Medicine and Health Sciences Commons^™

Community-Based Efforts Aim To Improve The Food Environment Within A Highly Obese Rural Appalachian County, Rachel Gillespie, Emily M. Dewitt, Heather Norman-Burgdolf, Brynnan Dunaway, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

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Rural communities in Appalachia are displaying increased obesity prevalence, yet traditional interventions have not provided a broad enough impact to improve dietary consumption patterns. Therefore, expanding efforts that address the food environment and incorporate behavioral nudges through community-developed marketing strategies may be a viable mechanism to improve food and beverage choices within this unique population. This study installed shelf-wobblers across n = 5 gas stations in one rural Appalachian county in Kentucky. Smart Snacks were identified from store inventory lists utilizing the CDC Food Service Guideline for Federal Facilities calculator and were categorized into high-protein snacks, low-fat carbohydrate snacks, meal …

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Nlrp3 Inflammasome Is A Key Driver Of Obesity-Induced Atrial Arrhythmias, Larry Scott, Anke C Fender, Arnela Saljic, Luge Li, Xiaohui Chen, Xiaolei Wang, Dominik Linz, Jilu Lang, Mathias Hohl, Darragh Twomey, Thuy T Pham, Rodrigo Diaz-Lankenau, Mihail G Chelu, Markus Kamler, Mark L Entman, George E Taffet, Prashanthan Sanders, Dobromir Dobrev, Na Li

Faculty, Staff and Students Publications

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AIMS: Obesity, an established risk factor of atrial fibrillation (AF), is frequently associated with enhanced inflammatory response. However, whether inflammatory signaling is causally linked to AF pathogenesis in obesity remains elusive. We recently demonstrated that the constitutive activation of the 'NACHT, LRR, and PYD Domains-containing Protein 3' (NLRP3) inflammasome promotes AF susceptibility. In this study, we hypothesized that the NLRP3 inflammasome is a key driver of obesity-induced AF.

METHODS AND RESULTS: Western blotting was performed to determine the level of NLRP3 inflammasome activation in atrial tissues of obese patients, sheep, and diet-induced obese (DIO) mice. The increased body weight in …

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Influence Of The Request And Purchase Of Television Advertised Foods On Dietary Intake And Obesity Among Children In China, Jinli Xian, Mao Zeng, Zhengjie Cai, Changxiao Xie, Yuqian Xie, Manoj Sharma, Yong Zhao, Zumin Shi

Environmental & Global Health Faculty Research

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Background: This study aims to examine the effects of the request and purchase of Television (TV) advertised foods on children’s dietary intake, overweight and obesity in China. Methods: Data from 1417 children (aged 6–17 years) in the 2011 China Health and Nutrition Survey were analysed. The request and purchase of TV advertised foods were assessed through the frequency of children’s requests to purchase TV advertised foods and the frequency of parents’ purchases of these advertised foods, as well as the frequency of children’s purchases of TV advertised foods. The height and weight of children were measured. Logistic regression models were …

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Household Food Insecurity And Children’S Physical Activity And Sedentary Behaviour In The United States: The Healthy Communities Study, Sophia M. Navarro, Marisa M. Tsai, Lorrene D. Ritchie, Edward A. Frongillo Jr., Barbara A. Laraia, Russell R. Pate, Lauren E. Au

Faculty Publications

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OBJECTIVE: To examine associations between household food insecurity and children's physical activity and sedentary behaviours. DESIGN: Secondary analysis was conducted on the Healthy Communities Study, an observational study from 2013 to 2015. Household food insecurity was assessed by two items from the US Department of Agriculture's 18-item US Household Food Security Survey Module. Physical activity was measured using the 7-d Physical Activity Behavior Recall instrument. Data were analyzed using multilevel statistical modelling. SETTING: A total of 130 communities in the USA. PARTICIPANTS: In sum, 5138 US children aged 4-15 years. RESULTS: No associations were found for the relationship between household …

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Deciphering An Agrp-Serotoninergic Neural Circuit In Distinct Control Of Energy Metabolism From Feeding, Yong Han, Guobin Xia, Dollada Srisai, Fantao Meng, Yanlin He, Yali Ran, Yang He, Monica Farias, Giang Hoang, István Tóth, Marcelo O Dietrich, Miao-Hsueh Chen, Yong Xu, Qi Wu

Children’s Nutrition Research Center Staff Publications

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Contrasting to the established role of the hypothalamic agouti-related protein (AgRP) neurons in feeding regulation, the neural circuit and signaling mechanisms by which they control energy expenditure remains unclear. Here, we report that energy expenditure is regulated by a subgroup of AgRP neurons that send non-collateral projections to neurons within the dorsal lateral part of dorsal raphe nucleus (dlDRN) expressing the melanocortin 4 receptor (MC4R), which in turn innervate nearby serotonergic (5-HT) neurons. Genetic manipulations reveal a bi-directional control of energy expenditure by this circuit without affecting food intake. Fiber photometry and electrophysiological results indicate that the thermo-sensing MC4RdlDRN neurons …

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Rap1 In The Vmh Regulates Glucose Homeostasis, Kentaro Kaneko, Hsiao-Yun Lin, Yukiko Fu, Pradip K Saha, Ana B De La Puente-Gomez, Yong Xu, Kousaku Ohinata, Peter Chen, Alexei Morozov, Makoto Fukuda

Faculty, Staff and Students Publications

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The hypothalamus is a critical regulator of glucose metabolism and is capable of correcting diabetes conditions independently of an effect on energy balance. The small GTPase Rap1 in the forebrain is implicated in high-fat diet-induced (HFD-induced) obesity and glucose imbalance. Here, we report that increasing Rap1 activity selectively in the medial hypothalamus elevated blood glucose without increasing the body weight of HFD-fed mice. In contrast, decreasing hypothalamic Rap1 activity protected mice from diet-induced hyperglycemia but did not prevent weight gain. The remarkable glycemic effect of Rap1 was reproduced when Rap1 was specifically deleted in steroidogenic factor-1-positive (SF-1-positive) neurons in the …

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Implementation Of The Center For Disease Control (Cdc) Prediabetes Risk Test In The Medical Weight Loss Setting, Gabriela Miller, Rn, Bsn

Doctor of Nursing Practice Final Manuscripts

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Background: Prediabetes is a serious health condition where blood sugars are higher than normal which increases risk of developing type 2 diabetes mellitus (T2DM), heart disease and stroke. One in three US adults have prediabetes and 90% of them do not know. Losing 5-7% of body weight and regular physical activity can lower the risk of developing T2DM by more than half.

Methods: Screening patients for prediabetes at a medical weight loss clinic using the evidence-based Centers for Disease Control (CDC) Prediabetes Risk Test. A score of five or higher on the screening tool indicates the patient is at risk …

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Obesity Prevention Toolkit To Combat Weight Gain Related To Sedentary Behavior And Dietary Habits In College Students: An Evidence-Based Project, Maria Amos, Martha Fuller

Doctor of Nursing Practice Final Manuscripts

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Abstract

Background: Forty percent of the US population ages 20-39 are categorized as obese,

their BMI is over 30, and 35% of college age students are obese or overweight. Issues related to obesity cost the US $147 billion annually. Between 40%-50% of college students are reported to be inactive. Inactivity can lead to increased morbidity and mortality related to increased risks of cardiovascular disease, diabetes, hypertension, musculoskeletal issues, and depression. Providing dietary and physical activity education and access to nutritional information promotes behavior change in young adults.

Aims of Service Change: This evidence-based project proposal aims to provide a toolkit …

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Examination Of Weight-Loss Motivators And Family Factors In Relation To Weight Management Strategies And Dietary Behaviors Among Adolescents With Obesity, Bridget K. Biggs, Dawn K. Wilson, Mary Quattlebaum, Seema Kumar, Alicia Meek, Teresa B. Jensen

Faculty Publications

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The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated …

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

Evidence-Based Practice Project Reports

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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 …

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Differences In Effectiveness And Use Of Laparoscopic Surgery In Locally Advanced Colon Cancer Patients, M. Schootman, Matthew Mutch, T. Loux, Jan M. Eberth Ph.D., N. O. Davidson

Faculty Publications

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Patients with locally advanced colon cancer have worse outcomes. Guidelines of various organizations are conflicting about the use of laparoscopic colectomy (LC) in locally advanced colon cancer. We determined whether patient outcomes of LC and open colectomy (OC) for locally advanced (T4) colon cancer are comparable in all colon cancer patients, T4a versus T4b patients, obese versus non-obese patients, and tumors located in the ascending, descending, and transverse colon. We used data from the 2013–2015 American College of Surgeons’ National Surgical Quality Improvement Program. Patients were diagnosed with nonmetastatic pT4 colon cancer, with or without obstruction, and underwent LC (n …

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

Masters Theses, 2020-current

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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, …

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Ring Based Wearable Bioelectrical Impedance Analyzer For Body Fat Estimation, Muhammad Usman, Adarsh Gupta, Wei Xue

Rowan-Virtua Research Day

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Introduction

• Obesity is the most serious public health problem because it is linked to cardiovascular diseases.
• Measuring fat mass is necessary to study the obesity epidemic.
• Fat mass can be estimated by measuring impedance of the human body.

Conclusions

• A novel bioelectrical impedance analyzer for body fat estimation.
• Device validated for 40 healthy human subjects against commercial analyzer.
• Great potential to replace commercial analyzers for wearable real-time body fat monitoring.

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Effect Of High Intensity Interval Training Vs Low Intensity Training On Fat Loss In Patients With Obesity, Jonathan Aaron Deck, Adarsh Gupta

Rowan-Virtua Research Day

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Nowadays, there are several exercise modalities to lose weight, retain, and or build lean body mass. A widely known training philosophy that has gained increased popularity is high intensity interval training (HIIT). HIIT is based on exercising at submaximal or maximal intensity for a brief period then reducing work to minimal intensity for a longer duration in a series of repeated bouts. The benefit of HIIT is to increase fat loss through the scientific principle of EPOC (excess post exercise oxygen consumption). Low intensity training (LIT) also has its benefits in that it is more sustainable but with the caveat …

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

Masters Theses, 2020-current

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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, …

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Predictive Value Of Hatch Scoring And Waist-To-Height Ratio In Atrial Fibrillation Following Coronary Artery Bypass Operations Performed With Cardiopulmonary Bypass, Muhammed Savran, Mesut Engin, Orhan Guvenc, Hasan F. Yüksek, Sadık Ahmet Sünbül, Tamer Turk, Yusuf Ata, Ufuk Aydın, Ahmet F. Ozyazicioglu

Journal of the Saudi Heart Association

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Objectives: Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. Methods: Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. Results: A total of 255 …

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You Are What You Think: The Impacts Of Body Weight Perception In Young Adolescent Women, Olivia Ceja

DNP Qualifying Manuscripts

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While research suggests a multifactorial array of contributors to adolescent obesity including lack of physical activity, dietary behaviors, psychosocial factors including the perception of being overweight and body dissatisfaction have been more recently associated with unhealthy weights, unhealthy behaviors and amplified risk of obesity. At an all girl’s private college preparatory middle and high school in Los Angeles, amid a competitive and rigorous academic environment, students face additional pressure to succeed and strive for perfection. Although body weight perception can be used to identify students who are at risk for eating disorders at the middle and high school levels, the …

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Leptin Activation Of Metabolically-Related Hypothalamic Neurons, Kailee Hixon

Undergraduate Honors Theses

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Obesity is often associated with multiple other clinical conditions, including hypertension and cardiovascular disease. Currently, more than one-third of the world’s population is classified as obese. Leptin is a neuropeptide that is released from adipose cells and is responsible for reducing appetite and increasing metabolism. Leptin also has a role in the activation of cardiovascular and metabolic pre-sympathetic neurons and has been reported to increase blood pressure and heart rate. Thus, understanding the activation of the autonomic nervous system by leptin has implications in the development and safety of drugs to avoid activation of cardiovascular pre-sympathetic neurons. This is important …

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Association Between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index And The Risk Of Obesity, Yoko B. Wang, Nitin Shivappa, James R. Hébert Scd, Amanda J. Page, Yohannes Adama Melaku

Faculty Publications

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Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent …

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

Honors Theses

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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. …

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Type 2 Diabetes Subgroups, Risk For Complications, And Differential Effects Due To An Intensive Lifestyle Intervention, Michael P Bancks, Haiying Chen, Ashok Balasubramanyam, Alain G Bertoni, Mark A Espeland, Steven E Kahn, Scott Pilla, Elizabeth Vaughan, Lynne E Wagenknecht

Faculty, Staff and Students Publications

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OBJECTIVE: We reevaluated the Action for Health in Diabetes (Look AHEAD) intervention, incorporating diabetes subgroups, to identify whether intensive lifestyle intervention (ILI) is associated with differential risk for cardiovascular disease (CVD) by diabetes subgroup.

RESEARCH DESIGN AND METHODS: In the Look AHEAD trial, 5,145 participants, aged 45-76 years, with type 2 diabetes (T2D) and overweight or obesity were randomly assigned to 10 years of ILI or a control condition of diabetes support and education. The ILI focused on weight loss through decreased caloric intake and increased physical activity. To characterize diabetes subgroups, we applied k-means clustering to data on age …

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Soda, Water, And Convenience: An Evaluation Of The Mexican Soda Tax, Benjamin Hager

Honors Theses

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This thesis seeks to evaluate the Mexican soda tax of 2014 by exploring the reasons for the tax and the underlying factors that the tax seems to ignore. This soda tax, in particular, was implemented to address obesity by curbing the consumption of sugary soft drinks due to the large quantities consumed by the Mexican populous. However, as this thesis shows there are some potential pitfalls in this type of obesity prevention policy. By exploring potable water data from the World Bank, the rural and urban noncommunicable disease rates of two Mexican states, and the penetration of levels of the …

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Sex Differences In Weight Perception And Weight Gain Among Black College Students In The Usa, Jounghee Lee, Jaesin Sa, Jean-Philippe Chaput, James Heimdal, Beatrice Nelson, Beom-Young Cho, Elizabeth Kwon

Human Performance and Sport Sciences faculty Research

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Objectives

The aims of this study were to examine the prevalence of overweight/obesity and to explore sex differences in body weight perceptions and correlates of weight gain among Black students at 2 historically Black colleges and universities (HBCUs) in the USA.

Methods

Participants completed a paper-based survey, and their height and weight were measured (67% completion rate).

Results

The overweight and obesity rates were 33.8% and 26.9%, respectively. More females than males accurately assessed their weight (p<0.05). Body weight underestimation was associated with male sex, excellent/very good perceived overall health, and not being informed by a doctor of having overweight or obesity (p<0.01). Higher odds of ≥5% weight gain were related to female sex, living on campus, and not being informed by a doctor of having overweight or obesity (p<0.05).

Conclusion

Given the high overweight and obesity rates among Black students, HBCUs in the USA should develop intervention strategies for …

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Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren

Evidence-Based Practice Project Reports

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The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …

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Final Culminating Project: Program Development, Erin Helms

Department of Occupational Therapy Entry-Level Capstone Projects

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This 16-week capstone project was completed at Parker Place, a children’s health, and wellness center, with a focus on program development and advocacy with additional work related to leadership and administration. The overall goal of the capstone project was to determine the benefit of using an occupation-based approach to enhance health outcomes for the patients at Parker Place. The capstone student provided education about the role of occupational therapy in a non-traditional setting, created a program to help patients acquire sustainable healthy habits, developed a workshop for families struggling to maintain a healthy lifestyle, and provided resources about picky eating …

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Dietary Strawberries Improve Cardiometabolic Risks In Adults With Obesity And Elevated Serum Ldl Cholesterol In A Randomized Controlled Crossover Trial, Arpita Basu, Kenneth Izuora, Nancy M. Betts, Jefferson W. Kinney, Arnold M. Salazar, Jeffrey L. Ebersole, R. Hal Scofield

Kinesiology and Nutrition Sciences Faculty Research

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Background and aims: Dietary berries, such as strawberries, are rich in bioactive compounds and have been shown to lower cardiometabolic risk. We examined the effects of two dietary achievable doses of strawberries on glycemic control and lipid profiles in obese adults with elevated serum LDL cholesterol (LDL-C). Methods: In this 14-week randomized controlled crossover study, participants were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, one serving (low dose: 13 g strawberry powder/day), or two-and-a-half servings (high dose: 32 g strawberry powder/day). Participants were instructed to follow their usual diet …

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In Men With Obesity, T2dm Is Associated With Poor Trabecular Microarchitecture And Bone Strength And Low Bone Turnover, Francesca Vigevano, Giulia Gregori, Georgia Colleluori, Rui Chen, Vimlin Autemrongsawat, Nicola Napoli, Clifford Qualls, Dennis T Villareal, Reina Armamento-Villareal

Faculty, Staff and Students Publications

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INTRODUCTION: Obesity and type 2 Diabetes (T2D) are both associated with greater bone mineral density (BMD) but increased risk of fractures. The effect of the combination of both conditions on bone metabolism, microarchitecture, and strength in the obese population remains unknown.

METHODS: Data from 112 obese men were collected. Bone turnover and biochemical markers were measured by enzyme-linked immunosorbent assay, body composition and BMD at all sites were assessed by dual energy X-ray absorptiometry, whereas bone microarchitecture and strength (stiffness and failure load) were measured by high-resolution peripheral computed tomography. Data were compared among metabolically healthy obese (MHO) and metabolically …

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Changes In Body Mass Index Among Antiretroviral Therapy Naïve People Living With Hiv In Southeastern Nigeria, John O. Olawepo, Jennifer R. Pharr, Chad L. Cross, Babayemi O. Olakunde, Chinedu Aniekwe, Mercy Niyang, Raisa Kabir, Ayodotun Olutola

Environmental & Global Health Faculty Research

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The proportion of people living with HIV (PLHIV) who are overweight or obese is rising, leading to a double epidemic of HIV and obesity. The purpose of this retrospective longitudinal study was to examine changes in body mass index (BMI) among PLHIV who were new to antiretroviral therapy (ART) in two states in Southeastern Nigeria. The BMI at baseline and 12 months were compared and the difference in proportions in each BMI category was tested. The association between the BMI at 12 months and the demographic and/or clinical variables was examined using multiway analysis of covariance. The study included 2,146 …

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Pediatric Obesity: Prevention, Assessment And Treatment In Primary Care, Susan Johnson

Theses and Graduate Projects

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People of all ages deserve care for the disease of obesity. Pediatric obesity affects one in three children in the United States, and the number of obese children has tripled since the 1970s (Centers for Disease Control and Prevention (CDC), 2018a). High blood pressure, high cholesterol, type 2 diabetes, and sleep apnea are complications that pediatric patients now face, and these diseases are well known to worsen quality of, and potentially shorten life. This scholarly project addresses the question: How can family nurse practitioners effectively address pediatric obesity in the primary care setting? Interventions early in life, perhaps even pre-conception, …

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Sacubitril/Valsartan Inhibits Obesity-Associated Diastolic Dysfunction Through Suppression Of Ventricular-Vascular Stiffness, Annayya R. Aroor, Srinivas Mummidi, Juan C. Lopez-Alvarenga, Nitin Das, Javad Habibi, Guanghong Jia, Guido Lastra, Bysani Chandrasekar

School of Medicine Publications

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Objective: Cardiac diastolic dysfunction (DD) and arterial stiffness are early manifestations of obesity-associated prediabetes, and both serve as risk factors for the development of heart failure with preserved ejection fraction (HFpEF). Since the incidence of DD and arterial stiffness are increasing worldwide due to exponential growth in obesity, an effective treatment is urgently needed to blunt their development and progression. Here we investigated whether the combination of an inhibitor of neprilysin (sacubitril), a natriuretic peptide-degrading enzyme, and an angiotensin II type 1 receptor blocker (valsartan), suppresses DD and arterial stiffness in an animal model of prediabetes more effectively than valsartan …

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