Introdução - O aumento da prevalência de obesidade entre a população jovem, motivou o crescimento do número de pesquisas que buscam identificar os fatores associados à ocorrência desse distúrbio nutricional. Objetivo - Identificar os fatores dietéticos e de atividade física associados à mudança do estado nutricional de adolescentes. Métodos - Trata-se de um estudo de coorte realizado com 256 adolescentes de ambos os sexos, com idade entre 10 e 17 anos, matriculados em escolas públicas de Piracicaba, São Paulo. Os adolescentes foram entrevistados em dois momentos, respeitando-se o intervalo médio de um ano. Avaliou-se o estado nutricional a partir do Índice de Massa Corporal, consumo alimentar habitual (questionário de freqüência alimentar para adolescentes - QFAA), padrão de atividade física (prática de atividades físicas e de atividades de baixa intensidade), maturação sexual e variáveis demográficas. A análise de regressão linear múltipla foi utilizada para identificar as possíveis associações. Definiu-se como variável dependente a variação anual do escore z do IMC e como variáveis independentes a variação anual do consumo de grupos alimentares de interesse e da prática de atividade física. Resultados - Verificou-se, para ambos os sexos, um aumento do uso de computador e consumo de bebidas artificiais adoçadas. Houve redução do consumo de lipídios, sucos naturais adicionados de açúcar e alimentos com elevado teor lipídico. O consumo de frutas, verduras e legumes aumentou no intervalo de um ano entre as meninas. Na análise múltipla, observou-se que o maior consumo de alimentos com elevado teor lipídico (=0,036, p=0,048) e de sucos naturais adicionados de açúcar (=0,053, p=0,034) associaram-se positivamente ao aumento do escore z do IMC. Conclusão - A variação do escore z do IMC de adolescentes no período de um ano mostra-se direta e independentemente associada a variações no consumo de alimentos ricos em lipídios e de sucos naturais adicionados de açúcar. 8 Novos estudos prospectivos com maior tempo de seguimento são necessários para que sejam produzidos resultados que esclareçam a complexa etiologia da obesidade / Introduction - With the rise of obesity prevalence among young people, is increasing the number of researches to identify factors associated with the occurrence of this nutritional disorder. Objective - To identify the dietary and physical activity factors associated with nutritional status change of adolescents. Methods - This is a cohort study conducted with 256 adolescents of both genders, with ages ranging from 10 and 17 years, from public schools of Piracicaba, Sao Paulo. Adolescents were interviewed on two occasions, with the average interval of one year. Nutritional status from body mass index, usual food intake (food-frequency questionnaire for adolescents-FFQA), physical activity pattern (physical activity and inactivity), sexual maturation and demographic variables were assessed. Multiple regression was used to identify possible associations. It was defined as dependent variable the annual BMI z-score change and as independent variables, the annual change in consumption of food groups of interest and practice of physical activity. Results - An increase of computer use, and sugar-sweetened beverages consumption was verified for both genders. The consumption of fat, sweetened fruit juices and fatty foods decreased. Among girls, the consumption of fruits and vegetables increased in an interval of one year. In the multiple analyses, it was observed that increased consumption of fatty foods ( = 0.036, p = 0.048) and sweetened fruit juices ( = 0.053, p = 0.034) was positively associated with the rise of BMI z-score. Conclusion - Change in adolescents BMI z-score over a year is directly and independently associated with changes in fatty foods and sweetened fruit juices. Further prospective researches with longer follow-up are necessary to better understand the complex etiology of obesity

Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) and GWG above, within, or below IOM guidelines based on gestational length. After controlling for pregnancy smoking, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to identify significant outcomes associated with high or low weight gain, with normal GWG as the control. Of the 913 participants, 208 (22.8%) had inadequate GWG, 255 (27.9%) gained within the recommended range, and 450 (49.3%) gained more than recommended. Inadequate GWG was associated with delivery before 39 weeks, oxygen administration to the infant, admission to the neonatal intensive care unit (NICU), and a hospital stay longer than seven days. Excess GWG was associated with preeclampsia, pregnancy-induced hypertension (PIH), gestational diabetes mellitus, cesarean delivery, labor longer than 12 hours, macrosomia, and large-for-gestational-age (LGA) infants. GWG outside IOM guidelines was prevalent in the sample and associated with numerous adverse outcomes, suggesting a need for increased awareness and improved management of GWG in this population.

Introduction: Obesity is an increasing public health burden in the USA. According to the National Obesity Trends, about one-third adults in the USA are obese. What is worse, this trend keeps increasing during the past twenty years. Appalachian region has higher prevalence for obesity and diabetes comparing with other places in the USA. Body Mass Index (BMI), as an important measure for obesity, is useful for determining effective preventions for obesity. However, as the most common index for obesity, BMI is influenced by other variables such as smoking, alcohol and physical activity. A single indicator is not enough to measure the complicated factors which lead to obesity and so do interventions to prevent obesity. This study is aimed to study the influence of race and gender differences in the association between smoking and alcohol consumption and BMI. Methods: We obtained data from the Health Aging and Body Composition (Health ABC) Study. This sample consists of 1663 European American (EA) and 1139 African American (AA) individuals (1367 males and 1435 females). Phenotypes include age, BMI, smoking and alcohol drinking status. The SASv9.2 was used to perform the data analysis. Firstly, the Wilcoxon ranks test was used to compares the gender differences in continuous variables such as age and BMI while chi-square test was used to test gender differences for binary variables such as alcohol and smoking status. Then, multiple general linear model (GLM) was used to test the association of alcohol drinking and smoking behaviors with BMI. Results: For the whole sample, multiple GLM showed age (pConclusion: There are gender and race differences in the association between smoking behavior and BMI. This discovery helps us to tailor interventions for different subgroups. For the future prevention of obesity by controlling BMI, the factors of gender and race/ethnicity should be taken into account.

Abstract available in The FASEB Journal.

Objective Genetic factors play an important role in modulating the vulnerability to body mass index (BMI). The purpose of this study is to identify novel genetic variants for BMI using genome-wide association (GWA) meta-analysis. Methods PLINK software was used to perform meta-analysis of two GWA studies (the FUSION and Marshfield samples) of 5218 Caucasian individuals with BMI. A replication study was conducted using the SAGE sample with 762 individuals. Results Through meta-analysis we identified 33 SNPs associated with BMI with p < 10− 4. The most significant association was observed with rs2967951 (p = 1.19 × 10− 6) at 5p15.2 within ROPN1L gene. Two additional SNPs within ROPN1L and 5 SNPs within MARCH6 (the top SNP was rs2607292 with 4.27 × 10− 6) further supported the association with BMI on 5p15.2 (p < 1.8 × 10− 5). Conditional analysis on 5p15.2 could not distinguish the effects of ROPN1L and MARCH6. Several SNPs within MARCH6 and ROPN1L were replicated in the SAGE sample (p < 0.05). Conclusion We identified a novel locus for BMI. These findings offer the potential for new insights into the pathogenesis of BMI and obesity and will serve as a resource for replication in other populations to elucidate the potential role of these genetic variants in BMI and obesity.

No description available.

Lymphedema of the arm is a complication that occurs in about 10-20% of women treated for breast cancer. Breast cancer treatment can damage or disrupt normal lymphatic pathways, causing fluid to accumulate in the arm. This condition is called lymphedema. Swelling of the arm can be painful and disfiguring, negatively impacting the quality of life of afflicted individuals. Lymphedema is a progressive disorder that requires prompt diagnosis and treatment to prevent the occurrence of more serious complications, such as infection or severe disability of the arm. Past research have attempted to identify risk factors that influenced the development of lymphedema, however conflicting results were observed between studies. Therefore, a comprehensive literature review was conducted to identify studies that examined the effect of prognostic and/or personal factors on lymphedema. In the meta-analyses, results from each independent study were abstracted and pooled with other studies using the random-effects model. In an effort to examine additional factors that were not widely studied, a retrospective cohort study was conducted on women diagnosed with breast cancer in Iowa during 2004. A questionnaire was developed to collect information on arm activities, co-morbidity, and lymphedema-related symptoms. Eligible women were identified from the State Health Registry of Iowa and data were collected through computer-assisted telephone interviews. At the end of the interview, each woman was asked to measure the circumference of her right and left arm one hand width above and below the elbow crease. The meta-analysis found that mastectomy (as opposed to a lumpectomy), axillary dissection (as opposed to sentinel node biopsy), radiation therapy, presence of positive nodes, obesity (body mass index >30), low education (less than high school), presence of any co-morbidity, injury and infection increased the risk of developing lymphedema. The cohort study found that the presence of axillary dissection and radiation, cancer stage, positive nodes, large tumor size, high body mass index, and younger women increased the risk of lymphedema.

The inflammatory process is important in protecting the body against the invasion of pathogens, but recent research has suggested that a long-term inflammatory response may lead to chronic diseases (e.g., Black, 2003; Wu, Dorn, Donahue, Sempos, & Trevisan, 2002). Two factors that have been implicated in the inflammatory and disease processes are stress and obesity (Black, 2003). While their individual lines of research continue to grow, few researchers have attempted to integrate these factors into one model to explain their effects on inflammation. This study aimed to replicate previous findings suggesting relationships between stress, obesity and inflammation and test an integrated model of stress and obesity by examining a possible interaction between the effects of stress and obesity on inflammation. Socioeconomic Status (SES) and depression were employed to examine the association between stress and the inflammatory marker, c-reactive protein (CRP). The study utilized the data resulting from the National Health and Nutrition Examination Survey (NHANES; National Center for Health Statistics, 2006). Included in the dataset are 4998 adults (2416 males and 2582 females) ranging in age from 18 years to over 85 years (M = 47.13, SD = 20.86). A subsample (N = 589) completed the Major Depression module of the Composite International Diagnostic Interview (CDCI). The results indicate that body mass index, waist circumference, income, education, and depression symptoms significantly predict CRP. The data also suggest an interaction between the adiposity variables and the SES variables. This supports the hypothesis that the inflammatory effect of stress on an individual is moderated by adiposity.

Background: Childhood obesity is a critical public health problem. There is a crucial need to identify environmental factors that either encourage or prevent obesogenic behaviors. The home food environment is one of the primary environments in which children are exposed to food. Therefore, it is crucial to study how the home food availability influences dietary intake and weight status. Objective: This study examines parental report of household food availability of fruits, vegetables, and milk, and its association with child weight status and child dietary intake of these foods. Methods: This is a cross-sectional study, based on surveys from 489 students in grades 3-12 their parents in 2009. Child participants were Destination ImagiNation® finalists. Child data collection included surveys based on the Youth Risk Surveillance Survey and anthropometric measurements of height and weight used to calculate child z-BMI. Parents self-reported their heights and weights and home food availability. Descriptive statistics were conducted and multiple linear regression was used to predict whether or not a relationship existed between home food availability, child weight status, and dietary intake of fruits, vegetables, and milk. Results: Overall, 12.5% of participants were overweight and 6.7% were obese. Approximately26% of participants consumed 5 or more servings of fruits and vegetables per day and 17% consumed 3 or more glasses of milk per day. However, a no significant relationship was found between home availability of fruits, vegetables, and milk and the reported intake of these foods. Although a significant association was also found between parent and child weight status, no significant association was found between home food availability and child weight status. Conclusions: Compared to national data, a larger proportion of this sample was classified as normal weight and consumed the recommended intake of fruits and vegetables and milk. Parents reported high availability of fruits, vegetables, and milk products. However, no significance was found between the reported availability of these foods and weight status or dietary intake of fruits, vegetables, or milk.

Obesity is a rapidly growing public health threat as well as an economic problem in the United States. The recent changes in eating habits, especially the relative increase of food away from home (FAFH) consumption over the last three decades raised the possibility of causal linkage between obesity and FAFH. This study confirms the positive, significant association between the body mass index and FAFH consumption in adults, consistent with previous findings in the economic and nutrition literature. This work goes a step further, however. We demonstrate FAFH consumption at quick-service restaurants has a significantly larger effect on body mass index than FAFH consumption at full-service restaurants. Further disaggregation of FAFH by meal occasion reveals that lunch consumed away from home has the largest positive effect on body mass index compared to other meal occasions (breakfast, dinner and snacks). Survey data with missing observations or latent variables are not rare phenomena. The missing value imputation methods are combined into two groups, contingent upon the existence or absence of an underlying explicit statistical model. Explicit modeling methods include unconditional mean value imputation, conditional mean and regression imputation, stochastic regression imputation, and multiple imputation. The methods based on implicit modeling include hot deck and cold deck imputation. In the second essay, we review imputation methods commonly used in the agricultural economics literature. Our analysis revealed strong preference of researchers for the regression imputation method. We consider several alternative (regression, mean and median) single imputation methods to impute and to append prices of foods consumed at home (foods commercially purchased and prepared from ingredients) from the National Health and Nutrition Examination Survey (NHANES) dietary intake data. We also demonstrate the superiority of regression imputation method compared to the mean and median imputation methods for commercially prepared foods. For ingredient foods, the results are ambiguous with no imputation method clearly outperforming the others.