Thesis (M.A.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains vi, 51 p. Includes bibliographical references (p. 46-51).

Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 95-103).

Background: The epidemic of childhood obesity is of increasing public health concern, with major implications for long-term health. Prevention strategies are urgently needed. Most of the evidence concerning risk factors for childhood obesity comes from observational studies, mainly from Western populations. In the West, socio-economic position (SEP) is often associated with potential risk factors and with childhood obesity, making these observational studies open to residual confounding. Evidence from a setting with a different confounding structure can be valuable in disentangling whether associations observed in Western settings reflect potentially reversible causal effects of risk factor or are confounded by SEP. Objectives: This thesis took advantage of a large (n=8327), population-representative Chinese birth cohort from a developed non-Western setting, Hong Kong, where the confounding structure between potential risk factors and childhood obesity is different, to examine the association of four modifiable risk factors (mode of delivery, the timing of solid food introduction, type of child care and dairy product consumption) with adiposity from infancy to early puberty. Methods: Adiposity from infancy to early puberty was proxied by age- and sex-specific body mass index (BMI) standardized scores (z-scores) from 3 months to 13 years, relative to the 2006 World Health Organization (WHO) child growth standards for 0-5 years and the 2007 WHO growth reference for 5-19 years. Overweight (including obesity) was defined according to International Obesity Task Force cut-off. I compared three marginal models (maximum likelihood estimation, generalized estimating equations and quantile regression) to ascertain the optimal way of modeling the population-averaged association of early life risk factors with BMI z-score because of the complex data structure with inevitably some missing data. All three methods were used to examine the adjusted associations of mode of delivery and the timing of solid food introduction with BMI z-score from infancy to early puberty and with overweight (including obesity) from early childhood to early puberty. Multivariable linear and logistic regression were used to examine the adjusted associations of the type of child care at 6 months, 3 years, 5 years and 11 years with BMI z-score and overweight (including obesity) at 13 years, and the association of dairy product consumption at 11 years with BMI z-score at 13 years. Results: My analyses were robust to the choice of marginal model. Mode of delivery, the timing of solid food introduction and dairy product consumption were not associated BMI z-score or overweight (including obesity), but informal child care was associated with higher BMI z-score and overweight at early puberty. Conclusions: In this population-representative birth cohort from an understudied non- Western developed setting with little patterning of childhood adiposity by SEP, informal child care (by family members and/or in-home employed help) may be a target for intervention. Conversely, cesarean section, early introduction of solid food and lack of dairy product consumption do not appear to be contributing to the current obesity epidemic. Non-replication in a different context suggests some observed associations in the West may be indicators of residual confounding rather than of causality. / published_or_final_version / Public Health / Doctoral / Doctor of Philosophy

Objective: The purpose of this systematic review is to investigate the effectiveness of school lunch programs for reducing childhood obesity by examining changes to the Body Mass Index (BMI) as an outcome measure to compare and assess the effectiveness of different school lunch interventions. Background: Childhood obesity has a high likelihood of leading to obesity in adulthood and this negative effect is well documented. School lunches have been widely implemented in this decade for tackling childhood obesity. Many countries are following this trend to align school lunches with national or standard nutrition guidelines as part of the school policy. Since many schools have only recently started to provide school lunches, the impact of these programs in terms of reducing childhood obesity has yet to be fully explored. Methods: Published literature about school lunch and body mass index from 2008 to 2014 was collected through PubMed and ScienceDirect. Relevant studies, including cohort studies, cross-sectional studies, case control studies, and observational studies, were included if they involved interventions that measured BMI as an independent outcome. Results: Nine studies from USA and one from Norway were included in this systematic review. For measuring school lunch participation, 4 were associated with increased BMI after intervention, 1 was associated with decreased BMI and 3 were not statistically significant with BMI. For studies that included consumption or observed energy intake, 3 were associated with lower BMI and 1 study showed that higher consumption lowered initial BMI but increased BMI over time. Overall, the results were inconsistent, and this may be attributed to confounding factors such as different food environments, meal quality, and availability of school snacks. Conclusion: The implications for school lunch programs as a key factor in lowering childhood obesity are complicated. No solid conclusions can be inferred for the effectiveness of school lunch program for lowering childhood obesity, as certain studies show positive relationships and others show no association. Future research with primary data and longitudinal cohort with years follow up may be considered for studying the relationship of between the school lunch program and the trend of BMI of children change at each level of school. Research on extending observed energy intake should also be applied in order to provide guidance for policy change on the meal quality, food options, competitive foods availability as well as nutrition guidelines. / published_or_final_version / Public Health / Master / Master of Public Health

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Thesis (M. P. H.)--University of Hong Kong, 2007.

Thesis (B.A. (Hons.)) -- University of Adelaide, Dept. of Psychology, 1978.

Thesis (Ph.D.) - University of Glasgow, 2008. / Ph.D. thesis submitted to the Faculty of Medicine, Division of Developmental Medicine, University of Glasgow, 2008. Includes bibliographical references. Print version also available.

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.