Medicine and Health Sciences Commons^™

Obesity: Policy And Practice Recommendations For High-Risk Populations Influenced By The Covid-19 Pandemic, Kathryn N. Robinson, Deborah A. Saber

Faculty Research 2022

Obesity has been linked to higher morbidity and mortality in those that contract novel viruses, such as H1N1 and SARS-CoV-2. Loss of life and the high cost of obesity highlight the need to focus on preventative measures. The state of Maine (United States) is profiled as a rural state with high rates of obesity and low health literacy that benefits from programs to improve health. However, more multidirectional efforts are needed. Four recommendations for building a healthier, more resilient patient population are discussed here: (i) state incentives and subsidies, (ii) employers to incentivize healthy living, (iii) federal incentives and initiatives, …

Facilitators And Barriers To Farmers’ Market Use In A Rural Area, Soghra Jarvandi, Kristen Johnson, Karen Franck

Journal of Extension

Farmers’ markets may improve access to healthful foods in rural areas. Our objective was to identify facilitators and barriers to farmers’ market use in a rural county. We collected data via surveys, focus group sessions, and key informant interviews. Study participants identified the two existing farmers’ markets as community assets. Barriers to use farmers’ markets included inconvenient market hours, not accepting nutrition assistance program benefits, limited transportation, and limited variety. Interventions to improve food access should include ways to meet the needs of specific populations such as low-income residents and residents living in outlying areas without farmers’ markets.

Context Matters: Preliminary Evidence That The Association Between Positive Affect And Adiposity In Infancy Varies In Social Vs Non-Social Situations, Alexis C Wood, Shabnam R Momin, Mackenzie K Senn, David J Bridgett

Children’s Nutrition Research Center Staff Publications

Previous studies have suggested that infants high in negative affect have higher levels of adiposity, arising in part via changes in nutrition (e.g., “feeding to soothe”). Few studies have examined whether positive affect shows similar or inverse associations with adiposity. The current study examined cross-sectional and longitudinal relationships between adiposity and observations of positive affect in both a social and a non-social context, using data from infants at four (n = 125) and 12 (n = 80) months of age. Our analyses did not find any cross-sectional associations between positive affect and adiposity (all p > 0.05). However, in the longitudinal …

French-Fried Potato Consumption And Energy Balance: A Randomized Controlled Trial, Daniel L Smith, Rebecca L Hanson, Stephanie L Dickinson, Xiwei Chen, Amy M Goss, John B Cleek, W Timothy Garvey, David B Allison

Children’s Nutrition Research Center Staff Publications

Background: Epidemiologic observations suggest increased potato consumption correlates with weight gain, adiposity, and diabetes risk, whereas nut consumption is associated with weight control and metabolic health. Randomized controlled trial (RCT) data indicate humans respond to changes in energy intake in single dietary components and compensate for extra energy consumed.

Objectives: We completed an RCT testing whether increased daily potato consumption influences energy balance [specifically, fat mass (FM)] compared with calorie-matched almond consumption.

Methods: A 30-d RCT of 180 adults prescribed calorie-matched (300 kcal/d, n = 60 participants/group) than consumed 1 of the following: 1) almonds (almond group), 2) French fries …

An Exercise-Inducible Metabolite That Suppresses Feeding And Obesity, Veronica L Li, Yang He, Kévin Contrepois, Hailan Liu, Joon T Kim, Amanda L Wiggenhorn, Julia T Tanzo, Alan Sheng-Hwa Tung, Xuchao Lyu, Peter-James H Zushin, Robert S Jansen, Basil Michael, Kang Yong Loh, Andrew C Yang, Christian S Carl, Christian T Voldstedlund, Wei Wei, Stephanie M Terrell, Benjamin C Moeller, Rick M Arthur, Gareth A Wallis, Koen Van De Wetering, Andreas Stahl, Bente Kiens, Erik A Richter, Steven M Banik, Michael P Snyder, Yong Xu, Jonathan Z Long

Children’s Nutrition Research Center Staff Publications

Exercise confers robust protection against obesity, type 2 diabetes, and other cardiometabolic diseases.1–5 However, the molecular and cellular mechanisms that mediate the metabolic benefits of physical activity remain unclear.6 Here we show that exercise stimulates production of Lac-Phe, a blood-borne signaling metabolite that suppresses feeding and obesity. Lac-Phe biosynthesis from lactate occurs in CNDP2+ cells including immune cells, epithelial cells, and mesenchymal stem cells localized to diverse organs. In diet-induced obese mice, pharmacological elevation of circulating Lac-Phe reduces food intake without affecting movement or energy expenditure. Chronic administration of Lac-Phe decreases adiposity and body weight and …

The Hypothalamus For Whole-Body Physiology: From Metabolism To Aging, Tiemin Liu, Yong Xu, Chun-Xia Yi, Qingchun Tong, Dongsheng Cai

Children’s Nutrition Research Center Staff Publications

Obesity and aging are two important epidemic factors for metabolic syndrome and many other health issues, which contribute to devastating diseases such as cardiovascular diseases, stroke and cancers. The brain plays a central role in controlling metabolic physiology in that it integrates information from other metabolic organs, sends regulatory projections and orchestrates the whole-body function. Emerging studies suggest that brain dysfunction in sensing various internal cues or processing external cues may have profound effects on metabolic and other physiological functions. This review highlights brain dysfunction linked to genetic mutations, sex, brain inflammation, microbiota, stress as causes for whole-body pathophysiology, arguing …

Co-Transmitting Neurons In The Lateral Septal Nucleus Exhibit Features Of Neurotransmitter Switching, Patrick J Hunt, Mikhail Kochukov, Brandon T Pekarek, Benjamin D W Belfort, Juan M Romero, Jessica L Swanson, Benjamin R Arenkiel

Faculty, Staff and Students Publications

The lateral septal nucleus (LSN) is a highly interconnected region of the central brain whose activity regulates widespread circuitry. As such, the mechanisms that govern neuronal activity within the LSN have far-reaching implications on numerous brain-wide nuclei, circuits, and behaviors. We found that GABAergic neurons within the LSN express markers that mediate the release of acetylcholine (ACh). Moreover, we show that these vGATLSN neurons release both GABA and ACh onto local glutamatergic LSN neurons. Using both short-term and long-term neuronal labeling techniques we observed expression of the cholinergic neuron marker Choline Acetyltransferase (ChAT) in vGATLSN neurons. These findings provide evidence …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

Constitutive Loss Of Dnmt3a Causes Morbid Obesity Through Misregulation Of Adipogenesis, Ayala Tovy, Jaime M Reyes, Linda Zhang, Yung-Hsin Huang, Carina Rosas, Alexes C Daquinag, Anna Guzman, Raghav Ramabadran, Chun-Wei Chen, Tianpeng Gu, Sinjini Gupta, Laura Ortinau, Dongsu Park, Aaron R Cox, Rachel E Rau, Sean M Hartig, Mikhail G Kolonin, Margaret A Goodell

Faculty, Staff and Students Publications

DNA Methyltransferase 3 A (DNMT3A) is an important facilitator of differentiation of both embryonic and hematopoietic stem cells. Heterozygous germline mutations in DNMT3A lead to Tatton-Brown-Rahman Syndrome (TBRS), characterized by obesity and excessive height. While DNMT3A is known to impact feeding behavior via the hypothalamus, here we investigated a role in adipocyte progenitors utilizing heterozygous knockout mice that recapitulate cardinal TBRS phenotypes. These mice become morbidly obese due to adipocyte enlargement and tissue expansion. Adipose tissue in these mice exhibited defects in preadipocyte maturation and precocious activation of inflammatory gene networks, including interleukin-6 signaling. Adipocyte progenitor cell lines lacking DNMT3A …

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Reno-Protective And Immune Effects Of Growth Differentiation Factor 15 In Obesity-Related Kidney Disease, Jessie T. Sullivan

Honors Thesis

According to the World Health Organization, worldwide obesity has tripled since 1975 and is still on the rise, putting people at a higher risk of some cardiovascular diseases and kidney disease. Growth differentiation factor 15 (GDF15) is a stress-responsive cytokine that has been studied recently for its role in multiple biological processes and diseases. The member of the transforming growth factor beta (TGF-b) family has been investigated as a therapeutic agent and biomarker for obesity and associated cardiovascular diseases, stroke, diabetes, osteoarthritis, cancer, and kidney disease. Studies have shown the anti-inflammation, anti-obesity, and anti-diabetic effects of GDF15, but few have …

Feasibility And Efficacy Of Bisphosphonate Use For The Prevention Of Bone And Muscle Loss, Laura E. Flores

Theses & Dissertations

Loss of bone and muscle mass often occurs in tandem, increasing the risk of fragility fractures. Whereas many drugs are approved for the treatment of bone loss, there are few treatments available for the concomitant loss of bone and muscle. Identification of a treatment to mitigate pathologic bone and muscle atrophy has the potential to impact countless populations and influence approaches for healthy aging. Bisphosphonates have emerged as a potential treatment for both bone and muscle loss in cellular, murine, and observational human studies. Our findings of modest weight maintenance in postmenopausal women treated with 12-months of risedronate, relative to …

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 …

Burden Of Cardiovascular Risk Factors And Disease In Five Asian Groups In Catalonia: A Disaggregated, Population-Based Analysis Of 121 000 First-Generation Asian Immigrants, Priyanka Satish, Emili Vela, Usama Bilal, Montse Cleries, Alka M Kanaya, Namratha Kandula, Salim S Virani, Nadia Islam, Javier Valero-Elizondo, Tamer Yahya, Josep Comin-Colet, Khurram Nasir, Josepa Mauri, Miguel Cainzos-Achirica

Faculty, Staff and Students Publications

AIMS: To evaluate the burden of cardiovascular risk factors and disease (CVD) among five Asian groups living in Catalonia (Spain): Indian, Pakistani, Bangladeshi, Filipino, and Chinese.

METHODS AND RESULTS: Retrospective cohort study using the Catalan Health Surveillance System database including 42 488 Pakistanis, 40 745 Chinese, 21 705 Indians, 9544 Filipinos, and 6907 Bangladeshis; and 5.3 million native individuals ('locals'). We estimated the age-adjusted prevalence (as of 31 December 2019) and incidence (during 2019) of diabetes, hypertension, hyperlipidaemia, obesity, tobacco use, coronary heart disease (CHD), cerebrovascular disease, atrial fibrillation, and heart failure (HF). Bangladeshis had the highest prevalence of diabetes …

Examining The Relationship Between Adolescent Obesity Rates And School Health Programs In Grades 9-12 In The United States, Joseph Melillo, Alison Mancuso

Rowan-Virtua Research Day

- In the United States, it was found that the prevalence of obese adolescents ages 12-19 was 21.2%.1

- According to a study by Ward et. al published in the New England Journal of Health (NEJH), the researchers estimated 88.2% of obese 19-year-olds would still be obese by the age of 35.2

- The purpose of this study was to evaluate school provided health programs and their impact on BMI values of students within these schools.

- This study aimed to compare health outcomes between different schools across the United States and identify aspects of school programming that can be …

Impact Of Body Mass Index And Body Fat Percentage On Subjective Weight Status, Kelly Staples, Adarsh Gupta

Rowan-Virtua Research Day

• In the United States, the prevalence of obesity in adults is 42.4% of the population
• Body mass index (BMI) is the most frequently used tool to screen and assess for obesity
• BMI fails to account for body composition and body fat percentage (BFP)
• The objective of our study is to assess for understanding of BMI, BFP, and how these two measures are related to self-perception of body mass.
• Findings showed positive correlations between BMI, gender, and perception of body figure

The Impact Of The Covid-19 Pandemic On Pediatric Obesity In School-Aged Children, Amaani Faizal, Maryanna Schweininger, Suzanna Hosein

Rowan-Virtua Research Day

The prevalence of childhood obesity in those aged 2-19 in the United States was 19.3% in 2017-2018. Childhood obesity is a major health concern with growing rates of incidence. Being overweight or obese put children at risk for developing several chronic conditions such as coronary artery disease, type 2 diabetes mellitus, hypertension and asthma at a younger age. Studies have shown that higher BMI numbers in childhood added an increased risk of being obese as an adult.

The pathophysiology of developing obesity includes several complex factors ranging from nutrition, physical activity, genetic background and lifestyle preferences. Among children, nutrition and …

Pediatric Obesity: A Survey Study Of Patients And Caregivers’ Concern And Interest In Specialized Programs, Dina Abdo, Ryan Rogers, Susan Edlibi, Aimee Pollak, Stacey Shubeck, Kerry P. Mychaliska

Posters

INTRODUCTION
Body mass index (BMI) ≥ the 85th percentile for age and sex is considered overweight in the pediatric population. Pediatric obesity is defined as a BMI at or above the 95th percentile. According to the Centers for Disease Control (CDC), obesity prevalence has tripled over the past 50 years; 1 in 5 school-aged children has a diagnosis of obesity. The purpose of this study is to survey caregivers’ perceptions and concerns about their child’s weight and patient and caregiver interest in a comprehensive healthy lifestyle program.

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 …

Efficacy Of Probiotic Supplementation For Weight Loss In Overweight And Obese Adults, Kelsie Tescher

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to assess current studies investigating the efficacy of using probiotic supplementation to promote weight loss in the overweight and obese adult populations. Three databases were used including PubMed, ClinicalKey, and Embase with a time frame of 15 years. A total of 17 studies met the research criteria and were therefore reviewed. Body weight loss and decrease in BMI were used as measurements of efficacy. Studies used were peer reviewed, randomized-control trials, double-blind, and placebo-controlled. Current research shows insufficient evidence to support the use of a specific genus and/or species of probiotic to promote …

Comparison Of Short Chain Volatile Fatty Acids In The Breastmilk Of Normal And Overweight/Obese Mothers, Ellen Gaskill, W Andrew Clark, Kristy L. Thomas, Amy Wahlquist, Michelle E. Johnson

Undergraduate Honors Theses

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body …

Epigenetics As Primary Prevention Of Coronary Artery Disease, David Majewski

Physician Assistant Scholarly Project Papers

This systematic literature review intended to ascertain if epigenetic testing for the primary prevention of Coronary Artery Disease (CAD) decreases mortality compared to the current standard of care. This systemic review used PubMed and Cochrane medical databases to assess epigenetic variances and their association with CAD. The Medical Subject Headings (MeSH) terms used were as follows: CAD, genetics, epigenomics, diabetes, hypertension, obesity, dyslipidemia, primary prevention, and standard of care. Further limiting the search results to Randomized Control Trials (RCT’s), meta-analysis, peer-reviewed, and published within the last 10 years. Exclusion criteria included publications before 2011, articles that did not compare genetic …

Adipocyte-Derived Serum Amyloid A Promotes Angiotensin Ii–Induced Abdominal Aortic Aneurysms In Obese C57bl/6j Mice, Preetha Shridas, Ailing Ji, Andrea C. Trumbauer, Victoria P. Noffsinger, Steve W. Leung, Adam J. Dugan, Sean E. Thatcher, Lisa A. Cassis, Frederick C. De Beer, Nancy R. Webb, Lisa R. Tannock

Internal Medicine Faculty Publications

Background: Obesity increases the risk for human abdominal aortic aneurysms (AAAs) and enhances Ang II (angiotensin II)-induced AAA formation in C57BL/6J mice. Obesity is also associated with increases in perivascular fat that expresses proinflammatory markers including SAA (serum amyloid A). We previously reported that deficiency of SAA significantly reduces Ang II-induced inflammation and AAA in hyperlipidemic apoE-deficient mice. In this study. we investigated whether adipose tissue-derived SAA plays a role in Ang II-induced AAA in obese C57BL/6J mice.

Methods: The development of AAA was compared between male C57BL/6J mice (wild type), C57BL/6J mice lacking SAA1.1, SAA2.1, and SAA3 …

The Role Of Obesity In Macrophage-Mediated Mechanisms Promoting Early-Onset Colon Cancer., Katharina Marietta Scheurlen

Electronic Theses and Dissertations

Early-onset colon cancer (EOCC) is a leading cause of cancer death among people younger than 50 years of age in the United States and is associated with metabolic dysfunction and obesity. Anti-inflammatory tumor-associated macrophages (TAM) and low Peroxisome Proliferator Activated Receptor Gamma (PPARγ) gene expression in colon cancer (CC) tissue promote tumor progression and decreased patient survival. Obesity-related hormones, such as leptin and adiponectin, have the potential to affect gene expression in TAM to promote CC progression and thereby link obesity and EOCC. The aim of this project was to identify target genes in human CC and to investigate the …

The Prevalence Of Iron Deficiency And Obesity Among Young Children In The United States, Mirriam Abunaja

Electronic Theses, Projects, and Dissertations

Background The coexistence of obesity and iron deficiency among children is one manifestation of the double burden of malnutrition (DBM) and is a public health concern. This study aims to provide useful insight on public health knowledge by presenting a current snapshot of the coexistence of obesity and iron deficiency among pre-school aged children as well as specific risk factors.

Methods This analysis utilizes secondary data from a publicly accessible, national database, the National Health and Nutritional Examination Survey (NHANES). The data examined were retrieved from the years 2015-2016 and 2017-2018. Chi-squared tests were used to test each thesis question. …

Weight Gain Trajectory Over Five Years For Adult Primary Care Patients In Nebraska, Elizabeth M. Morris

Capstone Experience: Master of Public Health

INTRODUCTION: The continued rise in the prevalence of adult obesity in the United States is a public health concern. Several studies have identified the increasing rates of obesity, its impacts, and the factors leading to obesity. Some researchers have made obesity prevalence projections at the national and state levels. This study aims to fill the critical gap in real-time weight data trends among primary care adult patients in Nebraska. The main goal of this study is to determine and analyze the weight trajectory of adults in Nebraska over the past five years and determine if the trends vary among age …

Comparative Effects Of High-Intensity Interval Warm-Up Exercise And Bronchodilator On Exercise-Induced Bronchoconstriction In Children With Mild Asthma, Michael Wong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The troubling link between obesity and asthma in children, along with greater associated detrimental health effects, warrants investigation to better understand the mechanisms driving this relationship as well as its consequences, especially during exercise. Bronchodilators and interval warm-up exercises are recommended by the American Thoracic Society to prevent exercise-induced bronchoconstriction (EIB). Whether interval warm-up exercise can prevent EIB to the same extent as bronchodilators in asthmatic children is unknown but clinically important. Therefore, the first purpose of this study is to investigate the effects of obesity on pulmonary function, exercise tolerance, and exercise-induced bronchoconstriction in asthmatic children. The second …

Berberine Remodels Adipose Tissue To Attenuate Metabolic Disorders By Activating Sirtuin 3, Dan Li, Chao Yang, Jian-Zhong Zhu, Eduardo Lopez, Tian Zhang, Qiang Tong, Cheng Peng, Li-Gen Lin

Faculty, Staff and Students Publications

Adipose tissue remodelling is considered a critical pathophysiological hallmark of obesity and related metabolic diseases. Berberine (BBR), a natural isoquinoline alkaloid, has potent anti-hyperlipidaemic and anti-hyperglycaemic effects. This study aimed to explore the role of BBR in modulating adipose tissue remodelling and the underlying mechanisms. BBR protected high fat diet (HFD)-fed mice against adiposity, insulin resistance and hyperlipidemia. BBR alleviated adipose tissue inflammation and fibrosis by inhibiting macrophage infiltration, pro-inflammatory macrophage polarization and the abnormal deposition of extracellular matrix, and the effect was mediated by BBR directly binding and activating the deacetylase Sirtuin 3 (SIRT3) and suppressing the activation of …