Nutritional and Metabolic Diseases Commons^™

Diet Quality As Assessed By The Healthy Eating Index-2020 Among Individuals Diagnosed With And Without Type 2 Diabetes, Minghao Zhou, Hairui Yu, Renee Underwood, Hongning Cai, Tung Sung Tseng, Susu Luo

School of Public Health Faculty Publications

Background: Dietary management is key to preventing and controlling type 2 diabetes mellitus (T2DM). However, few studies have examined differences in Healthy Eating Index (HEI-2020) scores and components among individuals with and without diagnosed T2DM. This study aimed to assess gender differences in HEI-2020 scores and its 13 components by T2DM status. Methods: Using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, this cross-sectional study analyzed 19,464 adults. Diagnosed T2DM was identified via self-report or diabetes medication use. Diet quality was assessed using the HEI-2020, scored from 0 to 100, with a higher HEI score indicates …

Fiber Content, Total Sugar, And Glycemic Index Of Jackfruit Seed And Pigeon Pea Flour Snack Bar, Dhiyaa Septi Kirana, Tesa Rafkhani

Indonesian Journal of Public Health Nutrition (IJPHN)

Diabetes Mellitus (DM) in Indonesia is the 7th leading cause of death. Diets high in sugar and glycemic index, and low in fiber are known to trigger hyperglycemia. Snack bars high in fiber and low in glycemic index are known to reduce blood glucose levels. This research aims to determine a snack bar formulation made from jackfruit seed and pigeon pea flour and analyze fiber content, total sugar, and glycemic index value. This study used a completely randomized design analyzing three different proportions of jackfruit seed and pigeon pea flour, namely F1 (30%:70%), F2 (40%:60%), and F3 (50%:50%) with two …

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Integrating Nutrition Education To Improve The Effectiveness And Sustainability Of Makan Bergizi Gratis Programs, Akifa Laila Rusyda, Dewi Firda Sari, Ida Fransiska Pandiangan, Putri Mulifajar Gintings

Indonesian Journal of Public Health Nutrition (IJPHN)

The Makan Bergizi Gratis (MBG) program represents Indonesia's strategic effort to strengthen human capital by addressing malnutrition among school-aged. However, evidence suggests that school feeding alone is insufficient without structured nutrition education to promote sustained behavioral change. The present study examines opportunities and feasibility for embedding nutrition education within MBG implementation. Two-stage design was performed, including curriculum content reviews and qualitative case study design. A systematic curriculum content analysis was conducted across the school-based curriculum (KTSP) (2006), K-13 curriculum (2013 – 2017), and the Merdeka curriculum (2022 - present), using predefined nutrition competencies and behavioral domains as analytical frameworks. Purposive …

Food Fortification Strategies To Address Micronutrient Deficiencies In Cambodia: A Scoping Review Of Policy Implementation, Industry Capacity, And Public Health Outcomes, Sokha Yem, Sreypeov Tun, Sokunthea Kem

Indonesian Journal of Public Health Nutrition (IJPHN)

Background: Micronutrient deficiencies remain a major public health challenge in Cambodia, with iron deficiency anaemia, iodine deficiency disorders, zinc deficiency, and vitamin A deficiency disproportionately affecting women of reproductive age and children under five. Food fortification—the deliberate addition of essential micronutrients to commonly consumed foods—has been widely recognised as a cost-effective population-level intervention to address nutritional gaps. Objective: To systematically map and synthesise existing evidence on food fortification strategies in Cambodia, focusing on policy implementation, industry production capacity and compliance, regulatory enforcement, and public health outcomes. Methods: A scoping review was conducted following the Arksey and O’Malley methodological framework and …

Long Acting Beta2-Adrenergic Receptor Agonists Reverse Diabetic Nephropathy And Liver Steatosis In Murine Models Of Diabetes And Are Associated With Protection In Retrospective Human Studies, Brennan Winkler

MUSC Theses and Dissertations

Diabetes Mellitus (DM) affects 13.9% of men and 14.3% of women worldwide, a total of approximately 828 million people. Patients with diabetes are at risk of several complications including diabetic nephropathy (DN) and metabolic-associated steatohepatitis (MASH). These diseases eventually lead to end stage kidney disease (ESKD) and liver failure requiring dialysis and organ transplantation. In addition, diabetes exacerbates disease severity of autosomal dominant polycystic kidney disease (ADPKD), the most common potentially lethal genetic disease to affect humans with a prevalence of 1 in 500-1000. Therefore, a therapeutic approach that can attenuate organ damage and restore function in patients with DM, …

Decreased Exercise-Induced Pulmonary Capillary Recruitment In Pulmonary Arterial Hypertension, David Langleben, Stylianos E. Orfanos, Benjamin D. Fox, Michele Giovinazzo, Magali Kaddis, John D. Catravas

Bioelectrics Publications

The human lung normally accommodates exercise-induced cardiac output increases mainly via recruitment of non-concomitantly perfused pulmonary capillaries. Recruitment is detectable by measuring the first-pass transpulmonary metabolism of ³H-benzoyl-Phe-Ala-Pro, providing an estimate of functional capillary surface area (FCSA). Pulmonary arterial hypertension (PAH) results from luminal narrowing of small precapillary arterioles, reducing downstream perfused FCSA. We hypothesized that exercising PAH patients would not be able to recruit FCSA normally. We studied two patients with severe PAH. Despite exercising to maximal dyspnea, neither could recruit FCSA. These limited data are the first direct measurements of FCSA in exercising PAH patients.

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

Metabolism As A Regulator Of Sleep And Cortical Activity In Health And Alzheimer’S Disease, Nicholas J. Constantino

Theses and Dissertations--Neuroscience

Metabolic flexibility is essential for maintaining normal physiological function, enabling an organism to sense, flux, utilize, and switch fuel sources in response to changing energetic availability, demand, and cellular needs. Energetic demands are state-dependent, with wake and sleep exhibiting distinct metabolic profiles. Sleep is highly sensitive to changes in metabolism and requires metabolic flexibility to both transition into and maintain sleep stability. Alzheimer’s disease (AD) is increasingly recognized as a disease of altered metabolism yet is often framed as a disease of energetic failure. We instead define AD as a disease of metabolic inflexibility, characterized not by insufficient energy availability, …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

Bariatric Surgery Impacts Immune Cell Metabolism And Function Dependent On Metabolic Status, Samantha N. Hart

University of Kentucky Doctoral Dissertations

Type 2 Diabetes (T2D), one of the top ten causes of death worldwide, is fueled by chronic inflammation. T2D is considered a metabolic disease, and there is a great push to target metabolic and associated inflammatory pathways to ameliorate the disease & its comorbidities i.e., obesity and cardiovascular disease. Thus far, clinical trials of anti-inflammatory drugs have had modest impacts on T2D and have not led to changes in clinical practice. This may in part be due to a gap in knowledge in the mechanism(s) driving obesity-associated chronic inflammation. I posit that metabolic abnormalities in immune cells in those with …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Genomic Determinants Of Appetite Regulation And Their Role In Obesity Risk, Timothy J. Renier

Dartmouth College Ph.D Dissertations

Over 40% of US adults and 20% of children live with obesity. It is related to increased risks of diseases including type II diabetes and cancer, is a source of harmful stigma, and impairs child development. Appetitive traits describing patterns of food approach and avoidance behaviors may serve as windows into the underlying pathophysiology of obesity. As both obesity and appetitive traits are heritable, common genetic drivers of obesity may lead to phenotypic obesity through appetitive traits as a disease mechanism. Additionally, GLP-1 receptor agonists (GLP-1RAs) have been shown to exert their profound clinical effects in part by modulating appetite. …

Biphasic Calcium Disturbance In Rhabdomyolysis: A Case Report Of Recovery Phase Severe Hypercalcemia, Maham Shahid, Jean C. Ramos-Cardona, Maria Toustsoglou, Gunjan Y. Gandhi

South Atlantic Division GME Research Days 2026

No abstract provided.

Metabolic Syndrome Beyond Diagnostic Criteria: Population-Scale Integrative Metabolomics Characterization, Marwa Talal

Theses and Dissertations

Background: Metabolic syndrome (MetS) is a complex cluster of interrelated metabolic abnormalities associated with elevated cardiometabolic risk. While diagnosis is based on well-established five clinical criteria, these may overlook early or atypical metabolic alterations. Large-scale metabolomic profiling offers an opportunity to identify biochemical signatures of MetS beyond diagnostic bias and to evaluate their relative importance across different presentations of the syndrome.

Methods: Data from 117,147 UK Biobank participants were analyzed in a cross-sectional design. High-throughput NMR quantified 75 circulating metabolites, for. Univariate analyses, MetS subtype stratification, and elastic net models with SHAP interpretation were applied to assess feature …

The Triangular Interaction Between Dietary Polyphenols, Gut Microbiota, And Metabolic Syndrome, Emily Bayliss

Senior Honors Theses

Type 2 diabetes mellitus (T2DM) is a growing global health concern characterized by peripheral insulin resistance as well as impaired insulin secretion from pancreatic β-cells. Emerging evidence suggests that the gut microbiome, specifically gut dysbiosis, an imbalance in the gut microbiome, is a critical modulator of the pathophysiology of T2DM. Dietary polyphenols, a diverse group of bioactive compounds that are abundant in plant-based foods, have recently gained attention for their potential to attenuate metabolic disorders through their antioxidant and anti-inflammatory properties as well as through modulating the composition and activity of gut microbes, thereby attenuating dysbiosis. However, the diabetic state …

Molecular Pathway Dysregulation In Chronic Liver Disease: Metabolic And Mechanotransductive Drivers Of Hepatic Pathophysiology, Samantha Harvat

Department of Chemical and Biomolecular Engineering: Dissertations, Theses, and Student Research

Metabolic dysfunction–associated steatotic liver disease (MASLD) represents a rapidly growing cause of chronic liver injury, yet the molecular interactions linking metabolic stress, inflammation, fibrosis, and hepatocellular carcinoma (HCC) remain incompletely defined. This thesis integrates transcriptomic analyses across multiple GEO datasets to identify coordinated metabolic, inflammatory, and mechanotransductive pathways that collectively drive disease progression.

Analysis of human liver biopsy datasets (GSE126848 and GSE89632) revealed consistent suppression of glycolysis, β-oxidation, and oxidative phosphorylation across MASLD and MASH samples, accompanied by modest compensatory TCA cycle activation. These alterations reflect impaired metabolic flexibility, mitochondrial stress, and increased ROS susceptibility. Concurrently, cytokine-network enrichment demonstrated activation …

Strengthening The Utah Diabetes Cook Along Program For Statewide Extension Delivery: Curriculum Refinement And Randomized Controlled Trial, Carrie Durward

Funded Research Records

No abstract provided.

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Determinants Of Abdominal Obesity In Adults (19 – 44 Years Old) In Riau Islands Province (Analysis Of Ski 2023 Data), Hanifah Mulia Rachman, Triyanti Triyanti, Ratu Ayu Dewi Sartika, Kusharisupeni Djokosujono

Indonesian Journal of Public Health Nutrition (IJPHN)

Abdominal obesity is a condition characterized by excessive fat accumulation in the abdominal region, which can increases the risk of type 2 diabetes mellitus, dyslipidemia, hypertension, and cardiovascular diseases. In 2023, Riau Islands Province recorded the highest prevalence of abdominal obesity in the island of Sumatra, at 42.5%. This study aimed to analyze the determinants of abdominal obesity among adults aged 19–44 years in Riau Islands Province based on gender, using secondary data from the 2023 Indonesia Health Survey (SKI). A total of 3,466 respondents were analyzed using chi-square tests and multiple logistic regression. The results showed that the prevalence …

Perceived Benefits And Side Effect Of High-Fiber, High-Protein Meal Replacements In Weight Loss Programs, Esti Nurwanti, Harry Fl Muhammad, Naufal M. Nurdin

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a major risk factor for chronic diseases and early mortality. Although dietary counseling is essential in managing obesity, maintaining a calorie deficit and preventing weight regain remain difficult. Functional foods like high-protein, high-fiber meal replacements may enhance adherence and support weight loss. This randomized controlled trial evaluated the subjective outcomes of a weight loss program incorporating a protein- and fiber-enriched meal replacement among 73 overweight women aged 20–30 years. Participants were randomized to an intervention group (n=38), receiving dietary counseling plus one daily meal replacement, or a control group (n=35), receiving counseling alone. Both groups followed an 8-week …

Analysis Of Macronutrient Content, Antioxidant Activity, And Organoleptic Quality Of Snack From Jackfruit Seed Flour (Artocarpus Heterophyllus) And Pigeon Pea Flour (Cajanus Cajanus) As A Snack For Patients With Type 2 Diabetes Mellitus, Maya Siwi Tri Nugroho Heni, Tesa Rafkhani

Indonesian Journal of Public Health Nutrition (IJPHN)

Type 2 diabetes mellitus characterized by chronic hyperglycemia and oxidative stress. Snack bars with functional ingredients such as legumes may help regulate blood glucose levels. Jackfruit seeds and pigeon peas are sources of protein, complex carbohydrates, and bioactive compounds. This study aimed to analyze macronutrient content, antioxidant activity, and organoleptic quality of jackfruit seeds and pigeon pea flour snack bars. This study used a completely randomized design (CRD) one factor with two replications. The proportions of jackfruit seeds and pigeon pea flour are: F1 (30%:70%), F2 (40%:60%), F3 (50%:50%). Macronutrient content was analyzed using proximate analysis, antioxidant activity using the …

Combination Of Irreversible Electroporation And Clostridium Novyi-Nt Bacterial Therapy For Colorectal Liver Metastasis, Zigeng Zhang, Guangbo Yu, Qiaoming Hou, Farideh Amirrad, Sha Webster, Surya M. Nauli, Jianhua Yu, Vahid Yaghmai, Aydin Eresen, Zhuoli Zhang

Pharmacy Faculty Articles and Research

Colorectal liver metastasis (CRLM) poses a significant challenge in oncology due to its high incidence and poor prognosis in unresectable cases. Current treatments, including surgical resection, systemic chemotherapy, and liver-directed therapies, often fail to effectively target hypoxic tumor regions, which are inherently more resistant to these interventions. This review examines the potential of a novel therapeutic strategy combining irreversible electroporation (IRE) ablation and Clostridium novyi-nontoxic (C. novyi-NT) bacterial therapy. IRE is a non-thermal tumor ablation technique that uses high-voltage electric pulses to create permanent nanopores in cell membranes, leading to cell death while preserving surrounding structures, and …

Chronic Inflammation: The Link Between A High Added Sugar Diet And Disease, Anna Collins

Senior Honors Theses

The modern diet includes many processed foods that contain added sugars, resulting in a significant increase in daily glucose and fructose consumption. Considering this, there is an increased effort to uncover the effects of excess sugar intake on the body’s health and metabolism. Strong evidence supports the connection between a high added sugar diet and the presence of chronic, low-grade inflammation due to cellular distress and metabolic dysfunction. Prolonged inflammatory responses are linked to tissue damage and the development of various metabolic diseases that are prevalent in modern society, such as obesity, fatty liver disease, cardiovascular disease, and type 2 …

Investigating The Effects Of Prenatal E-Cigarette Exposure On Postnatal Liver Histology, Emma Mcclellan

College of Arts & Sciences Senior Theses

The electronic cigarette (e-cigarette) entered the American market in the mid-2000s and quickly became popular. This product poses a significant threat to youth with 1.63 million students reporting use in 2024. Adverse health effects to different organs are well known. The liver is less studied, and despite its role in detoxification of e-cigarette chemicals, is a target of injury. Unlike the known effects of cigarettes and nicotine on the liver from adult or prenatal exposure, effects of prenatal exposure to e-cigarettes on liver remain to be defined. The current study investigated the effects of prenatal exposure of e-cigarettes on liver …

Intermittent Fasting And Cardiometabolic Health In Adults With Obesity: A Scoping Review, Tri Siswati, Lathifa Zahra Putri Nugroho, Natasya Nurul Gina, Almira Sitasari, Agus Wijanarka

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a significant global health challenge, with adverse impacts on cardiometabolic health such as hypertension, dyslipidemia, and insulin resistance. One promising intervention in obesity management is intermittent fasting (PI). However, scientific evidence on the impact of IF on cardiometabolic health is still limited. This study used a scoping review design to evaluate the association between IF and cardiometabolic health in obese adults. Reference sources are available in English at least abstract between 2015–2023 as well as from PubMed and Google Scholar web sources. The search keywords on PubMed are "Adult AND intermittent fasting AND cardiometabolic" and on Google Scholar …

The Relationship Between Ultra-Processed Food (Upf) Consumption, Sedentary Behavior, And Overweight Status Among Students At Sman 1 Tangerang, Banten, Indonesia, Husna Dzakya Azzahra, Zenia Elsa Fitri, Imas Arumsari

Indonesian Journal of Public Health Nutrition (IJPHN)

Overweight is a condition where excess body fat accumulates, leading to increased risks of diseases such as heart disease, stroke, diabetes, hypertension, arthritis, and cancer. The prevalence of overnutrition in adolescents aged 16-18 years has been rising over the years, from 5.7% in 2013 to 9.5% in 2018. This study aims to analyze the relationship between Ultra-Processed Food (UPF) consumption and sedentary behavior on overweight status among students at SMAN 1 Tangerang. A cross-sectional design, data were collected through interviews with 114 respondents using the SQ-FFQ Ultra-Processed Food questionnaire and the Sedentary Behavior Questionnaire (SBQ), with quota sampling employed. The …

Exploring The Non-Communicable Disease Burden In Indonesia – Findings From The 2023 Health Survey, Akifa Laila Rusyda

Indonesian Journal of Public Health Nutrition (IJPHN)

The present study rigorously examines the correlation between obesity, high-risk dietary consumption, and unhealthy lifestyles with the prevalence of non-communicable diseases (NCDs) in Indonesia. The study employed a cross-sectional study design using secondary data from the 2023 Indonesian Health Survey, analyzing 38 units (n) representing Indonesia's provinces in 2023. The correlation analysis, conducted using Pearson's test with a significance level of 95% (α<0.05), revealed significant regional disparities in the prevalence of NCDs, dietary consumption, and lifestyle factors across Indonesia. Moreover, the findings reveal a statistically significant positive correlation between obesity, high-risk food consumption, and lifestyle risk factors with the prevalence of several NCDs, including diabetes mellitus, heart disease, hypertension, and chronic kidney disease. These results underscore the potential impact of our research on public health in Indonesia. The results highlight also the urgent need for targeted public health initiatives, such as policies promoting healthier food choices, controlling the food environment, encouraging physical activity, and supporting smoking cessation to mitigate the growing burden of NCDs in Indonesia.