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.

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.

<p>The increasing prevalence of obesity in both developed and developing countries and its associated health risks have brought the issue of obesity prevention and management a public health debate. Health care professionals have been identified to have a role to play in directing the future of obesity management. However, among the numerous barriers for effective management of obesity is lack of knowledge of causes of obesity and negative attitudes towards obese patients by health care professionals. With limited or no studies available for the physiotherapy setting, the aim of the study was to determine the knowledge and attitudes of students of Physiotherapy at the University of the Western Cape, South Africa towards obese individual. A descriptive quantitative research design using a cross-sectional survey was used. One hundred and seventy five (175) students of Physiotherapy took part in the study using a convenience sampling technique. Data was collected by means of a structured, self-administered questionnaire adopted from the Obesity Risk Knowledge-10 scale, Beliefs About Obese Person scale and the Fat Phobia Scale. A response rate of 77.3% was obtained. Descriptive and inferential statistics were employed to describe the relationship and association between variables. Alpha level was set at 0.05. The mean age of the sample was 21.54 (SD = 4.903). Females constituted 73.5% and males 26.5% of the sample. The results showed that majority of the students of Physiotherapy (85%) reported having received no formal education regarding obesity.</p>

Tidigare forskning kring pojkars självkänsla och kroppsmissnöje i relation till massmedieanvändning, extraversion och BMI har utfallit något olika och är inte lika omfattande som forskningen kring flickor. Syftet med denna undersökning var att ta reda på om massmedia, extraversion och BMI har betydelse för tonåriga pojkars självkänsla och kroppsuppfattning. Kvantitativ metod i form av en enkätundersökning användes. Sjuttiotvå gymnasiestuderande pojkar besvarade enkäten som innehöll instrument för att mäta BMI, extraversion, kroppsmissnöje, massmedieanvändning och självkänsla. Resultatet visade att massmedieanvändning inte korrelerar med vare sig självkänsla eller kroppsmissnöje. Extraversion hade däremot betydelse för självkänsla; ju högre grad av extraversion desto högre självkänsla hade deltagarna. BMI hade betydelse för kroppsmissnöje enligt EDE-Q (Eating Disorder Examination Questionnaire); ju högre BMI desto högre kroppsmissnöje.

INTRODUCTION: Studies have shown that school-based childhood obesity programs can be effective, however, little is known about the effects of policy and environmental changes on student health outcomes. This study assessed the policy, environmental, and BMI percentile changes of 32 Georgia elementary schools participating in HealthMPowers programming. METHODS: This thesis used multilevel analysis to examine the changes to policy and environmental indicators within school participating in HealthMPowers and the extent to which these indicators predict BMI percentile change of 5th grade students. This research evaluated seven key indicators related to policy and environmental changes within 32 schools and the BMI percentile changes of 3458 students over the 2011-2012 academic year. Multilevel regression models were used to estimate the effects of school policy and environmental changes on mean BMI percentiles. RESULTS: Only 12 schools experienced a decrease in mean BMI percentiles from baseline to post-test, whereas 17 schools experienced increases in mean BMI percentiles. Students who were at or above the 85th percentile did not change significantly from baseline to post-test. For physical activity, schools that reported positive or no change in this indicator reported statistically significant increases in mean BMI percentiles from baseline to post-test. Schools that increased their CITT scores for physical education, school health team, assessment, and environment and policy indicators experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test. Schools that increased their CITT scores for improvement plan and communication experienced, on average, a non-statistically significant decrease in mean BMI percentiles from baseline to post-test. Schools that reported no change to their CITT scores for physical education, assessment, and environment and policy indicators experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test. Schools that reported no change for CITT scores for the school health team, improvement plan, and communication indicators experienced, on average, a non-statistically significant decrease in mean BMI percentiles from baseline to post-test. Lastly, when the school health team, assessment, improvement plan, and communication indicators were combined, schools who reported positive or no changes experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test. CONCLUSION: The findings of this study were inconclusive but do shed light on the importance of understanding system level policy and environmental change on individual level health outcomes. Additional research should be conducted to explore this relationship as well as evaluation of the Continuous Improvement Tracking Tool that HealthMPowers uses to help schools better capture the current state of their programs, policies, and environment in regards to student and staff health.

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.