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Overweight and obesity are a major problem today. It is a growing problem that harms health and is present in all ages. This study was designed to investigate the relationship between ISO-Body Mass Index in overweight children both boys and girls, and walking speed regardless of height. In addition, examine the relationship between weight, height and walking speed by using a six-minute walking test. The study included already collected measurements from the patients' first visit at the Energy Metabolic Laboratory, which is a research unit at the Department of Women's and Children's Health at the academic Hospital in Uppsala, between the years 2008–2021. Results were collected on 195 patients, 122 boys and 73 girls. Data collected were age, weight, height, walking speed, walking distance, heart rate, level of exertion and dyspnea. The results showed that the ISO-Body Mass Index affects walking speed in obese children. Regarding how walking speed differs between both genders of obese children, the results showed that higher ISO-Body Mass Index in boys leads to them walking more slowly compared to girls who are less affected. To be able to demonstrate how walking speed is affected by other continuous variables such as encouragement or motivation, more studies with greater focus on smaller age groups are needed to gain a better understanding of how the various variables affect walking speed.

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Objective: To determine the relationship between body mass index (BMI) and soft drink consumption among adolescents. It is hypothesized that soft drink consumption contributes to overweight and obesity among adolescents. Background: Research examining the relationship between body mass index and soft drink consumption is inconsistent. Several studies have found a negative association between total sugar intake and BMI; however, others have found a link between sugar-sweetened drinks and obesity. There are no known studies that have controlled for physical activity. Data and Methods: Data on approximately 225 adolescents were used. Frequency of soft drink consumption, type of milk, and calcium intake were assessed using the Youth and Adolescent Questionnaire (YAQ). Body Mass Index was calculated from height and weight measurements and adjusted for age. Physical activity levels were assessed using data recorded from the My Life Stepper 2515 digital pedometer. Age, birthday, grade, sex, and ethnicity were reported on the consent form. Results: When treated as a categorical variable, soft drink consumption was a marginal predictor of adjusted BMI (p = 0.0802). The relationship between soft drink consumption and adjusted BMI is not linear and does not follow a monotonic trend. Other variables found to significantly influence BMI were type of milk, total step mean, and calcium. Discussion and Conclusions: The results of this study conclude that soft drink consumption is related to BMI among adolescents. This relationship is marginally significant; it is significant at the 0.10 level but not at the 0.05 level. Those who were in the highest soft drink consumption category had a higher mean BMI than those in the other soft drink consumption categories. Soft drink consumption, type of milk, total step mean, and calcium together predict about 10% of the variability in BMI.

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Exposure to arsenic (As) is a major public health concern globally. Inorganic As (InAs) undergoes hepatic methylation to form monomethyl (MMAs)- and dimethyl (DMAs)-arsenical species, facilitating urinary As elimination. MMAsIII is considerably more toxic than either InAsIII or DMAsV, and a higher proportion of MMAs in urine has been associated with risk for a wide range of adverse health outcomes. One-carbon metabolism (OCM) is a biochemical pathway that provides methyl groups for the methylation of As, and is influenced by folate and other micronutrients, such as vitamin B12, choline, betaine and creatine. A growing body of evidence has demonstrated that OCM-related micronutrients play a critical role in As methylation. To analyze the impact of As exposure, it needs to be properly quantitated. Urinary As (uAs) is a biomarker of As exposure. Urinary creatinine (uCr) or specific gravity (SG) are used to correct uAs for urine dilution. However, uCr is correlated with As methylation, whereas SG has limitations in individuals with kidney damage. Therefore, it is important to determine which urine dilution proxy is appropriate in As-related research. In Chapter 2 we conducted a review that summarized observational epidemiological studies, interventions, and relevant experimental evidence examining the role that OCM-related micronutrients have on As methylation, toxicity of As, and risk for associated adverse health-related outcomes. People with higher relative percentage of MMAs (%MMAs) in urine (inefficient As methylation), have been shown to have a higher risk of cardiovascular disease and several cancers but appear to have a lower risk of diabetes and obesity in populations from the US, Mexico, and Taiwan. It is unknown if this opposite pattern with obesity is present in Bangladesh, a country with lower adiposity and higher As exposure in drinking water. Efficiency of As methylation differs substantially between species, between individuals, and across populations. In Chapter 3, we aimed to evaluate which urine dilution correction methods for uAs most accurately predicted blood As (bAs). We used data from the Folic Acid and Creatine Trial (FACT; N = 541) and Folate and Oxidative Stress (FOX; N = 343) study in Bangladesh. Three linear regression models were assessed using uAs (1) adjusted for uCr or SG as separate covariates, (2) standardized for uCr or SG, i.e., uAs/uCr, and (3) adjusted for residual corrected uCr or SG following adjustment for age, sex and BMI. Median uAs/bAs for FACT and FOX were 114/8.4 and 140/12.3 µg/L. In FACT, two-fold increases in uAs adjusted for uCr or SG were related to 34% and 22% increases in bAs, respectively, with similar patterns in FOX. In Chapter 4, we investigated the effects of folic acid (FA) and/or creatine supplementation on the concentrations of As species and primary (PMI: MMAs/InAs) and secondary (SMI: DMAs/MMAs) methylation indices in blood in Bangladeshi adults having a wide range of folate status. In a randomized, double-blinded, placebo-controlled trial, 622 participants were assigned to FA (400 or 800 μg/day), 3 g creatine/day, 3 g creatine + 400 μg FA/day, or placebo for 12 weeks. For the following 12 weeks, half of the FA participants were randomly switched to receive placebo. All participants received As-removal water filters at baseline. Blood As species were measured at baseline, and weeks 1, 12, and 24. In all groups, blood As species concentrations decreased due to filter use. After 1 week, the mean within-person increase in SMI for the creatine + 400FA group was greater than that of the placebo group (p = 0.05). The mean percent decrease (95% CI) in blood concentrations of MMAs (bMMAs) between baseline and week 12 was greater for all treatment groups compared to the placebo group [400FA: -10.3 (-11.9, -8.8); 800FA: -9.5 (-11.1, -8.0); creatine: -5.9 (-8.6, -3.0); creatine + 400FA: -8.4 (-10.0, -6.9); placebo: -2.0 (-4.0, 0.0)], and the percent increase in blood DMAs (bDMAs) concentrations for the FA treated groups all significantly exceeded that of placebo [400 FA: 12.8 (10.5, 15.2); 800 FA: 11.3 (8.90, 13.8); creatine + 400 FA: 7.40 (5.20, 9.70); placebo: -0.10 (-2.80, 2.60)]. The mean decrease in PMI and increase in SMI in all FA groups significantly exceeded placebo (p < 0.05). Data from week 24 showed evidence of a reversal of treatment effects on As species from week 12 in those who switched from 800FA to placebo, with significant decreases in SMI [-9.0% (-3.5, -14.8)] and bDMAs [-5.9% (-1.8, -10.2)] in those who switched from 800FA to placebo, whereas for those who remained on 800FA, PMI and bMMAs concentrations continued to decline [-7.2% (-0.5, -14.3) and -3.1% (-0.1, -6.2), respectively] for those who remained on 800FA supplementation. This trial was registered at https://clinicaltrials.gov as NCT01050556. In Chapter 5, we characterized the association between body mass index (BMI) and As methylation in Bangladeshi adults and adolescents participating in the FACT; FOX; and Metals, Arsenic, and Nutrition in Adolescents Study (MANAS). Arsenic species (InAs, MMAs, DMAs) were measured in urine and blood. Height and weight were measured to calculate BMI. The associations between concurrent BMI with urine and blood As species were analyzed using linear regression models, adjusting for nutrients involved in OCM such as choline. In FACT, we also evaluated the prospective association between weight change and As species. Mean BMIs were 19.2/20.4, 19.8/21.0, and 17.7/18.7 kg/m2 in males/females in FACT, FOX, and MANAS, respectively. BMI was associated with As species in female but not in male participants. In females, after adjustment for total urine As, age, and plasma folate, the adjusted mean differences (95% confidence) in urinary %MMAs and %DMAs for a 5 kg/m2 difference in BMI were -1.21 (-1.96, -0.45) and 2.47 (1.13, 3.81), respectively in FACT, -0.66 (-1.56, 0.25) and 1.43 (-0.23, 3.09) in FOX, and -0.59 (-1.19, 0.02) and 1.58 (-0.15, 3.30) in MANAS. The associations were attenuated after adjustment for choline. Similar associations were observed with blood As species. In FACT, a 1-kg of weight increase over 2 to 10 (mean 5.4) years in males/ females was prospectively associated with mean %DMAs that was 0.16%/0.19% higher. BMI was negatively associated with %MMAs and positively associated with %DMAs in females but not males in Bangladesh; associations were attenuated after plasma choline adjustment. In conclusion, we found that FA supplementation lowers bMMAs and increases bDMAs in a sample of primarily folate-replete adults, while creatine supplementation lowers bMMAs. Evidence of the reversal of treatment effects on As species following FA cessation suggests short-term benefits of supplementation and underscores the importance of long-term interventions such as FA fortification. Additionally, there is fairly robust evidence supporting the impact of folate on As methylation, and some evidence from case-control studies indicating that folate nutritional status influences risk for As-induced skin lesions and bladder cancer. However, the potential for folate to be protective for other As-related health outcomes, adverse health risks of high folate/FA levels (particularly in areas where folate supplements are common), and beneficial effects of other OCM-related micronutrients on As methylation and risk for health outcomes are not as well studied and warrant additional research. We also found that the role of body fat on estrogen levels that may influence OCM, e.g. by increasing choline synthesis. Research is needed to determine whether the associations between BMI and As species are causal and their influence on As-related health outcomes. Finally, we found that in assessing urine dilution correction approaches, models with uCr consistently had lower AIC values than SG across methods. The uAs associations with bAs were stronger after adjustment for uCr vs. SG. Decisions regarding urine dilution methods should consider whether the study outcomes are influenced by factors such as methylation or medical conditions.

The objectives of this study were to 1) calculate participant-specific segment inertial parameters using dual energy X-ray absorptiometry (DXA) data (referred to as full DXA-driven parameters) and compare the pitching arm kinetic predictions using full DXA-driven inverse dynamics vs scaled, DXA mass-driven (using DXA masses but scaled centers of mass and radii of gyration), and DXA scaled inverse dynamics(ID) (using the full DXA-driven inertial parameters averaged across all participants), 2) examine associations between full DXA-driven kinetics and body mass index (BMI) and 3) examine associations between full DXA-driven kinetics and segment mass index (SMI). Eighteen 10- to 11- year-olds pitched 10 fastballs. DXA scans were conducted and examined to obtain 3D inertial parameters of the upper arm, forearm, and hand. Full DXA-driven and scaled inertial parameters were compared using paired t-tests. Pitching arm kinetic predictions calculated with the four methods (i.e. scaled ID, DXA mass-driven ID, full DXA-driven ID, and DXA scaled ID) were compared using a repeated measures ANOVA with Tukey post-hoc tests. The major results were that 1) full DXA-driven participant specific inertial parameters differed from scaled inertial parameters 2) kinetic predictions significantly varied by method and 3) full DXA-driven ID predictions for shoulder compression force and shoulder internal rotation torque were significantly associated with BMI and/or SMI.

The objectives of this study were: (1) to evaluate consumer acceptance of cheeses varying in fat and sodium levels, (2) to determine if sensitivity to reward and body mass index has an effect on product liking based on fat or salt content, (3) to evaluate the use of FaceReader technology during consumer evaluation and, (4) to determine if consumer’s self-selected, conscious emotions matched with the expressed, subconscious emotions acquired by FaceReader. Consumer acceptance testing (n=108) was conducted on two medium cheddar cheeses with varying fat levels and two low-moisture part-skim mozzarella cheeses varying in sodium levels. Attributes were measured using a 9-point hedonic scale. In order to measure reward sensitivity, participants completed the BIS/BAS questionnaire and the SPSRQ prior to consumer acceptance testing. SIMS sensory software was used for data collection. The complete consumption experience was video recorded (n=83). A choose-all-that-apply format was used so participants could indicate all emotional states before and after consumption. A total of 332 pairs of videos (83 subjects, four samples, before and after consumption) were used for FaceReader analysis. Regular cheddar cheese scored significantly higher than the reduced fat cheddar cheese for mean overall liking, flavor, texture, creaminess, saltiness and aftertaste. The higher sodium mozzarella scored significantly higher than the lower sodium mozzarella for mean flavor, saltiness and aftertaste (p FaceReader Results indicated: Neutral was the most accurately matched self-selected emotion (100%) before and after consumption, followed by happy (82% and 63% respectively). FaceReader was unable to correctly match surprised/angry before consumption and angry/sad after consumption. FaceReader acquired 420 and 495 additional non-self-selected emotions before and after consumption, respectively. Neutral and angry were most commonly expressed when not self-selected. Disgusted and scared were rarely expressed when not self-selected. FaceReader was not as successful matching the self-selected emotions after consumption. Surprised and happy were commonly missed both before and after consumption. Disgusted was missed primarily after consumption. "Happy" is self-selected and expressed more times for regular cheddar than the reduced fat cheddar. The mean overall liking score was also significantly higher for the regular cheddar than reduced fat cheddar. Similar results were found with mozzarella. Although low fat and low sodium cheeses represent a healthier option, consumer acceptance indicated that the higher fat and higher sodium samples scored higher; changes in flavor and texture need to be made in order to produce a more liked product. There is a complex relationship between product liking, body mass index, gender and sensitivity to reward but further research needs to be conducted to investigate how the variables interact. FaceReader technology did match some of the self-selected emotions identified by the subject. However, one question remains: which emotions, self-selected/conscious emotions or subconscious/expressed emotions, are a better predictor of liking?