The purpose of this study was to investigate the effects of: 1) caffeine consumption; 2) Body Mass Index (BMI); and 3) frequency and intensity of physical activity on the frequency and severity of hot flashes, in pre-menopausal, peri-menopausal, menopausal and post-menopausal Hispanic women. Ordinary Least Squares regressions indicated there was a statistical significant correlation between daily total estimated caffeine intake with frequency (R2=0.078 (F(8, 207)=2.2, P=0.029) and severity of hot flashes (R2=0.086 (F(8, 208)=2.45, P=0.015). Analysis of variance revealed that and increase in frequency of 30 min strength physical activity reduced severity of hot flashes by 0.72 on a hedonic scale (p<0.05). Conversely, caffeine intake of 100 mg increased frequency and severity of hot flashes (p<0.001, p=0.004, respectively). / Department of Family and Consumer Sciences

Submitted in partial compliance with the requirements for the Master of Technology: Chiropractic, Durban University of Technology, 2014. / Background: Poor balance is a risk factor for injury in adolescent sport including soccer. Despite the rapid growth in female adolescent soccer especially in South Africa, the association between balance and injury in this population has not been fully explored. This study aimed to determine the relationship between injury and balance. Static and dynamic balance was monitored as sway index (SI) and limits of stability direction control (LOSDC). Objectives: The objectives of this study were to determine the body mass index of adolescent female soccer players; to determine the prevalence of injury in adolescent female soccer players; to determine static balance as revealed by the sway index (SI); to determine dynamic stability as revealed by limits of stability direction control (LOSDC) and to correlate body mass index (BMI) to sway index and limits of stability. Method: Eighty adolescent female soccer players, between the ages of fourteen and eighteen, were recruited through convenience sampling from schools in the eThekwini district of KwaZulu-Natal. After obtaining informed consent and assent, participants completed questionnaires and were scheduled for the balance and BMI assessments. The objective data for each participant consisted of height, weight, Sway Index (SI) and Limits of Stability Direction Control (LOSDC) readings, measured using a stadiometer, electronic scale and Biodex Biosway Balance System (Biodex Medical Systems Inc., Shirley, New York) respectively. The subjective and objective data were analyzed using SPSS version 21.0 (SPSS Inc. Chicago, Ill, USA). Statistical tests included descriptive statistics using frequency and cross-tabulation. Inferential statistics using t-tests and Pearson’s correlations at a significance level of 0.05 was also incorporated. The testing of hypotheses was performed using Fisher’s Exact tests for nominal data and ordinal data. A p value of < 0.05 was considered as statistically significant. The statistical analysis also included Odds Ratio calculations. Results: The mean body mass index of the injured participants was 23.54±3.56 kg/m2 and the mean body mass index of the uninjured participants was 23.00±4.63. Only 27.5% of the participants sustained an injury. Injured participants performed poorly on average in the SI assessment involving their eyes open when standing on a soft surface. The results were similar for the LOSDC in the overall, right, left, backward-right and backward-left directions. However, there were no significant correlations calculated. Significant relationships existed between BMI and the SI assessments in the injured participants which involved standing on a firm surface with their eyes open (p = 0.05), their eyes closed when also standing on a firm surface (p = 0.05), their eyes open when standing on a soft surface (p = 0.02), and their eyes closed when standing on a soft surface (p = 0.04). A significant relationship also existed between BMI and LOS right direction control (p = 0.02). Conclusion: This research paper revealed that the body mass index as investigated in this study is similar to other studies involving female adolescents; soccer injury as investigated in this study is similar to other studies involving female adolescents; poor static and dynamic balance is not associated with injury in adolescent female soccer players and lastly, body mass index is linked to the balance of an individual.

Cardiovascular disease is known as one of the leading causes of mortality worldwide, where low income countries or developing countries have the highest prevalence of cardiovascular disease. One of the main reasons for this statistics is acculturation that leads to changes in behavioral lifestyle and malnutrition within these countries. Low body mass index was found to be an independent risk factor for cardiovascular disease in several studies. From literature it is found that body mass index is lower than the ideal body mass index and is associated with cardiovascular disease. According to Higashi (2003) a body mass index of 22.2 kg/m2 is associated with the lowest morbidity. If body mass index decreases to lower values than the ideal body mass index, a J–curve will be evident suggesting higher prevalence of cardiovascular disease associated with low body mass index. These findings imply that not only high body mass index but also a low body mass index may be a risk factor for cardiovascular disease, morbidity and mortality. Whether low body mass index is associated with cardiovascular risk in an African population remains unclear. Objective: The aim of this study was to investigate the possible associations of low body mass index with variables of cardiovascular function in Africans, with a low socio–economic status. Methodology: This prospective cohort study (N= 2 010) is part of the Prospective Urban and Rural Epidemiology study (PURE) conducted in the North–West Province of South Africa in 2005, where the health transition in urban and rural subjects was investigated within an apparently low socio–economic status group. Our crosssectional PURE sub–study included 496 African people from rural and urban settings, (men, N= 252 and women, N= 244) aged between 35–65 years and body mass index lower than 25 kg/m2. Subjects were sub–divided into two groups. The first group consisted of Africans with a low body mass index smaller or equal to 20 kg/m2 (men; N= 152, women; N= 94) whilst the second group consisted of Africans with a normal body mass index larger than 20 kg/m2 and smaller or equal to 25 kg/m2 (men; N= 100, women; N= 150). Systolic blood pressure and diastolic blood pressure measurements were obtained with the validated OMRON HEM–757 device. The pulse wave velocity was measured using the Complior SP device. Blood was drawn by a registered nurse from the antebrachial vein using a sterile winged infusion set and syringes. Analyses for cholesterol, high density lipoprotein, triglycerides, gamma–glutamyl transferase and high sensitive C–reactive protein were completed utilizing the Konelab 20i. Data analyses were performed using the Statistica 10 program. Statistical analyses were executed to determine significant differences between age, body mass index and lifestyle factors as well as cardiovascular related variables in the different groups. T–tests were used to determine significant differences between independent groups. ANCOVA tests were used to determine BMI group differences independent of age, smoking and alcohol consumption. Partial correlations, which were adjusted for age, smoking and alcohol consumption, determined associations between the BMI groups and cardiovascular variables. Results: Our results indicated significantly higher mean values for the African men, with low body mass index, for cardiovascular variables (Diastolic blood pressure, 88.0 ± standard deviation (SD) 13.4 mmHg; mean arterial pressure, 103.8 ± SD 14.4 mmHg and carotid–radial pulse wave velocity, 12.6 ± SD 2.47 m/s) compared to the normal body mass index group (Diastolic blood pressure, 84.2 ± SD 12.2 mmHg; mean arterial pressure, 100.0 ± SD 13.2 mmHg and carotid–radial pulse wave velocity, 11.6 ± SD 2.00 m/s). The African women with low body mass index had a significant difference for carotid–radial pulse wave velocity (11.3 ± SD 2.43 m/s) compared to the normal body mass index group (10.6 ± SD 2.10 m/s). In African men, after the variables were adjusted for age, smoking and alcohol consumption, we revealed that diastolic blood pressure (88.0 with confidence interval (CI) [86.0– 90.0] mmHg) and carotid–radial pulse wave velocity (12.5 with CI [12.1–12.9] m/s) remained significant higher in the low body mass index group. Additionally, carotidradial pulse wave velocity was negatively associated with body mass index in African men. In the low body mass index group, Pearson and partial correlations of r= – 0.204; p= 0.012 and r= –0.200; p= 0.020 were found respectively in carotid–radial pulse wave velocity. Furthermore, in our unadjusted scatter plot with body mass index versus pulse wave velocity this negative trend of increasing carotid–radial pulse wave velocity with decreasing body mass index was noticeable in both African men and women. Even when carotid–radial pulse wave velocity was adjusted for age, smoking, alcohol consumption, mean arterial pressure and heart rate, a J–curve between carotid–radial pulse wave velocity and body mass index was still evident. Conclusion: A detrimental effect of low body mass index is evident on cardiovascular function in Africans. If body mass index decreases from the optimum value of 22.2 kg/m2 to lower values, a J–curve is evident between body mass index and cardiovascular variables suggesting higher prevalence of cardiovascular disease associated with low body mass index. In our sub–study the carotid–radial pulse wave velocity increases significantly in African men with low body mass index, thus supporting the theory that stiffening of the arteries is evident in Africans with a low body mass index. Low body mass index may contribute to the high prevalence of cardiovascular disease mortality within developing countries and therefore, increase the risk for cardiovascular disease. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

60 % of Canadians have suboptimal vitamin D (<75 nmol/L) and 25% are obese. Obesity has been reported to be a risk factor for low vitamin D, but there is uncertainty about the magnitude of the association. Linear regression was performed using data from the nationally representative cross-sectional Canadian Health Measures Survey (2007-2009). Height, weight, waist circumference (WC), and vitamin D levels were directly measured. There were 5298 participants aged 6 to 79 years. Using a conservative p value of 0.001, body mass index (BMI) category obese / obese I was positively associated and WC was inversely associated with vitamin D level in crude analysis. WC was inversely associated with vitamin D level in multivariate analysis. The pattern of relationship is not the same as other studies, yet this was a large study with direct measurements. There may be issues with linearity of relationships or subgroups disturbing the relationship.

Cardiovascular disease is known as one of the leading causes of mortality worldwide, where low income countries or developing countries have the highest prevalence of cardiovascular disease. One of the main reasons for this statistics is acculturation that leads to changes in behavioral lifestyle and malnutrition within these countries. Low body mass index was found to be an independent risk factor for cardiovascular disease in several studies. From literature it is found that body mass index is lower than the ideal body mass index and is associated with cardiovascular disease. According to Higashi (2003) a body mass index of 22.2 kg/m2 is associated with the lowest morbidity. If body mass index decreases to lower values than the ideal body mass index, a J–curve will be evident suggesting higher prevalence of cardiovascular disease associated with low body mass index. These findings imply that not only high body mass index but also a low body mass index may be a risk factor for cardiovascular disease, morbidity and mortality. Whether low body mass index is associated with cardiovascular risk in an African population remains unclear. Objective: The aim of this study was to investigate the possible associations of low body mass index with variables of cardiovascular function in Africans, with a low socio–economic status. Methodology: This prospective cohort study (N= 2 010) is part of the Prospective Urban and Rural Epidemiology study (PURE) conducted in the North–West Province of South Africa in 2005, where the health transition in urban and rural subjects was investigated within an apparently low socio–economic status group. Our crosssectional PURE sub–study included 496 African people from rural and urban settings, (men, N= 252 and women, N= 244) aged between 35–65 years and body mass index lower than 25 kg/m2. Subjects were sub–divided into two groups. The first group consisted of Africans with a low body mass index smaller or equal to 20 kg/m2 (men; N= 152, women; N= 94) whilst the second group consisted of Africans with a normal body mass index larger than 20 kg/m2 and smaller or equal to 25 kg/m2 (men; N= 100, women; N= 150). Systolic blood pressure and diastolic blood pressure measurements were obtained with the validated OMRON HEM–757 device. The pulse wave velocity was measured using the Complior SP device. Blood was drawn by a registered nurse from the antebrachial vein using a sterile winged infusion set and syringes. Analyses for cholesterol, high density lipoprotein, triglycerides, gamma–glutamyl transferase and high sensitive C–reactive protein were completed utilizing the Konelab 20i. Data analyses were performed using the Statistica 10 program. Statistical analyses were executed to determine significant differences between age, body mass index and lifestyle factors as well as cardiovascular related variables in the different groups. T–tests were used to determine significant differences between independent groups. ANCOVA tests were used to determine BMI group differences independent of age, smoking and alcohol consumption. Partial correlations, which were adjusted for age, smoking and alcohol consumption, determined associations between the BMI groups and cardiovascular variables. Results: Our results indicated significantly higher mean values for the African men, with low body mass index, for cardiovascular variables (Diastolic blood pressure, 88.0 ± standard deviation (SD) 13.4 mmHg; mean arterial pressure, 103.8 ± SD 14.4 mmHg and carotid–radial pulse wave velocity, 12.6 ± SD 2.47 m/s) compared to the normal body mass index group (Diastolic blood pressure, 84.2 ± SD 12.2 mmHg; mean arterial pressure, 100.0 ± SD 13.2 mmHg and carotid–radial pulse wave velocity, 11.6 ± SD 2.00 m/s). The African women with low body mass index had a significant difference for carotid–radial pulse wave velocity (11.3 ± SD 2.43 m/s) compared to the normal body mass index group (10.6 ± SD 2.10 m/s). In African men, after the variables were adjusted for age, smoking and alcohol consumption, we revealed that diastolic blood pressure (88.0 with confidence interval (CI) [86.0– 90.0] mmHg) and carotid–radial pulse wave velocity (12.5 with CI [12.1–12.9] m/s) remained significant higher in the low body mass index group. Additionally, carotidradial pulse wave velocity was negatively associated with body mass index in African men. In the low body mass index group, Pearson and partial correlations of r= – 0.204; p= 0.012 and r= –0.200; p= 0.020 were found respectively in carotid–radial pulse wave velocity. Furthermore, in our unadjusted scatter plot with body mass index versus pulse wave velocity this negative trend of increasing carotid–radial pulse wave velocity with decreasing body mass index was noticeable in both African men and women. Even when carotid–radial pulse wave velocity was adjusted for age, smoking, alcohol consumption, mean arterial pressure and heart rate, a J–curve between carotid–radial pulse wave velocity and body mass index was still evident. Conclusion: A detrimental effect of low body mass index is evident on cardiovascular function in Africans. If body mass index decreases from the optimum value of 22.2 kg/m2 to lower values, a J–curve is evident between body mass index and cardiovascular variables suggesting higher prevalence of cardiovascular disease associated with low body mass index. In our sub–study the carotid–radial pulse wave velocity increases significantly in African men with low body mass index, thus supporting the theory that stiffening of the arteries is evident in Africans with a low body mass index. Low body mass index may contribute to the high prevalence of cardiovascular disease mortality within developing countries and therefore, increase the risk for cardiovascular disease. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Background: Factors that contribute to body fat and adiposity include energy consumption, macronutrient intake, and physical activity. Alcohol not only contributes to total energy consumed but also influences metabolic pathways that may alter fat oxidation and storage. Alcohol provides 7.1 kilocalories per gram (kcal/g) and makes up 6-10% of the daily caloric intake of adults in the United States. Cross-sectional studies have shown that increased alcohol intake is associated with higher body mass index (BMI), especially in men. Other studies suggest that there is a “U” shaped association whereby non-drinkers and heavy drinkers have a higher BMI and waist-to-hip ratio (WHR) then low to moderate drinkers. While many previous studies evaluate alcohol based on the average consumption (g/day), there is increasing evidence that it is the pattern of alcohol consumption (ie. frequency) that influences body composition. The purpose of this study is to evaluate the effect of the frequency of wine, beer, and liquor consumption on body fat percent (BF%) and WHR in a population of university faculty and staff. Methods: The Center for Health Discovery and Well Being (CHDWB) cohort trial is being conducted at Emory University in Atlanta, GA. Recruitment of faculty and staff for the study began in 2007. Demographic, reported dietary intake including wine, beer, and liquor consumption, and anthropometric data including weight, height, BF%, and waist circumference are collected at baseline and annually thereafter. We used linear regression models to determine the effect of frequency and quantity of wine, beer, and liquor consumption on BF% while controlling for age and the effects of the other types of alcohol. We applied the Kruskal-Wallis test to determine if the median BF% and waist-hip ratio (WHR) was significantly different for those that reported at different five different frequencies (several times a year to 5-7 days a week). Results: Baseline visits have been conducted on 700 participants. Their median age was 51 years (66% female). Median weight was 76.9 kg (range, 65.3 - 90.5 kg) and mean BMI was 27.9 + 6.4 kg/m2. A significant negative relationship was observed between frequency of beer consumption and BF% in women (p Conclusions: The frequency of wine intake consumed by university employees and staff independently predicted BF% and BMI. Greater frequency of wine consumption was associated with lower BF%.

Background: Obesity and physical inactivity rates have reached epidemic levels in Canada, but differ based on whether they are self-reported or directly measured. Canadian research examining the combined and independent effects of social and built environments on adult physical activity (PA) and body mass index (BMI) is limited. Furthermore there is a lack of Canadian studies to assess these relationships using directly measured PA and BMI. Objectives: The objectives of this thesis were to systematically compare self-reported and directly measured PA and to examine associations between neighbourhood built and social environmental factors with both self-reported and directly measured PA and overweight/obesity in adults living in Ottawa, Canada. Methods: A systematic review was conducted to identify observational and experimental studies of adult populations that used both self-report and direct measures of PA and to assess the agreement between the measures. Associations between objectively measured neighbourhood-level built recreation and social environmental factors and self-reported individual-level data including total and leisure-time PA (LTPA) and overweight/obesity were examined in the adult population of Ottawa, Canada using multilevel models. Neighbourhood differences in directly measured BMI and PA (using accelerometry) were evaluated in a convenience sample of adults from four City of Ottawa neighbourhoods with contrasting socioeconomic (SES) and built recreation (REC) environments. Results: Results from the review generally indicate a poor level of agreement between self-report and direct measures of PA, with trends differing based on the measures of PA, the level of PA examined and the sex of the participants. Results of the multilevel analyses identified that very few of the built and social environmental variables were ii significantly associated with PA or overweight/obesity. Greater park area was significantly associated with total PA in females. Greater green space was shown to be associated with lower odds of male LTPA. Factors from the social environment were generally more strongly related to male outcomes. Further to the recreation and social environment, factors in the food landscape were significantly associated with male and female PA and overweight/obesity. Results of the directly measured PA and BMI investigation showed significant neighbourhood-group effects for light intensity PA and sedentary time. Post-hoc tests identified that the low REC/high SES neighbourhood had significantly more minutes of light PA than the low REC/low SES. BMI differed between the four neighbourhoods, but the differences were not significant after controlling for age, sex and household income. Conclusions: Results of this dissertation show that the quantity of PA can differ based on its method of measurement (i.e. between self-report and direct methods) with implications for the interpretation of study findings. It also identifies that PA and BMI can differ by neighbourhood and recognizes that the relationships between neighbourhood environments and PA and body composition are complex, may be differ between males and females, and may not always follow intuitive relationships. Furthermore it suggests that other factors in the environment not examined in this dissertation may influence adult PA and BMI and that longitudinal and intervention studies are needed.

Thesis (M.S.)--University of Hawaii at Manoa, 2006. / Includes bibliographical references (leaves 14-15). / vi, 15 leaves, bound ill. 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2006. / Includes bibliographical references (leaves 16-18). / vi, 18 leaves, bound ill. 29 cm

The increasing prevalence of overweight and obesity in young people is a major global public health concern, especially in developed countries. In Australia, studies in 2001 have suggested that 20% of boys and 21.5% of girls aged 7-15 years were overweight or obese, while in 1985 the figures were 10.7% and 11.8%, respectively. In the short-term, overweight and obese children and adolescents suffer from both adverse physical and psychological consequences. The most significant long-term consequence of childhood obesity is its persistence into adulthood, along with numerous associated health risks. A number of studies have shown that there is an association between being an overweight child and subsequent adulthood obesity. In general, childhood overweight and obesity is a multifactorial disease and its development is due to multiple interactions between genes and environment. A number of risk factors such as socioeconomic status, dietary patterns, and physical activity have been frequently identified as contributors to its development. However, the results of recent studies provide conflicting evidence. The statistical limitations also make it difficult to compare the studies on childhood obesity between countries. In addition, existing research in Australia that examines the contribution of different risk factors to childhood obesity is limited. There are no published data on the relationship between overweight/obesity, dietary patterns, and physical activity/inactivity in Australian children and adolescents. This study examined the influences of household income, dietary factors, physical activity/inactivity and ethnicity on overweight and obesity among Australian children and adolescents. It also explored the relationship between self-reported weight and height to actual weight and height in older Australian adolescents in order to clarify the accuracy of self-reported data among Australian youth. Data from the two national cross-sectional surveys, the 1995 Australian National Health Survey (NHS) and the 1995 National Nutrition Survey (NNS) were analysed to explore the influences of household income, intake of energy and fat and percentage of energy from fat on childhood obesity. The study focused on 1585 children and adolescents aged 7-15 years. These data were also used to examine the relationship of self-reported weight and height to measured weight and height in older adolescents. Additionally, another cross-sectional survey among a group of Australian primary school children from a multi-cultural school in southern Brisbane was undertaken as well as providing indicative data on the relationship of overweight/obesity to physical activity levels and ethnicity, and to provide a protocol on the methodology and practicality of measuring physical activity level in such a school setting. The results suggested that boys from households with low incomes were more likely to be overweight or obese compared with those from households with higher incomes. Having parents, especially mothers, who were overweight or obese increased the risk of children being overweight or obese. The results do not provide evidence that there are statistically significantly differences in the average intake of energy and fat and percentage of energy from fat between non-overweight and overweight or obese boys and girls. The correct classification of weight or obesity from self-reported height and weight by Australian older adolescents was about 70%, bias in reporting weight and height is higher among overweight or obese older adolescents than non-overweight counterparts. In addition, preliminary, indicative data from the pilot study on the relationship between body mass index (BMI) and physical activity in 10-12 year old Australian school children from a multi-cultural school revealed that the average daily physical activity level (PAL) was 2.3 Metabolic Equivalents (METs) when the PAL was measured using self-reported activity diary. The proportion of light, moderate and heavy PAL was 2.9%, 20.4% and 76.7% in children, respectively. Additionally no ethnic differences in the prevalence of overweight /obesity was found. There was no statistically significant difference in average daily TV view times between non-overweight and overweight or obese boys and girls. The average daily number of steps measured using pedometer in the weekdays was 16,505 in boys and 12766 in girls. Most of boys (94.0%) have a medium and over level of steps taken daily while nearly one-third of the girls had not reached the minimum level in the number of steps for optimal health. However it must be noted this school-based study was a small cross-sectional survey in a single school. The results should be viewed as indicative, not generalisable. The study does not provide any longitudinal data on physical activity patterns and the trends in relationship to body mass index. In spite of the limitations of this study, it did provide some preliminary data on PAL and its relationship to overweight/ obesity among young Australian schoolchildren from diverse cultural backgrounds. Most importantly, this pilot study has provided a protocol on the methodology and practicality of measuring physical activity levels of children using self-reported activity diaries and pedometers in a multicultural school setting. A number of strategies for the prevention and treatment of childhood overweight and obesity are discussed. In future studies, a population-based and randomly selected sample would ensure findings that are more representative of general Australian children, and the longitudinal studies would help to define the association between the risk factors and childhood obesity, as well as enabling conclusions on causality to be drawn.