Browsing by Subject "obesity"
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Item A Role for Adipocytes and Adipose Stem Cells in the Breast Tumor Microenvironment and Regenerative Medicine(Frontiers Media S.A., 2021-11-29) Brock, Courtney K.; Hebert, Katherine L.; Artiles, Maria; Wright, Maryl K.; Cheng, Thomas; Windsor, Gabreille O.; Nguyen, Khao; Alzoubi, Madlin S.; Collins-Burow, Bridgette M.; Martin, Elizabeth C.; Lau, Frank H.; Bunnell, Bruce A.; Burow, Matthew E.Obesity rates are climbing, representing a confounding and contributing factor to many disease states, including cancer. With respect to breast cancer, obesity plays a prominent role in the etiology of this disease, with certain subtypes such as triple-negative breast cancer having a strong correlation between obesity and poor outcomes. Therefore, it is critical to examine the obesity-related alterations to the normal stroma and the tumor microenvironment (TME). Adipocytes and adipose stem cells (ASCs) are major components of breast tissue stroma that have essential functions in both physiological and pathological states, including energy storage and metabolic homeostasis, physical support of breast epithelial cells, and directing inflammatory and wound healing responses through secreted factors. However, these processes can become dysregulated in both metabolic disorders, such as obesity and also in the context of breast cancer. Given the well-established obesity-neoplasia axis, it is critical to understand how interactions between different cell types in the tumor microenvironment, including adipocytes and ASCs, govern carcinogenesis, tumorigenesis, and ultimately metastasis. ASCs and adipocytes have multifactorial roles in cancer progression; however, due to the plastic nature of these cells, they also have a role in regenerative medicine, making them promising tools for tissue engineering. At the physiological level, the interactions between obesity and breast cancer have been examined; here, we will delineate the mechanisms that regulate ASCs and adipocytes in these different contexts through interactions between cancer cells, immune cells, and other cell types present in the tumor microenvironment. We will define the current state of understanding of how adipocytes and ASCs contribute to tumor progression through their role in the tumor microenvironment and how this is altered in the context of obesity. We will also introduce recent developments in utilizing adipocytes and ASCs in novel approaches to breast reconstruction and regenerative medicine.Item Adipose-Derived Stem Cells from Obese Donors Polarize Macrophages and Microglia toward a Pro-Inflammatory Phenotype(MDPI, 2020-12-25) Harrison, Mark A. A.; Wise, Rachel M.; Benjamin, Brooke P.; Hochreiner, Emily M.; Mohiuddin, Omair A.; Bunnell, Bruce A.Macrophages and microglia represent the primary phagocytes and first line of defense in the peripheral and central immune systems. They activate and polarize into a spectrum of pro- and anti-inflammatory phenotypes in response to various stimuli. This activation is tightly regulated to balance the appropriate immune response with tissue repair and homeostasis. Disruption of this balance results in inflammatory disease states and tissue damage. Adipose stem cells (ASCs) have great therapeutic potential because of the potent immunomodulatory capabilities which induce the polarization of microglia and macrophages to the anti-inflammatory, M2, phenotype. In this study, we examined the effects of donor heterogeneity on ASC function. Specifically, we investigated the impact of donor obesity on ASC stemness and immunomodulatory abilities. Our findings revealed that ASCs from obese donors (ObASCs) exhibited reduced stem cell characteristics when compared to ASCs from lean donors (LnASCs). We also found that ObASCs promote a pro-inflammatory phenotype in murine macrophage and microglial cells, as indicated by the upregulated expression of pro-inflammatory genes, increased nitric oxide pathway activity, and impaired phagocytosis and migration. These findings highlight the importance of considering individual donor characteristics such as obesity when selecting donors and cells for use in ASC therapeutic applications and regenerative medicine.Item Bodyweight Changes During COVID-19 for Patients Diagnosed with Depression: A Retrospective Cohort Study(2022-05) Arellano Villanueva, Elias; Fulda, Kimberly; Franks, Susan; Schranz, DamonBackground: The COVID-19 pandemic led to an unprecedented lockdown of millions of Americans from the spring of 2020 to the fall of 2020 This lockdown exacerbated the mental and physical health status of millions of individuals worldwide. Studies done on the impact of COVID-19 on mental health and body weight have been important to our understanding of the effects of the pandemic. However, these studies on depression and BMI change have not identified a possible direction of the causality of the relationship between depression and body weight as affected by lockdown measures during a pandemic. Therefore, this study examined whether a diagnosis of depression is associated with changes in BMI during the COVID-19 pandemic for adults (aged ≥ 18 years). Methods: A retrospective cohort study design using EHR data from a family medicine university clinic was utilized. Adults > 18 years who visited the clinic within a 6-month period prior to lockdown and at least once in the 6-month post-lockdown period were included. Diagnosis of depression, BMI, and potential confounding variables were obtained from EHR. Mann-Whitney U was used to compare the median change in BMI between depressed and non-depressed patients Simple linear regression was used to identify the relationship between diagnosis of depression and BMI change. Multiple linear regression was used to control for age, sex, race/ethnicity, medications, and chronic conditions; and to predict age effects in BMI change while stratified by diagnosis of depression and no diagnosis of depression. Results: Statistical analysis showed that there was a significant difference in BMI changes (p=<0.001) between the group diagnosed with depression and the group with no depression. Similarly, a diagnosis of depression significantly predicted BMI changes (p = >0.001]). This significance was maintained even while including confounding variables in the model (p=0.009). Further statistical analysis showed that age between 31 and 50 significantly predicted BMI changes in those patients with no depression while controlling for confounding variables (p = 0.027). Conclusion: This study demonstrated that individuals with depression had significant changes in BMI during the COVID-19 pandemic and age predicted these changes in middle-aged adults (30-50 years old). The significance of this finding places importance in identifying and following up with individuals with a depression diagnosis given the effects on their BMI in extended isolation periods. Future studies could investigate other variables that might impact BMI change to influence the directionality of this relationship. Providing insight into this relationship could enable providers to inform patients that might be at risk for these types of changes over extended periods of isolation, and hopefully result in positive patient health outcomes.Item Brainstem mechanisms that impair autonomic regulation of blood pressure with obesity(2018-12) Chaudhary, Parul; Schreihofer, Ann M.; Mifflin, Steve W.; Cunningham, J. Thomas; Schreihofer, Derek A.Metabolic syndrome (MetS) is emerging as a global health threat due to its strong association with increased risk for cardiovascular disease and diabetes. Currently, 20-25% of the world's population exhibits some traits of MetS, namely obesity, dyslipidemia, hyperinsulinemia, hypertension, and hyperglycemia. In addition, MetS also promotes the development of impaired short-term regulation of mean arterial pressure (AP) by baroreflexes, which normally act to stabilize AP. The resulting increased AP variability, which is an independent risk factor for poor outcomes, is overlooked as a trait of MetS and goes without evaluation or treatment. People who have controlled hypertension without minimizing elevated AP variability are still at significant risk for detrimental cardiovascular events such as stroke and cognitive decline. Therefore, understanding mechanisms impairing baroreflexes with MetS will help determine appropriate therapeutic management to restore baroreflexes and promote stability of AP. Furthermore, because sex differences in the development of impaired baroreflexes with obesity have been reported, an understanding of how females are protected would provide valuable insights for underlying causes for early onset of impaired baroreflexes in obese males and eventual development of impaired baroreflexes in obese females. In this project, I utilized a rodent model of MetS, obese Zucker rats (OZR), to examine contributions of hypertension and hyperglycemia in the development of impaired baroreflexes in male OZR, and whether hypertensive female OZR have delayed onset of impaired baroreflexes because they have the ability to maintain glycemic control. Male and female OZR have excess weight gain from an early age because the mutation of a leptin receptor renders them insensitive to leptin's actions to regulate appetite and metabolism, promoting excess intake of standard chow and storage of ingested calories. Like obese humans, OZR develop dyslipidemia, hypertension, and insulin resistance that eventually progresses to type 2 diabetes, making them a suitable model for the consequences of MetS. Young adult male OZR (12-15 weeks) develop sympathetically driven hypertension with pronounced attenuation of baroreflex control of heart rate (HR) and sympathetic nerve activity (SNA) compared to juvenile OZR and lean Zucker rats (LZR). In male OZR, the development of impaired baroreflexes coincides with blunted activation of the NTS, the brain stem region that receives baroreceptor afferent inputs to promote baroreflex-mediated changes in HR and SNA, and this deficit likely yields diminished baroreflexes observed in young adult male OZR. In the first project I examined whether improvement of impaired glycemic control in young adult male OZR restores baroreflex-mediated bradycardia and activation of the NTS. Both type 1 and type 2 diabetic rats have impaired vagally-mediated activation of the NTS, in agreement with the reported loss of glucose's ability to enhance glutamatergic neurotransmission within the NTS of hyperglycemic, diabetic rodents. Male OZR develop insulin resistance at an early age, characterized by elevated insulin and triglycerides with impaired glucose tolerance but normal fasting hyperglycemia. We examined glucose homeostasis using chronic measures of blood glucose by telemetry in undisturbed rats because of previous reports of exaggerated stress responses. We observed that although young adult (12-14 weeks old) male OZR have normal fasting blood glucose, they are chronically hyperglycemic with access to food. Treatment of OZR with metformin or pioglitazone restored fed blood glucose levels with access to food and enhanced baroreflex-mediated bradycardia and activation of the NTS, as suggested by phenylehphrine-induced c-Fos expression. In contrast, treatment of LZR did not alter glucose or affect baroreflex-mediated bradycardia and activation of the NTS. Neither treatment reduced elevated AP and insulin in OZR, suggesting the lowering of blood glucose was effective for restoring baroreflexes in young adult male OZR, even in the face of hypertension. In the second project I examined whether the delayed onset of impaired baroreflexes in hypertensive female OZR could be due to their ability to maintain a normal blood glucose and baroreflex-mediated activation of the NTS. Premenopausal obese women protected from diabetes, suggesting they would be protected from deficits produced by hyperglycemia. I observed that intact baroreflex-mediated bradycardia in young adult female OZR extended to preserved sympathetic baroreflexes and baroreflex-mediated activation of the NTS in 12-15-week-old female OZR. Furthermore, although these OZR were hypertensive and hyperinsulinemic, fed glucose levels and glucose tolerance are comparable to LZR. In contrast, by 6 months of age, baroreflex-mediated bradycardia was blunted in female OZR. However, fed glucose was only mildly elevated and baroreflex-mediated activation of the NTS was comparable in OZR and LZR. These data suggest the ability to maintain glucose homeostasis in young adult female OZR coincides with a preservation of baroreflex-mediated bradycardia and activation of the NTS. However, the later development of impaired baroreflex-mediated bradycardia in female OZR occurs through mechanisms distinct from those observed in male OZR. The third project examined whether preventing hypertension in male OZR protected against the development of impaired baroreflexes and activation of the NTS. Treatment with losartan or hydralazine normalized baseline AP in male OZR without affecting hyperinsulinemia, dyslipidemia, or hyperglycemia. Furthermore, these treatments enhanced baroreflex-mediated bradycardia and activation of the NTS in male OZR. However, even when AP was normalized in male OZR, baroreflex-mediated bradycardia was still smaller in treated OZR compared to like-treated LZR, suggesting other mechanisms also contribute to the blunted baroreflexes. Together these studies suggest that the development of hyperglycemia and hypertension in male OZR contribute to impaired baroreflex-mediated bradycardia and activation of the NTS in male OZR. However, the ability of female OZR to maintain glucose homeostasis preserves baroreflexes despite the presence of hypertension and hyperinsulinemia. Furthermore, when female OZR later develop impaired baroreflex-mediated bradycardia, this deficit occurs by mechanisms that differ from male OZR, highlighting the need to examine both sexes for the development of cardiovascular and metabolic disorders.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 Effects of Popular Diets without Specific Calorie Targets on Weight Loss Outcomes: Systematic Review of Findings from Clinical Trials(MDPI, 2017-07-31) Anton, Stephen D.; Hida, Azumi; Heekin, Kacey; Sowalsky, Kristen; Karabetian, Christy; Mutchie, Heather; Leeuwenburgh, Christiaan; Manini, Todd M.; Barnett, Tracey E.The present review examined the evidence base for current popular diets, as listed in the 2016 U.S. News & World Report, on short-term (≤six months) and long-term (≥one year) weight loss outcomes in overweight and obese adults. For the present review, all diets in the 2016 U.S. News & World Report Rankings for "Best Weight-Loss Diets", which did not involve specific calorie targets, meal replacements, supplementation with commercial products, and/or were not categorized as "low-calorie" diets were examined. Of the 38 popular diets listed in the U.S. News & World Report, 20 met our pre-defined criteria. Literature searches were conducted through PubMed, Cochrane Library, and Web of Science using preset key terms to identify all relevant clinical trials for these 20 diets. A total of 16 articles were identified which reported findings of clinical trials for seven of these 20 diets: (1) Atkins; (2) Dietary Approaches to Stop Hypertension (DASH); (3) Glycemic-Index; (4) Mediterranean; (5) Ornish; (6) Paleolithic; and (7) Zone. Of the diets evaluated, the Atkins Diet showed the most evidence in producing clinically meaningful short-term (≤six months) and long-term (≥one-year) weight loss. Other popular diets may be equally or even more effective at producing weight loss, but this is unknown at the present time since there is a paucity of studies on these diets.Item Effects of Testosterone on Obesity-Related Cardiac Hypertrophy and Fibrosis(2009-08-01) Wilson, Ana Kaye; Joan F. Carroll; James L. Caffrey; Robert T. MalletWilson, Ana Kaye. Effects of testosterone on obesity-related cardiac hypertrophy and fibrosis. Master of Science (Integrative Physiology), August 2009, 71 pp, 3 tables, 6 figures. Both testosterone and obesity are known to increase renin-angiotensin system activity, leading to cardiovascular dysfunction. This study determined the interactive effects of obesity and testosterone on left ventricular hypertrophy and cardiac fibrotic factors. Male New Zealand White rabbits were fed a lean or 10% added fat diet. After 12 weeks, fat-fed rabbits exhibited increased left ventricular weight (6.05±0.16 vs. 4.75±0.10 g, respectively, p≤0.05) and cardiomyocyte cross-sectional area compared to lean rabbits (372.3±19.0 vs. 305.0±13.4μm2, respectively; p≤0.01). These effects were attenuated by both castration and treatment with the angiotensin type 1 receptor blocker, losartan. Obese rabbits did not exhibit increased myocardial collagen as expected. However, castration and losartan treatment increased matrix metalloproteinase-2 (MMP-2) activity in obese rabbits. Despite the effects of castration hypertrophy and MMP-2 activity, castration did not attenuate plasma renin activity of aldosterone. These data suggest that testosterone contributes to obesity-related left ventricular hypertrophy and decreases collagen degradation, independent of renin activity.Item Ethnic Differences in the Distribution of Factors Associated with Obesity in Children(2002-08-01) Ahmad, Naveed; Bayona, Manuel; Urrutia-Rojas, XimenaAhmad, Naveed M.D., Ethnic Differences in the Distribution of Factors Associated with Obesity in Children. Masters of Public Health (Biostatistics), August 2002, 31 pp., 6 tables, 1 illustration, references, 24 titles. Childhood obesity has risen dramatically during the last few decades and the factors associated with it vary for different ethnicities. The purpose of this study is to find ethnic differences in the distribution of factors associated with obesity in children. The data used in this study was collected in a school-based study of 1,076 school children in Fort Worth, Texas. Obesity was found to be more prevalent in Hispanics and African Americans than in Caucasians. Reported factors associated with childhood obesity, that were more prevalent in Hispanics were: eating more sweets and less vegetables, not doing regular daily exercise and watching more TV. In African Americans children the more common correlates of obesity were: reported eating more sweets, fewer fruits, watching more TV, and not doing daily exercise. For Caucasians reported correlates of obesity were: eating more chips, and being less involved in active sports, when compared to African American and Hispanic children.Item Exploratory Analysis on the Prevalence of Rapid Growth and Overweight in Normal Weight Infants(2004-06-01) Bell, Karen; Urrutia-Rojas, Ximena; Cipher, Daisha; Menchaca, JohnBell, Karen. Exploratory Analysis on the Prevalence of Rapid Growth and Overweight in Normal Birth Weight Infants. Master of Public Health. June 2004. 33 pp, 5 tables, bibliography, 24 titles. Rapid growth can be defined as a period of growth acceleration that occurs in infants who are born of normal birth weight. Research has shown that children who experience this phenomenon exhibit future health conditions such as cardiovascular disease and obesity. Furthermore, these conditions can manifest in childhood and persist to adulthood. The exploratory study reported here examined rapid growth and overweight in this group. This study also included a review of literature that examined health complications and predictors associated with rapid growth and overweight in this group. This study also included a review of literature that examined health complications and predictors associated with rapid growth. In addition, the author investigated the history of the Centers for Disease Control and Prevention (CDC) growth charts. The exploratory analysis studied data on ninety-one infants from a Cook Children’s Network pediatric office. The infants’ weight and height information were obtained every two months after birth for a six-month time period. This information was used to plot each infant’s growth on 2000 CDC growth charts which would indicate if a child was either growing rapidly, or overweight. Nineteen infants exhibited rapid growth within the first six to nine months of life. Eight were found to be either obese, overweight or at risk of being overweight. The health complications associated with rapid growth in these infants needs to be assessed. Therefore, it is important that more research is performed that examines this phenomenon.Item Is All Fat Created Equal?: Assessing Self-Reported Obesity Risk between Racial Groups with Structural Equation Modeling of the Eating Inventory(2009-05-01) Kaiser, Kathryn A.; Franks, SusanBackground: Obesity prevalence rates differ widely between gender and racial groups in the United States. African American women have the highest prevalence rates, while Caucasian women have the lowest rates. Better assessment methods are needed to discern the varied and complex biopsychosocial risk factors for this disease for each individual. Psychological measures must be tested for cultural validity in the populations in which they will be used. One commonly used measure of eating behavior, the Eating Inventory (Stunkard & Messick, 1988), has not been assessed for cultural bias between the major ethnic groups in the Unites States in terms of its validity for assessment of obesity risk. Methods: Structural equation modeling techniques are used to compare invariance of factor structure of the Eating Inventory between adult Caucasian (n=110) and African American women (n=100). Alternate proposed factor structures are also tested for factor invariance between groups. Body Mass Index (BMI) is used as an optional covariate in the models. Additionally, socio-economic status indicators are examined for differential influence in the models, due to previously demonstrated, highly positive correlation with rates of obesity. Experimenter/participant race dyads are examined for systematic influence on response patterns. Results: The factor invariance of the original, three factor structure (Cognitive Restraint, Disinhibition and Hunger) of the Eating Inventory is supported with this sample. The invariance of alternate factor structures could not be supported with this sample, with one exception (Cognitive Restraint). Relative covariance of factors with BMI appears to be consistent between groups for all models tested. No participant/experimenter race interaction with factor scores was observed. Conclusions: The original three factor structure of the Eating Inventory appears to have invariance of the factor structure between the two groups measured, implying cultural validity. The relative covariance of factor scores with BMI is equivalent between groups. However, alternate factor structures could not be fully assessed due to sample size limitations. Further research is needed to replicate and expand these findings.Item Lessons Learned from the Design and Implementation of a Health Promotion Intervention for African American Women(2022-08) Dodgen, Leilani, A.; Spence-Almaguer, EmilyThe purpose of this dissertation is to explore how intervention design can be enhanced to influence the health of African American women through examining the processes and methods related to health behavior theory, cultural adaptation, and participatory approaches. Data from African American women who participated in the Better Me Within (BMW)Trial, as well as, formative data from focus groups with African American women were used to investigate these intervention planning approaches through the following aims: Aim 1 addressed the question how do theoretical constructs of behavior change help to explain health outcomes in the BMW trial? This was quantitatively explored by examining theoretical constructs with outcomes of weight, diet and physical activity. Aim 2 explored the perspectives of African American women through qualitative analysis of focus groups for cultural and contextual elements that may influence the approach to intervention design, increase knowledge about cultural adaptations, and contribute methods to enhance weight management. Aim 3 critically examined how the community-based participatory research (CBPR) approach with African American faith communities in the BMW Trial aligned with the CBPR conceptual model through a case study. Understanding how processes, operations, and decisions in intervention design contribute to health improvements is imperative for ensuring programs are relevant and effective in specific populations. One size does not fit all. The current state of health inequities and chronic conditions in African American women require thoughtful intervention strategies that center community knowledge, culture, and context. This dissertation seeks to arrive at intervention strategies that are relevant to African American women, and influence how public health professionals approach intervention development for meaningful, community-identified health improvements.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 Overweightness and Obesity as Risk Factors for Acanthosis Nigricans(2001-12-01) Wadley, Wendy Whittaker; Urrutia-Rojas, Ximena; Bae, Sejong; Bayona, ManuelWadley, Wendy Whittaker, Overweightness and Obesity as Risk Factors for Acanthosis Nigricans. Master of Public Health (Community Health), December, 2001, 42 pp., 6 tables, references, 54 titles. This study was a secondary analysis of data from a cross-sectional study of 1,066 fifth grade students, who were screened for risk factors for type 2 diabetes (T2DM) at Fort Worth Independent School District in Texas. Participants (ages 8 to 13) were 55.8% Hispanic, 23.6% African American, 16.1% Caucasian, and 4.5% other minorities. The study’s hypotheses were a) overweight or obese children (Body Mass Index [BMI] ≥85th percentile) were more likely to have acanthosis nigricans (AN) than non-overweight of non-obese children, b) obese children (BMI≥85th-94.9th percentile). Findings supported both hypotheses, overweight or obese children are 17 times (OR=17.24) more likely to have AN that non-overweight or non-obese children, and obese children were about four times (OR=3.88) more likely than overweight children to have AN.Item Potential Predictors of Hypertension Among Children in Fort Worth, Texas: A Cross-Sectional Epidemiologic Study(2002-05-01) Egbuchunam, Christie U.; Bayona, Manuel; Urrutia-Rojas, Ximena; Wilkinson, GreggEgbuchunam, Christie U., Potential Predictors of Hypertension Among Children in Fort Worth, Texas; A Cross-Sectional Epidemiologic Study. Master of Public Health (Epidemiology), May, 2002, 110 pp., 15 tables, 2 illustrations, bibliography, 84 titles. Most studies have identified obesity, gender and age as major factors that influence blood pressure increase in children. The objective of this study was to assess factors that may either directly influence hypertension in children, or interact with obesity, age and gender. A cross-sectional study was carried out to identify and assess the crude and multiple logistic regression adjusted associations between selected variables and hypertension. Obesity and Acanthosis Nigricans (AN) were importantly associated with hypertension. Reduced playing time, and excessive television watching or playing of video games were also associated with hypertension; especially among those who were obese or had AN. Hispanic and African American children had higher likelihood of hypertension than Caucasian children.Item Regional Adipose Tissue Deposition, Its Rate of Lipolysis, and Subsequent Effect of Insulin Resistance-in Type II Diabetes Mellitus(1999-06-01) Schalscha, Alan G.; Raven, Peter B.; Downey, H. Fred; Caffrey, James L.Diabetes mellitus is a disease that plagues populations world wide. More than 5 percent of U.S. citizens are afflicted with one or another form of this disease (22). This paper begins by discussing the incidence of this illness as it affects Americans. An explanation of the four forms in which diabetes mellitus itself will be offered, and these will be classified according to etiology. Non-insulin dependent diabetes mellitus (NIDDM), also called type II diabetes mellitus, will be the last of these forms mentioned. Due to its prevalence, NIDDM will be the focus of this paper. The proposed pathophysiology of NIDDM will be discussed, though to researchers it still remains somewhat of a mystery. This paper will then briefly the genetic and environmental interaction responsible for the onset of non-insulin dependent diabetes mellitus. A brief discussion of the interrelationship between decreasing physical activity and a subsequent increase in obesity will follow (38). The location of adipose tissue seems to have adverse effects on certain aspects of NIDDM, including its sensitivity to insulin. This paper proposes that either subcutaneous or visceral adipose deposits specifically reduce insulin sensitivity more than other fat stores. The connection between adipose tissue and insulin sensitivity appears to be mediated by fatty acids released from specific depots and their destination immediately following release.Item Relationship Between Sense of Control, Obesity and Healthy Behaviors in a Primary Care Setting - North Texas Healthy Heart 1 Study(2009-08-01) Oberdorfer, Ewa; Jeffries, ShawnThe purpose of the study is to analyze if sense of control (SOC) is associated with body mass index (BMI), having a PCP, exercise behavior and a routine health check-up. Using the NTHHS' (North Texas Healthly Heart I Study) questionnaire, numerous models were run using both linear and logistical regressions to analyze the relationship between SOC, BMI, PCP, exercise behavior, and having a routine check-up as well as if PCP modifies these relationships. SOC was associated with exercise behavior but not BMI, PCP or having a routine check-up. PCP did not modify the associations. SOC can help PCP's identify individuals who engage in exercise behavior.Item The Geography of the Risk Factors for Type 2 Diabetes in Fifth-Grade School Children in Fort Worth, Texas: Spatial Associations with Obesity and Fast Food Restaurants(2006-05-01) Pepper, Catherine A.Pepper, Catherine A. The Geography of the Risk Factors for Type 2 Diabetes in Fifth-Grade Schoolchildren in Fort Worth, Texas: Spatial Associations with Obesity and Fast Food Restaurants. Master of Public Health (Public Health Informatics), May 2006, 48pp., 3 tables, 5 illustrations, bibliography, 47 titles. In examining risk for Type 2 Diabetes Mellitus (T2DM) in Fort Worth elementary schools, the investigator answered the following questions: What is the geographical distribution of risk for T2DM in Fort Worth elementary schoolchildren? How is that related to the prevalence of obesity? To what extent is the spatial concentration of fast food restaurants a factor in the risk for diabetes and obesity prevalence in this population? The investigator also makes policy recommendations regarding the prevention of diabetes in children. Statistical and spatial analysis of data, provided from a previous study at UNTHSC that assessed overweight and risk for T2DM in elementary school children in the Fort Worth Independent School District, was used to assess the association between risk of diabetes in children and proximity to fast food restaurants. Geographic Information Systems (GIS) analysis was applied to the data to determine if such an association could elucidated.Item Use of Body Mass Index as a Predictor of Health Status in Firefighters(2002-05-01) Theurer, Wesley M.; Antonio A. Rene; Sharon ClarkTheurer, Wesley M., Use of Body Mass Index as a Predictor of Health Status in Firefighters. Master of Public Health (DO/MPH), May, 2002, 28 pp., 3 tables, 29 References. This study evaluated the usefulness of BMI as a screening tool for health parameters and duty fitness among firefighters. Our cohort consisted of 218 active firefighters between the ages of 18 and 58 (men 33.5 ±8.6). Two major BMI categorization methods were used: standard [low (30)] and obesity [(normal([less than] 25), overweight(≥25 [less than] 30), obese(≥30 [less than] 39), morbidly obese ≥39)] The mean BMI was 28.8 (±4.5). Standard categorization revealed that nearly 60% had medium or high BMI's; obesity categorization showed 80.7% to be overweight, obese, or morbidly obese. Statistically significant, adverse relationships between BMI and each of the following were found: systolic and diastolic blood pressure, VO2max, METS, and total cholesterol. Inconsistent or statistically insignificant relations were found between BMI and HDL, Chol/HDL ratios, Triglycerides, FVC, and FEV1sec. Tobacco use and participation in an exercise program is also reported. BMI continues to prove useful as a screening tool and may be useful in identifying individual firefighters for health and fitness intervention measures.