The purpose of this study was to examine maternal and infant factors associated with body mass index (e.g., maternal weight gain, infant birth weight, infant feeding methods, and motor coordination) among obese pre-adolescents and adolescents aged 8-18 years enrolled in the Pediatric OverWeight Education and Research (POWER) program operated by Riley Hospital for Children in Indianapolis, IN, between October 2008 and September 2011. POWER, a three-phase, 12-month multi-disciplinary program to reduce childhood obesity funded by Indiana University Health, enrolls obese children (Body Mass Index [BMI] greater than the 95th percentile for age and gender) through referrals from pediatricians throughout Indiana. Prior to the child’s initial visit, each family completes a comprehensive background and family history profile, approved by the Indiana University-Purdue University (IUPUI) Institutional Review Board, that includes questions related to the obese child’s motor skill development, infant feeding methods, maternal prenatal weight gain, and infant birth weight. Data related to these four categories collected during Phase 1 (12 weeks) was examined using date from 253 pre-adolescents (8-12 years of age), and 285 adolescents (13-18 years of age), to determine their impact on the subjects’ BMI. No relationship between a mother’s prenatal weight gain and the child’s BMI was seen. There was a significant correlation between infant birth weight and BMI in the pre-adolescent group. Breastfed subjects entered the POWER program at a lower BMI than non-breast fed subjects and had consistently lower BMIs throughout the program compared to the non-breastfed subjects. Differences in physical activity were observed between adolescents and pre-adolescents. Paired analysis indicated the POWER program was associated with a significant reduction in BMI overall, and among both age groups throughout Phase 1 of the program. Adolescents were especially successful in reducing their BMI compared to preadolescents. Further research is needed to identify the association of maternal and infant factors and BMI among obese children. / Department of Family and Consumer Sciences

The purpose of this project was to determine the effects of 6 g of ground cinnamon added to farina (Cream of Wheat) cereal on blood glucose levels between obese and normal weight individuals. Thirty students, aged 19-30 years, were recruited to participate in this study. During study visits, participants were given one of two test meals (74 g of farina with and without 6 g of cinnamon) followed by seven blood glucose measurements over a two-hour period. A significant difference was seen in glycemic response between the two dietary conditions, but not between the two BMI groups (normal and obese). The two BMI groups were combined for analysis of dietary conditions. Ingestion of the cinnamon cereal resulted in significantly lower blood glucose responses at minutes 15, 30, 45 and 60 compared to the plain cereal. The results of this study confirm the positive glucose-lowering effects of cinnamon. / Department of Family and Consumer Sciences

Bakgrund: Förekomsten av övervikt och fetma bland 6 till 16 år gamla svenska barn har ökat i takt med att fysisk inaktivitet har blivit allt vanligare. För att övervinna fetman måste åtgärder göras för att kunna öka den fysiska aktiviteten samt att man måste kunna förstå innerbörden med den. Syfte: Att beskriva vilken betydelse fysisk aktivitet har för svenska pojkar och flickor i grundskoleålder med övervikt och fetma. Metod: Studien genomfördes som en litteraturstudie, där tio artiklar har granskats. Resultaten sammanfattades efter att de mest meningsfulla enheter samlats och teman valts ut utifrån dessa. Resultat: Fysisk aktivitet har flera betydelser för barn med övervikt och fetma. Den fysiska aktiviteten har effekter på barns sovvanor, kondition, insulinkoncentrationer, BMI och syreupptagningsförmåga. Slutsats: Slutsatsen av denna studie var att innehållet i fysisk aktivitet har olika effekter på barns fysiska hälsa. Många av de effekterna har en positiv påverkan på barn med övervikt och fetma. / Background: The prevalence of overweight and obesity among Swedish school children aged 6 to 16 years has increased at the same time as the physical activity levels has decreased. To overcome overweight or obesity actions need to be taken to improve physical activity in Swedish school children. Aim: To describe the significance of physical activity for Swedish school children with overweight and obesity. Method: The study was carried out as a literature study where ten articles were reviewed. The results were summarized after that the most meaningful units had been collected. Then themes were created based on these units. Results: Physical activity has a number of different impacts for children with overweight and obesity. It affects the children’s sleeping habits, fitness, insulin concentrations, BMI and oxygen uptake. Conclusion: The conclusion from this study showed that the performance of physical activity has different effects on Swedish school children's physical health. Many of the effects have a positive influence on these children.

Counselor physical attractiveness has been shown to affect subject perceptions and expectations. One characteristic which is particularly at odds with the attractiveness ideal is obesity. This study examined the potential effect of counselor obesity level on subjects' perceptions, expectations, and willingness to pursue counseling. Two hundred twenty-five students (146 women and 79 men) participated. Each subject rated one of six randomly selected counselor descriptions, including a photograph when appropriate, on the dependent measures (i.e., Counselor Rating Form-Short Version, Personal Problem Inventory, and questions rating physical attractiveness and willingness to pursue counseling). The data were analyzed using 2 (Gender of Counselor) X 3 (Obesity Level: Obese, Nonobese, Control) and 2 (Gender of Counselor) X 3 (Obesity Level) X 2 (Gender of Subject) ANOVA and MANOVA techniques, as appropriate. Male subjects perceived obese counselors to be less expert than did females. No other statistically significant differences based on Counselor Obesity Level were identified. Instead, main effects for both Gender of Counselor and Gender of Subject were obtained. Generally, the woman counselor was rated more positively than the man. Also, women subjects generally gave more positive ratings than did men. While the effects identified were statistically significant, their small effect sizes and small mean differences may limit their practical effect. Obesity level does not appear to affect how counselors are perceived or treated, particularly when they are moderately obese. / Department of Counseling Psychology and Guidance Services

A case study was conducted to examine the discourse of two groups of participants learning about bariatric surgery: those who used a computer software patient education program and those who used more traditional patient-education materials. Participants were interviewed, given a multiple-choice questionnaire, and given a modified Cloze test over the content. The analysis of the interview discourse showed that participants who used the software application were able to recall and produce answers with more details, examples, and specific information than those who used other materials to learn about their surgery. The implications of these findings could indicate that the multimodal nature of the patient education software program may have been able to help mediate the complex medical information. / Access to thesis permanently restricted to Ball State community only. / Department of English

Bakgrund: Övervikt ökar idag bland svenska barn och skolsköterskor inom elevhälsan har en viktig del i arbetet för att få ner barns övervikt.   Syfte: Beskriva skolsköterskors erfarenheter av hälsofrämjande arbete med övervikt hos elever i högstadiet och gymnasiet. Metod: Nio skolsköterskor har intervjuats individuellt med hjälp av semistrukturerade intervjuer. Intervjuerna analyserades utifrån en innehållsanalys. Kategorier och subkategorier utformades sedan för att få en överblick av skolsköterskornas erfarenheter. Resultat: Skolsköterskorna möter vanligtvis eleverna vid hälsosamtalet och detta samtal är ofta grunden till hälsoarbetet när de har identifierat övervikt hos eleven. Skolsköterskorna eftersträvar att individualisera hjälpen eleverna får och de använder sig ofta av metoden motiverande samtal för att motivera eleverna till att genomföra en förändring.  De utgör även en rådgivande funktion då de kan bistå med olika kost- och motionsråd.  Skolsköterskorna förklarar att det även behövs ett samarbete för att få eleverna att bli aktiva och gå ner i vikt. Dels inom den egna professionen men framförallt interprofessionellt samarbete i skolmiljön. Föräldrarna involveras i detta arbete av några skolsköterskor samtidigt som andra anser att eleven måste få känna sig självständig i detta arbete. Konklusion: Skolsköterskornas arbetssätt har både likheter och skillnader. Att utveckla gemensamma strategier och riktlinjer för deras arbete kan därför vara en del av att förbättra det hälsofrämjande arbetet med övervikt hos elever. / Background: Overweight increases among Swedish children and school nurses have an important part to reduce overweight among children. Aim: Describe school nurses experiences of their health promotion for overweight in students. Method: Nine school nurses were interviewed individually by semi-structured interviews. The interviews were analyzed based on a content analysis, categories and subcategories were designed to provide an overview of the school nurses experiences. Results: School nurses usually meet students during a health conversation, this meeting is usually the foundation of their health work. The school nurses strive to individualize the support they give the students and they often use the method of motivational interviewing to motivate students to make a change. They can also assist with various diet and exercise advice. The school nurses explain that there is often a need for collaboration in order to get students to become active and lose weight. Both within their own profession but especially inter professional collaboration in the school environment. The parents get involved in this work by some of the school nurses while others believe that the student needs to feel independent. Conclusion: This study thus suggests both differences and similarities in health promotion for overweight among student. To develop a united strategy and guidelines for their work can therefore be a part of the improvement of their health promotion against overweight among students.

Various research studies have indicated that the prevalence of overweight and obesity among children and adolescents has increased worldwide and has, therefore, become a serious health problem. Besides the various health implications of childhood obesity, it can also have psychological consequences for these children and they have a greater risk than a normal weight child to suffer from poor self perception. The effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure, physical activity levels and self perception of 9 to 12 year old overweight and obese children is, however, not clear. The aim of the study was firstly to determine the effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure and physical activity levels of 9 to 12 year old overweight and obese children. Secondly, to determine the effect of such an intervention on the self perception, and more specifically athletic and physical self perception of these children. An availability sample of 20 overweight and obese subjects (13 girls and 7 boys) between the ages of 9 and 12 years with a mean age of 11 years, participated in a 13 week (3 times/week) multidisciplinary intervention programme. Actical® monitors were used to monitor energy expenditure as well as physical activity levels during 2 weekdays and 1 weekend day before and after the intervention programme. From the results, analyzed by means of t-testing and linear regression, it is apparent that the total energy expenditure of the group, when adjusted for the effect of the intervention, showed a significant increase (p < 0.05) and body fat percentage as well as waist and upper arm circumferences decreased significantly. Although not significant, a decrease of 2,9 kg in body mass and 2,00 kg.rh" in body mass index were also indicated. However, the moderate and high intensity physical activity levels of the groups decreased significantly after the intervention programme. A possible reason for this decrease can be ascribed to the fact that the post-test took place during the school holidays. Further analysis of the data also indicated that the group slept longer hours, which increased their hours spent in the sedentary activity zone. The group also spent more time during the day watching television which also contributed to a decrease in the percentage of time spent in the moderate intensity zone. It is, however, concluded that increased total energy expenditure alone could not bring about effective weight loss and must, therefore, be accompanied by activity in the moderate and high intensity zones. For the purpose of the second aim, twenty children (13 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, participated in a 13 week multidisciplinary intervention programme (3 times per week). Eighteen children (11 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, served as a control group. Self perception, which consisted of 6 subcomponents, was determined by using the Harter Scale for Self Perception (Harter, 1985). It is clear from the results of the t-test (p < 0.05) that all subcomponents of self perception of the experimental group, especially physical, athletic and global self perception, increased significantly in relation to the control group which remained the same in all the subcomponents (p > 0.05), while a decrease in their social self perception was noted (p < 0.05). The experimental and control group did not differ significantly before the intervention programme, therefore the significant differences with regard to the subcomponents during the post-test, confirm the effect of the programme. On the basis of the abovementioned results the assumption can be made that a multidisciplinary intervention programme holds various benefits for overweight and obese children and is, therefore, another strategy in the prevention of overweight and obesity in children in South Africa. A multidisciplinary intervention programme, as used in this programme, is not only advantageous for weight loss in overweight and obese children, but also significantly improves their self perception. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2010.

Various research studies have indicated that the prevalence of overweight and obesity among children and adolescents has increased worldwide and has, therefore, become a serious health problem. Besides the various health implications of childhood obesity, it can also have psychological consequences for these children and they have a greater risk than a normal weight child to suffer from poor self perception. The effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure, physical activity levels and self perception of 9 to 12 year old overweight and obese children is, however, not clear. The aim of the study was firstly to determine the effect of a physical activity, diet and behaviour modification intervention on the total energy expenditure and physical activity levels of 9 to 12 year old overweight and obese children. Secondly, to determine the effect of such an intervention on the self perception, and more specifically athletic and physical self perception of these children. An availability sample of 20 overweight and obese subjects (13 girls and 7 boys) between the ages of 9 and 12 years with a mean age of 11 years, participated in a 13 week (3 times/week) multidisciplinary intervention programme. Actical® monitors were used to monitor energy expenditure as well as physical activity levels during 2 weekdays and 1 weekend day before and after the intervention programme. From the results, analyzed by means of t-testing and linear regression, it is apparent that the total energy expenditure of the group, when adjusted for the effect of the intervention, showed a significant increase (p < 0.05) and body fat percentage as well as waist and upper arm circumferences decreased significantly. Although not significant, a decrease of 2,9 kg in body mass and 2,00 kg.rh" in body mass index were also indicated. However, the moderate and high intensity physical activity levels of the groups decreased significantly after the intervention programme. A possible reason for this decrease can be ascribed to the fact that the post-test took place during the school holidays. Further analysis of the data also indicated that the group slept longer hours, which increased their hours spent in the sedentary activity zone. The group also spent more time during the day watching television which also contributed to a decrease in the percentage of time spent in the moderate intensity zone. It is, however, concluded that increased total energy expenditure alone could not bring about effective weight loss and must, therefore, be accompanied by activity in the moderate and high intensity zones. For the purpose of the second aim, twenty children (13 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, participated in a 13 week multidisciplinary intervention programme (3 times per week). Eighteen children (11 girls and 7 boys) between the ages of 9 and 12 years, with a mean age of 11 years, served as a control group. Self perception, which consisted of 6 subcomponents, was determined by using the Harter Scale for Self Perception (Harter, 1985). It is clear from the results of the t-test (p < 0.05) that all subcomponents of self perception of the experimental group, especially physical, athletic and global self perception, increased significantly in relation to the control group which remained the same in all the subcomponents (p > 0.05), while a decrease in their social self perception was noted (p < 0.05). The experimental and control group did not differ significantly before the intervention programme, therefore the significant differences with regard to the subcomponents during the post-test, confirm the effect of the programme. On the basis of the abovementioned results the assumption can be made that a multidisciplinary intervention programme holds various benefits for overweight and obese children and is, therefore, another strategy in the prevention of overweight and obesity in children in South Africa. A multidisciplinary intervention programme, as used in this programme, is not only advantageous for weight loss in overweight and obese children, but also significantly improves their self perception. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2010.