Medicine and Health Sciences Commons^™

Comparing Clinician Knowledge And Online Information Regarding Alli (Orlistat), Stuart Nelson, Kevin O Hwang, Elmer V Bernstam

Faculty, Staff and Student Publications

BACKGROUND: Many consumers join online communities focused on health. Online forums are a popular medium for the exchange of health information between consumers, so it is important to determine the accuracy and completeness of information posted to online forums.

OBJECTIVE: We compared the accuracy and completeness of information regarding the FDA-approved over-the counter weight-loss drug Alli (Orlistat) from forums and from clinicians.

METHODS: We identified Alli-related questions posted on online forums and then posed the questions to 11 primary care providers. We then compared the clinicians' answers to the answers given on the forums. A panel of blinded experts evaluated …

Obesity And Cancer, Rickie Brawer, Phd, Mph, Nancy Brisbon, Md, James Plumb, Md

Department of Family & Community Medicine Faculty Papers

Obesity has become the second leading preventable cause of disease and death in the United States, trailing only tobacco use. Weight control, dietary choices, and levels of physical activity are important modifiable determinants of cancer risk. If multi-factorial approaches to prevention and management are not implemented, obesity will likely become the leading modifiable cause of death in the coming years. Physicians have a key role in integrating these approaches into clinical care and advocating for systemic prevention efforts. This article provides: 1) an introduction to the epidemiology and magnitude of childhood and adult obesity; 2) the relationship of overweight/obesity to …

Senate Bill 42: Implementation And Impact On Physical Activity In Middle Schools, Cristina S. Barroso, Steven H. Kelder, Andrew E. Springer, Carolyn L. Smith, Nalini Ranjit, Christopher Ledingham, Deanna M. Hoelscher

Health & Human Performance Faculty Publications

Purpose

In 2005, the Texas State Legislature passed Senate Bill 42 (SB42), which required public middle school students (grades 6–8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity.

Methods

Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n = 112). Direct observation, …

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …

Number Of Aberrant Crypt Foci Associated With Adiposity And Igf1 Bioavailability, Helen Swede, Joseph C. Anderson, Richard G. Stevens, Joel Levine, Bruce M. Brenner, Carl D. Malchoff, Valerie B. Duffy, Devon C. Pleau, Daniel W. Rosenberg

Articles - Patient Care

Background Dysregulation of the insulin-like growth factor (IGF) system, a common consequence of adiposity-induced insulin resistance, may be a key underlying mechanism linking excess body weight with colon cancer. Evidence has been derived from studies of cancer and polyps. Supporting data about aberrant crypt foci (ACF), putative pre-polyp changes, have been generated only from animal studies to date. Methods We randomly selected 26 patients with sex-specific elevated waist-hip-ratio (WHR) and 26 with normal values from a series of 150 patients seeking routine colonoscopy at the University of Connecticut Health Center. Cross-sectional analyses were performed of ACF number (<5, ≥5) in relation to total IGF1, IGF-binding protein-3 (IGFBP3), insulin, body mass index (BMI), WHR and waist circumference (WC). Visualized ACF in the 20 cm of the distal colon were counted using advanced endoscopic imaging. Results Patients …

Metabolic Syndrome And Risk Of Cancer Mortality In Men, Jason R. Jaggers, Xuemei Sui, Steven P. Hooker, Michael J. Lamonte, Charles E. Matthews, Gregory A. Hand, Steven N. Blair

Faculty and Staff Scholarship

Background—Metabolic syndrome (MetS) has been linked with an increased risk of developing cancer; however the association between MetS and cancer mortality remains less clear. Little research has focused on pre-cancer risk factors that may affect the outcome of treatment. The purpose of this study was to examine the association between MetS and all-cancer mortality in men. Methods—The participants included 33,230 men aged 20-88 years who were enrolled in the Aerobics Center Longitudinal Study and free of known cancer at baseline. Results—At baseline 28% of all the participants had MetS. During an average of 14 years followup there were a total …

Carbohydrate Intake And Overweight And Obesity Among Healthy Adults, Anwar T. Merchant, Hassanali Vatanparast, Shahzaib Barlas, Mahshid Dehghan, Syed Mahboob Ali Shah, Lawrence De Koning, Susan E. Steck

Faculty Publications

Background - Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective - To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults

Design - We used a cross-sectional analysis

Subjects/setting - The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures - Outcome variables were body mass index (BMI; calculated as kg/m^{2 …}

Chronic Illness And Smoking Cessation, Kushal Patel, David Schlundt, Celia Larson, Hong Wang, Anne Brown, Margaret Hargreaves

Public Health, Health Administration, and Health Sciences Faculty Research

Introduction

Smoking is among the leading causes of premature mortality and preventable death in the United States. Although smoking contributes to the probability of developing chronic illness, little is known about the relationship between quitting smoking and the presence of chronic illness. The present study investigated the association between diagnoses of one or more chronic diseases (diabetes, hypertension, or high cholesterol) and smoking status (former or current smoker). Methods

The data analyzed were a subset of questions from a 155-item telephone-administered community survey that assessed smoking status, demographic characteristics, and presence of chronic disease. The study sample consisted of 3,802 …

Am 6545: A Novel Peripheral Cb1 Antagonist, Seth Hosmer

Honors Scholar Theses

Obesity and other related metabolic disorders are a common problem in the United States. Consequently, several drug therapies have been developed in an attempt to address this problem. Many older appetite suppressants, such as amphetamines, were dangerous and potentially addictive. For the last few years, the endocannabinoid system was investigated as a potential target for appetite suppression. Unfortunately, early cannabinoid CB1 antagonists came with an unacceptable side effect profile of their own, which is largely due to central actions of these drugs. In an attempt to reduce the side effect profile, researchers are investigating peripherally acting cannabinoid antagonists, which do …

The Effects Of Glucose Tolerance, Hypertension, And Race On Heart Rate Variability, Qt Interval Duration, And Left Ventricular Hypertrophy In Overweight-Obese Adolescents, Shirleatha T. Lee

Theses and Dissertations (ETD)

The prevalence of childhood obesity has increased remarkably within the past ten years with black youth disproportionately affected. Childhood obesity is linked to cardiovascular risk. Purposes of this study were to explore relationships between cardiac autonomic risk factors of heart rate variability (HRV), QT corrected (QTc) Interval duration, and Cornell voltage measures for left ventricular hypertrophy (LVH) to body mass index (BMI), relative body mass index (RBMI), and blood pressure (BP) measures, and to examine the effects of impaired glucose tolerance (IGT), hypertension, and race on these cardiac autonomic risk factors in overweight-obese adolescents.

Methods: Overweight and obese adolescents (N …

Effect Of Obesity On The Traditional And Emerging Cardiovascular Disease Risk Factors In African American Women, Queen Obiageli Henry-Okafor

Theses and Dissertations (ETD)

Background: Obesity is a growing health care concern with cardiovascular disease (CVD) implications. African American women (AAW) have the highest prevalence rate of obesity and highest CVD morbidity and mortality rate of all ethnic groups. The traditional CVD risk factors have not been sufficient to explain this disparity in disease prevalence and outcomes. Current knowledge is limited regarding the interaction between various levels of adiposity and both traditional and emerging CVD risk factors, particularly in AAW. This study sought to explore these interactions.

Methods: The study design was a cross-sectional, descriptive, correlational analysis of 48 AAW ages 18 to 45 …

Meta-Analysis: Racial Disparities In Prostate Cancer Survival And Case-Control Study: Association Between Family History Of Cancers, Obesity And Prostate Cancer, Gayathri Sridhar

Theses and Dissertations

This is a compilation of 3 abstracts for the three manuscripts included in this dissertation. I. Meta-Analysis: Racial Disparities in Prostate Cancer Survival: Prostate cancer is the second leading cause of cancer-related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of published articles from 1968 to 2007 assessing survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Analysis of unadjusted studies showed African American …

Obesity, Adiposity, And Satiety In Mouse Models Of Smith-Magenis Syndrome And Dup(17)(P11.2) Syndrome, Brooke Burns

Theses and Dissertations

Smith-Magenis syndrome (SMS) is a complex disorder caused by haploinsufficiency of RAI1 and characterized by sleep disturbances, behavioral abnormalities, mental retardation, and obesity in teens and adults. Rai1+/- mice are obese after 20 weeks. Dup(17)(p11.2) syndrome is a complex disorder associated with overexpression of RAI1. A transgenic mouse model of dup(17)(p11.2) syndrome overexpresses Rai1 and results in a mouse that is growth delayed. In order to characterize the obese phenotypes of mouse models of SMS and the role of RAI1 in obesity, daily food intake and serum levels of insulin, glucose, PPY, and leptin were measured; adiposity was studied by …

Mechanisms Of Regulation Of Proximal Tubule Sodium Transporters In Obesity-Induced Hypertension, Marta A. Ambrozewicz

Theses and Dissertations in Biomedical Sciences

Hypertension is one of the common complications of obesity. Using a rat model of diet induced obesity and hypertension we investigated some of the mechanisms that are involved in regulation of blood pressure in obesity. The first aim of this study was to determine the role of proximal tubule transporters on the renal sodium handling in obese hypertensive (OP) and lean normotensive (OR) rats. An acute increase in renal perfusion pressure resulted in a blunted natriuretic response in OP vs. OR rats and indicated that increased sodium reabsorption in the proximal tubule is casual, at least in part, for hypertension …

An Examination Of Alcohol Use In The Gastric Bypass Patient, Kathleen Winston Phd, Msn, Rn

Dissertations

Introduction: Obesity and morbid obesity, along with their co-morbidities, are impacting the national and international healthcare delivery systems and policy agendas. Bariatric surgery is a dynamic and fast-changing medical and surgical practice designed to mitigate the consequences of 60 million obese adults in the United States alone. Alcohol consumption after gastric bypass surgery presents potential physiological and psychological problems. Purpose: Examine the prevalence and incidence of increased alcohol consumption among a group of post-gastric bypass patients; identify the relationship of the alcohol use with time since surgery, psychosocial issues (depressive symptomatology, anxiety, coping) and demographic variables. Theoretical Framework: Coping serves …

Prevalence Of Obesity In School-Going Children Of Karachi., Haider Javed Warraich, Faisal Javed, Mohammed Faraz-Ul-Haq, Fariha Batool Khawaja, Sarah Saleem

Community Health Sciences

Background: Obesity is an emerging problem in Pakistan. The authors sought to determine prevalence of obesity and malnutrition in school-going children, from grades 6(th) to 8(th) of different schools of Karachi and assess associations that affect the weight of the children.
Methodology/Principal Findings: A cross sectional Study Design with children studying in grades 6(th) to 8(th) grade, in different schools of Karachi. We visited 10 schools of which 4 consented, two subsidized government schools and two private schools. A questionnaire was developed in consultation with a qualified nutritionist. Height and weight were measured on calibrated scales. A modified BMI criterion …

Environment And Obesity In The National Children's Study, Leonardo Trasande, Christine E. Cronk, Maureen S. Durkin, Marianne E. Weiss, Dale A. Schoeller, Elizabeth A. Gall, Jeanne B. Hewitt, Aaron L. Carrel, Philip J. Landrigan, Matthew W. Gillman

College of Nursing Faculty Research and Publications

Objective: In this review we describe the approach taken by the National Children’s Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity.

Data sources and extraction: We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis.

Data synthesis: Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of …

Impact Of Obesity On Perioperative Morbidity And Mortality Following Pancreaticoduodenectomy, Timothy K. Williams, Ernest L. Rosato, Eugune P. Kennedy, Karen A. Chojnacki, Jocelyn Andrel, Terry Hyslop, Cataldo Doria, Patricia K. Sauter, Jordan Bloom, Charles J. Yeo, Adam C. Berger

Department of Surgery Faculty Papers

Background: Obesity has been implicated as a risk factor for perioperative and postoperative complications. The aim of this study was determine the impact of obesity on morbidity and mortality in patients undergoing pancreaticoduodenectomy (PD).

Study Design: Between January 2000 and July 2007, 262 patients underwent PD at Thomas Jefferson University Hospital (TJUH), of whom 240 had complete data, including body mass index (BMI) for analysis. Data on BMI, preoperative parameters, operative details, and post-operative course were collected. Patients were categorized as obese (BMI >30 kg/m2), overweight (25≤BMI<30), or normal weight (BMI<25). Complications were graded according to previous published scales. Other endpoints included length of postoperative hospital stay, blood loss, and operative duration. Analyses were performed using univariate and multivariable models.

Results: There were 103 (42.9%) normal weight, 71 (29.6%) overweight and 66 (27.5%) …

Enhanced Estrogen-Induced Proliferation In Obese Rat Endometrium, Qian Zhang, Qi Shen, Joseph Celestino, Michael R Milam, Shannon N Westin, Robin A Lacour, Larissa A Meyer, Gregory L Shipley, Peter J A Davies, Lei Deng, Adrienne S Mccampbell, Russell R Broaddus, Karen H Lu

Faculty, Staff and Student Publications

OBJECTIVE: We tested the hypothesis that the proliferative estrogen effect on the endometrium is enhanced in obese vs lean animals.

STUDY DESIGN: Using Zucker fa/fa obese rats and lean control, we examined endometrial cell proliferation and the expression patterns of certain estrogen-regulated proproliferative and antiproliferative genes after short-term treatment with estradiol.

RESULTS: No significant morphologic/histologic difference was seen between the obese rats and the lean rats. Estrogen-induced proproliferative genes cyclin A and c-Myc messenger RNA expression were significantly higher in the endometrium of obese rats compared with those of the lean control. Expression of the antiproliferative gene p27Kip1 was suppressed …

Obesity-Relevant Behaviors: Patterns And Correlates In A Hispanic College Sample., D. Hu, T. Taylor, Theodore Cooper

Selected Works Temporary Series

No abstract provided.

Chasms In Care: Implications Of A Disparate System On Childhood Obesity, Sara Dianne Miller

Mahurin Honors College Capstone Experience/Thesis Projects

There are disparities that exist between public health and personal health care in addressing childhood obesity. Public health efforts to reduce the prevalence of this epidemic have focused on preventive strategies because a coordinated system of health care to address the treatment of obesity in children does not exist. For children who are already overweight, these strategies are not enough. What programs do exist are typically fee-for-service. This study examines the ethics and implications of the disparities that exists in our nation, as well as the role socioeconomic status plays in adolescent overweight and obesity and its primary behavior risk …

Hyperandrogenism And Obesity: Ominous Co-Morbidities, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This review has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Overweight Children And Adolescents: Impact On Psychological And Social Development, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent overweight has become a major public health concern. Not only are these youth more likely to become obese as adults, and thus more prone to obesity-related diseases than their non overweight peers, they are also likely to suffer emotional and social effects associated with overweight. Overweight in youth has been linked to depression, low self-esteem, eating disorders, negative body image, and stigma. It appears to be bi-directional in nature, with overweight sometimes predicting certain psychological effects and psychosocial issues sometimes predicting overweight. Effective assessment and treatment of psychological and mental health issues in …

Patterns Of Commodity Food Use Among American Indians, Michelle Chino, Darlene R. Haff, Carolee Dodge Francis

Environmental & Global Health Faculty Research

Objectives: To better understand risks for obesity and diabetes among American Indians.

Methods: Adults from tribes across the country surveyed to explore commodity food use patterns and food choice.

Results: Respondents reported second and third generation commodity food use. Current commodity users stated preferences for canned and packaged meals and were more likely to participate in other federal food programs.

Conclusions: Low-income, nutritionally stressed families relying on federal food programs may be at increased risk of obesity and diet-related chronic conditions due to long-term use of foods that are high in fat and calories and low in fiber.

Body Fat, Dyslipidemia, Blood Pressure And The Effects Of Smoking In Germans And Turks, Günay Can, Peter Schwandt, Altan Onat, Gülay Hergenç, Gerda-Maria Haas

Turkish Journal of Medical Sciences

Aim: Determining the difference regarding obesity in German and Turkish adults. Materials and Methods: This study examined a cross-section of adults aged 30-79 years old. Age-adjustment was uniformly provided for comparisons. Results: Among 3055 Germans and 2925 Turks, Turkish women had significantly higher markers of (abdominal) obesity than German women, while waist circumference (WC) was similar among males. Blood pressure (BP), concentrations of total, LDL-cholesterol, and apolipoprotein B were significantly higher among Germans, whereas Turks had markedly higher fasting triglycerides and lower HDL-cholesterol. Unlike Germans, the current trend of smoking among Turks correlates with lower WC and lower systolic BP …

Does Employment Status Influence Obesity Prevalence Among Females? A Comparative Study From Ankara, Turkey, Di̇lek Aslan, Zeynep Altin, Necmi̇ye Beydağ, Celi̇le Hati̇poğlu

Turkish Journal of Medical Sciences

Aim: In this study, we aimed to compare the nutritional habits and obesity status of employed and not-employed (i.e. homemakers) women from an urban population in Ankara between April 2 and 17, 2007. Materials and methods: Employed females (107) were amongst Keçiören (a district of Ankara) municipal employees, and homemakers were selected among the residents of the catchment area of a primary health care unit (PHCU) within the same district. The 2 groups (employed and homemakers) were high school and university graduates and were similar to each other in terms of education and age. The World Health Organization defines "overweight" …

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Obesity And Hyperandrogenism, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Lack Of Physical Activity, Hatim A. Omar, Efrat Merrick-Kenig, Joav Merrick

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

Zinc-Finger Protein Mcpip In Cell Death And Differentiation, Craig Younce

Electronic Theses and Dissertations

Monocyte chemotactic protein-1 (MCP-1) plays a critical role in the development of cardiovascular diseases. How MCP-1 contributes to the development of heart disease is not understood. We present evidence that MCP-1 causes death in cardiac myoblasts, H9c2 by inducing oxidative stress, ER stress and autophagy via a novel Znfinger protein, MCP-1 induced protein (MCPIP). MCPIP expression caused cell death and knockdown of MCPIP, attenuated MCP-1 induced cell death. Expression of MCPIP resulted in induction of iNOS and production of reactive oxygen (ROS). It caused induction of NADPH oxidase subunit phox47 and its translocation to the cytoplasmic membrane. Oxidative stress led …