INTRODUCTION: Research has strongly linked increased consumption of sugar-sweetened beverages (SSBs) to obesity/overweight in youth. AIM: This study aims to: (1) examine SSB consumption rates in high school students nationwide, (2) explore association between SSB consumption and adiposity (overweight/obesity), (3) examine gender, racial/ethnic, and physical activity (PA) status differences in SSB consumption. METHODS: The Youth Risk Behavior Survey (YRBS)-2015 was employed in this study. Weighted percentages were used to examine differences in SSB consumption and adiposity prevalence by gender, race and PA status. Multivariate logistic regression was used to determine association between SSB consumption and adiposity. Adjusted and unadjusted odds ratios and 95% CIs were calculated. RESULTS: Overall, 20% of students drank sodas daily ≥ 1 times a day and about 14% drank sports drinks daily. More male students consumed both sodas and sports drinks than female students. Soda consumption was largest in the group with zero days PA (25%) and consumption of sports drinks was highest in the daily PA category (24%) than the other categories. Multivariate logistic regression revealed higher odds of obesity among male students as compared to female students (OR=1.7, 95% CI=1.4, 2.1) and among Hispanic students as compared to white students (OR=1.5, 95% CI=1.2, 1.8), after adjusting for all other covariates. Students who engaged in daily PA had lower odds of obesity than those who had no PA (OR=0.6, 95% CI=0.5, 0.8). There was no significant difference in the odds of obesity between those who consumed SSBs and those who did not. DISCUSSION: This study provides insight into SSB consumption trends in US adolescents by socio- demographic factors and PA status, as well as its association with adiposity. Male gender, certain racial minorities and lack of physical activity can potentially be responsible for greater SSB consumption. Sports drinks consumption is high even in physically active youth. Lack of association between SSB intake and adiposity may be due to the limited SSBs included.

Rising rates of obesity among children have become one of the most pressing issues in modern public health. Childhood obesity threatens both the mental and physical well-being of children. Attempts to halt the rise in obesity take many forms, but one of them is the recent implementation of a programme of measurement of primary children at reception and in year 6, with results being fed back to parents. This National Child Measurement Programme (NCMP) is controversial and has been criticised in some quarters as unethical, in being a form of screening programme with no clear or effective interventions available for those detected as having a problem. Study aims and objectives The main aim of the study was to explore the relationship between weight status and children’s mental wellbeing, especially in the context of the NCMP. Within this overall aim, key specific objectives of the study were: i) to investigate the association between weight status of 10-11 year old school children and their mental well-being; ii) to assess the impact on the mental wellbeing of children, of participating in the NCMP; and iii) to collect information about parents’/guardians’ and children’s reaction to the NCMP, with particular interest in identifying whether parents/guardians and their children found the feedback useful in moving towards the adoption of a healthy lifestyle. Methods The study was undertaken in primary schools in the catchment area of Gateshead Primary Care Trust (PCT). The overall study used a mixed methods study design. The study involved administering a questionnaire prior to NCMP measurement to a total sample of 264 children, sampled using a proportionate stratified random sampling technique. One-to-one semi-structured interviews were also conducted post measurement with 21 children purposively sub-sampled from the larger group, and with 16 parents/guardians. Results Prior to measurement, most children misclassified their weight status. About 1 in 10 children who were of ideal weight perceived themselves as overweight. Over three quarters of overweight children perceived themselves to be of ideal weight. There was no significant relationship between any of the indicators of mental wellbeing and actual weight status of children. However, there was very strong evidence for a Preface xxv significant relationship between perceived weight status and mental wellbeing among children. Seven major themes emerged from the post measurement interview data, but perhaps the most intriguing was the cycle of emotional reaction of families to the NCMP and weight feedback. Discussion The reactions of parents/guardians whose children are indicated to have weight problems follow a sequence of behaviours ranging from shock, disgust with the programme, through denial and self-blame to acceptance, worry and help seeking. Reasons for these responses relate in many cases to the way the weight problem is portrayed to the parents. While health authorities are keen to portray this problem as a medical one, parents/guardians see it as social one. The roots of overeating and lack of exercise are seen as lying in the complex social and cultural milieu in which this sample of people live. Consequently, associating this problem in feedback letters with dangerous diseases like cancer, and advising parents to visit GPs to resolve child weight issues, seems inappropriate to the recipients and causes controversy and anger. Conclusion The NCMP’s routine feedback could potentially induce families into the state of readiness to change lifestyle behaviours; however, given the reactions described in this study, it seems critical to avoid placing blame on individuals but rather to acknowledge the influence of the environment surrounding families and to provide non-medical support aimed at bringing families on board to support interventions for combating child weight problems.

Purpose: Obesity/Overweight in children is an epidemic and the most common disorder of childhood in the developed world. Prevalence is increasing, leading to short- and long-term complications. Breastfeeding may protect against childhood obesity, but the debate is ongoing. The main purpose of this project was to assess the relationship between breastfeeding and being overweight in early childhood.Methods: Data were collected from the State and Local Area Integrated Telephone survey; National Survey of Children's Health, 2003. Overall, 16,358 children, ages 3 to 5, were included in the sample. SPSS Complex Sample software was utilized to generate for all analyses. Complex samples crosstabs was utilized to see if there is association between the outcome and risk factors. Complex samples logistic regression was done to assess whether breastfeeding is associated with being overweight in childhood after adjustment for potential confounders.Results: Being overweight was more prevalent among children who are Black, living at 95th percentile). After adjusting for confounders, the effect remained statistically significant (OR: 1.6; 95% confidence interval: 1.2-2.1).Conclusions: Breastfeeding has a protective effect against being overweight in children 3 to 5 years of age. While more research is needed to investigate the risk factors for overweight, public health efforts should continue to promote breastfeeding as a safe and effective method for nutrition, which has the potential to improve the overall health of children.

Overweight and obesity are associated with an array of negative physical and psychosocial symptoms in adolescents. Numerous pediatric obesity interventions have emerged in an attempt to address this significant public health concern. However, few have focused on African American females, a particularly high risk group for negative health behaviors and associated complications. Moreover, research examining the psychosocial changes associated with increases in physical activity and fitness, although promising in elder and adult populations, is nearly nonexistent in adolescents. Thus, the current study addressed limitations in the research and examined the psychosocial outcomes of adolescent participants in T.E.E.N.S., a culturally sensitive, multidisciplinary weight loss intervention. From baseline to 6 month post-testing, program participants demonstrated significant improvements in physical, emotional, and social functioning, as well as body dissatisfaction. Moreover, increases in physical activity and cardiorespiratory fitness were associated with significant enhancements in several domains of psychological well-being.

Title: Possibilities of influencing overweight and fitness in volleyball players. Objective: To determine whether women playing volleyball competitively, overweight and lack of physical prowess, will be fundamental changes in body weight and physical fitness ment based on the intervention program, which consisted of dietary modifications and exercise aimed at increasing physical fitness. Method: For the study were selected twelve women who competed pays the third highest league in volleyball. These women suffer from mild overweight and poor fitness levels. The women are aged between 19-29 years. The probands were selected on the basis of observation and subjective evaluation. This study should demonstrate that the probands if they focus more on activities promoting physical fitness and acquire new habits in the diet, there is a positive change in the body and there will be a success and satisfaction on the playing field and in personal life. Selected individuals were asked questions about their health, leisure activities and tracks the weekly menu. Based on the answers to the questionnaire, baseline and motor tests were drawn up individual plans of intervention program to influence fitness and weight for 125 days. After the time allotted to an evaluation of the impact of the intervention program in...

Title: Designing eating plans for women and men suffering from overweight. Objectives: Show an importance of lifestyle changes, a modification of diet habits and an inclusion of physical activities in overweight or obesity therapy. Find which aspects made positive influence to the state. Methods: The study selected five women and five men suffering from overweight. None of them did not operate or operate professionally or competitively any sports. Selected men and women would like to change your lifestyle and this study they had to be developed. I put probands and their questions about their past activities, health and relationship with food. In addition, I measured using bioelectrical impedance and tailoring meter. The last parameter that interested me was the weight, which I measured using scales. Based on all the identified model parameters was compiled weekly individual eating plan and recommended physical activity. The study lasted six months, during which I attended probands and continuously measured them. After 180 days was made final assessment of the impact of changes in eating habits to influence overweight and obesity. Results: The study demonstrate that physical activities, diet changes and lifestyle changes have a big influence on overweight or obesity fight. Keywords: obesity,...

Master of Science / Department of Kinesiology / Katie Heinrich / Background: The American College of Sports Medicine physical activity guidelines call for 150 minutes of moderate or 75 minutes of vigorous aerobic exercise plus two days of resistance training (A-RT) per week for health benefits. Yet, most adults do not achieve the recommended amount of physical activity per week frequently citing lack of time as a barrier. High-intensity exercise protocols have improved glucose control, insulin sensitivity, fitness, and body composition, in less total time than lower intensity protocols, but have been studied as singular modes of exercise. CrossFit (CF) temporally combines A-RT together utilizing constantly varied multi-joint, full range-of-motion movements in substantially less training time than lower-intensity protocols. The aim of this study was to compare the effects of CF versus A-RT on glucose control in overweight/obese, physically inactive individuals. Methods: Eighteen overweight/obese (BMI 30.3 ± 2.8) adults (28.5 ± 5.9 years) were randomized to one of two groups: CF (3 days/week for 60 minute sessions) or A-RT (3 days/week of aerobic exercise for 50 minutes, plus ~20 minutes resistance exercise on 2 of those days) over 8-weeks. Fasting plasma glucose and 1-hour oral glucose tolerance tests were taken at baseline and post-training along with Eurofit fitness measures, VO2 peak, and body composition via dual energy X-ray absorptiometry. Results: Glucose control and body composition did not change significantly within or between groups. Both groups significantly improved muscular endurance (pushups completed on knees, CF+39.5%, p < 0.05; A-RT+24.4%, p = 0.01). The CF group improved on number of situps (CF+6.8%, p = 0.01) and VO2 peak (CF+9.1%, p < 0.05). Time spent exercising was significantly different between groups with the CF group averaging 38.7 ± 15.6 minutes per week and 13.1 ± 0.9 minutes per workout, and the A-RT group averaging 190.0 ± 10.7 minutes per week and 63.3 ± 3.6 minutes per workout. Conclusion: Eight weeks of A-RT or CF did not produce significant changes in glucose control or body composition in overweight/obese adults. However, despite exercising significantly less time per week CF training demonstrated greater improvements in fitness measures than A-RT.

Doctor of Philosophy / Department of Civil Engineering / Eugene Russell / It has been well documented that roundabouts can offer several safety and operational benefits over signalized and stop controlled intersection alternatives. However the growing use of roundabouts and their benefits could be greatly diminished because they may not be well designed for large trucks, or to accommodate oversize/overweight (OSOW) vehicles which may be essential to a state’s industry and economy. This dissertation addresses concepts to better design roundabouts for use by owners/operators of typical large trucks, and that will also accommodate OSOW vehicles where appropriate. Roundabout safety generally decreases with increased roundabout size, wider lanes and larger radii, the geometric parameters that benefit large trucks and OSOW, thus a better balance is needed. This study accomplishes this balance by initially reviewing and incorporating those portions of the study “Accommodating Oversize Overweight Vehicles at Roundabouts” that were researched, completed and written by the author of this dissertation, and which compiled current practice, research and concerns by various U.S. states and concerns of the trucking industry, by conducting four different surveys. Then to meet these concerns expressed by survey respondents, a great number of possible accommodation, strategies and design templates were developed by using existing design software. An evaluation method was also developed. Two additional, needed studies, not previously reported in any published literature, addressed : 1. a vertical, ground clearance analysis, and 2. a study of the use of roundabouts in urban freight networks to incorporate their inherent benefits ,such as, reducing congestion, delay and pollution. The first analysis described above was conducted by using software with 3D analysis capabilities to check and recommend critical vertical grades and maximum dimensions for a range of large truck types and OSOW vehicle configurations. Guidelines were developed to avoid problems of low, ground clearance vehicles scraping roundabout surfaces (“hanging up”). The second study used existing software that relates intersection types to intersection traffic flow efficiency and related pollution, on a number of routing scenarios to test the hypothesis that integration of roundabouts in these freight networks improves traffic flow, and decreases delay, congestion and pollution. The results were mixed but the procedure is sound and should be beneficial for future use by researchers and decision makers.

This study examined personal, social, and demographic factors related to physical activity (PA) level and body mass index (BMI) in adolescent African American (AA) females. The participants were 211 AA females from selected parochial schools in a city in the southern U.S. Participants completed the Physical Activity Determinant Scale (PADS: Mitchell & Kontos, 2002), the Three Day Physical Activity Recall (3DPAR: Weston, Petosa & Pate, 1997), the Leisure Time Exercise Questionnaire (LTEQ: Godin & Shepard, 1985), and demographic items. Height and weight measures were taken to assess BMI. Results from logistic regression indicated that the personal factor was a significant (p<.001, ExpB=4.65) predictor of PA level, and the social factor (p<.05, ExpB=1.43), age (p<.05, ExpB=.74), and age at menarche (p<.05, ExpB=.80) were significant predictors of low BMI for age. Results from ANOVA revealed that late maturers had significantly (p<.05) lower BMI scores, but were no more physically active than early and average maturers. Findings suggest that female adolescent AAs exert more control over personal PA factors, than social PA factors, such as peer pressure and sport socialization. Additionally, BMI was not related to PA for this sample, suggesting that BMI may be influenced by other factors not investigated in the current study. Based on these findings, potential interventions should focus on aspects of the personal factor for increasing PA in adolescent AA females. Future investigations are needed to further explore the relationship between personal, social, and demographic factors, and PA and BMI for adolescent AA females.

INTRODUÇÃO - A obesidade é uma preocupação de saúde pública cada vez mais importante, em todo o mundo. A obesidade infantil, por sua vez, vem sendo associada a um alto risco de agravos infantis e de obesidade e doenças crônicas não transmissíveis na fase adulta. Admite-se que o início da vida seja um momento crítico e determinante para o risco do indivíduo desenvolver sobrepeso ou obesidade. Entretanto, não está definido se existe algum período de maior vulnerabilidade na fase pós-natal e qual seria o melhor marcador do crescimento da criança para indicar uma possível intervenção precoce que possa minimizar o risco de desenvolver excesso de peso ou obesidade. OBJETIVO - Analisar as relações existentes entre indicadores antropométricos de crescimento no primeiro ano de vida e o desenvolvimento de excesso de peso no início da idade escolar. MÉTODOS - Estudo de uma coorte histórica de uma unidade básica de saúde em São Paulo, Brasil. Os momentos analisados foram aos três, seis e doze meses e aos sete anos de idade. Avaliou-se a velocidade de crescimento e o crescimento alcançado durante o primeiro ano de vida frente aos desfechos: excesso de peso e obesidade aos sete anos de idade. As variáveis foram analisadas estatisticamente através do Coeficiente de Correlação de Pearson e das curvas ROC, além de terem sido estimadas a sensibilidade, a especificidade e o risco relativo. RESULTADOS - Os Coeficientes de Correlação de Pearson do ganho de peso por ganho de comprimento nos períodos de 0 a 3 meses, 0 a 6 meses e 0 a 12 meses foram, respectivamente, 0,23 (IC 95 por cento : 0,13 a 0,33), 0,29 (IC 95 por cento : 0,19 a 0,39) e 0,34 (IC 95 por cento : 0,24 a 0,43), todos significantes estatisticamente. Os Coeficientes de Correlação de Pearson do escore z do Índice de Massa Corpórea (IMC) para 3, 6 e 12 meses foram, respectivamente, 0,39 (IC 95 por cento : 0,29 a 0,48), 0,41 (IC 95 por cento : 0,32 a 0,50) e 0,42 (IC 95 por cento : 0,33 a 0,51). Para excesso de peso na idade escolar, a utilização do marcador escore z do IMC aos 12 meses maior que 0,49 apresentou sensibilidade de 68,29 por cento (IC 95 por cento : 59,3 por cento a 76,4 por cento ), especificidade de 63,51 por cento (IC 95 por cento : 56,6 por cento a 70,0 por cento ) e risco relativo estimado de 2,31 (IC 95 por cento : 1,69 a 3,17). Para obesidade, o mesmo marcador apresentou sensibilidade de 76,47 por cento (IC 95 por cento : 62,5 por cento a 87,2 por cento ), especificidade de 56,89 por cento (IC 95 por cento : 50,9 por cento a 62,7 por cento ) e risco relativo estimado de 3,49 (IC 95 por cento : 1,90 a 6,43). CONCLUSÕES - O primeiro trimestre de vida se revelou como sendo o período mais crítico, entre os estudados, para o desenvolvimento de sobrepeso ou obesidade no início da idade escolar. No entanto, o escore z do IMC acima de 0,49 aos 12 meses de vida se mostrou como o melhor marcador para esses dois desfechos. / INTRODUCTION - Obesity is a public health concern increasingly important worldwide. Childhood obesity, in turn, has been linked to a high risk of childhood diseases and obesity and chronic diseases in adulthood. It is assumed that the beginning of life is a critical and decisive time for the individuals risk of developing overweight or obese. However, it is not clear whether there is a period of greatest vulnerability at the early stage of postnatal life and which would be the best indicator of the child\'s growth to indicate a possible early intervention that can minimize the risk of overweight and obesity. OBJECTIVE Analyze the relationship between anthropometric parameters of growth in the first year of life and the presence of overweight at early school age. METHODS - A historical cohort study of a basic health unit in São Paulo, Brazil. The moments analyzed were at three, six and twelve months, and seven years old. It was evaluated the growth rate and the growth achieved during the first year of life compared to the outcomes: overweight and obesity at seven years old. The variables were statistically analyzed using Pearson Correlation Coefficient, ROC curves, sensitivity, specificity and relative risks. RESULTS - The Pearson Correlation Coefficients between the ratio of weight gain per height gain in 0-3 months, 0-6 months and 0-12 months were respectively 0.23 (95 per cent CI: 0.13 the 0.33), 0.29 (95 per cent CI: 0.19 to 0.39) and 0.34 (95 per cent CI: 0.24 to 0.43), all statistically significant. The Pearson Correlation Coefficients of body mass index (BMI) z scores for 3, 6 and 12 months were respectively 0.39 (95 per cent CI: 0.29 to 0.48), 0.41 (95 per cent CI: 0.32 to 0.50) and 0.42 (95 per cent CI: .33-.51). For overweight schoolchildren, the use of Z score of BMI at 12 months greater than 0.49 had a sensitivity of 68.29 per cent (95 per cent CI: 59.3 per cent to 76.4 per cent ), specificity of 63.51 per cent (95 per cent CI: 56.6 per cent to 70.0 per cent ) and estimated relative risk of 2.31 (95 per cent CI: 1.69 to 3.17). For obesity, the same marker had a sensitivity of 76.47 per cent (95 per cent CI: 62.5 per cent to 87.2 per cent ), specificity of 56.89 per cent (95 per cent CI: 50.9 per cent to 62.7 per cent ) and estimated relative risk of 3.49 (95 per cent CI: 1.90 to 6.43). CONCLUSIONS - The first three months of life is probably the most crucial period for the development of overweight or obesity at early school age. However, BMI z scores above 0.49 at 12 months of life proved to be the best indicator for these two outcomes.