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<p>Protecting public health is the most legitimate use of zoning, and yet there is minimal progress in applying it to the obesity problem. Zoning could potentially be used to address both unhealthy and healthy food retailers, but lack of evidence regarding the impact of zoning and public opinion on zoning changes are barriers to implementing zoning restrictions on fast food on a larger scale. My dissertation addresses these gaps in our understanding of health zoning as a policy option for altering built, food environments. </p><p>Chapter 1 examines the relationship between food swamps and obesity and whether spatial mapping might be useful in identifying priority geographic areas for zoning interventions. I employ an instrumental variables (IV) strategy to correct for the endogeneity problems associated with food environments, namely that individuals may self-select into certain neighborhoods and may consider food availability in their decision process. I utilize highway exits as a source of exogenous variation .Using secondary data from the USDA Food Environment Atlas, ordinary least squares (OLS) and IV regression models were employed to analyze cross-sectional associations between local food environments and the prevalence of obesity. I find even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates.</p><p>Chapter 2 applies theories of message framing and prospect theory to the emerging discussion around health zoning policies targeting food environments and to explore public opinion toward a list of potential zoning restrictions on fast-food restaurants (beyond moratoriums on new establishments). In order to explore causality, I employ an online survey experiment manipulating exposure to vignettes with different message frames about health zoning restrictions with two national samples of adult Americans age 18 and over (N1=2,768 and N2=3,236). The second sample oversamples Black Americans (N=1,000) and individuals with high school as their highest level of education. Respondents were randomly assigned to one of six conditions where they were primed with different message frames about the benefits of zoning restrictions on fast food retailers. Participants were then asked to indicate their support for six zoning policies on a Likert scale. Subjects also answered questions about their food store access, eating behaviors, health status and perceptions of food stores by type. </p><p>I find that a message frame about Nutrition and increasing Equity in the food system was particularly effective at increasing support for health zoning policies targeting fast food outlets across policy categories (Conditional, Youth-related, Performance and Incentive) and across racial groups. This finding is consistent with an influential environmental justice scholar’s description of “injustice frames” as effective in mobilizing supporters around environmental issues (Taylor 2000). I extend this rationale to food environment obesity prevention efforts and identify Nutrition combined with Equity frames as an arguably universal campaign strategy for bolstering public support of zoning restrictions on fast food retailers.</p><p>Bridging my findings from both Chapters 1 and 2, using food swamps as a spatial metaphor may work to identify priority areas for policy intervention, but only if there is an equitable distribution of resources and mobilization efforts to improve consumer food environments. If the structural forces which ration access to land-use planning persist (arguably including the media as gatekeepers to information and producers of message frames) disparities in obesity are likely to widen.</p> / Dissertation

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Sea Man Mei. / "September 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 194-218). / 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. / Electronic reproduction. Ann Arbor, MI : ProQuest dissertations and theses, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Thesis (MScMedSc)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: INTRODUCTION: Obesity and its associated complications such as diabetes and cardiovascular disease are escalating worldwide. Cardiovascular mortality and the occurrence of heart failure following a myocardial infarction are increased among diabetics. A high caloric diet has been associated with specific metabolic alterations such as increased FA utilization and decreased glucose utilization. We therefore hypothesized that, in a rat model of diet-induced obesity, pathways involved in myocardial glucose utilization would be down regulated with simultaneous up regulation of FA utilization pathways and that this will lead to certain metabolic adaptations which will eventually become maladaptive. We aimed to elucidate mitochondrial oxidative capacity, biogenesis, and signaling pathways involved in substrate utilization and energy production in rats on the obesity inducing diet for a period of 8 or 16 weeks. METHODS: The diet of male Wistar rats (180-200 g) was supplemented with sucrose and condensed milk for 8 or 16 weeks (DIO) and compared to age-matched controls. We determined the fasting blood glucose and serum insulin levels, which was used to calculate the HOMA index. Furthermore, (i) A set of hearts were removed and freeze-clamped immediately. (ii) Isolated hearts were perfused with Krebs-Henseleit buffer (10 mM glucose), subjected to regional ischaemia by ligating the left anterior descending artery (35 min). After 10 min reperfusion, the infarcted and non-infarcted zones were freeze-clamped separately. Isolated mitochondria prepared from fresh tissue were used to measure oxidative capacity using either glutamate or palmitoyl-L-carnitine as substrates and exposed to anoxia (20 min) /reperfusion and used in e- transport chain complex analysis. Additionally we determined (i) ATP production (HPLC), (ii) citrate synthase activity and quantity as measure of active mitochondria per mg of protein and (iii) PDH complex expression and activity (ELISA). Levels of GLUT1, GLUT 4, PGC-1α, PPARα, PKB/Akt, GSK-3, PTEN, AMPK and PI3K activity were measured via Western blotting and Real-time PCR was used to measure the expression of PDK 4 and FAT/CD36. RESULTS: The blood glucose and serum insulin levels were significantly elevated in the diet group after 8 weeks of DIO. The PPARα, PGC-1α and PDK 4 levels were also significantly elevated in the diet group with no significant difference in the levels of any of the other proteins measured or the level of citrate synthase activity. After 16 weeks of DIO the citrate synthase, PTEN and p-PI3K activity was significantly reduced and the %recovery after anoxia/reperfusion when using palmitoyl was significantly increased in the diet group. There was no change in mitochondrial oxidative function in both groups after 8 and 16 weeks, as well as no difference in ATP production during state 3 respiration. CONCLUSION: The increased blood glucose and serum insulin levels as well as the increase in the HOMA index in the diet group after 8 weeks of DIO indicates that these obese animals were insulin resistant. An increase in the level of PPARα and PGC-1α expression indicates an early compensatory effect which facilitates enhanced fatty acid utilization. This is underscored by elevated levels of PDK 4. We could find no significant difference in the quantity of the PDH enzyme but there was a significant increase in the level of PDH activity in the diet group after 16 weeks of DIO. Mitochondria from the 16 weeks DIO animals were able to withstand anoxia/reperfusion and showed no malfunctioning of the electron transport chain, despite a reduction in PI3K & PTEN activity and the presence of insulin resistance. Mitochondrial biogenesis does not seem to play a significant role in the heart‟s adaptive response as there was no increase in the citrate synthase activity in both groups. We conclude that the hearts from these obese and insulin resistant rats are coping well and have adapted metabolically to compensate for any reduction in glucose oxidation. It is plausible that this initial metabolic adaptation may become maladaptive as obesity progresses. / AFRIKAANSE OPSOMMING: INLEIDING: Vetsug en die geassosieerde komplikasies, naamlik diabetes en kardiovaskulêre siektes is besig om wêreldwyd toe te neem. Kardiovaskulêre sterftes en die voorkoms van hartversaking ná 'n miokardiale infarksie is verhoog onder diabete. 'n Dieet met 'n hoë vetinname word ook geassosieer met spesifieke metabolise veranderings, soos verhoogde vetsuur gebruik en 'n afname in glukoseverbruik. Ons het dus vermoed dat seintransduksie paaie betrokke by miokardiale glukose verbruik afgereguleer sal wees met tesame opreguleering van seintransduksie paaie betrokke by vetsuur verbruik, en dat dit sal lei tot sekere metaboliese aanpassings wat uiteindelik wanaanpaslik sal word. Ons DOESTELLING in hierdie studie was dus om meer lig te werp op mitokondriale oksidatiewe kapasiteit, biogenese, en seintransduksie betrokke by substraatverbruik en energieproduksie in rotte op die vetsugveroorsakende-dieet (vir 'n tydperk van 8 tot 16 weke). METODE: Die dieet van die manlike Wistar rotte (180-200 g) is aangevul met sucrose en gekondenseerde melk vir 8 of 16 weke (DIO) en is dan vergelyk met kontrole rotte van dieselfde ouderdom. Die vastende bloedglukose-en insulienvlakke is bepaal en hierdie waardes is gebruik om die HOMA indeks te bereken. Verder is, (i) 'n stel harte verwyder en onmiddelik gevriesklamp (ii) geïsoleerde harte met Krebs-Henseleit buffer (10 mM glukose) geperfuseer en dan aan 35 min streeksiskemie en 10 min herperfusie blottgestel. Na 10 min herperfusie, is die infarct en nie-infarktsones apart gevriesklamp. Geïsoleerde mitokonderieë is voorberei van vars weefsel en is gebruik a) om oksidatiewe kapasiteit te meet met behulp van glutamaat of palmitoiel-L-karnitien as substrate of b) blootgestel aan 20 min anoksie gevolg deur heroksigenasie of c) is gebruik in elektronvervoerkettingkompleks analise. Verder is die volgende ook bepaal: (i) ATP-produksie (HPLC), (ii) sitraat sintase aktiwiteit en hoeveelheid, gemeet as maatstaf van die aktiewe mitkondrieë per mg van proteïen en (iii) PDH-komplekuitdrukking en aktiwiteit (ELISA). Vlakke van GLUT 1, GLUT 4, PGC-1 alpha, PPAR alpha, PKB/Akt, GSK-3, PTEN, AMPK, en PI 3 kinase is bepaal deur Western klad analise en “Real –time PCR” is gebruik om die uitdrukking van PDK 4 en FAT/CD 36 te bepaal. RESULTATE: Die bloedglukose- en serum insulinvlakke was beduidend verhoog in die dieetgroep na 8 weke van DIO. Die PPAR alpha, PGC-1 alpha en PDK 4 vlakke was ook beduidend verhoog in die dieetgroep met geen beduidende verskil in die vlakke van enige van die ander proteïene gemeet of die vlakke van sitraat-sintase aktiwiteit nie. Na 16 weke van DIO het die vlakke van sitraat-sintase, PTEN en p-PI 3 kinase beduidend verlaag en die % herstel na anoksie/heroksigenering (met die gebruik van palmitoiel-L-karnitien) het beduidend toegeneem in die dieetgroep. Geen ander mitokondriale veranderinge kon waargeneem word nie. Ons kon geen verandering vind in die mitokondriale oksidatiewe funksie tussen die twee groepe na 8 en 16 weke van DIO. Daar was ook geen verandering in die hoeveelheid ATP geproduseer gedurende staat 3 respirasie. GEVOLGTREKKING: Die verhoogde bloedglukose en serum insulienvlakke, sowel as die toename in die HOMA indeks in die dieetgroep na 8 weke van DIO, dui daarop dat hierdie oorgewig diere insulienweerstandig is. 'n Toename in die vlak van PPAR alpha en PGC-1 alpha uitdrukking dui op 'n vroeë kompenserende effek, wat die verhoogde verbruik van vetsure fasiliteer. Dit is beklemtoon deur verhoogde vlakke van PDK 4. Ons kon geen beduidende verskil in die hoeveelheid PDH-ensiem vind nie, maar daar was wel 'n beduidende toename in die vlak van PDH aktiwiteit in die dieetgroep na 16 weke van DIO. Mitokondrieë van die 16 weke DIO diere kon anoksie/heroksigenering weestaan en het geen wanfunksionering van die elektronvervoerketting getoon nie, ten spyte van 'n vermindering in PI 3 kinase en PTEN aktiwiteit en die teenwoordigheid van insulienweerstandigheid. Mitokondriale biogenese blyk nie 'n beduidende rol te speel in die hart se aanpassingreaksie nie, want daar was geen verhoging in die sitraat-sintase aktiwiteit in beide groepe nie. Na aanluiding van die resultate verkry met hierdie studie, maak ons ook die gevolgtrekking dat die harte van rotte na 16 weke se blootstelling aan 'n hoë vet omgewing, metabolies kon aanpas en goed funksioneer. Ons gevolgtrekking is dus dat die harte van diere wat lei aan vetsug en wat insulien weerstandig is die verlaaging in glukose metabolisme goed hanteer en metabolies aangepas het hierby. Dit is moontlik dat hierdie aanvanklike aanpasing wanaanpaslik kan word soos vetsug vorder.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Considering the growing concern about the rising rates of obesity in children and adolescents, as well as changes in eating habits, it is necessary to adopt preventive and awareness measures for better quality of life and to implement proper eating habits. For this, multidisciplinary science teaching becomes a key element to help increase nutritional knowledge and change unhealthy eating habits. Thus, school becomes a privileged space to develop health promotion. Teachers have undergone a process of continuing education during the research, this allowed them different interactions with new pedagogical strategies that were used, thus providing they appropriated them. The training provided to teachers to reflect on their practice, resulting in the quality of that education and how it is taught, as well as opportunities for the exchange of experiences, leading changes in their teaching behavior. Therefore, the main objective of this study was to evaluate the advancement of knowledge through nutritional health habits, such as nutritional status, level of nutrition knowledge and dietary practices of primary schools through strategies that allowed to approach these issues in the teaching of school subjects. The research is a case study held in the city of Santa Maria/RS, with students from 6th to 9th grade of a public state school, totaling 175 students. A survey was conducted in order to gather data on body mass index (BMI), weight, height, sex, age, eating habits and nutrition information. From the results obtained, it can be observed that there was an improvement in the nutritional status, as well as in the levels of nutritional knowledge. However, it was also that noticed that the habit of skipping meals is common among students. Therefore, it was verified the importance of creating adequate spaces so that the necessary changes in nutritional status and obesity prevention can occur, in order to achieve so, it is necessary to involve school, families, and community through educational strategies for heal promotion. / A preocupação com o aumento dos índices de obesidade em crianças e adolescentes, além das mudanças nos hábitos alimentares, torna-se necessária a adoção de medidas de prevenção e conscientização para uma melhor qualidade de vida e adoção de hábitos alimentares corretos. Para isso, o ensino multidisciplinar se torna peça-chave para auxiliar no aumento sobre conhecimentos nutricionais e na mudança de hábitos inadequados. Assim, a escola torna-se um espaço privilegiado para trabalhar a promoção da saúde. Os professores passaram por um processo de formação continuada no decorrer da pesquisa, isso possibilitou a eles interações com novas estratégias pedagógicas diferentes das que estavam habituados, proporcionando assim que eles se apropriassem das mesmas. A formação proporcionou aos docentes a reflexão sobre sua práxis, resultando na qualidade daquilo que é ensino e como é ensinado, além de oportunizar a troca de experiências, permitindo a mudança em seu comportamento pedagógico. Neste sentido, o principal objetivo deste estudo foi avaliar o avanço do conhecimento nutricional através de hábitos de saúde, tais como estado nutricional, nível de conhecimento de nutrição e práticas alimentares de escolas primárias por meio de estratégias que permitiram abordar estas questões no ensino das disciplinas escolares. Trata-se de um estudo de caso realizado na cidade de Santa Maria/RS, com escolares do 6º ao 9º ano de uma escola estadual pública, totalizando 175 alunos. Foi realizado um levantamento de dados sobre índice de massa corporal (IMC), peso, estatura, sexo, idade, hábitos alimentares e informações nutricionais. A partir dos resultados obtidos, pode-se observar que ocorreu uma melhoria quanto ao estado nutricional, assim como dos níveis de conhecimento nutricional. Porém, notou-se também que a prática de omitir refeições é frequente entre os escolares. Portanto, verificou-se a importância da criação de espaços favoráveis para que ocorra alteração do estado nutricional e prevenção à obesidade, para isso, é necessário envolver escola, família e sociedade através de estratégias educativas de promoção da saúde.

The objective of this study was to determine the effectiveness of a 6 week afterschool nutrition and physical activity intervention administered by a registered dietitian with the help of a humanoid robot targeting elementary school aged children aged 6-12 years. The study was conducted across four Young Men’s Christian’s Association (YMCA) sites in Miami-Dade County, Florida (N= 114, Mean age: 8.16 ±1.57 years) using a pretest-posttest quasi-experimental design via randomly assigned intervention (two sites; n=63) and comparison groups (two sites; n=51). The validated Coordinated Approach to Child Health (CATCH) kids club questionnaire and the validated Previous Day Physical Activity Recall (PDPAR) were used to assess nutrition and physical activity knowledge, attitudes/beliefs and behavior change. The Inbody 230 instrument (Biospace, California) was used to calculate body composition and weight. Body Mass Index (BMI) percentiles and associated BMI z-scores for age and gender were calculated based on the Center for Disease Control and Prevention (CDC) growth charts. Data measures were collected at baseline (week 0) and one-week post intervention (week 7). Statistical analysis included independent t-test, paired t-test, chi-squared test, Wilcoxon signed ranks test and logistic regression. Results indicated that nutrition knowledge score significantly increased from 67.43% ±21.03 to 81.31% ±18.47 in the intervention group (p

Bakgrund: Övervikt och fetma är ett hälsoproblem som har ökat i samhället och globalt. Forskningen visar att barnen drabbas av livsstilssjukdomar i vuxen ålder. Distriktssköterskorna har en unik arbetsplats på barnavårdscentral och möter barn med viktproblem. Genom hälsosamtal med föräldrarna får föräldrarna de råd och upplysningar som det behövs för att bekämpa eller förebygga övervikt och fetma hos barn. Genom distriktsköterskornas hälsosamtal stöds föräldrar och barn med råd och information för att förebygga övervikt och framtida livsstilssjukdomar. Syfte: Syftet med denna litteraturöversikt var att belysa distriktssköterskors upplevelse av hälsosamtal med föräldrar till barn med övervikt och fetma. Metod: En litteraturöversikt genomfördes baserad på 15 originalartiklar. Artiklarna söktes fram i databaserna PubMed och CINAHL. Data analyserades med stöd av uppdaterad integrativ granskningsmetod enligt Whittemore och Knafl (2005). Analysen resulterade i tre kategorier och tolv underkategorier. Resultat: Resultatet visade att distriktssköterskor upplevde olika svårigheter som hindrade de att utföra ett effektivt arbete med övervikt och fetmaproblem hos spädbarn och barn under fem år. Det behövs aktuella riktlinjer och även utbildning till både föräldrar och distriktssjuksköterskor för att spädbarn och barn under fem år får en fetmafri barndom. Diskussion: Låg kunskapsnivå om övervikt och fetma hos föräldrarna kan ökas med hjälp av olika bland annat digitala verktyg. Distriktssjuksköterskorna kan i sina ordinarie arbetstider få regelbundna utbildningar och det är viktigt att organisationer uppdaterar riktlinjer. Slutsats: Samhället förändras och teknologi växer och i och med det, förändras mat- och aktivitetskultur hos samhället. Nya organisationsbestämmelser och riktlinjer behövs. Nya verktyg och uppdaterad kunskap hos distriktssjuksköterskor behövs för att säkerställa samhällets hälsa nu och i framtiden. / Background: Obesity are a health problem that has increased in society and globally. Research shows that children suffer from lifestyle diseases in adulthood. The district nurses have a unique workplace at the child care center and meet children with weight problems. Through health conversations with the parents, the parents receive the advice and information needed to fight or prevent overweight and obesity in children. Through the district nurses' health talks, parents and children are supported with advice and information to prevent obesity and future lifestyle diseases. Aim: The aim of this literature review was to shed light on district nurses' experience of health conversations with parents of overweight and obese children. Method: A literature review was conducted based on 15 original articles. The articles were searched in the databases PubMed and CINAHL. Data were analyzed using an updated integrative review method according to Whittemore and Knafl (2005). The analysis resulted in three categories and twelve subcategories. Results: The results showed that district nurses experienced various difficulties that prevented them from performing effective work with obesity and obesity problems in infants and children under five years of age. Current guidelines and also training for both parents and district nurses are needed for infants and children under the age of five to have an obesityfree childhood. Discussion: Low level of knowledge about overweight and obesity in parents can be increased with the help of various digital tools, among others. The district nurses can receive regular training during their regular working hours and it is important that the organization updates guidelines. Conclusion: Society is changing and technology is growing and with it, food and activity culture in society is changing. New organizational rules and guidelines are needed. New tools and updated knowledge of district nurses are needed to ensure the health of society now and in the future. / <p>Datum för godkännande: 2021-12-06</p>