The oxygen uptake (VO2) kinetic response to exercise provides insight into aerobic performance and the efficiency of the body to maintain oxygen demand during the initiation of exercise. Previous research in normal weight children reports insignificant differences in gender VO2 on-kinetic responses to moderate exercise. No study has evaluated the impact obesity may have on gender VO2 on-kinetics. PURPOSE: To determine if sex differences exist in the VO2 kinetic response to moderate exercise in obese adolescents. METHODS: Male (n=16) and female (n=39) adolescents completed a graded exercise test to exhaustion on a treadmill. Data from initial 4-min treadmill walking was used to determine a time constant. RESULTS: The time constant was significantly different (P=0.009) between obese male and female adolescents (15.42±7.31 s vs. 22.03±8.56 s, respectively). CONCLUSION: Sex differences exist in VO2 on-kinetics during moderate exercise in obese adolescents indicating an enhanced potential for males to deliver and/or utilize oxygen.

Childhood obesity has become an increasingly important public health concern in Canada. This paper provides an econometric analysis of the role of income and other explanatory factors on adolescent overweight and obese statuses within Canada using data from the 2009/2010 Canadian Community Health Survey. Results reveal the importance of low-income status on adolescent body weight. The effect of low income is particularly pronounced after accounting for household size. However, it does not account for much of the additional incidence of overweight and obesity in the Atlantic region of Canada.

Objective: To evaluate the SickKids Team Obesity Management Program (STOMP), an obesity management program for severely obese adolescents. Methods: Non-randomized study of 6 and 12 month outcomes in STOMP patients vs. a comparison group of obese adolescents. Results: At 6 months, STOMP patients stabilized their BMI (0.08±0.3 kg/m2;p=0.79) and reported improved psychological and health behaviour measures, whereas comparison participants increased their BMI (0.7±0.2 kg/m2;p=0.004) and had worsening of cardiometabolic outcomes. Between-group differences included improved cardiometabolic, psychological and health behaviour measures in STOMP patients. At 12 months, STOMP patients stabilized their BMI (0.8±0.5 kg/m2;p=0.07), had improvements in anthropometric and cardiometabolic outcomes and reported an increase in health behaviours, whereas comparison participants increased their BMI (1.2±0.4 kg/m2;p=0.001) and had worsening of cardiometabolic outcomes. Between-group differences included improved anthropometric, cardiometabolic and health behaviour outcomes in STOMP patients. Conclusions: Participation in STOMP improved anthropometric, cardiometabolic, psychological and health behaviour outcomes among severely obese adolescents.

Objective: To evaluate the SickKids Team Obesity Management Program (STOMP), an obesity management program for severely obese adolescents. Methods: Non-randomized study of 6 and 12 month outcomes in STOMP patients vs. a comparison group of obese adolescents. Results: At 6 months, STOMP patients stabilized their BMI (0.08±0.3 kg/m2;p=0.79) and reported improved psychological and health behaviour measures, whereas comparison participants increased their BMI (0.7±0.2 kg/m2;p=0.004) and had worsening of cardiometabolic outcomes. Between-group differences included improved cardiometabolic, psychological and health behaviour measures in STOMP patients. At 12 months, STOMP patients stabilized their BMI (0.8±0.5 kg/m2;p=0.07), had improvements in anthropometric and cardiometabolic outcomes and reported an increase in health behaviours, whereas comparison participants increased their BMI (1.2±0.4 kg/m2;p=0.001) and had worsening of cardiometabolic outcomes. Between-group differences included improved anthropometric, cardiometabolic and health behaviour outcomes in STOMP patients. Conclusions: Participation in STOMP improved anthropometric, cardiometabolic, psychological and health behaviour outcomes among severely obese adolescents.

Objectives: Coordinated School Health (CSH) is a systematic approach to improving the health and well-being of school-age children. It is recommended for its potential to promote healthy weight in adolescents through strategic programming. Resources and programming for adolescent obesity prevention varies among schools, thereby limiting the intended benefits of CSH. The purpose of this study was to understand gaps in schools approaches to healthy weight promotion and support for overweight/obese students. We evaluated perceptions of adolescent obesity and environmental factors and programs facilitating healthy weight in high schools in Appalachian Tennessee. Methods: In 2012, 17 key school personnel from 5 randomly selected high schools were interviewed. Questions addressed their perceptions of adolescent obesity, school-based physical activity and nutrition programming, and support available to overweight/obese students. Thematic analysis was conducted to identify emerging themes. Results: Participants consistently identified adolescent obesity and/ or associated risk factors as major health problems within their schools. Barriers to physical activity and healthful eating were identified at multiple levels. Because of the sensitivity surrounding overweight/obesity, no particular programs or curricula targeted overweight/obese adolescents specifically, but they were available to all students. Support is not explicitly available; therefore, overweight/ obese students must seek out these resources. Conclusions: Findings suggest that although school personnel are concerned about the impact of adolescent obesity on health outcomes, there is wide variation across schools on the types and quality of programming available to address the issue. Results can be used to encourage school-based strengths and identify gaps in the CSH infrastructure in school systems.

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The following research integrated the Theory of Planned Behavior with variables from the consumer socialization and parenting literatures to explore parental impact on adolescent food decision-making. Three specific types of parenting practices (expectation, monitoring, and inducement/enforcement behaviors), parenting style, and family communication style were investigated. A multi-method approach was taken to develop and test the integrated model. Study 1 used interviews to identify food-related parental expectation, monitoring, and inducement/enforcement behaviors reported by both normal and overweight parents and adolescents. Study 2 evaluated a structural model of adolescent food choice, including predictors from the Theory of Planned Behavior, the food-related parenting practices identified in the interviews, parenting style, and family communication style. The findings suggest that specific parenting practices have an impact on adolescent food choices beyond predictors from the TPB. / Ph. D.

ABSTRACT ASSOCIATION BETWEEN SEDENTARY BEHAVIORS AND BMI IN US ADOLESCENTS: ANALYSIS OF THE 2015 YOUTH RISK BEHAVIOR SURVEY By SARAH SADRUDDIN KABANI April 27, 2017 INTRODUCTION: Research has shown a strong link between sedentary behaviors and obesity among adolescents. AIM: This study aims: 1) To determine sedentary behaviors in US high school adolescent nationally 2) To determine the association between sedentary behaviors and BMI after controlling for demographics, recreational behaviors, diet, and physical activity 3) To examine the association between engaging in more than one sedentary behavior and BMI after controlling for demographics, recreational behaviors, diet, and physical activity METHODS: The Youth Risk Behavioral Survey (YRBS) 2015 data was utilized in this study by using weighted percentages to determine the association between sedentary behaviors and BMI while controlling for demographics such as age, sex, race, and grade, recreational behaviors such as smoking and alcohol consumption, diet such as fruit, vegetable, and soda consumption, and physical activity. Univariate logistic regressions and multivariate logistic regressions were conducted to determine the association between sedentary behaviors and BMI. Adjusted and unadjusted odds ratio, 95% confidence intervals, and p-values were calculated. RESULTS: 81.6% of adolescents watched TV during a school day, while 18.4% did not watch TV during a school day. For video games/computer usage/social media (PG) usage, 82.6% engaged in PG usage during a school day, while 17.4% did not engage in PG usage during a school day. When stratifying by BMI, overweight adolescents and obese adolescents have significantly different sex distribution (p=<0.0001), race/ethnicity distribution (p=0.047), TV usage during a school day (p=0.04), PG usage during a school day (p=0.047), and TV & PG usage during a school day (p=<0.02). For TV & PG usage during the school days, adolescents who watch TV and PG, were at higher odds of being obese [AOR =1.3 (1.04, 1.6), p = 0.02] when comparing to adolescents who did not watch TV and PG. DISCUSSION: This study concludes that there is an association between obesity and adolescents who watch TV and use video games/computer/social media during a school day. Sociodemographic factors such as some races, age, and gender are also responsible for obesity among adolescents.

In obesity research, it is assumed that the population is homogeneous. While this approach has yielded important insights, testing this supposition might reveal information that could impact our understanding of the phenomena and its treatment. In this study, data from obese teenagers (N = 248, Mean BMI percentile = 99%; Mean age = 13.9, SD = 1.8) who were predominantly minority (n = 182), female (n = 169), and enrolled in a weight loss intervention were analyzed. Latent profile analysis (LPA) was used to segment patients into groups based on their scores on PedsQL 4.0 scales (physical-, emotional-, social-, and school functioning) and the Coopersmith Self-Esteem Scale. A 3-class solution was parsimonious and demonstrated the best statistical fit (Bayesian information criterion = 10596.96; Lo-Mendell-Rubin-adjusted likelihood ratio test = 73.020, p < .05). The 3 groups were ordinal and composed of respondents with high- (HF; n = 72, 29%), medium- (MF; n = 110, 44%), and low functioning (LF; n = 66, 27%). Further analyses (chi squares and linear regressions) showed that the LF group had a significantly higher proportion of Caucasians and males compared to the HF (referent) group. Also, when controlling for demographics and weight, the LF group had significantly higher blood pressure (diastolic and systolic), lower self-reported physical activity (on two different measures), and a higher total score on a scale of depressed mood. Four groups of ordinal regressions (since the pair of self-reported exercise variables and blood pressure variables were correlated, only one from each pair was included in each set) consistently found that self-reported physical activity and blood pressure improved significantly from the LF to HF groups. However, when depressed mood was included, it became the only significant variable. These findings suggest that LF group members are demographically and clinically distinct and that depressed mood may be the critical factor connecting self-report and metabolic dysfunction. Theory suggests depressed mood is both associated with cognitive schemas that affect responses on self-report measures; skewing them negative, and is also manifested metabolically.