Browsing by Subject "Pediatric Obesity"
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Item 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 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.