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 …

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Using Geospatial Analysis To Compare Metropolitan Greenspace And Adolescent Obesity, Rachel Schild, Denyelle Kenyon, Zachary Schild

Scholarship Pathways Program

Using Geospatial Analysis and Machine Learning to Compare Metropolitan Greenspace and Rates of Adolescents with Obesity

 Rachel Schild MD | DenYelle Kenyon PhD

 Introduction: Insufficient outdoor activity, influenced by limited access to exercise-friendly greenspaces, may contribute to increasing childhood obesity rates. However, rigorous evaluation of greenspace quality on a citywide scale is lacking. This study aims to characterize greenspace vegetation types and correlate them with adolescent obesity outcomes, identifying optimal characteristics for promoting health. This data could aid city planners in optimizing greenspace allocation and improving vegetation choices.

Methods: Satellite imagery and municipal data were used to map ten cities, …

Addressing Diabetes Risk Through Preventative Education In Multicultural And Economically Underserved South Jersey Communities, Bavly Nagy Halaka, Janet Jimenez-Merino, Izayah Diaz

Rowan-Virtua Research Day

BACKGROUND: Diabetes and prediabetes affect a substantial and growing portion of the U.S. population, with adolescent prediabetes rates more than doubling from 11% in 1999 to 28% in 2018. In multicultural and economically underserved South Jersey communities, structural barriers including food insecurity, limited access to preventive healthcare, and language gaps make early detection and prevention particularly difficult. We aimed to assess diabetes risk, management behaviors, and preferred education formats among a Camden-area bilingual community, and to identify culturally responsive intervention strategies.

METHODS: We conducted a literature review utilizing data from the CDC, NJ Department of Health, NJSHAD, and the U.S. …

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

No abstract provided.

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 …

Beyond The Numbers: Supporting Young Adults With Diabetes In The Transition To Adulthood, Alexis Salkovick

Honors Projects

This project focuses on the transition to adulthood for young people with diabetes, a chronic medical condition. Both Type 1 and Type 2 diabetes are included. The main research focus is two-part: first examining this transition including barriers to health care, changes in lifestyle, and mental health, and then creating a new, innovative tool to support young adults with diabetes. An independent literature review was conducted to investigate diabetes management, barriers to health care, how transitioning to adulthood impacts diabetes care, and the importance of patient support systems. Then, a board game was developed with the dual purpose of educating …

From Tradition To Transition: Evaluating Culinary Medicine As A Tool For Metabolic Health Among Nigerian Immigrants In The United States And The United Kingdom, Simi Oduwole M.S.

Department of Nutrition Student Projects

This scoping review examines existing publications to evaluate whether Culinary Medicine can be used as a tool for metabolic health among Nigerian immigrants in the United States and the United Kingdom. Nigeria is one of the fastest-growing populations globally, with increasing migration to high-income countries such as the United States and the United Kingdom. Evidence suggests that Nigerian immigrants experience a rise in diet-related chronic diseases, including obesity, diabetes, and cardiovascular disease, as duration of residence increases. This phenomenon is often attributed to dietary acculturation and shifts toward Westernized eating patterns. This scoping review evaluates whether culinary medicine can mitigate …

Evaluating The Feasibility And Preliminary Effectiveness Of A Tailored Diabetes Education Program For Rural Residents, Brittany L. Smalls, Oluwatosin Leshi, Suraksha Khanal, Grejika E. Abram-Erby

Journal of Appalachian Health

Introduction: Diabetes is a top ten Rural Healthy People 2030 priority for health improvement among rural Americans. Socioeconomic, environmental, geographic and political barriers contribute to the type 2 diabetes (T2D) prevalence and its disparate impact in rural communities. However, promoting proper self-care behaviors via self-management education can help people with diabetes better manage their condition.

Purpose: To account for the social environmental factors that affect rural residents, a tailored diabetes education program was developed, and the program’s effectiveness in improving diabetes knowledge and T2D-related health outcomes was assessed.

Methods: Using data collected from Appalachian Kentucky residents enrolled in a six-week, …

The Effect Of A Low-Glycemic Index Diet On Polycystic Ovary Syndrome Symptoms Among University-Aged Women, Angelika A. Gonzalez, Annalise M. Sankar, Noelle D. Nguyen

Department of Nutrition Student Projects

Polycystic Ovary Syndrome is an endocrine disorder among women of reproductive age and is associated with insulin resistance, menstrual irregularities, hyperandrogenism, and metabolic dysfunction. Dietary modifications targeting glycemic response have emerged as a nonpharmacologic approach for PCOS management. However, long-term randomized controlled trials targeting young adult populations remain limited.

The purpose of this study is to evaluate long-term effects of adherence to a low-glycemic index diet on the frequency and severity of PCOS symptoms among female college students ages 18-22. This 12-month randomized controlled trial will recruit participants meeting the Rotterdam criteria from university health clinics. Participants will be randomly …

The Effects Of Body Mass Index On Fertility And In Vitro Fertilization, Morgan R. Kidd

Honors College Theses

In-vitro fertilization (IVF) is the most widely used type of assisted reproductive technology for treating infertility arising from a number of conditions. As obesity rates continue to climb in the United States, infertility has been discovered to have a direct correlation. Individuals that fall below or above the healthy body mass index range are found to have disrupted regulation of the hypothalamic-pituitary-gonadal axis, resulting in diminished reproductive health. Those that are diagnosed as infertile due to conditions caused by the effects of low body mass index or high body mass index may seek assisted reproductive technologies to intervene in achieving …

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 …

The Connection Between Medicaid And Obesity In Northeast Ohio, Sophie Kheder, Emmie Kelley

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Investigating Racial And Ethnic Disparities In Cardiometabolic Outcomes Among Women With Polycystic Ovarian Syndrome: An Umbrella Review, Gianna C. Santoni

Honors Undergraduate Theses

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinological disorders affecting women of reproductive age. Due to the possibility of a genetic component affecting women with PCOS, evidence supports varying health outcomes among racial and ethnic groups. This literature aims to answer the question: Does the prevalence of cardiometabolic outcomes differ among women with polycystic ovarian syndrome across racial/ethnic groups? This umbrella review was conducted in accordance with JBI Manual for Evidence Synthesis and PRIOR reporting guidelines and was registered on PROSPERO (CRD420261303872) before completion. PubMed, MEDLINE via EBSCOhost, and Web of Science via EBSCOhost were searched from …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

Diabetes And Hypertension Frequencies And Trends In The Health Districts Of Sololá, Alejandro Cerón, Sophie Perfetto, Ana Textor, Sidona Alemayehu, Emilia Alvear Escobar, Adele Beard, Sarah Berson, Rachel Bryant, Jennifer Calzontzi, Rylee Castro, Eva Cress Palencia, Jake Czarnecki, Jordyn Epstein, Nikki Harris, Patience Hinojos, Max Hippisley, Erin House, Jackson Hullett, Nathan Johnson, Amelie King, Saule Lankelyte, Juan Loya, Ashley Mackenzie, Ilana Mighdoll, Molly Morrill, Maria De Jesus Ramos Jimenez, Lilly Teklemedhin, Joseph Trujillo, Lauren Verachtert, Nathan Verachtert, Violet Vreeland, Alex Welch, Jada Wright

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students, Graduate Teaching Assistants, and instructor of “The Social Determination of Health” class taught in the fall of 2025 at the University of Denver. The report was prepared for Dr. Luis Pablo Méndez, of the Vice Ministry of Health Regulation, Surveillance and Control, of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: How can available data about service production can be used to inform the planning process for the implementation of the Global Hearts Initiative’s HEARTS technical package in the Distrito de Redes Integradas de …

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

Association Of Obesity Severity With Cardiometabolic And Renal Disease Burden In The United States, Florina Corpodean, Michael Kachmar, Shengping Yang, Steven B. Heymsfield, Peter T. Katzmarzyk, Philip R. Schauer, Michael W. Cook, Vance L. Albaugh

School of Medicine Faculty Publications

Objective This study examined the association between obesity severity and cardiometabolic and renal disease, using BMI as a surrogate for obesity severity. Methods This is a cross-sectional study using data from the United States Behavioral Risk Factor Surveillance System (BRFSS), 2011–2023. Survey-weighted logistic regression estimated odds ratios (OR) for the diagnosis of diabetes, hypertension, hyperlipidemia, kidney disease, myocardial infarction, stroke, and coronary artery disease among increasing BMI categories. Results Higher BMI was associated with increased odds of all conditions. For BMI ≥ 50 kg/m2, odds were notably elevated for diabetes (OR 8.32; 95% CI: 7.78–8.91), hypertension (OR 6.07; 95% CI: …

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 …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Trajectory Of Iron And Red Cell Parameters In Moderately Anemic Iron-Deficient Pregnant Women Receiving Daily Iron-Folic Acid Supplementation: A Prospective Cohort Study, J. P. Akshaykirthan, Manjunath S. Somannavar, S. Yogeshkumar, M. S. Deepthy, Umesh Charantimath, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: The objective is to study the trajectories of hematologic and biochemical markers in moderately anemic pregnant women receiving oral iron supplementation throughout pregnancy. Methods: This prospective cohort study was conducted from August 2021 to September 2023 involving 315 pregnant women from rural areas of Belgaum, Karnataka, India, with hemoglobin levels between 7.0 and 9.9 g/dL and serum ferritin < 30 ng/mL and/or TSAT < 20%. Participants received iron-folic acid supplementation (IFAS) as per Anaemia Mukt Bharat guidelines. Blood samples were collected to measure various hematologic and iron markers and compared across each visits. Results: We report a complete adherence rate of 95.3% for iron and 97.8% for folic acid supplementation throughout pregnancy and also observed significant improvements in hemoglobin (9.36 (8.55, 9.74) to 12.03 (11.49, 12.72)) g/dL, hematocrit (29.93 ± 2.87 to …