Thesis (Ph. D.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains ix, 145 p. : ill. (some col.), maps (some col.). Includes abstract. Includes bibliographical references (p. 129-141).

Background: The obesity epidemic is the greatest public health problem of our time, and exerts an enormous health and economic burden by acting as a risk factor for multiple disorders and all-cause mortality. While environmental and social factors certainly contribute to the complex etiology of obesity, there is strong evidence of a substantial genetic component. The majority of obesity genes are involved the leptin-melanocortin receptor pathway governing energy homeostasis, but mutations affecting this circuit are often untreatable and rare, and an improved understanding of other genetic risk factors could aid in the development of novel therapies. In this thesis I study two obesity candidate genes with unclear direct relevance to disease: 1) rare structural variation at the 16p11.2 BP4-BP5 locus and 2) common variation in the Fat Mass and Obesity-Associated (FTO) gene. Methods: 1) I analyzed disinhibited eating measurements from families with 16p11.2 copy number variation (CNV) carriers, to test whether eating in the absence of hunger (EAH) and loss of control (LOC) eating behaviors mediate the dosage-dependent CNV-BMI relationship. 2) Using association data from a study of over 20,000 African Americans and 1,145 functional annotations from the Encyclopedia of Non-coding Elements (ENCODE) and Roadmap Epigenomics projects, I statistically fine-mapped the FTO locus to identify the SNP(s) and cellular contexts underlying the association between FTO and obesity. Results: 1) EAH due to external triggers mediates over 30% of the 16p11.2 deletion’s effect on obesity, while other EAH and LOC behaviors were not significant mediators. This result was independent of IQ deficits and autism related to the CNV, as well as parents’ feeding behaviors and practices. 2) Given 51 FTO SNPs’ association statistics, correlation, and overlap with functional annotations, rs9927317 and rs62033405 had the highest posterior probability of association with obesity. Obesity-associated SNPs may regulate expression of FTO and/or nearby genes through the activity of enhancers and 5’ ends of transcribed genes in the substantia nigra of the brain, bone chondrocytes, and white adipose. Conclusions: These results may help pinpoint the specific genes, regulatory elements, and cellular contexts through which the 16p11.2 and FTO loci exert their effects on obesity.

Yu Chung Wah. / "August 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 260-296). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Hui Lai Ling. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 180-204). / Abstracts in English and Chinese. / acknowledgements --- p.I / contents --- p.II / list of abbreviation --- p.IX / list of tables --- p.X / LIST OF FIGURES --- p.XII / abstract --- p.XIII / Chapter chapter 1 --- introduction --- p.1 / Chapter 1.1 --- Overview --- p.1 / Chapter 1.2 --- Objectives & Hypotheses --- p.2 / Chapter chapter 2 --- literature review --- p.6 / Chapter 2.1 --- Definition of obesity --- p.6 / Chapter 2.1.1 --- Densitometric measurement --- p.6 / Chapter 2.1.2 --- Anthropometric measurement --- p.6 / Chapter 2.1.2.1 --- Body circumferences --- p.7 / Chapter 2.1.2.2 --- Skinfold thickness --- p.8 / Chapter 2.1.2.3 --- Weight and height ratios --- p.8 / Chapter 2.1.3 --- Body Mass Index to define obesity --- p.9 / Chapter 2.1.3.1 --- In adults --- p.9 / Chapter 2.1.3.2 --- In children & Adolescents --- p.9 / Chapter 2.2 --- Epidemic of obesity --- p.13 / Chapter 2.2.1 --- Worldwide prevalence & trends of obesity --- p.13 / Chapter 2.2.2 --- Obesity rates in Hong Kong --- p.16 / Chapter 2.3 --- Consequences of obesity --- p.17 / Chapter 2.3.1 --- Health consequences --- p.77 / Chapter 2.3.1.1 --- Adulthood obesity --- p.17 / Chapter 2.3.1.2 --- Childhood & adolescent obesity --- p.19 / Chapter 2.3.1.3 --- Controversy of health risk studies --- p.20 / Chapter 2.3.2 --- Quality of life --- p.21 / Chapter 2.3.3 --- Economic consequences of obesity --- p.21 / Chapter 2.3.4 --- Persistence of childhood obesity into adulthood --- p.22 / Chapter 2.5 --- Risk factors for childhood obesity --- p.24 / Chapter 2.5.1 --- Genetic factors --- p.24 / Chapter 2.5.1.1 --- Parental weight status --- p.24 / Chapter 2.5.1.2 --- Birth weight --- p.28 / Chapter 2.5.2 --- Demographic factors --- p.30 / Chapter 2.5.2.1 --- Socio-economic Status --- p.30 / Chapter 2.5.2.2 --- Family environment --- p.31 / Chapter 2.5.3 --- Dietary factors --- p.33 / Chapter 2.5.3.1 --- Infancy diet --- p.33 / Chapter 2.5.3.2 --- Dietary intake --- p.34 / Chapter 2.5.3.3 --- Eating behaviour --- p.39 / Chapter 2.5.4 --- Physical activity factors --- p.42 / Chapter 2.5.4.1 --- Inactivity --- p.42 / Chapter 2.5.4.2 --- Determinants of physical activity level --- p.44 / Chapter 2.5.4.3 --- Television-watching --- p.46 / Chapter 2.5.5 --- Other risk factors --- p.47 / Chapter 2.6 --- Management of childhood obesity --- p.49 / Chapter 2.6.1 --- Goals & Difficulties in childhood obesity treatment --- p.49 / Chapter 2.6.2 --- Dietary approach --- p.50 / Chapter 2.6.2.1 --- General healthy eating --- p.50 / Chapter 2.6.2.2 --- Decrease fat intake --- p.51 / Chapter 2.6.2.3 --- Increase fibre intake --- p.52 / Chapter 2.6.2.4 --- Reducing meal Glycaemic Index --- p.53 / Chapter 2.6.3 --- Increase activity level --- p.56 / Chapter 2.6.3.1 --- Reinforce active behaviour --- p.56 / Chapter 2.6.3.2 --- Decrease sedentary lifestyle --- p.57 / Chapter 2.6.4 --- Roles of parents and schools in obesity managements --- p.58 / Chapter CHAPTER 3 --- METHODOLOGY --- p.59 / Chapter 3.1 --- Overview --- p.59 / Chapter 3.2 --- Study population --- p.59 / Chapter 3.2.1 --- Reason for selecting 6-7 years old children --- p.59 / Chapter 3.2.2 --- Classification of case and control groups --- p.60 / Chapter 3.2.3 --- Reasons for using BMI --- p.62 / Chapter 3.2.4 --- Development of BMI cut-offs --- p.63 / Chapter 3.3 --- Estimation of sample size --- p.64 / Chapter 3.4 --- Subject recruitment --- p.65 / Chapter 3.4.1 --- Sample Source --- p.65 / Chapter 3.4.2 --- Inclusion criteria --- p.61 / Chapter 3.4.3 --- Recruitment --- p.67 / Chapter 3.4.4 --- Pilot Testing --- p.70 / Chapter 3.5 --- Data collection --- p.70 / Chapter 3.5.1 --- Overview --- p.70 / Chapter 3.5.2 --- Lifestyle data --- p.77 / Chapter 3.5.2.1 --- Scope of data --- p.71 / Chapter 3.5.2.2 --- References for questionnaire design --- p.71 / Chapter 3.5.2.3 --- Questionnaire content --- p.72 / Chapter 3.5.2.4 --- Data validity --- p.73 / Chapter 3.5.3 --- Dietary data --- p.76 / Chapter 3.5.3.1 --- The assessment method --- p.76 / Chapter 3.5.3.2 --- Data validity --- p.76 / Chapter 3.6 --- Data entry & analyses --- p.77 / Chapter 3.6.1 --- Data entry --- p.77 / Chapter 3.6.2 --- Dietary data analyses --- p.78 / Chapter 3.6.2.1 --- Nutrient intake --- p.78 / Chapter 3.6.2.2 --- Meal Glycaemic response --- p.78 / Chapter 3.6.3 --- Risk factor analyses --- p.79 / Chapter 3.6.3.1 --- Univariate analyses --- p.79 / Chapter 3.6.3.2 --- Multivariate analyses --- p.79 / Chapter 3.6.3.3 --- Further analyses --- p.80 / Chapter 3.6.4 --- Childhood lifestyle descriptive analyses --- p.80 / Chapter CHAPTER 4 --- RESULTS --- p.81 / Chapter 4.1 --- Overview --- p.81 / Chapter 4.2 --- Descriptive analyses --- p.82 / Chapter 4.2.1 --- Sample Size & sample source --- p.82 / Chapter 4.2.2 --- Sample Characteristics --- p.83 / Chapter 4.2.3 --- Demographic background --- p.86 / Chapter 4.3 --- Risk factors identification --- p.90 / Chapter 4.3.1 --- Overview --- p.90 / Chapter 4.3.2 --- Univariate analyses --- p.90 / Chapter 4.3.3 --- Multivariate analyses --- p.90 / Chapter 4.3.3.1 --- Variable selection --- p.90 / Chapter 4.3.3.2 --- Test for Multicollinearity --- p.91 / Chapter 4.3.3.3 --- Logistic regression results --- p.91 / Chapter 4.3.4 --- Further analyses --- p.98 / Chapter 4.3.4.1 --- Purposes --- p.98 / Chapter 4.3.4.2 --- Parental BMI --- p.99 / Chapter 4.3.4.3 --- Child's birth weight --- p.102 / Chapter 4.3.4.4 --- Eating Behaviour --- p.105 / Chapter 4.3.4.5 --- Dietary intake --- p.108 / Chapter 4.3.4.6 --- Physical activity --- p.109 / Chapter 4.3.4.7 --- Parental smoking --- p.110 / Chapter 4.3.4.8 --- Socio-economic status --- p.111 / Chapter 4.4 --- Children lifestyle descriptive analyses --- p.113 / Chapter 4.4.1 --- Inactivity in young children --- p.113 / Chapter 4.4.1.1 --- Exercise time and frequency --- p.113 / Chapter 4.4.1.2 --- Exercise preference & encouragement --- p.115 / Chapter 4.4.1.3 --- Determinants of exercise time --- p.117 / Chapter 4.4.2 --- Weight beliefs & Nutrition knowledge --- p.118 / Chapter 4.4.2.1 --- Weight and health beliefs --- p.118 / Chapter 4.4.2.2 --- Nutrition knowledge --- p.121 / Chapter 4.4.3 --- Dietary habits & Nutrient intake --- p.123 / Chapter 4.4.3.1 --- Dietary practice --- p.123 / Chapter 4.4.3.2 --- Nutrient intake --- p.129 / Chapter CHAPTER 5 --- DISCUSSION --- p.137 / Chapter 5.1 --- Risk factors for childhood overweight development --- p.137 / Chapter 5.1.1 --- Overview --- p.137 / Chapter 5.1.2 --- Genetic factors --- p.138 / Chapter 5.1.2.1 --- Parental BMI --- p.138 / Chapter 5.1.2.2 --- Birth weight --- p.142 / Chapter 5.1.3 --- Dietary factors --- p.144 / Chapter 5.1.3.1 --- Eating behaviours --- p.144 / Chapter 5.1.3.2 --- Infancy diet --- p.150 / Chapter 5.1.3.3 --- Current dietary intake --- p.151 / Chapter 5.1.4 --- Physical activity --- p.154 / Chapter 5.1.4.1 --- Exercise --- p.154 / Chapter 5.1.4.2 --- Sedentary activities --- p.155 / Chapter 5.1.5 --- Family environment --- p.157 / Chapter 5.1.5.1 --- Social class & Custody --- p.157 / Chapter 5.1.5.2 --- Parental smoking --- p.159 / Chapter 5.2 --- Lifestyle in Hong Kong young children --- p.161 / Chapter 5.2.1 --- Childhood inactivity --- p.161 / Chapter 5.2.2 --- Weight perception & Nutrition knowledge --- p.163 / Chapter 5.2.3 --- Dietary habits & Nutrient intake --- p.165 / Chapter 5.3 --- Limitations --- p.169 / Chapter 5.3.1 --- Study sample --- p.169 / Chapter 5.3.2 --- Study method --- p.171 / Chapter 5.4 --- Implication of the study results --- p.173 / Chapter 5.4.1 --- Overview --- p.173 / Chapter 5.4.2 --- Strategies on obesity treatments and prevention --- p.173 / Chapter 5.4.3 --- Conclusion --- p.775 / Chapter 5.5 --- Suggestions for further study --- p.176 / CONCLUSION --- p.178 / REFERENCES --- p.180 / APPENDICES --- p.205 / Chapter A. --- Communications for sample recruitment / Appendix A1 Invitation to Parents --- p.A-l / Appendix A2 Contact Details Form --- p.A-3 / Appendix A3 Letter of thanks to SHSC Nurses --- p.A-4 / Appendix A4 Second letter to parents --- p.A-12 / Appendix A5 Written consent from parents --- p.A-14 / Chapter B --- Study Tools / Appendix B1 The Questionnaire --- p.B-l / Appendix B2 3-day dietary record --- p.B-49 / Chapter C --- Childhood overweight risk factors - univariate analyses / Appendix C1 Genetic factors --- p.C-1 / Appendix C2 Demographic factors --- p.C-2 / Appendix C3 Custody & Home environments --- p.C-3 / Appendix C4 Infant feeding factors --- p.C-4 / Appendix C5 Dietary manipulation & Eating desire --- p.C-5 / Appendix C6 Eating habits & Food preference --- p.C-6 / Appendix C7 Physical activity factors --- p.C-7 / Appendix C8 Factors influencing physical activity --- p.C-8 / Appendix C9 Nutrition knowledge & weight perception --- p.C-9 / Appendix C10 Nutrients factors --- p.C-10 / Appendix C11 School life & unclassified factors --- p.C-11 / Chapter D --- Miscellaneous / Appendix D1 Research questions and related questions in the questionnaire --- p.D-l / Appendix D2 Food GI estimation list --- p.D-3

[Truncated abstract] Introduction: Childhood obesity is currently a serious worldwide public health issue associated with many medical and psychosocial complications. The increasing disease burden with the potential for the development of medical co-morbidities has implications for future health care provision. This thesis adds to the understanding of the medical complications of overweight and obesity in childhood. Design and Aims: Two different, but related, research studies are reported. The first study is a cross-sectional study, designed to quantify the medical complications of childhood obesity in primary school-aged children in Western Australia. This study aims to identify the medical complications of primary school children with overweight/obesity. The study also aims to compare the medical complications of obesity in a community sample who have never sought treatment with a clinical sample who are actively seeking treatment for overweight/obesity. Finally, this study also aims to examine the relationship between the medical complications of childhood obesity and a continuum of children's Body Mass Index z-scores, including those in the normal range. The second study is an exercise intervention study to investigate the effect of exercise on one specific medical complication of obesity, namely insulin resistance. This study aims to determine if a structured eight-week exercise program significantly changes insulin resistance in obese children, and to determine if this decrease in insulin resistance is associated with changes in body composition and inflammatory markers. ... Conclusion: The prevalence of the medical complications of overweight and obesity in primary school children indicates that all children should have body mass index regularly checked from a young age. Children who are overweight/obese should be screened for the presence of co-morbidities despite a young age. Parents and health professionals needs to be educated that childhood obesity is associated with medical co-morbidities and is not simply a social or cosmetic concern. The continuous nature of the BMI z-score/co-morbidities relationship suggests that public health and health education strategies should include adopting a populationbased approach to weight management. This continuous relationship means that even in the normal BMI spectrum, the risk of developing co-morbidities rises with increasing BMI. Such an approach would encourage maintenance of normal weight for all children, rather than targeting overweight/obese children only. Increased activity and decreased sedentary behaviours should be recommended for all children in line with the population-based public health approach suggested above. However, exercise has a specific role in weight management strategies for overweight/obese children, and in management strategies for adiposityrelated co-morbidities. Significant metabolic benefits of exercise occur in the absence of changes in body shape and weight. After an exercise program, simple blood investigations (such as lipid profiles, fasting insulin and OGTTs) are likely to miss important metabolic improvements and anthropometry (BMI calculation, waist circumference) may be more indicative of potential metabolic improvement and decreased co-morbidity risk.

This thesis explores race and gender differences in perceptions and behaviors regarding weight and obesity, along with the relative influence of individual and structural factors on the personal weight status of black and white adults. In addition, this study examines the extent to which black and white adults differ in their perceptions of discrimination attributed to their personal weight. Based on an analysis of data from a national poll conducted by ABC News and TIME magazine, results indicate that weight status perceptions of overweight black females were consistent, while incongruity was found in perceived and actual weight status among obese black women. On the other hand, a greater proportion of obese white women under-assessed their weight status compared to obese black women. However, regardless of race, men were more likely to under-assess their weight than women. There were no differences by race and gender in reports of having felt discriminated against because of personal weight status. Findings also revealed that black females and males face greater constraints than their white counterparts related to controlling weight and fighting obesity, including such factors as a lack of information on how to establish good eating habits, the need to monitor food content, and being able to afford the cost of purchasing healthy food. A discussion of these findings in relation to previous research is provided along with recommendations for further study.

This research study focuses on examining the views of patients, their families, and staff member providers of the Centre for Healthy Active Living a clinical obesity management program for children and youth at the Children’s Hospital of Eastern Ontario, in Ottawa, Canada. Qualitative methodology was used and content analysis was conducted with data obtained from family questionnaires and a provider focus group. Analysis of obtained data was conducted to determine alignment of views between patient, family, and provider views, and the formal goals of the program. Emerging themes from the data indicated that patients and families place higher value on the formal goals of “improve quality of life; improve eating behaviours; improving fitness, increasing activity levels; and empower/strengthen families.” (Children’s Hospital of Eastern Ontario, 2012). Specific recommendations with regards to each component of these goals were provided. Instrumental, procedural, systemic, and conceptual recommendations of program components were also provided.

This research study focuses on examining the views of patients, their families, and staff member providers of the Centre for Healthy Active Living a clinical obesity management program for children and youth at the Children’s Hospital of Eastern Ontario, in Ottawa, Canada. Qualitative methodology was used and content analysis was conducted with data obtained from family questionnaires and a provider focus group. Analysis of obtained data was conducted to determine alignment of views between patient, family, and provider views, and the formal goals of the program. Emerging themes from the data indicated that patients and families place higher value on the formal goals of “improve quality of life; improve eating behaviours; improving fitness, increasing activity levels; and empower/strengthen families.” (Children’s Hospital of Eastern Ontario, 2012). Specific recommendations with regards to each component of these goals were provided. Instrumental, procedural, systemic, and conceptual recommendations of program components were also provided.

The purpose of this study was to investigate the prevalence and present food intake and morbidity patterns of obesity in men (n = 162) and women (n = 286) 15 to 80 years of age. Data were collected in a community-based longitudinal study from 1983 to 1985 in a semi-rural Egyptian village. Degree of obesity was estimated using body mass index (BMI) and a derived measure of adiposity from principal components analysis of several anthropometric variables. BMI was significantly correlated with other available measures of adiposity, lean mass and age and uncorrelated with height. Derived measures of adiposity were related to all other measures of relative weight and adiposity in both sexes and related to age in women. Within agricultural households, men were shorter and had higher adiposity levels, and women were taller than non-agricultural households. The presence of chronic disease was unrelated to BMI in men. However, chronic disease and respiratory difficulties occurred more often in overweight and obese women. There was no difference in the prevalence of acute illness for lean and normal weight compared to overweight and obese men. Skin problems occurred more often in overweight and obese women. There was a risk of low pregnancy weight gain across the range of BMI. Obese women produced heavier infants than normal weight or overweight women; overweight women produce heavier infants than leaner women. Infant birthweight was predicted by prepregnancy BMI or adiposity level, pregnancy weight gain and height. For men, animal products contributed to the higher intakes of fat, vitamin A and zinc in overweight and obese, and fats and oils contributed to higher vitamin E intakes. For women, bread contributed to higher intakes of dietary fiber and lower intakes of calcium in overweight and obese.

M.Ed. (Educational Psychology) / The World Health Organisation (2011) states that overweight and obesity is one of the most serious health problems of the 21st century. This is true of Africa as well. It is estimated that the number of overweight children in Africa has doubled since 1990 and growth rates of overweight and obesity are among the highest in Africa. South Africa’s overweight and obesity rates are among the highest in Africa. The South African National Health and Nutrition Survey (2013) found that the combined overweight and obesity prevalence in South Africa is 13,5% for children between the ages of six and 14 years; this is higher than the global prevalence of 10%. Therefore, overweight and obesity is threatening to become a major health concern in South Africa. When considering adolescents who are overweight and obese, it becomes apparent that it has a great impact on their mental health. Overweight and obesity during adolescence not only has a negative impact on their physical health but also their mental health, thus overweight and obesity should not only be addressed to improve the physical health but also the mental health of adolescents. The researcher aimed to explore the lived experiences of adolescent boys who are overweight and obese, to suggest guidelines to facilitate mental health in these boys. A qualitative, explorative, descriptive and contextual study design was followed. Research took place in two phases. The first phase was concerned with the description of the lived experiences of adolescent boys who are overweight and obese. In the second phase, guidelines were described to facilitate mental health in these boys. Ethical principles were adhered to from the onset of the study to ensure participants’ human rights were respected, that participants were treated with dignity and that no harm would come to them. Further, principles of fairness and justice were considered. The data were collected through in-depth phenomenological interviews. Interviews were conducted with 10 participants who met the sampling criteria and who were purposively selected. However, one participant’s interview was too short to be included. Consent was obtained from the participants.