Public Health Commons^™

Health Care Access By Weight Status In The State Of Georgia, Elizabeth Pullekines, Janani Rajbhandari-Thapa

Journal of the Georgia Public Health Association

Background: Obesity continues to grow in prevalence in the United States and within the state of Georgia. Obesity is a risk factor for many chronic and preventable diseases. As such, obese individuals have higher demand for health care services than non-obese individuals. In addition, the health care system can play a role in preventing obesity and other conditions caused by obesity.

Methods: This research follows the established positive relationship between health care use and access to health care services through insurance coverage. The paper analyzes how the Affordable Care Act (ACA) affected insurance coverage and access to health care services …

Sociodemographic And Biometric Factors Associated With Eating Behaviors Among African American Women Aged 18-74, Takiyah J. Thomas, Jammie M. Hopkins, Riba Kelsey-Harris, Folashade Omole, Ernest Alema-Mensah

Journal of the Georgia Public Health Association

Background: Obesity is a growing problem in the United States and is disproportionately increasing among African Americans. The objective of this study is to examine the sociodemographic and biometric factors associated with eating behaviors among African American women.

Methods: We analyzed data from the 2009-2010 dietary screener and weight history questionnaire from the National Health and Nutrition Examination Survey. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine the association between six specific eating behaviors and different sociodemographic and biometric factors. Analyses were conducted using SAS 9.4.

Results: The analyses show …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Energy Cost Of Land And Shallow Water Walking In Females Who Are Overweight And Obese, Jacquelyn N. Zera, Elizabeth F. Nagle, Bethany B. Gibbs, John P. Abt, John M. Jakicic

International Journal of Aquatic Research and Education

Nineteen overweight or obese females completed three 10-minute experimental trials including a self-selected pace shallow water walking trial, a matched heart rate response land walking trial, and a self-selected pace land walking trial. Energy expenditure (kcal·min^-1)was computed from expired gases assessed via indirect calorimetry. Results showed energy expenditure was lower (p= 0.046) during shallow water walking (6.46 ± 1.38 kcal·min^-1) compared to matched heart rate response land walking trial (7.26 ± 1.29 kcal·min^-1), with no significant difference in between shallow water and self-selected pace land walking (6.92 ± 1.61 kcal·min^-1). …

Prevalence And Correlates Of Cardiometabolic Multimorbidity Among Hypertensive Individuals: A Cross-Sectional Study In Rural South Asia—Bangladesh, Pakistan And Sri Lanka, Liang Feng, Imtiaz Jehan, H Asita De Silva, Aliya Naheed, Hamida Farazdaq, Samina Hirani Samina Hirani, Anuradhani Kasturiratne, Channa D. Ranasinha, Md Tauhidul Islam, Ali Tanweer Siddiquee, Tazeen Jafar

Community Health Sciences

Objective: To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.
Design: A cross-sectional study.
Setting: Rural communities in Bangladesh, Pakistan and Sri Lanka.
Participants: A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.
Main outcome measures: CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.
Results: …

Colostrum And Mature Breast Milk Analysis Of Serum Irisin And Sterol Regulatory Element-Binding Proteins-1c In Gestational Diabetes Mellitus, Syeda Sadia Fatima, Erum Khalid, Asma Akbar Ladak, Syed Adnan Ali

Department of Biological & Biomedical Sciences

Background: We aimed to evaluate irisin and SREBP-1c levels in serum, colostrum and mature breast milk in women with and without gestational diabetes (GDM); and to relate them with maternal glucose, lipid profile and weight status of babies.
Methods: GDM positive women (n = 33) and normal glucose tolerant women (NGT) (n = 33) were recruited. Maternal blood samples were collected at 28th week of gestation and later at 6-week post-partum while breast milk samples of the lactating mothers were collected within 72 hours of birth (colostrum) and at 6 weeks post-partum (mature milk). Irisin and SREBP-1c levels were analyzed …

The Risk Of Hypertension In Adulthood As A Consequence Of Adolescent Obesity, Demsa Simbolon, Epti Yorita, Ruzita Abd Talib

Kesmas

Population increase in adolescence are associated with increased overweight and obesity problems. If this problem not early intervention will have an impact on increasing hypertension prevalence and risk of death. This research aimed to explain the consequences of overweight and obesity in adolescent to hypertension in adults. The study used Indonesian Family Life Survey (IFLS) data with a retrospective cohort study. Adolescent BMI measurements on 2007 and the risk of hypertension on 2014. Population are all adolescents aged 10-20 years in 2007. Sample of 1,697 adolescent who randomly IFLS 2007 with the inclusion criteria: biological children and a single birth, …

Dietary Inflammatory Index And Non-Communicable Disease Risk: A Narrative Review, Catherine M. Phillips, Ling-Wei Chen, Barbara Heude, Jonathan Y. Bernard, Nicholas C. Harvey, Liesbeth Duijts, Sara M. Mensink-Bout, Kinga Polanska, Giulia Mancano, Matthew Suderman, Nitin Shivappa, James R. Hébert

Faculty Publications

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII^®), a literature-derived …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

West Virginia’S Sugary Drink Tax: Examining Print Media Frames In Local News Sources, Lauri Andress, Ogaga Urhie, Christine Compton

Journal of Appalachian Health

Introduction: Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful.

Methods: Using quantitative content analysis, this study assessed news articles—published …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

The Tampa Gym Study: An Ethnographic Exploration Of Gyms, Female Gym-Goers And The Quest For Fitness In Tampa, Fl, Danielle Reneé Rosen

USF Tampa Graduate Theses and Dissertations

The Tampa Gym Study was an ethnographic examination of veteran women exercisers, their workout routines, and their attitudes towards the workouts that they undertake in two Tampa area gyms. The study’s principle objective was to study “fitness culture” in these facilities and the manner in which that culture is embodied in the language women use to describe themselves and their exercise behaviors.

The obesity crisis in the United States has been significantly responsible for an increase in membership in gyms and fitness facilities nationwide. The “culture of fitness” as it is embodied in these facilities has impacted women and their …

The Nutritional Value Of Children's Menus In Chain Restaurants In The United Kingdom And Ireland, Michelle Young, Tara Coppinger, Sue Reeves

Publications

Objective: Obesity in the United Kingdom and the Republic of Ireland is rising, as is the frequency of eating out in restaurants. The aim of this study was to investigate the nutritional quality of children's menus in restaurants. Design: Cross-sectional review of menus aimed at children from 20 popular chain restaurants in the United Kingdom and Ireland. Main Outcome Measures: Total energy, fat, saturated fat, and salt were collected from every food item on the menu in each restaurant. All potential meal combinations were created. A total of 39,266 meals were analysed. Analysis: Meals were compared with UK nutritional guidelines. …

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

Using Physician Champions To Extend The Reach Of The Let’S Go! 5-2-1-0 Obesity Prevention Program In Clinical Practice, Michael Dedekian, Jackie Vine, Jonathan Fanburg, Naomi Anderson Schucker, Victoria Rogers

Journal of Maine Medical Center

ABSTRACT

Introduction: There is limited evidence for large scale interventions to address childhood obesity. Let’s Go! is a Maine-based obesity prevention program that deploys a consistent message across multiple community settings to encourage children and families to make healthy choices. This report describes implementation of Let's Go! in primary care offices.

Methods: Consideration for physician champion recruitment included previous involvement with Let’s Go! and ensuring statewide geographic coverage. Champions received standardized training and became local leaders in obesity prevention and treatment. 13 champions engaged 99 practices at baseline; 71 practices were engaged all 4 years (2012-2015). Data were analyzed on …

An Integrative Cross-Omics Analysis Of Dna Methylation Sites Of Glucose And Insulin Homeostasis, Jun Liu, Elena Carnero-Montoro, Jenny Van Dongen, Samantha Lent, Ivana Nedeljkovic, Symen Ligthart, Pei-Chien Tsai, Tiphaine C. Martin, Pooja R. Mandaviya, Rick Jansen, Marjolein J. Peters, Liesbeth Duijts, Vincent W. V. Jaddoe, Henning Tiemeier, Janine F. Felix, Gonneke Willemsen, Eco J. C. De Geus, Audrey Y. Chu, Daniel Levy, Shih-Jen Hwang, Jan Bressler, Rahul Gondalia, Elias L. Salfati, Christian Herder, Bertha A. Hidalgo, Toshiko Tanaka, Ann Zenobia Moore, Rozenn N. Lemaitre, Min A. Jhun, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Despite existing reports on differential DNA methylation in type 2 diabetes (T2D) and obesity, our understanding of its functional relevance remains limited. Here we show the effect of differential methylation in the early phases of T2D pathology by a blood-based epigenome-wide association study of 4808 non-diabetic Europeans in the discovery phase and 11,750 individuals in the replication. We identify CpGs in LETM1, RBM20, IRS2, MAN2A2 and the 1q25.3 region associated with fasting insulin, and in FCRL6, SLAMF1, APOBEC3H and the 15q26.1 region with fasting glucose. In silico cross-omics analyses highlight the role of differential methylation …

An Interdisciplinary Weight Loss Program Improves Body Composition And Metabolic Profile In Adolescents With Obesity: Associations With The Dietary Inflammatory Index, Yasmin Alaby Martins Ferreira, Ana Claudia Pelissari Kravchychyn, Sofia De Castro Ferreira Vicente, Raquel Munhoz Da Silveira Campos, Lian Tock, Lila Missae Oyama, Valter Tadeu Boldarine, Deborah Cristina Landi Masquio, David Thivel, Nitin Shivappa, James R. Hébert, Ana R. Dâmaso

Faculty Publications

Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals' diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores …

Obesity As Type 2 Diabetes Common Comorbidity: Study Of Type 2 Diabetes Patients’ Eating Behaviour And Other Determinants In Jakarta, Indonesia, Isna Aulia Fajarini, Ratu Ayu Dewi Sartika

Kesmas

Obesity is one of the comorbidities widely occurred among type 2 diabetes patients. It is one of the most modifiable risk factors for the prevention of other comorbid conditions such as diabetic nephropathy and cardiovascular disease. The aim of this study was to recognize eating behaviour, physical activity, and other related factors, also their correlation with obesity as comorbidity among type 2 diabetes patients. Using cross-sectional design, data were collected from purposively selected 133 members of “PROLANIS” in Jatinegara Primary Health Care, East Jakarta. Food intake was assessed by 1x24 hours food recall and FFQ, physical activity by GPAQ. The …

Risk Factor Analysis Of Overnutrition Among Elementary School Children In Pekanbaru: An Urban-Rural Perspective, Arfianti Arfianti

Kesmas

The prevalence of childhood overnutrition is increasing in many parts of the world including Indonesia. National basic health research (RISKESDAS) 2010 showed that over-nutrition in urban children (10.4%) was greater than in rural areas (8.1%). The purpose of this study was to analyse risk factors for overnutrition on elementary students in urban and rural areas in Pekanbaru. This was an observasional analytical study with cross-sectional design. This study involved 137 urban and 113 rural students from six elementary schools in Pekanbaru recruited by quota sampling technique. This study was conducted between April-May 2018. The results showed that the proportions of …

Adiposity Mediates The Association Between The Dietary Inflammatory Index And Markers Of Type 2 Diabetes Risk In Middle-Aged Black South African Women, Asanda Mtintsilana, Lisa K. Micklesfield, Elin Chorell, Tommy Olsson, Nitin Shivappa, James R. Hebert, Andre P. Kengne, Julia H. Goedecke

Faculty Publications

The dietary inflammatory index (DII^®), a validated tool used to measure the inflammatory potential of the diet, has been associated with metabolic disorders in various settings, but not in African populations. The aim of this study was to investigate whether the DII is associated with markers of type 2 diabetes (T2D) risk, and if this association is mediated by adiposity and/or low-grade inflammation, in black South Africa women. Energy-adjusted-DII (E-DII) scores were calculated in 190 women (median age, 53 years) from the Birth-to-Twenty plus cohort using a validated food frequency questionnaire. Fasting glucose, insulin, HbA1c, and inflammatory cytokines …

Leptin Produced By Obesity-Altered Adipose Stem Cells Promotes Metastasis But Not Tumorigenesis Of Triple-Negative Breast Cancer In Orthotopic Xenograft And Patient-Derived Xenograft Models, Rachel A. Sabol, Annie C. Bowles, Alex Côté, Rachel Wise, Benjamen O'Donnell, Margarite D. Matossian, Fokhrul M. Hossain, Hope E. Burks, Luis Del Valle, Lucio Miele, Bridgette M. Collins-Burow, Matthew E. Burow, Bruce A. Bunnell

School of Medicine Faculty Publications

BACKGROUND: Breast cancer is the second leading cause of cancer deaths in the USA. Triple-negative breast cancer (TNBC) is a clinically aggressive subtype of breast cancer with high rates of metastasis, tumor recurrence, and resistance to therapeutics. Obesity, defined by a high body mass index (BMI), is an established risk factor for breast cancer. Women with a high BMI have increased incidence and mortality of breast cancer; however, the mechanisms(s) by which obesity promotes tumor progression are not well understood. METHODS: In this study, obesity-altered adipose stem cells (obASCs) were used to evaluate obesity-mediated effects of TNBC. Both in vitro …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Rising Rural Body-Mass Index Is The Main Driver Of The Global Obesity Epidemic In Adults, Con Burns, Tara Coppinger, Janette Walton, Et Al

Publications

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to …

Correlation Of Chronic Conditions And Pain Scale With Varying Levels Of Obesity In The Geriatric Population, Shabbir Hossain, Adarsh Gupta

Rowan-Virtua Research Day

The overall objective of this study was to establish whether obesity’s contribution to pain is stronger than vice versa – the medical debilities in elderly patients that contribute to obesity. In the process, this study will allow us to achieve whether different age samples with similar BMIs demonstrate the same level of medical complexities in geriatric patients. In summary, the purpose of this research study was to correlate a relationship between obesity and aging. We hypothesized that obesity will contribute to greater pain in the aging population, and that patients – regardless of their age groups in the aging population …

Pre-Operative Clinical Variation By Health Insurance Carrier In 12,285 Male Surgical Patients With Moderate Morbid Obesity, Matthew E. Moore, Gus J. Slotman

Rowan-Virtua Research Day

In the ongoing obesity epidemic, every surgeon now treats patients with weight-related medical problems. In managing these medically fragile surgical patients, every clinical insight helps. While variation according to health insurance has been reported in mixed sex bariatric surgery populations, whether or not clinical characteristics in the subset of moderately obese male surgical patients vary by insurance carrier is unknown. The objective of this study was to identify clinical variation by insurance type in moderately obese men.

Results showed that pre-operative clinical characteristics of moderately obese male surgical patients vary by the health insurance coverage type to which they subscribe. …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu

Electronic Theses and Dissertations

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Adapting An Elementary School Nutrition Context Assessment For High School Settings And Students, Deborah H. John, Beret Halverson, Tia H. Ho

Urban Studies and Planning Faculty Publications and Presentations

The school nutrition context is comprised of supportive environmental features, programs, policies, and social relationships that shape students’ healthy dietary choices and patterns. When engaging students as change agents, advocates, and partners in making healthy nutrition choices easier, environmental assessment tools developed for adults may be too complex or inappropriately tailored for youth. Adolescents need practical, user-tailored tools that reliably measure the food and beverage environments they encounter in school to inform youth-led changes to the school nutrition context. To meet this need, an evidence-based school environmental assessment was adapted for use in high schools by students as evaluators. Cooperative …