O aumento da prevalência do sobrepeso e da obesidade tem se revelado um problema de saúde pública mundial. O desenvolvimento da obesidade envolve múltiplos fatores, como padrão de atividade física, padrão de alimentação, variáveis sociais e ambientais, fatores biológicos e genéticos. O objetivo deste estudo, que está aninhado no Projeto de Pesquisa OBEDIARP, foi avaliar a prevalência do sobrepeso e da obesidade na população adulta residente no município de Ribeirão Preto, estado de São Paulo, no ano de 2006 e estimá-la segundo variáveis sóciodemográficas, padrão de atividade física, padrão alimentar e saúde auto-referida. O estudo teve um delineamento transversal e foi desenvolvido no período de março de 2006 a junho de 2009. O processo de amostragem foi desenvolvido em três estágios, sendo o setor censitário a unidade primária de amostragem. Utilizou-se amostra ponderada de 2197 participantes. As variáveis do estudo foram: estado nutricional, sexo, idade, nível educacional, padrão de atividade física, tempo sentado, escores de freqüência de consumo de alimentos e auto-percepção do estado de saúde. A coleta dos dados ocorreu mediante a aplicação de entrevistas estruturadas que foram aplicadas nos domicílios dos elegíveis por uma equipe de entrevistadores previamente treinada. A taxa de resposta foi de 78%. Médias e proporções foram estimadas por pontos e por intervalos, com 95% de confiança. Para a avaliação de associações globais utilizou-se a estatística \"F\", adotando-se nível de significância de 5%. Para avaliar as relações entre o Índice de Massa Corporal e variáveis relacionadas ao padrão alimentar, ao gasto metabólico em atividade física e ao tempo sentado, utilizou-se modelo de regressão linear, adotando-se nível de significância de 5%. Todas as análises foram desenvolvidas no software STATA para Windows, versão 8.2. As estimativas levaram em consideração o efeito de desenho. Do total dos participantes do estudo 69.96% eram do sexo feminino e 30.04% do sexo masculino, com média de idade de 48.52 anos. A prevalência do excesso de peso encontrada foi de 64.65%, sendo que 39,23% foram classificados como pré-obesos e 25.42% como obesos. Os indivíduos classificados como insuficientemente ativos foram 66.29% da amostra. As variáveis sexo, faixa etária, escolaridade, estado de saúde auto-referida e estado de saúde comparado aos amigos apresentaram associação com o estado nutricional. Foi possível identificar que o consumo de alimentos de alta densidade energética e a média diária de tempo sentado estiveram positivamente associados ao índice de massa corporal, embora apenas em alguns estratos das variáveis sóciodemográficas. Conclui-se que a elevada prevalência de excesso de peso e de inatividade física na população adulta de Ribeirão Preto, apontam para a necessidade de implementação de medidas específicas de promoção e prevenção em saúde. / The increased prevalence of overweight and obesity has revealed to be a global public health problem. The development of obesity involves multiple factors, such as physical activity pattern, eating pattern, social and environmental variables, biological and genetic factors This study, part of the OBEDIARP Research Project, aimed to assess the prevalence of overweight and obesity in the adult population living in Ribeirão Preto, a city in the state of São Paulo, Brazil in 2006 and to estimate it according to socio-demographic variables, physical activity pattern, eating pattern and self-referred health. The research, with a cross-sectional design, was developed between March 2006 and June 2009. The sampling process was developed in three stages, with the census sector serving as the primary sampling unit. A weighted sample of 2197 participants was used. The study variables were: nutritional state, gender, age, education level, physical activity pattern, sitting time, food consumption frequency scores and self-perception of health state. Data were collected through structured interviews, held at the eligible participants\' homes by a previously trained team of interviewers. The response rate was 78%. Means and proportions were estimated by points and intervals, at a 95% confidence level. \"F\" statistics were used to assess global associations, adopting a 5% significance level. To assess the relations between Body Mass Index and food pattern-related variables, metabolic rate in physical activity and sitting time, a linear regression model was used, adopting a 5% significance level. All analyses were developed in STATA for Windows software, version 8.2. The effect of design was taken into account in all estimates. Of all study participants, 69.96% were women and 30.04% men, with a mean age of 48.52 years. The prevalence rate of overweight was 64.65%, with 39.23% classified as pre-obese and 25.42% as obese. Individuals classified as insufficiently active corresponded to 66.29% of the sample. The variables gender, age range, education level, self-referred health state and health state compared to friends were associated with the nutritional state. It could be identified that consumption of high-energy foods and mean daily sitting time were positively associated with the body mass index, although in some socio-demographic layers only. It is concluded that the high prevalence of overweight and physical inactivity in the adult population of Ribeirão Preto point towards the need for specific health promotion and prevention measures.

The study of circulating biomarkers and their association with disease outcomes has become progressively complex due to advances in the measurement of these biomarkers through multiplex technologies. Although the availability of numerous serum biomarkers is highly promising, multiplex assays present statistical challenges due to the high dimensionality of these data. In this dissertation, three studies are presented that address these challenges using L1 penalized regression methods. In the first part of the dissertation, an extensive simulation study is performed for the logistic regression model that compares the Least Absolute Shrinkage and Selection Operator (LASSO) method with five LASSO-type methods given scenarios that are present in serum biomarker research, such as high correlation between biomarkers, weak associations with the outcome, and sparse number of true signals. Results show that choice of optimal LASSO-type method is dependent on data structure and should be guided by the research objective. Methods are then applied to the Tucson Epidemiological Study of Airway Obstructive Disease (TESAOD) study for the identification of serum biomarkers of overweight and obesity. Measurement of serum biomarkers using multiplex technologies may be more variable as compared to traditional single biomarker methods. Measurement error may induce bias in parameter estimation and complicate the variable selection process. In the second part of the dissertation, an existing measurement error correction method for penalized linear regression with L1 penalty has been adapted to accommodate validation data on a randomly selected subset of the study sample. A simulation study and analysis of TESAOD data demonstrate that the proposed approach improves variable selection and reduces bias in parameter estimation for validation data as small as 10 percent of the study sample. In the third part of the dissertation, a measurement error correction method that utilizes validation data is proposed for the penalized logistic regression model with the L1 penalty. A simulation study and analysis of TESAOD data are used to evaluate the proposed method. Results show an improvement in variable selection.

Master of Science / Department of Human Nutrition / Mark D. Haub / BACKGROUND: Dietary supplements are increasing in popularity; individuals are looking beyond traditional methods of calorie restriction and exercise to improve health. Calcium is a critical nutrient for bone metabolism that has also been shown to enhance weight loss effects secondary to diet. PURPOSE: To determine whether eight months of calcium supplementation, in a liquid, shelf-stable form, increases bone mineral density or decreases body weight and/or body fat in free-living young adult women. METHODS: Volunteer subjects (n=42) were randomly assigned to a supplement group receiving 1,125 mg Ca2+/day (CA-BEV) or to a free-living control group (CON), which did not receive the supplement. At baseline and after the 8-month intervention (POST), dietary intake was assessed using 3-day diet records. Total body composition (body fat percentage, %FatTB; abdominal percentage fat, %FatAb; fat mass, FM; non-bone fat-free mass, FFM) and bone mineral density (lumbar spine and femoral neck; BMD) were measured via dual energy x-ray absorptiometry. Subjects also completed a sub-maximal treadmill exercise test to estimate respiratory fitness at baseline and POST. RESULTS: At POST, the CA-BEV group's calcium intake (1,868[plus or minus]941 mg/d) was significantly greater than (p<0.05) the CON group (867[plus or minus]405 mg/d) and the calcium:protein ratio of the CA-BEV group (29.5[plus or minus]17.1 mg/g) was greater than (p<0.05) the CON group (12.9 ±6.2 mg/g). Those differences in calcium did not lead to predicted differences (p<0.05) between groups for BMD, body weight, %FatTB, %FatAB, FM or FFM. CONCLUSION: Our findings do not support the hypothesis that increasing calcium intake increases BMD or decreases body weight or body fat in healthy young women over an 8-month period despite a nearly two-fold increase in calcium intake.

>Magister Scientiae - MSc / Being overweight or obese are major factors contributing to the increased morbidity and mortality due to non-communicable diseases such as type 2 diabetes, cardiovascular disease and cancer. The treatment of obesity with pharmaceutical drugs is plagued by side effects. Plants and their phytochemicals possess a number of beneficial health effects including anti-oxidant,anti-mutagenic, anti-inflammatory, anti-obesity and anti-cancer effects, mediated by activation of the adenosine monophosphate protein kinase (AMPK).AMPK controls many metabolic processes including glucose uptake and utilisation, and adipogenesis, and is often referred to as the master regulator establishing cellular homeostasis.Cyclopia maculata, commonly known as honeybush, is an indigenous South Africa plant possessing anti-oxidant, anti-inflammatory and anti-cancer properties. Recently, others in our laboratory have shown that a hot water extract of fermented C. maculata inhibits adipocyte differentiation in 3T3-L1 pre-adipocytes, with some evidence of weight regulatory properties in a Wistar rat model of diet-induced obesity. In the rat study, 21 day old weanlings were fed a high fat, high sugar cafeteria diet for 3 months with (n=10) or without (n=10) C. maculata supplementation. This group of rats was referred to as the lean group (n=20). Another group of rats were fed a cafeteria diet for 4 months to induce obesity (obese group, n=20) and thereafter treated as described for the lean rats. The aim of this MSc study was to determine whether C. maculata induces AMPK activation.Proteins were extracted from the liver and muscle tissue of lean and obese Wistar rats using an optimized extraction method with a commercial lysis buffer and the TissueLyser.Treatment with the C. maculata extract had no effect on the protein yield in lean and obese rats. Interestingly, the protein yield in the liver of obese rats was significantly higher than that observed in lean rats. Although C. maculata treatment slightly increased AMPK activation (calculated as the ratio of phosphorylated AMPK to total AMPK) in the liver of lean and obese rats, the difference was not statistical significant. Conversely, C.maculata treatment decreased AMPK activity in muscle of lean and obese rats, with statistical significance observed in the lean group only (2.3-fold, p<0.05). Differences in AMPK activation between the groups were also noted, a 1.3-fold decreased activity observed in obese groups compared to their lean counterparts, although this was not statistically significant. Expression of PPARα, a downstream protein target affected by AMPK activation was reduced in the liver of lean and obese rats after C. maculata treatment. Moreover, PPARα expression was significantly higher in obese compared to lean rats (2.7-fold, p<0.001). PPARα is a transcription factor mediating fat metabolism (β-oxidation) and its expression is induced by circulating free fatty acids, which are increased in obese compared to lean rats. The expression of PPARα in muscle was too low for Western blot analysis and quantification.Cyclopia maculata treatment did not affect hepatic expression of UCP2, another protein important in establishing energy homeostasis. The expression of UCP2 was 2.9-fold higher in the liver of obese rats compared to their lean counterparts, although the difference was not statistically significant. The opposite results were observed in the muscle where C. maculata treatment decreased UCP2 expression in lean rats (2.8-fold,p<0.0001), and UCP2 expression was decreased 1.4-fold in obese rats compared to lean rats, although the difference was not statistically significant.ELISA results for AMPK activation revealed that C. maculata treatment increased AMPK activity, although not statistically significant. Histological analysis of retroperitoneal fat showed that C. maculata did not affect adipocyte size and number, although a slight decrease in adipocyte size was observed after treatment .This study has demonstrated that treatment of the cafeteria diet fed Wistar rats with 300 mg/kg of a hot water extract of fermented C. maculata does activate AMPK. This study revealed important differences between lean and obese rats. In particular, increased hepatic protein content, PPARα and UCP2 expression was observed in obese rats compared to the lean group. This suggests an adaptive response to the increased circulating free fatty acids during obesity and an increase in β-oxidation in these animals.

The purpose of this study was two-fold: (a) to identify, in a large representative sample of Canadian children, the age-related trajectories of overweight and obesity from toddlerhood into childhood and (b) to investigate the associations between these trajectories and children’s temperaments, their parents’ parenting practices and their interactions. Potentially important familial characteristics (i.e., the parents’ or surrogates’ age, income level, and educational attainment) were considered in the models. The sample for this study was drawn from the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Group-based mixture modeling analyses were conducted to identify the number and types of distinct trajectories in the development of obesity (i.e., to explicate the developmental processes in the variability of childhood obesity) in a representative sample of children who were between 24 to 35 months of age, at baseline, and followed biennially over a 6-year span. Discriminant analysis was conducted to assess the theoretical notion of goodness-of-fit between parenting practices and children’s temperament, and their association with membership in the BMI trajectory groups. The results of the group-based modeling established three different BMI trajectories for the boys, namely: stable-normal BMI, transient-high BMI, and j-curve obesity. The analyses revealed four different trajectories of BMI change for the girls: stable-normal BMI, early-declining BMI, late-declining BMI, and accelerating rise to obesity. The multivariate analysis revealed that the combined predictors of the obesity trajectories of the girls (group membership) included having a fussy temperament, ineffective parenting, and parents’ educational attainment. Predictors of the boys’ obesity trajectory (group membership) included household income, parental education, and effective parenting practices. Understanding the different ways in which a child may develop obesity will allow nurses and other health professionals to take different approaches in the assessment, intervention and evaluation of obesity and obesity-related health problems. The results of this study further our understanding of factors associated with the development of obesity at a young age and hence may inform the development of early preventive programs. / Applied Science, Faculty of / Nursing, School of / Graduate

For many women, body weight is a health concern both in relation to physical health and to social and psychological health. Both overweight and underweight are associated with increased risks to health. Furthermore, the literature largely supports the view that sociological and psychological factors influence a woman's perception of weight and body image. In the Western world, weight loss efforts among women are high, and even those who are within or below the healthy weight range are trying to lose weight. Relatively little is known about weight loss efforts among Yukon women.. Moreover, it is not known whether societal pressures surrounding weight are similar in the Yukon and the rest of Canada. For reasons related mainly to its northern geographical location and culture, and because of the health implications related to women's weight issues, this study was conducted to determine the prevalence of Yukon women trying to lose weight; to determine the weight loss practices of Yukon women; and to compare the characteristics of women who are trying to lose weight vs. those who are not; women who are satisfied with their weight vs. those who are not; and women who are at health risk due to overweight or underweight vs. those with healthy weights. Data for a representative sample of non-pregnant, non-institutionalized women > 15 years of age (n=711) were obtained from the population-based 1993 Yukon Health Promotion Survey. Those living in the census unorganized portions of the Yukon were not included in the sample. The prevalence of weight loss efforts in the Yukon (51.8%) was higher than the published value for women in the rest of Canada (39%). Among Yukon women with body mass index (BMI) values classified as overweight, possible overweight, healthy weight, and underweight, 80%, 67%, 46%, and 9%, respectively, were trying to lose weight. The corresponding values for the rest of Canada are lower. The most frequent weight loss practices were dieting (35.8%), changing diet and exercise (26.1%), and sensible eating (17.2%). Compared to women not trying to lose weight, women trying to lose weight were younger (35.8 ± 13.2 vs 38.6 ± 15.0 yr, P<0.01), were more likely to be employed (71.6% vs 64%, P<0.05), had higher BMI values (25.7 ± 4.1 vs 22.3 ± 3.9 kg/m2, P<0.0001), and were more likely to be dissatisfied with their current weight (88.5% vs 35.6%, P<0.0001). Both groups reported similar food consumption and activity patterns, yet women trying to lose weight had more positive nutrition behaviours and health knowledge. The mean eating knowledge index (EKI) score was significantly higher (2.36 ± 2.89) for women trying to lose weight than for women not trying to lose weight (1.75 ± 3.44). Similarly, the mean eating behaviour index (EBI) score was higher (4.19 ± 3.83 vs. 3.46 ± 4.94, respectively). Weight loss efforts did not appear to be related to the Yukon environment since neither First Nations status nor length of residence in the Yukon varied for women trying to lose weight and women not trying to lose weight. Yukon women who were overweight were less likely to live in Whitehorse, were older, were more likely to be poor, and were less likely to engage in vigorous physical activity three or more times per week compared to those with healthy weights; however, their food consumption patterns and nutrition knowledge and behaviour scores did not differ. Overweight women expressed less satisfaction with their quality of life and with their physical health and social relationships. Yukon women who were underweight were more likely to be poor and to find it difficult to afford the basic necessities and less likely to indicate they were eating well enough to maintain good health compared to healthy weight women. Both groups had similar activity patterns and food consumption patterns; yet, underweight women had lower scores for nutrition knowledge and behaviour (EKI: 1.03 ± 2.97 vs. 2.38 ± 3.24; EBI: 2.68 ± 4.71 vs. 4.07 i 4.51). Underweight women and healthy weight women rated their quality of life similarly. Based on this study, it appears that many Yukon women, regardless of weight status, are engaging in weight loss efforts. Furthermore, the goal of losing weight, rather than relative weight status, seems to be an important motive for healthy eating and for seeking health knowledge. Being physically active in the Yukon appears to be influenced by time of year and other barriers. Self-ratings of health were associated with engaging in weight loss efforts and with relative weight status. Overall, the findings of this study suggest that weight loss efforts of Yukon women are similar to those of the dominant Western society. In view of the findings of this study, health promotion messages should incorporate healthy eating, regular physical activity, and the concept of healthy weight and positive body image to deter weight loss efforts among women who do not need to lose weight. Tailored approaches which consider the different characteristics of the groups in this study may prove to be useful. / Land and Food Systems, Faculty of / Graduate

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-15T11:34:31Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESEFINALCORRIGIDA.pdf: 1731965 bytes, checksum: 0c2655bd764a7c13ce7735e4f93f9fd5 (MD5) / Made available in DSpace on 2016-04-15T11:34:31Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESEFINALCORRIGIDA.pdf: 1731965 bytes, checksum: 0c2655bd764a7c13ce7735e4f93f9fd5 (MD5) Previous issue date: 2015-02-02 / CNPq / A doença cardiovascular (DCV), em especial a sua apresentação como doença arterial coronariana, permanece como grande causa de morte e de incapacidade no Brasil e no mundo, determinando um impacto médico-social e econômico de elevada magnitude. Existem várias evidências sobre a forte correlação entre a presença e extensão de DCV aterosclerótica e a ocorrência de seus fatores de risco já em estágios iniciais da vida. Essa Tese tem como objetivos analisar a evolução das dislipidemias, do excesso de peso e de outros fatores de risco cardiovascular em uma coorte de adolescentes; além de identificar o poder preditivo do indicador circunferência da cintura/altura (CC/Alt) e estabelecer seus pontos de corte como discriminador de alterações lipídicas em jovens. O procedimento metodológico compreendeu um estudo de acompanhamento longitudinal e outro transversal. O primeiro, uma coorte prospectiva, foi realizado em 2 etapas: uma em 2007 e a segunda após o seguimento de 5 anos; sendo a população composta por 253 estudantes entre 10 e 18 anos. Foram avaliados os seguintes fatores de risco cardiovascular: excesso de peso, obesidade abdominal, dislipidemias, sedentarismo, tempo gasto com atividades sedentárias, hábito alimentar e uso de tabaco. O segundo estudo foi realizado nos anos de 2012/13, com 666 adolescentes (12 a 18 anos) de escolas públicas do Recife. Nessa etapa foram coletadas medidas de circunferência da cintura, altura e análise das frações lipídicas. Foi utilizada a curva Receiver Operating Characteristic para verificação do índice CC/Alt como preditor do perfil lipídico alterado. A análise estatística dos estudos foi realizada no programa SPSS e adotou-se o valor de p <0,05 para significância. Os resultados mostraram: um percentual de dislipidemia ainda elevado (65,3% vs 72,1); um aumento da obesidade abdominal (3,3% vs 15,8%); redução no sedentarismo (81% vs 64%); e uma elevada prevalência de adolescentes com hábito alimentar inadequado na linha de base do estudo (66,3% consumo moderado/alto de alimentos de risco cardiovascular e 66,4% com baixo/moderado consumo de alimentos protetores para doenças cardiovasculares). No trabalho transversal, os resultados indicaram que as áreas sobre a curva para todas as variáveis lipídicas apresentaram significância estatística, nos adolescentes do sexo masculino; e entre os adolescentes do sexo feminino, o índice apenas não apresentou poder discriminatório para as frações CT e LDL-c . Os pontos de corte de 0,40 a 0,43 foram os que apresentaram um equilíbrio mais adequado entre os valores de sensibilidade e especificidade, em ambos os sexos. Os dados encontrados apontam elevada prevalência dos fatores de risco cardiovasculares na população jovem e mostra que esse cenário não apresentou uma evolução favorável; e sugere o uso da razão CC/Alt na triagem de dislipidemias da população juvenil. Aconselha-se também a adoção de estratégias de prevenção que promovam um estilo de vida saudável, além da necessidade de implantação de medidas de saúde que intervenham no perfil identificado; reduzindo assim a ocorrência de futuros problemas cardiovasculares. / Cardiovascular disease (CVD), and in special its presentation as a coronary artery disease, still represents a high cause of death and disability in Brazil and around the world, therefore promoting significant economic and social-medical impact. There is abundant evidence about the strong correlation between the presence and the extension of atherosclerotic CVD, and the occurrence of its risk factors in the early stages of life. This Dissertation aims to review the evolution of dyslipidemia, overweight and other cardiovascular risk factors in a cohort of adolescents and identify the predictive power of the waist circumference/height ratio (WHtR) indicator and establish its cutoff points as discriminators of lipid alterations in adolescents. The methodological procedure included a longitudinal follow-up study, and a transversal study. The first study – the prospective cohort – was conducted in two stages: one in 2007, and another one after a five-year follow-up period. The studied population included 253 students from 10 to 18 years of age. The following cardiovascular risk factors were evaluated: overweight, abdominal obesity, dyslipidemia, sedentary lifestyle, time spent in sedentary activities, dietary habits and smoking. The second study was conducted in the years 2012/13, and included 666 adolescents (from 12 to 18 years of age) of public schools in Recife. At this stage, the waist circumferences and the heights were measured, and the lipid fractions were analyzed. The Receiver Operating Characteristic curve was used to verify the WHtR index as a predictor of altered lipid profiles. The statistical analysis of the studies was done using the SPSS software and the value of p <0.05 was adopted for significance purposes. The results showed the following: a still high percentage of dyslipidemia; an increased abdominal obesity (3.3% versus 15.8%); a decline in sedentary lifestyle levels (81% versus 64%); a high prevalence of adolescents with inadequate dietary habits in the baseline of the study (66.3% with moderate/high consumption of cardiovascular risk food, and 66.4% with low/moderate consumption of protective food against cardiovascular disease). In the transversal study, the results show that the areas under the curve for all lipid variables have statistical significance (p<0.05) in male adolescents and, for female adolescents, the index did not show a discriminatory power only for TC and LDL-c. Cutoff points from 0.40 to 0.43 offered a more appropriate balance between the sensitivity and specificity values for both genders. The data found in the study point at a high prevalence of cardiovascular risk factors in the young population, and show that this scenario did not evolve favorably. It also suggests the use of WHtR in the screening of dyslipidemia in the juvenile population. The adoption of prevention strategies to promote a healthy lifestyle is also advised. It is also necessary to deploy health measures that may intervene in the identified profile, thus reducing the occurrence of future cardiovascular problems.

Issues of body image and ability to achieve intimacy are connected to body weight, yet remain largely unexplored and have not been evaluated by gender. The underlying purpose of this research was to determine if avoidant attitudes and perceptions of one’s body may hold implications toward its use in intimate interactions, and if an above average body weight would tend to increase this avoidance. The National Health and Nutrition Examination Survey (NHANES, 1999-2002) finds that 64.5% of US adults are overweight, with 61.9% of women and 67.2% of men. The increasing prevalence of overweight and obesity in men and women shows no reverse trend, nor have prevention and treatment proven effective in the long term. The researcher gathered self-reported age, gender, height and weight data from 55 male and 58 female subjects (determined by a prospective power analysis with a desired medium effect size (r =.30) to determine body mass index (BMI), determining a mean age of 21.6 years and mean BMI of 25.6. Survey instruments consisted of two scales that are germane to the variables being examined. They were (1) Descutner and Thelen of the University of Missouri’s (1991) Fear-of-Intimacy scale and (2) Rosen, Srebnik, Saltzberg, and Wendt’s (1991) Body Image Avoidance Questionnaire. Results indicated that as body mass index increases, fear of intimacy increases (p<0.05) and that as body mass index increases, body image avoidance increases (p<0.05). The relationship that as body image avoidance increases, fear of intimacy increases was not supported, but approached significance at (p<0.07). No differences in these relationships were determined between gender groups. For age, the only observed relationship was that of a difference between scores for age groups [18 to 22 (group 1) and ages 23 to 34 (group 2)] for the relationship of body image avoidance and fear of intimacy (p<0.02). The results suggest that the relationship of body image avoidance and fear of intimacy, as well as age, bear consideration toward the escalating prevalence of overweight and obesity. An integrative approach to body weight that addresses issues of body image and intimacy may prove effective in prevention and treatment.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-13T12:50:13Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Influência da prática educativa parental na alimentação e do ambiente obesogênico no excesso de peso na.pdf: 1847504 bytes, checksum: 3d712ae6e75aedfaa4d686b7f0d0e0d0 (MD5) / Made available in DSpace on 2017-07-13T12:50:13Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Influência da prática educativa parental na alimentação e do ambiente obesogênico no excesso de peso na.pdf: 1847504 bytes, checksum: 3d712ae6e75aedfaa4d686b7f0d0e0d0 (MD5) Previous issue date: 2016-05-31 / O ambiente obesogênico consiste em uma relação ambiental favorecedora ao desenvolvimento e/ou manutenção da obesidade. Práticas educativas parentais relacionadas a alimentação são estratégias utilizadas para incentivar a adesão de comportamentos alimentares considerados adequados. Diante da crescente ocorrência do sobrepeso em crianças delineamos um estudo cujo objetivo foi avaliar a associação das práticas educativas parentais relacionadas à alimentação e do ambiente obesogênico com a ocorrência do excesso de peso em crianças na idade escolar. Trata-se de um estudo caso-controle realizado com uma amostra de 222 pares de crianças/mães, 74 crianças com excesso de peso e 148 eutróficas, com idade entre 6 e 10 anos. O desfecho consistiu do estado nutricional, definindo-se como “caso” as crianças com excesso de peso (IMC/Idade e sexo ≥ 2 escores-z) e “controle” as eutróficas (IMC/Idade e sexo > -1 escore-z e < 1 escore-z). Como variáveis independentes avaliamos as características ambientais obesogênicas e as práticas educativas parentais na alimentação, e como co-variáveis os fatores socioeconômicos familiares, biológicas da criança (sexo e peso ao nascer) e da mãe (índice de massa corporal) e a época de introdução de líquidos nos primeiros meses de vida. Observamos uma chance significantemente maior de excesso de peso nas crianças quando o entorno da residência era desprovido de ambiente destinado a práticas esportivas (como quadras e praças), em ambientes que propiciavam menor gasto de energia em atividades de vida diárias, quando a exposição a telas (televisão, computador ou videogame) ultrapassava 3h/dia. A chance de apresentar excesso de peso também foi detectada em famílias com práticas educativas alimentares restritivas, pouca pressão para comer e elevada monitoração dos alimentos consumidos. Observamos resultados similares nas crianças cujo peso ao nascer foi ≥3500g, tiveram a introdução de líquidos em torno de 3 a 4 meses de vida e cujas mães tinham IMC ≥ 25,0 kg/m2. Concluímos que o ambiente obesogênico, bem como as práticas educativas parentais relacionadas à alimentação, tem influência positiva com o excesso de peso infantil. Intervenções para prevenção e tratamento deste transtorno nutricional devem mobilizar diversos setores e atores sociais para obtenção de resultados positivos. / The obesogenic environment consists of an environment that favors the development and/or maintenance of obesity. Parental feeding practices are strategies to encourage membership of appropriate eating behaviors. Given the increasing occurrence of overweight in children we outlined a study that aimed to assess the association between parental feeding practices and obesogenic environment with the occurrence of overweight in children at school age. This is a case-control study conducted with a sample of 222 children/mothers pairs, 74 overweight children and 148 normal weight, aged 6 to 10 years. The outcome was the nutritional status, being defined as "case" the overweight children (BMI/Age and sex ≥ 2 z-scores) and "control" the normal weight (BMI/Age and sex >-1 z-score and <1 z-score). As independent variables we evaluated obesogenic environmental characteristics and parenting feeding practices, and as covariates family socioeconomic factors, biological of the child (sex and birthweight) and of the mother (body mass index), as well as the period liquids were introduced during the first months of life. We observed a significantly higher chance of child overweight when there was a lack of facilities for sporting practices in the surroundings of the residence (such as sports courts and squares). The same was found when the environment provided lower energy expenditure in daily life activities and the exposure to screens (TV, computer or video game) exceeded 3h/day. The restrictive parental feeding practices, little pressure to eat and high monitoring of food intake increased the chances of overweight. We observed similar results in children whose birthweight was ≥3500g; when there was an introduction of liquids around 3 to 4 months of life and among those, whose mothers had BMI ≥ 25kg/m2. We conclude that the obesogenic environment, as well as the parenting feeding practices had a positive influence for childhood overweight. Interventions for preventing and treating this nutritional disorder should mobilize different sectors in the society to obtain positive results.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: To describe and compare attitudes, lifestyle behaviors, and cardiometabolic risk factors between individuals with and without a relative with type 2 diabetes mellitus (T2DM) living in the same household. Methods: A secondary analysis of baseline data from an implementation study in Peru was conducted. The outcomes were attitudes towards changing lifestyle behaviors (e.g. intentions towards losing weight, increasing physical activity, reducing salt consumption, etc), profiles of health lifestyle behaviors (e.g. daily smoking, heavy drinking, and physical activity), and cardiometabolic risk factors (e.g., overweight [body mass index ≥25 kg/m2] and hypertension); whereas the exposure was the presence of at least one relative with known diagnosis of T2DM living in the same household. Multilevel logistic mixed effect regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Results: A total of 2298 records, 1134 (49.4%) males, mean age 43.3 (SD: 17.2) years, were analyzed. There was no evidence of a difference in lifestyle-changing attitudes, smoking, alcohol drinking, physical activity levels, and hypertension between individuals with and without relatives with T2DM. Overweight was 63% more common among individuals having a relative with a T2DM in multivariable model (OR = 1.63; 95% CI: 1.03–2.61). Conclusions: Individuals with relatives with T2DM have higher probabilities of being overweight compared to those who did not have relatives with T2DM in the same household. The absence of differences on lifestyle-related attitudes and behaviors highlight the need of involving relatives of patients with T2DM on intervention strategies to further enhance diabetes prevention and management efforts. / National Heart, Lung, and Blood Institute / Revisión por pares / Revisión por pares