Browsing by Subject "Obesity"
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Item Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community - A Six Month Follow-Up(1999-12-01) Coustasse, Alberto; Antonio Rene; Doug A. Mains; Gilbert RamirezCoustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results demonstrated a 46% increase in BMI [Body Mass Index]; 62% remained obese; 62% maintained elevated cholesterol or increased cholesterol values to abnormal values; 61% maintained or increased their BP [blood pressure] to abnormal values. A significant finding was that a change of one unit in the BMI correlated with a change of 19.88 mmHg [millimeter mercury] of SBP [systolic blood pressure] and 18.59 mmHg of DBP [diastolic blood pressure]. The societal economic impact of mortality and morbidity (without the benefit of target interventions) for the initial forty-four seniors was projected at & 74,949. Keywords: Health fairs; obesity; cardiovascular; cost; case management.Item Bariatric Surgery And The Lap Band: An Analysis of Efficacy(2003-12-01) Crane, Dave; Doug A. Mains; Claudia Coggin; Karan SinghCrane, B.A., M.A., Dave, Master of Public Health (Health Management and Policy), December 2003, Bariatric Surgery and the Lap Band: An Analysis of Efficacy, 40 pages, 15 tables, references, 45 titles. Obesity has quickly become both a national and global health issue. The evidence is increasingly consistent that obesity has a causal relationship with serious medical complications. The Lap Band, a surgical procedure for weight control, was approved by the Food and Drug Administration in June, 2001. The purpose of this study was to assess the efficacy of this procedure by reviewing existing literature and studying a patient population that had received Lap Band surgery. The retrospective review included information on 93 patients in the bariatric program at the University of North Texas Health Science Center at Fort Worth. The preliminary data in this study agrees with other studies , which shows that the Lap Band is an effective intervention for morbidly obese patients.Item Comparison of Dietary Micronutrient Intakes by Body Weight Status among Mexican-American and Non-Hispanic Black Women Aged 19-39 Years: An Analysis of NHANES 2003-2014(MDPI, 2019-11-20) Liu, Jialiang; Zhu, Xiangzhu; Fulda, Kimberly G.; Chen, Shande; Tao, Meng-HuaThe objective of the current study was to examine micronutrient intake from foods in women of childbearing age and to better understand potential nutritional problems varied by body weight status in minority women. A sample of women aged 19-39 years from the National Health and Nutrition Examination Surveys (NHANES) 2003-2014 was analyzed. Dietary intakes of 13 micronutrients were estimated using the National Cancer Institute method. Mexican-American and non-Hispanic Black women were categorized into normal/under-weight, overweight, or obese groups according to their body mass index (BMI). Mexican-American and non-Hispanic Black women had lower dietary intakes for vitamins A, B2, B6, B12, and D, folate, calcium, and magnesium than non-Hispanic Whites. Among Mexican-Americans, obese women had the lowest dietary intake of vitamins A, B2, C and D. Obese non-Hispanic Black women had significantly lower dietary intakes of iron and zinc than their normal/under-weight counterparts. Comparable percentages (>30%) of Mexican-American and non-Hispanic Black women had dietary intake less than the Estimated Average Requirements (EARs) for several key nutrients including vitamin A, C and D, folate, calcium and magnesium, and the percentages varied by body weight status. These results indicate micronutrient inadequacies persist among and within racial/ethnic and body weight groups.Item Editorial: Diabetes and obesity effects on lung function, volume II(Frontiers Media S.A., 2023-12-25) Zheng, Hong; Ma, Wei-Xing; Tang, Xiaoqiang; Lecube, Albert; Yan, Liang-JunItem Environment-Wide Association Study on Childhood Obesity(2020-05) Uche, Uloma I.; Suzuki, Sumihiro; Zhou, Zhengyang; Fulda, KimberlyBackground: Obesity is both a global and national public health issue with increasing prevalence over the last decades. It is associated with adverse health effects as well as social and economic costs. Both children and adults are affected; however, much more impact and prevalence are seen in children because of their growing bodies. While the etiology and prevention of childhood obesity are not fully understood, studies have linked it to lack of built environment, diet, lack of physical activities, and genetic susceptibility, with growing evidence that it could also result from other environmental factors. Studies linking it to other environmental factors are quite limited, unsystematic, incomprehensive and inconclusive. Thus, using the concept of an environment-wide association study (EWAS) and while accounting for already known risk factors (lifestyle factors) associated with childhood obesity, the aims of this dissertation were 1) to comprehensively and systematically investigate all the environmental factors available in the National Health and Nutrition Examination Survey (NHANES) to determine factors associated with childhood obesity and 2) to validate my findings from aim1 on a different cohort of children and adults to see if factors persist. Methods: I utilized NHANES datasets 1999-2016, retrieving data files for children/adolescents (6-17yrs) and adults (>18yrs). Obesity was measured using BMI measures and waist to height ratio. A multinomial and binary logistic regression was conducted while adjusting for age, sex, race/ethnicity, creatinine, calorie intake, physical activity, screen time (TV hours & computer/video games hours), limitation to physical activities, and socioeconomic status. As in EWAS, multiple hypothesis testing was controlled, and validation analyses were done. Results: I found that metals such as beryllium (OR: 3.305 CI: 1.460-7.479) and platinum (OR: 1.346 CI: 1.107-1.636); vitamins such as gamma- tocopherol (OR: 8.297 CI: 5.683-12.114) and delta- tocopherol (OR: 1.841 CI:1.476-2.297); heterocyclic aromatic amines such as 2-Amino-9H-pyrido (2,3-b) indole (A-a-C) [OR: 1.323 CI: 1.083-1.617] and 2-Amino-3-methyl-9H-pyriodo[2,3-b]indole (MeA-a-C) [OR: 2.799 CI: 1.442-5.433]; polycyclic aromatic amines such as 9- fluorene (OR: 1.509 CI: 1.230-1.851), 4- phenanthrene (OR: 2.828 CI: 1.632-4.899) and caffeine metabolites such as 1,3,7-trimethyluric acid (OR: 1.22 CI: 1.029-1.414) and 1,3,7-trimethylxanthine(caffeine) (OR: 1.258 CI: 1.075-1.473) were positively and significantly associated with childhood obesity. More so, I found that factors such as gamma- and delta-tocopherols, as well as manganese, copper, caffeine, 2-napthol and 2-phenanthrene were associated with both childhood and adulthood obesity. Finally, I found that vitamin B6, B12 and C as well as carotenoids, enterolactone, harmane and iron are protective factors of both childhood and adulthood obesity. Discussion: These novel findings are of public health significance since these factors are potentially modifiable risk factors of childhood obesity and they are valuable for prevention and reducing the risk of obesity among U.S. children and adolescents. Exposures to some of these factors are mainly from vehicle exhaust, tobacco combustion, tea, and contaminated air and water. They may have the capability of eliciting stress, inhibiting enzymes needed for metabolic processes or disrupting lipid homeostasis which subsequently increases the risk of obesity. Conclusion: Despite the difficulty of ascertaining causality, this dissertation found novel pathways to the etiology of childhood obesity as well as adulthood obesity that needs further investigation.Item EVALUATING CLINIC TO COMMUNITY REFERRAL SYSTEMS TO ADDRESS OBESITY RELATED HEALTH DISPARITIES(2014-03) Taylor, Devynn A.; Waverka, Rachael; Mallaiah, Janhavi; Nguyen, Dawn; Fox, Doug; Kitzman-Ulrich, HeatherTo evaluate referral systems between clinic and community organizations in order to identify gaps for future implementation efforts in a primarily low-income and ethnic minority community. Purpose (a): The prevalence of obesity among high-socioeconomic status youth has decreased in recent years, whereas the prevalence of obesity among their low-socioeconomic status peers has continued to increase. Several programs and resources exist to provide obesity treatment, prevention and reductions in obesity related chronic diseases in youth. However, referral systems between these entities are often lacking. Thus, the goal of this project was to evaluate referral systems between clinic and community organizations in order to identify gaps for future implementation efforts in a primarily low-income, ethnic minority community. Methods (b): Assessment interviews were conducted with nineteen community organization members ranging from community and school-based organizational directors to clinical physicians. (Community-Based Organizations =5; Clinics =11; School-Based Organizations = 3). Four individuals were trained to administer surveys that assessed (1) access to healthcare facilities & preventative screenings (2) healthy eating (3) physical activity, (4) referral systems, and (5) chronic disease care. Results (c): Scores for each component were averaged per site, along with summing scores to create an overall indicator of clinic to community practices related to obesity-related health behaviors. The clinic to community assessments found an overall score of 62% (out of 100%) with PA screening, nutrition screening, chronic disease referral systems, and stroke care all falling below 60%. Tobacco screening (62%), chronic disease screening (68%), chronic disease education and counseling (67%), and pre-diabetes (71%) were all above 60%. Community-based organizations that provided outreach services (N=2) had very low levels of screening (0 – 1%), however both had high ratings related to chronic disease referrals (67% – 75%). Conclusions (d): To be successful in promoting health equity, we must close gaps between groups by offering better access through community organizations. Research is needed to determine how to improve the referral infrastructure between clinics, community-based, and school-based organizations to address obesity-related health disparities.Item How often parents make decisions with their children is associated with obesity(BioMed Central Ltd., 2018-09-25) Rahman, Adrita; Fulda, Kimberly G.; Franks, Susan F.; Fernando, Shane I.; Habiba, Nusrath; Muzaffar, OmairBackground: Evidence supports that better parental involvement and communication are related to reduced obesity in children. Parent-child collaborative decision-making is associated with lower BMI among children; while child-unilateral and parent-unilateral decision-making are associated with overweight children. However, little is known about associations between joint decision-making and obesity among Hispanic youth. The purpose of this analysis was to determine the relationship between parent-child decision making and obesity in a sample of predominantly Hispanic adolescents. Methods: Data from two studies focused on risk for type II diabetes were analyzed. A total of 298 adolescents 10-14 years of age and their parent/legal guardian were included. Parents completed questionnaires related to psychosocial, family functioning, and environmental factors. Multiple logistic regression was used to determine the association between obesity (≥ 95th percentile for age and gender), the dependent variable, and how often the parent felt they made decisions together with their child (rarely/never, sometimes, usually, always), the primary independent variable. Covariates included gender, age, ethnicity, total family income, and days participated in a physical activity for at least 20 min. ORs and 95% CIs were calculated. Results: Adolescent participants were predominantly Hispanic n = 233 (78.2%), and approximately half n = 150 (50.3%) were female. In multivariate analyses, adolescents who rarely/never made decisions together with their family had significantly higher odds (OR = 3.50; 95% CI [1.25-9.83]) of being obese than those who always did. No association was observed between either those who sometimes make decisions together or those who usually did and those that always did. Conclusions: Parents and children not making decisions together, an essential aspect of parent-child communication, is associated with increased childhood obesity. The results of our study contribute to evidence of parental involvement in decision-making as an important determinant of adolescent health. Further studies should explore temporal relationships between parenting or communication style and obesity.Item “IS SKINNY HEALTHY”? : FOCUS GROUP FINDINGS AMONG AFRICAN AMERICAN WOMEN REGARDING BARRIERS TO WEIGHT LOSS(2014-03) Cole, Jennifer; Dodgen, Leilani; Kitzman-Ulrich, Heather; Lee, Jenny; DeHaven, MarkFocus group discussions among African American women and their perceptions of body image and how this impacts weight loss. Purpose (a): To examine how motivation and appearance is related to weight loss among African American (AA) women. Studies indicate AA women are more satisfied with their body and accept a larger body size. Yet, obesity rates leading to chronic disease are highest among AA women with nearly 60% considered overweight/obese. Methods (b): Focus groups were conducted with 51 AA women (mean age=45.6 years; 21% high school; 38% college; 62% full time employed). Social Cognitive Theory and Social Ecological Framework informed questions evaluating barriers and facilitators to weight loss. Classic content analysis identified themes related to motivation for weight loss and body appearance. Inter-rater reliability was adequate (K=0.65). Results (c): Motivation was mentioned 73 times and appearance 28 times. Prominent subthemes of motivation were lack of discipline, needing accountability, and excuses. Prominent subthemes for appearance were disconnection of obesity to health, acceptance of current size, and concern of losing desired shape. Concerns related to appearance may be related to motivation for weight loss in AA women such that preferences for appearance may interfere with motivation to adhere to weight loss behaviors. Conclusions (d): Research is needed to determine how to improve motivation for weight loss while considering AA women’s preferences for appearance.Item Obesity and Risk of Stroke in NHANES I Follow Up Study(2002-12-01) Soman, Ashwini; Umed Ajani; Antonio Rene; Karan SinghSoman, Ashwini, Obesity and risk of stroke in NHANES-I follow-up study, Masters of Public Health (Epidemiology), December 2002. 79pp., 20 tables, 3 illustrations, bibliography, 46 titles. Stroke is the third leading cause of death in the US. Role of obesity as an independent risk factor has been relatively well established for coronary heart diseases but not for stroke. Purpose of this study was to assess long-term risk of stroke due to obesity measured at baseline. The research was conducted using First National Nutritional Health and Examination Survey and its follow ups. Overall, increased risk of stroke was observed in obese individuals (BMI [greater than] 30 kg/m2). Similar association was observed in different subgroups of race, gender, those with or without diabetes and cardiovascular disease.Item Prevalence of Obesity and Associated Factors for Diabetes in United States - 2005(2007-04-01) Tomer, Vikas; Sejong Bae; Karan Singh; Raghbir SandhuTomer, Vikas, Prevalence of obesity and associated factors for diabetes in United States –2005, Master of Public Health (Biostatistics), May 2007, 27 pp, 9 tables. Diabetes is one of the major public health problems in the United States. The purpose of this research is to explore whether there is a relationship between obesity and diabetes and to understand the effects of some other associated factors on diabetes in the United States in the year 2005. The data studied is from the Behavioral Risk Factor Surveillance System (BRFSS) 2005. A univariate analysis for frequency distribution was used to evaluate and edit the data. Binary logistic regression was used to assess the association of diabetes and the variables through crude and adjusted odd ratio. The result of the study showed significant association between diabetes and obesity and the associated factors among US adults. The prevalence of diabetes has been found to be highest among African Americans followed by Hispanics and Others. Our results indicate that being an obese non-Hispanic black with low income level over the age of 65 years is indicative of being at the highest risk for diabetes. Therefore, for preventive measures to decrease the risk of being overweight and obesity healthy eating habits and regular exercise are recommended. As, income level increases, there is a significant decrease in the diabetes population. The strongest predictor of all appears to be obesity followed by age. Age, gender, income level, race and BMI all had significant effect on diabetes.Item Rural Vs. Urban Residents and Obesity in Texas(2005-05-01) Ohagi, Emeka J.; Ty Borders; Peter Hilsenrath; Kathryn CardarelliOhagi, Emeka J., Rural vs. Urban Residents and Obesity in Texas. Master of Public Health (Health Informatics), May 2005, 52 pp., 3 tables, bibliography, 90 titles. Obesity in the United States has been described as an epidemic and Texas has been identified as one of the most obese states in the country. The purpose of this study is to examine obesity among Texas adults in order to determine if there are differences in obesity levels based on residence, and to explore the influence of other demographic, socioeconomic, health and behavioral factors on the distribution of obesity. Results indicate that urban and suburban dwellers are less likely than rural dwellers to be obese (adj. OR=0.64; 0.68, respectively). However, residents of frontier communities have slightly higher odds of obesity (adj. OR=1.09) than rural residents. Age was found to be an important factor in obesity. It is hoped that these and other results will facilitate appropriate channeling of public health response.Item STUDY OF OBESITY IN SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA(2013-04-12) Bhat, Nikhil U.Purpose: The Purpose of the project was to: Establish a data base for evaluating the problem of obesity in ALL survivors. Measure the frequency of obesity in a population of patients treated at CCMC on Total XV. Evaluate changes in BMI according to key time points during patient's ALL therapy and follow up and observe if there is a trend seen in any variable like ethnicity or gender. Methods: Ninety ALL patients were identified that were diagnosed and treated on the St. Jude Total Therapy XV at Cook Children's Medical Center(CCMC) between the years 2004-2007 and later followed up through August 2012. A database was created to record the measurements of each patient.Later a retrospective observational study to measure the frequency of obesity in a subset of 90 ALL patients treated at CCMC on the Total Therapy XV Protocol was conducted and the risk factors that may have influenced the development of obesity in these ALL survivors were evaluated. Results: The mean BMI for all the patients who were followed from diagnosis to 2 years after end of therapy increased over time. For the obese category, it was observed that the percentage and number of obese patients increased from baseline to at 2 year post therapy. The results of a mixed regression model reveal that there is significant individual variation with respect to BMI changes across time (p=0.0008). Considering the side effects of steroids and anthracyclines, which include weight gain and osteonecrosis, further research is needed to look at the effect of these predictors on BMI. Conclusions: Based on the results and the statistical interpretation, it is observed that this group of childhood ALL survivors show an increase in BMI with time. It is observed that the number of obese and overweight patients has increased from diagnosis to 2 years post therapy in this group. Hence, preventive measures need to be taken to minimize the risk of obesity in childhood ALL survivors. Preventive measures need to be taken at the primary level, secondary level and tertiary level. We need to reduce the number of new cases of obesity in ALL survivors, decrease the number of existing cases of obesity in ALL survivors and prevent the complications related to obesity in ALL survivors who are already obese. It is essential to involve the entire family of a child to take preventive measures related to obesity in ALL survivorsItem Study of Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia (All)(2013-05-01) Bhat, Nikhil U.; Jerry SimeckaThe number of childhood cancer survivors has dramatically increased over the last two decades (1, 2). Survivorship programs focus on the health problems childhood cancer survivors face because of their cancer treatments. These programs provide surveillance for health problems, and educate survivors about their risk for health problems, to encourage them to engage in activities to minimize the development of severe health related problems. Clinicians perceive there to be a problem of increasing obesity among leukemia survivors. Obesity should not be considered simply a consequence of an unhealthy lifestyle: it is a condition in which weight gain has reached the point where it poses significant risks to health (3). The use of chemotherapy agents such as anthracyclines and radiation (to the thorax) are associated with cardiovascular disease (4, 5, 6). Obesity in cancer survivors is not yet well understood but may further increase cardiovascular risks. Cancer treatments, lifestyles, and medications other than chemotherapy may contribute to obesity among cancer survivors. Survivors of acute lymphoblastic leukemia (ALL) may be more likely to develop obesity or cardiovascular diseases due to their cancer treatments, which include chemotherapy, steroids, and sometimes radiotherapy (7). Strategies to reduce obesity in ALL survivors include a multifaceted approach, drug therapy and interventions to address psychological problems, as well as lifestyle modifications (7, 8). This practicum project examined obesity as an adverse health condition among survivors of childhood ALL. Considering the fact that the there are various factors which may lead to obesity among cancer survivors and all are not proven yet, this practicum project examined whether the type of treatment and the medications given to the patients contributed to the changes in BMI in 2 the patients. The project also evaluated trends in Body Mass Index (BMI) among patients at each time points and the changes in BMI with respect to variables like ethnicity. The objective of this study was to evaluate these trends was to use a database to determine the frequency of obesity among ALL survivors and thereby get some concrete information as to how the type of treatment affected the BMI in the group of patients who were considered for the study and whether there was a trend related to changes in BMI seen in a specific ethnic group which was part of the study. Since obesity is a major risk factor among ALL survivors, steps need to be taken to reduce its threat not only among survivors but also among other people in the community. This project was a step taken in that direction to combat the threat of obesity among ALL survivors.Item Synergy 2011: Annual Research Report(2011-01-01)Item The Association between Obesity, Cognition, and Visual Function(2011-05-01) Currie-Elolf, Lauren M.; Nathalie SumienPurpose: Obesity is an adverse health condition characterized by excessive weight gain. Aside from the pathological conditions most commonly associated with obesity, recent epidemiological studies have suggested that obesity may be associated with impaired learning and memory. Previous research has linked inflammation and oxidative stress, cellular changes that occur consequent to obesity, to impaired cognitive function. Obese rodent models have been established and are commonly used for obesity-related research; however, with respect to the effect of obesity on cognitive function, the data remain inconclusive. In these studies, two obese mouse models, representing two obesity-inducing causes: genetic vs. environment, were behaviorally characterized in order to determine which model was best suited to study behavioral and cellular changes associated with obesity. Furthermore, a suitable model needed to be identified to carry on studies focusing on the relation between aging and obesity, as one would predict an exacerbation of the impairment in old obese models with age. The current studies were also based on the rationale that a dietary intervention at mid-life would ameliorate behavioral and biochemical changes observed with obesity. Methods: In study I, separate groups of 6-month old male and female C57BL/6 and leptin-deficient (ob/ob) were subjected to a battery of behavioral tests for motor, cognitive and visual function. In study II, separate groups of male C57BL/6 mice aged to 6- or 12-months were fed ad libitum either a control diet or a high-fat diet since 6- weeks of age. In a subset of the aged mice, a dietary intervention was introduced such that these mice were switched from the high-fat diet to the control diet at 6-months of age. Mice were subjected to a battery of behavioral tests at 6- or 12-months that required utilization of various component of memory, learning and visual function. Results: In study I, cognitive impairments were observed in the obese mice, and were exacerbated in female mice. While overall spatial learning was unaffected, male and female ob/ob mice performed worse on an active avoidance paradigm, indicating frontal cortical impairment. The ob/ob mice also performed worse on vision-associated tests. The results from this study suggested that obesity impairs cognitive and visual function in a sex-dependent manner. In study II, increased anxiety was observed in diet-induced obese mice; however, spontaneous activity, spatial capacity and performance on the active avoidance paradigm were unaffected. The dietary intervention reversed the effect of obesity on anxiety-like behaviors, but failed to improve cognitive and motor function. Visual impairments were observed in diet-induced obese mice, and these impairments were exacerbated with age. The results from study II indicated that diet- induced obese mice could be used to study the effects of obesity on visual, but not cognitive function. Conclusions: Overall, the hypothesis that obesity impairs cognitive function and exacerbates age-related impairments was not supported and the dietary intervention had minor effects. However, in both models, obesity impaired visual function and it was exacerbated at older ages. These findings suggest that ob/ob and diet-induced obese mice are valid animal models for investigating obesity-induced visual disorders.