Bisphenol A (BPA) and phthalates are chemicals found in many consumer products including water bottles, food packaging and cosmetics. Previous research has shown that there is potential for these compounds to contribute to obesity. In this analysis, the Canadian Health Measures Survey was used to investigate possible associations between urinary concentrations of these compounds and measures of adiposity. BPA urine concentrations were found to decrease with age, and significant associations with BMI and waist circumference were found in linear regression in adults. No associations with measures of adiposity were found in logistic regression for adults and significant negative associations were found in children. A similar discrepancy was found for mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-oxohexyl) phthalate, which were significantly associated with obesity in adults, but showed several significant negative associations in children. Overall, this analysis showed that it is unlikely that BPA and phthalates are contributing to adiposity in the Canadian population.

Choline is an essential nutrient, in the liver it is a precursor necessary for the synthesis of phosphatidylcholine (PC) and is also required as a methyl donor towards the synthesis of betaine and later regeneration of S-adenomethionine (SAM). Choline deficiency is known to trigger the development of non-alcoholic fatty liver disease and affect mitochondrial homeostasis along with a myriad of methylation related regulatory mechanisms. Because of its importance in maintaining liver lipid and mitochondrial homeostasis, choline metabolism has been well characterized with the exception of its transport. The identification of choline transporters has only been recently discovered and because of this, relatively little is known about their expression and regulation. This study has established that choline transporter like proteins 1-5 (CTL1-5) is an intermediate affinity transport system responsible for ~80% of hepatic choline uptake with a smaller percentage accomplished through the low affinity organic cation transporter 1-3/N1-2 (OCT1-3/N1-2) transporters. SLC44A1 expression and choline incorporation have been shown to follow a 24 hour rhythmic trend suggesting the presence of a circadian regulatory mechanism. This finding is supported by the significant decrease in choline expression and aberrant pattern of choline incorporation discovered among rhythmic deficient BMAL-/- mice and through a bioinformatics analysis which revealed the existence of four REV-ERBα consensus sequences. Hepatic SLC44A1 expression and choline incorporation have also been shown to decrease with the onset of obesity. Choline uptake was also shown to decrease following treatment with the free fatty acid oleate. This work increases our knowledge of hepatic choline transport and demonstrates a link between the circadian rhythm and obesity with the hepatic CTL1 transporter.

The purpose of this study was to evaluate the changes in work capacity, personality and body fat in obese women undergoing training. Twenty-six subjects from the Vancouver Y.W.C.A. "180-Plus Club" voluntarily participated in the study. The subjects were tested before and after a nine month program. The pretraining and posttraining test environments and test procedures were standardized for all subjects. The experimental group met once per week, until halfway through the program, and then met twice a week. The program consisted of a gymnasium and pool exercise session. A control group of eleven subjects was used to help establish the reliability of the Astrand test of physical work capacity. The following variables were measured as follows: (a) physical work capacity -- Astrand submaximal test, (b) personality -- Cattell's Sixteen Personality Factor Questionnaire, Forms A and B, and (c) body fat -- determination of body density by underwater weighing and the use of Brozek and Keys formula, as well as subcutaneous fat measurements taken at six sites. Three groups were formed on the basis of attendance. The results of the study show that there was a slight improvement associated with a higher frequency of attendance, however, even the group with the highest frequency of attendance failed to show any physiologically important change in work capacity or 'percent body fat’. The combined group results showed a departure from the general female adult population for intelligence, which was higher than the population mean, and for ego strength, which was lower at pretest. The poorest attenders, Group I, showed evidence of departures from the population in factors which described them as being happy-go-lucky, absent-minded, casual and undependable. It is, therefore, not unexpected that persons with these characteristics would drop out of the program. Groups II and III, with respective higher frequencies of attendance, showed significant changes from pretest to posttest in factors which indicated that they became more emotionally mature (Group II) and more sensitive and composed (Group III). These would appear to be desirable changes in view of the Y.W.C.A.'s objectives for psychological as well as physical changes. On the basis of the findings of this study, it does not appear that the time, money and effort required to run the "180-Plus Club" program can be justified. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Obesity and being overweight have become growing concerns due to their association with many diseases, such as type II diabetes, several types of cancer and heart disease. Thus, obesity treatments have been the focus of a large number of recent studies. Because of these studies, researchers have found that the treatment of obesity and being overweight requires constant monitoring of the patient’s diet. Therefore, measuring food intake each day is considered an important step in the success of a healthy diet. Measuring daily food consumption for obese patients is one of the challenges in obesity management studies. Countless recent studies have suggested that using technology like smartphones may enhance the under-reporting issue in dietary intake consumption. In this thesis, we propose a Food Recognition System (FRS) for calories and nutrient values assumption. The user employs the built-in camera of the smartphone to take a picture of any food before and after eating. The system then processes and classifies the images to detect the type of food and portion size, then uses the information to estimate the number of calories in the food. The estimation and calculation of the food volume and amount of calories in the image is an essential step in our system. Via special approaches, the FRS can estimate the food volume and the existing calories with a high level of accuracy. Our experiment shows high reliability and accuracy of this approach, with less than 15% error.

Ninety-four children (age 8-17 yrs; BMI ≥ 95th percentile) were staged according to their risk profile in manuscript one by the Edmonton Obesity Staging System for Pediatrics (EOSS-P) based on metabolic, mechanical, mental and/or family risk factors. Children completed a maximal treadmill test yielding VO2peak data (mlO2/kg/min). Children were stratified into three groups: (Stage 1 n=28; Stage 2 n=47; Stage 3 n=19). VO2peak was significantly lower in Stage 3 (p = 0.02) compared to Stages 1 and 2. Children were re-stratified into three groups for manuscript two without the family category of the EOSS-P applied: Low Risk (LR) (n=40); Elevated Risk (ER) (n=45); and High Risk (HR) (n=9). VO2peak was significantly lower in the HR group (p = 0.04) compared to the LR group. Stage 3/HR children (highest risk category) in both manuscripts displayed the lowest levels of cardiorespiratory fitness, suggesting an increased risk for complications associated with pediatric obesity.

Class of 2008 Abstract / Objectives: This was a retrospective chart review and survey of pediatric residents. This study aimed to examine standards for aminoglycosides in obese pediatrics; increase awareness of drug monitoring in obese populations; and reduce medication errors. Methods: 101 patients aged three to seventeen that received aminoglycoside treatment were included. Subjects were divided into three groups based on weight and height percentiles as defined by growth charts. Collecting retrospective data provided measured concentrations of aminoglycosides in order to evaluate pharmacokinetics. Data collected included: dose and frequency; time dose was given; length of infusion; two measured concentrations (peak and trough); and time concentration was measured. ANOVA allowed comparisons between aminoglycoside volumes of distribution to weight (based on specific weight groups). Tukey’s post hoc analysis further tested the significance of the pair-wise comparisons (p<0.05). Secondly, a questionnaire was administered to 26 pediatric medical residents at University Medical Center to assess current treatment protocols and attitudes towards medication dosing in obese pediatric patients. Results: The volume of distribution was not significantly different between normal weight and overweight patients (p=0.927); normal weight and obese patients (p=0.174); or overweight and obese patients (p=0.211). Most (81.8%) study participants have some difficulty finding references on dosing in overweight and obese patients. Conclusions: The positive correlation between volume of distribution and total body weight was not statistically significant. Pediatric residents agree that there is a lack of resources regarding obese pediatric medication dosing. Further research is warranted to ensure the reliability and validity of aminoglycoside dosing in obese children.

Philosophiae Doctor - PhD / Over the past decades there has been a global increase in the prevalence of overweight and obesity. The increase in the prevalence of overweight and obesity leads to surging of associated co-morbidities of overweight and obesity in low/medium income countries which eventually overburdens the vulnerable health systems threatens by malnutrition and communicable diseases in low/medium income countries. The designed interventions to curb overweight/obesity in high income countries might be inappropriate to apply in low income countries, such as Nigeria, due to the different cultural norms and values regarding types of food, and physical activity. The overall aim of this study is to design an intervention that will be culturally appropriate for overweight and obesity management among Nigerians. The convergent parallel mixed method design specifically was used in this study. This involves simultaneous timing of carrying out both quantitative and qualitative strands of mixed methods during the same phase of the research process, prioritizes the methods equally, and keeps the strands autonomous during analysis and then mixes the results during overall implementation/execution. The population for the quantitative part was Nigerians residing within sixteen enumeration areas of Alimosho Local Government area of Lagos State, Nigeria. Overweight and obese Nigerians as well as traditional healers and healthcare professionals were purposely selected for the qualitative phase. Delphi study was the last phase of study which involved recruitment of healthcare professionals in the management of overweight and obesity. A sample size of 2250 was projected and approached for this while 1571 consented and participated in the study. This gave a response rate of 69.82%. About 51.2% of the sample population was male and 48.8% female. The mean age of the total sample was 35.36(SD =11.66). Using BMI, the prevalence of overweight/obesity was 42.3% using BF%, the prevalence of body fatness was 39.2% of which 62.5% were females. Data analysis shows strong positive correlation between other measures of body fatness (.694 to .872) except WHR with low but positive relationships between BF% (184), BMI (.280), WC (.495), and negative relationships with HC (-.077) and BAI (-.076). Gender, marital status and age are predictors of overweight and obesity among Nigerians. Type of diet, meal timing, reduced physical activity and genetic factor were perceived as the causes of overweight and obesity. Diet therapy, an increase in physical activity and the use of herbs were various ways perceived to assist in reducing excess body weight. Among the challenges faced by overweight and obese Nigerians were lack of time for exercise because of the nature of their jobs, lack of recreational facilities, lack of motivations and support from family members to reduce weight, lack of money and poor/lack of knowledge to reduce weight. Experts unanimously agreed that the content of a culturally appropriate intervention should be individualised and to include physical activity/exercise, diet therapy, education and self-monitoring. There was a unanimous decision that the intervention should be done for a duration of 12 weeks at health facility and should be held for between 1-2 times per week if holding at community (excluding community/ public health facility) for 12 weeks in total. In addition, experts agreed that the use of media such as television, radio, weekly newspapers and magazines should be used for preventive campaigns.

Obesity has reached epidemic proportions, highlighting the need to better understand contributors to under-exercise and overeating. Anxiety Sensitivity (AS) is hypothesized to amplify negative affect and avoidance motives, and has been linked to maladaptive coping behaviors such as eating pathology as well as distress during and avoidance of exercise. The current series of studies was designed to extend research that relied on self-report assessments, and investigate the role of AS in objectively-assessed eating and exercise behavior across three community samples. The first two studies examined eating in the context of experimentally-induced negative affect in a sample representing all weight categories (N = 57); and distress, perceived exertion, and affect changes during exercise in normal and obese weight groups (N = 38). The third study extended this investigation to a naturalistic setting, using actigraphy, affect, and dietary monitoring across a three-day period in normal and obese weight groups (N = 32). The hypotheses were that AS would predict more eating in the context of negative affect; greater perceived exertion and distress during exercise, as well as avoidance of exercise, with findings most pronounced in obese participants. Results were as follows. In the first study, more calories consumed following a negative affect induction was predicted by the interaction between a dimension of AS (mental concern) and the expectancy of loss of control from eating in overweight/obese participants. In the second study, there was no significant association between AS and ratings of exertion or distress during exercise; however, a trend suggested the expected affective benefits of acute exercise were not evident in obese participants with greater AS and exertion. The final study found that AS was associated with more calories consumed across the monitoring period in women but not men (who were equally represented across AS and weight groups), and was also predictive of more calories consumed in the context of negative affect. Additionally, high AS predicted less engagement in moderate-intensity exercise in obese participants and more in normal weight participants. Overall, these studies provide support for the hypothesis that AS is a predictor of both exercise avoidance and overeating behavior.

Overcapacity is a self-reflexive, personal journey film that explores the filmmaker's exploration of his lifelong problem with obesity and health. The film follows his progress as he discusses his weight problem with his partner and parents as well as works with a personal trainer and doctor in an effort to affect a lifestyle change while also confronting issues that have led to and perpetuate his current health situation.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22725号 / 医博第4643号 / 新制||医||1045(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 伊藤 貴浩, 教授 岩田 想 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM