. In the United States, black women have the highest prevalence of obesity of any other group with approximately 80% of black women over age 20 having a body mass index (BMI) ≥ 25 kg/m2. We aimed to examine the association between weight and quality of life in this high risk population and compare it to weight-related quality of life in white women using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. Data for 343 women were analyzed (172 black, 171 white). …


Development And Validation Of A Scale To Measure Fear Of Physical Response To Exercise Among Overweight And Obese Adults, Brooks Cotton Wingo Jan 2010

Development And Validation Of A Scale To Measure Fear Of Physical Response To Exercise Among Overweight And Obese Adults, Brooks Cotton Wingo

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Fear-avoidance beliefs have been correlated with disability and physical function in populations with pain, but research has primarily focused on the impact of these beliefs on daily functioning, not leisure time physical activity. Current screening tools focus on a specific type or source of pain, making them inadequate for assessing fear of exercise-induced pain. The purpose of this study was to develop and establish preliminary validity of a scale to measure fear of physical response to exercise among overweight and obese adults. Additionally, the study sought to assess the relationships between scale responses and body mass index, physical activity level …