Background: Despite several decades of research, the relevance of body fat and body fat distribution to the risk of cardiovascular disease remains unclear. This thesis aims to investigate associations of body-mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with risk of first-onset cardiovascular disease under a range of different circumstances. Methods: This thesis used individual records from the Emerging Risk Factors Collaboration to calculate risk ratios, and measures of discrimination and reclassification. 118 prospective studies, involving 1,064,541 participants without known history of cardiovascular disease, had information on BMI at baseline examination. 58 of these studies, involving 221,934 participants, had additional information on waist and hip circumference at baseline examination. Serial measurements made in 42,300 participants from 12 studies with concomitant information on these adiposity measures enabled quantification of within-person variability in BMI, WC and WHR. Results: Cross-sectional analyses demonstrated that although the correlations of adiposity measures differed with one another, BMI, WC and WHR were similarly and importantly associated with mediating cardiovascular risk factors, such as blood pressure, fasting glucose and lipids. Within-person variability was lower in BMI (regression dilution ratio: 0.96) than in WC (0.88) and WHR (0.66). The variability of adiposity measures was not materially influenced by several characteristics, although the variability of WHR varied somewhat by sex, diabetes status and baseline WHR values. 1,064,541 individuals with information on BMI recorded 161,903 deaths or non-fatal cardiovascular outcomes during 15.0 million person-years of follow-up. In analyses adjusted for age, sex and smoking status, BMI had positive and nearly loge-linear associations with coronary heart disease and ischaemic stroke (except at BMI values below 20 kg/m2), which were largely explained by the intermediate risk factors noted above. The association between BMI and non-vascular mortality was curvilinear. Data on 221,934 individuals with complete information on weight, height, and waist and hip circumference (14,297 incident cardiovascular outcomes; 1.87 million person-years of follow-up) demonstrated that BMI, WC and WHR were substantially and similarly related to risk of coronary heart disease and ischaemic stroke. For cardiovascular risk prediction, additional information on BMI, WC or WHR to a prediction model containing conventional risk factors did not importantly improve risk discrimination, nor classification of participants to risk categories of predicted 10-year risk. Conclusions: BMI, WC and WHR are similarly associated with risk of cardiovascular disease, with much of the risk explained by intermediate risk factors. These clinical measures of adiposity do not importantly improve cardiovascular risk prediction when additional information is available on blood pressures, history of diabetes and lipids.

Background: Research concerning child's food intake have considered various influencing factors, for example parental feeding strategies, demographic and weight factors. At this time, however, there are few findings that explore these factors simultaneously. Accordingly, the aim of this study was to test a structural equation model regarding the associations between maternal feeding strategies and child's food intake. Methods: 556 mothers and their children between 1 and 10 years of age participated in this crosssectional study. Besides socio-demographic and weight data, the mothers were asked about their feeding strategies as well as their child's food intake. Results: The well-fitting model explained 73% of the variance in the child's consumption of healthy and 34% of unhealthy food. In addition to the effect of the mother's social status and the child's age, a rewarding and modeling feeding behavior significantly influenced the child's food intake. Conclusion: The results highlight the relevance of maternal feeding behavior on the child's food intake. In terms of preventing eating- or weight-related problems, the findings indicate the usefulness of training parents in explicit modeling behavior and avoiding food as a reward.

The rates of childhood obesity remain high in spite of the enormous efforts dedicated to tackling the disease. This dissertation investigates the effect of two of its causes, including parental time and children's obesity risk behaviors. Trends in these causes have changed over time and might explain changes in obesity. The two factors are analyzed separately given the differences in impact process and concentration of literature. The data for the investigation is drawn from the Parental Time, Role Strains, Coping, and Children's Diet and Nutrition project. In examining parental time, the attention is directed towards the mother's actual time spent with the child which has been associated with reduction in child weight status. The major aim is to test and correct for the problem of endogeneity stemming from unobserved health factors that can distort any meaningful causal impact of maternal time on child weight status. Using the household production theory, parental time allocation decisions towards child health are modeled and analyzed using instrument variable (IV) methods. Results indicate that the effect of mother's time allocation reduces child weight status. Her decision to allocate time to the child is affected by unseen factors. Father's work to family spillover was found to be a valid instrument for mother's time with the child. Results were robust across different estimators. In analyzing the relationship between childhood obesity risk behaviors and weight status, this study focuses on three child practices including breakfast intake, fast food consumption and sleep patterns. The main aim was to score their joint impact, while at the same time accounting for contextual factors. This work adopted the ecological systems framework which accommodates multiple factors. Based on this theory, a simultaneous system of equations considering child weight status, risk behavior and contextual factors was set up and analyzed using 3SLS. Findings indicated that dietary behaviors remain a major factor in affecting weight status. In addition, feedback mechanism from child weight status will influence the diet pattern adopted by the child. Sleep sufficiency had no effect on child weight status.

The purpose of this study was to explore the association between parenting stress and child body mass index (BMI). Behaviours known to increase childhood obesity risk were also examined in relation to parent stress: poor eating habits, increased television viewing, decreased physical activity and poor sleep habits. Cross-sectional, baseline data were collected from 110 parent-child dyads participating in a family-based obesity prevention intervention. The majority of participants identified as Hispanic/Latino and belonged to low-income households. Parents scored an average of 28.4 +/- 10.7 on the PSI-3-SF, classifying 20% as high stress. Using the World Health Organization (WHO) growth charts, 48% of children were categorized as overweight or obese. Parenting stress was not found to be associated with child weight status in this study. Parenting stress was, however, significantly associated with unhealthful behaviours that are associated with increased obesity risk. In comparison to children with unstressed parents, the children of highly stressed parents were less likely to meet the recommendation of 60 minutes spent in active play per day on weekdays. Highly stressed parents also were less likely to limit the amount of television their child viewed. While it is important to target activity and television behaviours among young children, our results suggest that interventions may also need to address parental stress as a possible underlying factor associated with unhealthful behaviours among young children.

Obesity is a major public health problem and is a risk factor for hypertension, diabetes, heart disease and cancer. In addition, the prevalence of obesity appears to be increasing worldwide, making it important to determine the nature and extent of obesity in populations at risk. The aim of this study was to determine the predictors of body mass index (BMI) in Taiwanese adults 19 through 44 years old. Independent variables from the Nutrition and Health Survey in Taiwan (NAHSIT) included biological factors (age and sex), dietary factors (energy intake and fat intake), environmental factors (educational level, residence area, and nutrition knowledge), and lifestyle factors (leisure time physical activity, smoking habits, and alcohol consumption). Results indicated that nearly 40% of the 1,182 adult survey participants were obese or overweight, by Taiwanese standards. Regression analysis found that significant predictors of BMI were residence area, educational level, and age. Taiwanese adults more likely to have higher BMIs were from the mountainous area, had less education. An increase in ten years of age was related to an average increase in BMI of 1.13 kg/m�� (p<0.0001), controlling for other variables. These three factors accounted for 21% of the variance in all adults (15% of the variance in men, and 28% of the variance in women). In addition, smoking was a predictor of higher BMI in males, and alcohol intake was a predictor for higher BMI in females. Energy intake, fat intake, leisure time physical activity, and nutrition knowledge were not significant predictors for either males or females. The findings from this study will help public health professionals identify target areas and program needs to reduce obesity in Taiwan, particularly in the mountainous areas where the prevalence of obesity/overweight was seventy percent. / Graduation date: 2004

The aim of this study was to explore and describe the body fatness and associated selected health risk factors among 10 to 12 year old adolescents attending schools in Port Elizabeth. Therefore the objectives of the study were to determine the following for the participants: • Level of fatness: weight, height, waist circumference, maximum hip circumference and skinfolds; • Fat intake; • Level of physical activity involvement (IPAQ). To achieve the aim and objectives of this study, the literature pertaining to Childhood Obesity and the possible effects thereof, were reviewed. Both an ex post facto quasi experimental and randomized one-group posttest only designs were used to describe the level of fatness and to identify the incidence of overweight and obesity among adolescents aged 10 to 12 years attending schools in Port Elizabeth. The test battery included anthropometric measurements that were identified from the literature as the factors most important to categorise body fatness such as weight, height, circumferences and skinfolds to determine the level of fatness of the participants. A 21-item Fat Measure for Dietary Intake and International Physical Activity Questionnaire were administered to determine the levels of fat intake and physical activity. Three hundred (300) adolescents were assessed of which 143 were male and 157 were female. In terms of socioeconomic status, 71.3 percent were from the ‘less poor’ quintile schools and 28.7 percent were from the ‘more poor’ quintile schools. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences were tested for statistical and practical significance. The results from the study showed that 26.7 percent of the participants were overweight and 14.7 percent were obese according to their skinfold measurements. In terms of body mass index, 79.7 percent of the participants were overweight and 14.3 percent were obese. These results are far higher than majority of the studies included. Physical activity indicated a reduction in body fatness and the most physically active participants were obese. Lastly, body fat percentage and body mass index are very closely related.

Source: Masters Abstracts International, Volume: 46-03, page: 1373. Advisers: Robert J. Hardy; Asha S. Kapadia. Includes bibliographical references.

Indiana University-Purdue University Indianapolis (IUPUI) / Factors released from coronary perivascular adipose tissue (PVAT), which surrounds large coronary arteries, have been implicated in the development of coronary disease. However, the precise contribution of coronary PVAT-derived factors to the initiation and progression of coronary vascular dysfunction remains ill defined. Accordingly, this investigation was designed to delineate the mechanisms by which PVAT-derived factors influence obesity-induced coronary smooth muscle dysfunction. Isometric tension studies of coronary arteries from lean and obese swine demonstrated that both lean and obese coronary PVAT attenuate vasodilation via inhibitory effects on smooth muscle K+ channels. Specifically, lean coronary PVAT attenuated KCa and KV7 channel-mediated dilation, whereas obese coronary PVAT impaired KATP channel-mediated dilation. Importantly, these effects were independent of alterations in underlying smooth muscle function in obese arteries. The PVAT-derived factor calpastatin impaired adenosine dilation in lean but not obese arteries, suggesting that alterations in specific factors may contribute to the development of smooth muscle dysfunction. Further studies tested the hypothesis that leptin, which is expressed in coronary PVAT and is upregulated in obesity, acts as an upstream mediator of coronary smooth muscle dysfunction. Long-term administration (3 day culture) of obese concentrations of leptin markedly altered the coronary artery proteome, favoring pathways associated with calcium signaling and cellular proliferation. Isometric tension studies demonstrated that short-term (30 min) exposure to leptin potentiated depolarization-induced contraction of coronary arteries and that this effect was augmented following longer-term leptin administration (3 days). Inhibition of Rho kinase reduced leptin-mediated increases in coronary artery contractions. Acute treatment was associated with increased Rho kinase activity, whereas longer-term exposure was associated with increases in Rho kinase protein abundance. Alterations in Rho kinase signaling were also associated with leptin-mediated increases in coronary vascular smooth muscle proliferation. These findings provide novel mechanistic evidence linking coronary PVAT with vascular dysfunction and further support a role for coronary PVAT in the pathogenesis of coronary disease.

Diploma thesis is divided into a theoretical and practical part. I dedicated the theoretical part not only to prenatal and perinatal obesity risk factors, but also to diagnosis, management, health complications and prevention. In the practical part, I described the outcomes of the questionnaire survey dedicated to the mothers of children aged 1-7 years. The aim of this thesis was to find out the occurrence of selected risk factors for childhood obesity. I found out that in my study group, there were some risk factors represented in relatively small quantity (for example smoking during pregnancy, smoking during breastfeeding, gestational diabetes mellitus). Other risk factors, such as mother's or father's obesity were frequent. Some risk factors for childhood obesity are obvious, while others have not yet been proved to be directly related to obesity. However, we can certainly suggest, that the healthy parents' weight, alcohol and nicotine abstinence and exclusive breastfeeding at least until the end of fourth month of life are the factors beneficial not only for the health of the child. Key words: childhood obesity; diet during pregnancy; nutritional programming; obesity prevention; obesity risk factors

This research focuses on obesity and other major risk factors for chronic diseases such as Type II Diabetes Mellitus, Heart Disease, and Stroke. Worksite wellness programs have been successful in this realm of health promotion and disease prevention for heart disease and stroke, but their effectiveness in treating diabetes has been uncertain partially due to poor patient compliance, lack of stress reduction strategies, poor diet and lack of persuasive health education on the risk of being obese. Published peer-reviewed articles were reviewed, coded and analyzed to determine best practices, using a modified systematic review approach. The findings from these studies yield results that were used to develop a new employer-sponsored wellness program that is in accordance with the recently passed Affordable Care Act. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection