Prior studies of immigrants to the United States show significant weight gain after 10 years of US residence. Pediatric refugees are a vulnerable population whose post-immigration weight trajectory has not been studied. We examined the longitudinal weight trajectory of 1067 pediatric refugees seen in a single university based refugee health program between the dates of September 3, 2012 and September 3, 2014 to determine how quickly significant weight gain occurs post-arrival. The most recent BMI was abstracted from the electronic health record and charts reviewed to obtain serial BMI measurements in 3 year increments after the date of US arrival. The mean arrival BMI percentile for all refugees was 47th percentile. This increased significantly to the 63rd percentile within 3 years of US arrival (p < 0.01). This rapid increase was largely attributable to African and South and Southeast Asian refugees. The overall prevalence of age and sex adjusted obesity rose from 7.4 % at arrival to 18.3 % within 9 years of US immigration exceeding the pediatric US national obesity prevalence of 16.9 %. Pediatric refugees are at increased risk of rapid weight gain after US immigration. Targeted interventions focused on prevention of weight gain in specific populations are warranted.

Background: Since inmates in Canada are excluded from household statistics, very little information is known about obesity prevalence or associated risks in this vulnerable population. This is a problem since obesity rates are high in Canada, and obesity is considered a public health crisis. Furthermore, the burden of obesity is disproportionately carried by low-income, vulnerable and marginalized populations (such as inmates). The goal of this study was to determine weight changes during incarceration in Canadian federal penitentiaries, and to determine which factors were influential at the socio-demographic, behavioral, institutional and policy level. Methods: This study was a retrospective cohort study that used a quantitative approach. The setting for this study was 12 correctional institutions in Ontario, New Brunswick and Nova Scotia (or the “Atlantic region”). Administrative data were collected from 1420 inmates, with 754 of these participants also participating in a face to face interview to gather additional data on self-reported behavioral determinants and measured anthropometric data. Eligibility criteria for inmates to participate were: a recorded admission weight in their medical chart, housed in their current institution for at least 6 months, not acutely or terminally ill (and requiring hospitalization), and not pregnant or in a wheelchair. Results: We found that almost three quarters of inmates (73%) gained weight during incarceration. Obesity rates increased by 71%, going from 26.6% to 45.4%. The observed weight gain was associated with the tobacco ban (macrosystem level), the use of commissary store (or “canteen”) (at the microsystem level), and many determinants at the individual level (physical activity, diet, smoking status). The observed weight gain was also significantly associated with age, ethnicity, length of incarceration, duration of total sentence and region. It was however not associated with the national menu, food service/feeding system, sleep, screen time, mental health status or psychotropic medication use. Some inmates who gained excessive weight also developed obesity related illnesses. Interpretation: The observed weight gain was deemed to be unhealthy, since obesity rates increased significantly (and the proportion of inmates with normal weight decreased). These findings have potential repercussions on inmate health, since the observed weight gain was associated with the development of obesity related illnesses. Lastly, many of the factors associated with the observed weight gain were modifiable, which means it is possible to intervene to manage weight gain during incarceration.

This study was conducted to determine the change in weight and body composition over a 6-week holiday period. Change in body composition was measured using air displacement plethysmography technology (Bod Pod®). Thirteen men and 21 women ranging in age from 23-61 years were participants for this study. Baseline testing occurred the week of Thanksgiving Day (November 24 or 25), and the post-holiday assessment was the week after Utah State University's holiday break (January 5 or 6). Results from a nutrition and exercise questionnaire revealed a significant difference between pre-holiday and post-holiday consumption of vegetables (8.6 ± 8.3 vs. 6.2 ± 4.0), special holiday foods (1.6 ± 1.9 vs. 2.5 ± 2.1), regular soda (1.5 ± 2.2 vs. 2.2 ± 2.6), and social gatherings attended (1.6 ± 1.5 vs. 2.2 ± 1.7). There was also a statistically significant decline in the number of days per week individuals exercised pre-holiday (3.7 ± 2.0 day/week) versus post-holiday (2.6 ± 2.3 day/week). Despite these differences, there was no statistically significant difference between pre-holiday weight (74.0 ± 17.8 kg) and post-holiday weight (73.9 ± 18.1 kg), nor between pre-holiday body fat percentage (25.4 ± 9.0%) and post-holiday body fat percentage (25.4 ± 8.9%).

Menopause is the time in a womans life when regular menstrual periods cease, due to a natural change in sex hormones, which may be accompanied by unwelcome symptoms. PURPOSE: To determine whether physical activity is associated with a reduction in menopausal symptoms (hot flashes, insomnia, numbness, fatigue, headaches, psychological symptoms, urogenital symptoms and physical symptoms). Providing that symptom differences among activity levels exist, a secondary purpose was to suggest an adequate level of physical activity for relief of menopausal symptoms. METHODS: Women (n=401) who were not taking hormone replacement therapy completed two questionnaires based on a 7-day recall of an average week: the Leisure-Time Exercise Questionnaire (Godin & Shephard, 1985) and the Menopausal Index (St. Germain, Peterson, Robinson, & Alekel, 2001). Women were divided into quintiles according to their physical activity scores (1=least active, 5=most active) and compared for menopausal symptoms using first a MANCOVA with covariate percent fat, as this was the only covariate that had significant group mean differences. Secondly a MANOVA with the appropriate post-hoc analysis was conducted. RESULTS: The mean (SD) age of the participants was 58.2 (6.3), the mean years postmenopausal was 6.7 (6.0), the mean percent body fat was 37.4 (5.6) %, and 16.5% had a previous hysterectomy. Univariate tests did not identify significant group differences for hysterectomy (p=0.774) or time since menopause (p=0.440); however, there were significant group differences for percent body fat (p=0). The MANCOVA was not significant between physical activity groups with percent fat as a covariate (Wilks Lamda p = 0.126). The MANOVA indicated a significant group main effect of physical activity on menopausal symptoms (Wilks Lamda p = 0.034). Of the 8 symptoms under review there were significant group differences for fatigue (p=0.05), and physical symptoms (p=0.004). The post-hoc analyses identified that two least active groups reported above average fatigue occurrence whereas the three most active groups reported below average fatigue occurrence. Group 2 had significantly more physical symptom complaints than groups 4 & 5. Of the three symptoms comprising physical symptoms, there were significant differences for weight gain (p=0.004) but not for breast tenderness (p=0.742) or aches and pains (p=0.175). Groups 1 & 2 reported significantly higher frequency of weight gain than groups 4 & 5. CONCLUSION: Any indirect effect of physical activity on menopausal symptoms is most likely through the alteration of body composition. Women with lower percent body fat report less weight gain and fatigue. There was no significant relationship between physical activity levels and reporting of hot flashes/night sweats, insomnia, limb numbness, headache, psychological symptoms or urogenital symptoms. A randomized controlled clinical trial would likely determine the relationship between higher activity levels and symptom reduction. For future research it is recommended that groups be matched based on percent body fat prior to randomization and that a greater amount of physical activity be prescribed.

<p>Olanzapine is an atypical antipsychotic drug exhibiting a low incidence of extrapyramidal side effects. It is not only effective in treating positive symptoms of schizophrenia, but also more efficacious against negative and depressive symptoms than classical antipsychotics. Olanzapine has been recommended as the first-line drug for the treatment of schizophrenia. Unfortunately, a common side effect of olanzapine, namely weight gain, has also been observed. A comprehensive literature analysis revealed that olanzapine induced higher weight gain than most other antipsychotics, only second to clozapine. The incidence of olanzapine-induced weight gain and related diseases, such as diabetes and cardiovascular diseases, is higher than that of the general population. These unwanted side effects have decreased the adherence to treatment. Many clinical observations and preliminary animal studies have attempted to elucidate the possible mechanism involved. To date, the mechanism for olanzapine-induced weight gain remains unclear.</p><p>This research project utilizes an animal model to investigate the possible mechanism of olanzapine-induced weight gain. The specific research objectives include: 1) does olanzapine affect feeding behavior; 2) can olanzapine influence the levels of glucose and triglyceride; 3) are cytokines, such as insulin, leptin, and TNF-Ñ involved in olanzapine-induced weight gain; 4) how does olanzapine affect adipose tissue?</p><p> An olanzapine-induced weight gain animal model has been established in the present investigation. An increase in food and water intake and increase in fat deposition accompanied with weight gain after treatment were observed. No significant increase in levels of glucose and triglyceride was detected. The changes of insulin and leptin levels in blood suggest that olanzapine may affect the endocrine system. A dramatic morphological alteration of adipose tissue by olanzapine was serendipitously observed. Immunohistochemical staining revealed that olanzapine stimulated collagen VI expression and deposition in the extracellular matrix suggesting that adipocyte differentiation may be enhanced. The effect of olanzapine on fat deposition might play a critical role in olanzapine-induced weight gain. The data from adipose tissue have provided a new clue on future research in understanding the mechanism of olanzapine-induced weight gain. Due to limitation of small number of animals and relatively short term of treatment, a large variation in groups diminished the power of analysis regarding the effects of olanzapine related to weigh gain.

<p>Olanzapine is an atypical antipsychotic drug exhibiting a low incidence of extrapyramidal side effects. It is not only effective in treating positive symptoms of schizophrenia, but also more efficacious against negative and depressive symptoms than classical antipsychotics. Olanzapine has been recommended as the first-line drug for the treatment of schizophrenia. Unfortunately, a common side effect of olanzapine, namely weight gain, has also been observed. A comprehensive literature analysis revealed that olanzapine induced higher weight gain than most other antipsychotics, only second to clozapine. The incidence of olanzapine-induced weight gain and related diseases, such as diabetes and cardiovascular diseases, is higher than that of the general population. These unwanted side effects have decreased the adherence to treatment. Many clinical observations and preliminary animal studies have attempted to elucidate the possible mechanism involved. To date, the mechanism for olanzapine-induced weight gain remains unclear.</p><p>This research project utilizes an animal model to investigate the possible mechanism of olanzapine-induced weight gain. The specific research objectives include: 1) does olanzapine affect feeding behavior; 2) can olanzapine influence the levels of glucose and triglyceride; 3) are cytokines, such as insulin, leptin, and TNF-Ñ involved in olanzapine-induced weight gain; 4) how does olanzapine affect adipose tissue?</p><p> An olanzapine-induced weight gain animal model has been established in the present investigation. An increase in food and water intake and increase in fat deposition accompanied with weight gain after treatment were observed. No significant increase in levels of glucose and triglyceride was detected. The changes of insulin and leptin levels in blood suggest that olanzapine may affect the endocrine system. A dramatic morphological alteration of adipose tissue by olanzapine was serendipitously observed. Immunohistochemical staining revealed that olanzapine stimulated collagen VI expression and deposition in the extracellular matrix suggesting that adipocyte differentiation may be enhanced. The effect of olanzapine on fat deposition might play a critical role in olanzapine-induced weight gain. The data from adipose tissue have provided a new clue on future research in understanding the mechanism of olanzapine-induced weight gain. Due to limitation of small number of animals and relatively short term of treatment, a large variation in groups diminished the power of analysis regarding the effects of olanzapine related to weigh gain.

Menopause is the time in a womans life when regular menstrual periods cease, due to a natural change in sex hormones, which may be accompanied by unwelcome symptoms. PURPOSE: To determine whether physical activity is associated with a reduction in menopausal symptoms (hot flashes, insomnia, numbness, fatigue, headaches, psychological symptoms, urogenital symptoms and physical symptoms). Providing that symptom differences among activity levels exist, a secondary purpose was to suggest an adequate level of physical activity for relief of menopausal symptoms. METHODS: Women (n=401) who were not taking hormone replacement therapy completed two questionnaires based on a 7-day recall of an average week: the Leisure-Time Exercise Questionnaire (Godin & Shephard, 1985) and the Menopausal Index (St. Germain, Peterson, Robinson, & Alekel, 2001). Women were divided into quintiles according to their physical activity scores (1=least active, 5=most active) and compared for menopausal symptoms using first a MANCOVA with covariate percent fat, as this was the only covariate that had significant group mean differences. Secondly a MANOVA with the appropriate post-hoc analysis was conducted. RESULTS: The mean (SD) age of the participants was 58.2 (6.3), the mean years postmenopausal was 6.7 (6.0), the mean percent body fat was 37.4 (5.6) %, and 16.5% had a previous hysterectomy. Univariate tests did not identify significant group differences for hysterectomy (p=0.774) or time since menopause (p=0.440); however, there were significant group differences for percent body fat (p=0). The MANCOVA was not significant between physical activity groups with percent fat as a covariate (Wilks Lamda p = 0.126). The MANOVA indicated a significant group main effect of physical activity on menopausal symptoms (Wilks Lamda p = 0.034). Of the 8 symptoms under review there were significant group differences for fatigue (p=0.05), and physical symptoms (p=0.004). The post-hoc analyses identified that two least active groups reported above average fatigue occurrence whereas the three most active groups reported below average fatigue occurrence. Group 2 had significantly more physical symptom complaints than groups 4 & 5. Of the three symptoms comprising physical symptoms, there were significant differences for weight gain (p=0.004) but not for breast tenderness (p=0.742) or aches and pains (p=0.175). Groups 1 & 2 reported significantly higher frequency of weight gain than groups 4 & 5. CONCLUSION: Any indirect effect of physical activity on menopausal symptoms is most likely through the alteration of body composition. Women with lower percent body fat report less weight gain and fatigue. There was no significant relationship between physical activity levels and reporting of hot flashes/night sweats, insomnia, limb numbness, headache, psychological symptoms or urogenital symptoms. A randomized controlled clinical trial would likely determine the relationship between higher activity levels and symptom reduction. For future research it is recommended that groups be matched based on percent body fat prior to randomization and that a greater amount of physical activity be prescribed.

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographic references (p.70-79).

Interventions to date have been minimally effective in reducing the rates of women gaining more weight than recommended by the Institute of Medicine in pregnancy. Food cravings are common in pregnancy, but their relationship, if any, with prenatal weight gain has received little attention in the literature. The purpose of this retrospective chart review study was to describe the frequency of cravings, associations between cravings and weight gain, and to determine what factors were predictive of reporting more cravings in pregnancy. A total of 1,259 charts were reviewed of women receiving care in an urban, community health center between 2006 and 2012. Women with healthy, singleton pregnancies were eligible to be included in the study. Of the 812 eligible women, 620 were excluded due to incomplete data. One-third of women in the sample (n = 194) were primiparous women. Their mean BMI was 28.3 (SD = 6.9). Almost 80% identified themselves as being Multi-Racial or African American. Cravings were reported by 75.3% of women in early pregnancy and 81.4% in late pregnancy. No differences in prenatal weight gain were seen between women with and without cravings. BMI, smoking, stress in early pregnancy, and emotional distress were not related to the numbers of cravings reported in pregnancy. The results of multiple regression analyses indicated that two predictors, age and stress in late pregnancy, accounted for 8.7% of the variance in the numbers of cravings reported in pregnancy (R² =.087, R² adjusted = .070, F (2, 108) = 5.14, p = .007). Younger age was associated with reporting a greater number of cravings, β = -.205, t (110) = -2.222, p =.028, as was higher stress in late pregnancy, β = .201, t (110) =2.184, p =.031. The findings of this study suggest that cravings are not related to prenatal weight gain, although the quality of this study was undermined by its small sample size and problems with the way cravings were measured. Developing a valid and reliable measure of cravings would be a fruitful next step.

Increasing obesity rates in Canadian women are at an all time high with more than 50% of Canadian women falling into one of the four overweight to obese categories. Further to this 11-21% of Canadian women who are of child-bearing age are being described as overweight or obese. Along with the increasing rates of obesity is an increase in the number of operative deliveries experienced by pregnant women in Canada. Canadian women experience cesarean section (CS) approximately 21% of the time while women in Ontario experience an even higher rate of CS (26%). While currently there are several studies examining the relationship between pre-pregnancy overweight and obesity and its association with CS, there is little research examining the relationship between excess weight gain in pregnancy and operative delivery methods. Data were collected through a retrospective chart review to examine the relationship between excess weight gain in pregnancy and operative delivery methods. Mean weight gain throughout pregnancy was measured. Data analysis was conducted using t-tests, Chi-Squared analyses and Fisher’s Exact test of significance, accepting a significance level of alpha = 0.05 with a 95% Confidence Interval of difference. The analysis conducted demonstrated no significant relationship between weight gain in pregnancy and operative delivery methods. When examining maternal weight and labour type, statistical significance was reached (p = 0.04) demonstrating increased likelihood of induction with excess weight gain in pregnancy; statistical significance was also reached with maternal age greater than 35 years and increased risk for operative delivery(p = 0.04). Further analysis demonstrated statistically significant results when examining one minute Apgar scores between the group of women with recorded weights in comparison to those women whose charts did not contain weights. The lack of findings in this study may be largely attributed to the small sample size.Important practice issues were identified. It is important that pre-pregnancy or early pregnancy weight and height be recorded on all women in hospital databases as well paper charts. Consistency in recording weight units in either pounds or kilograms is imperative. Dietary consultation is an important component of prenatal care and women who enter pregnancy overweight or obese should have immediate access to nutritional counseling. / Thesis (Master, Nursing) -- Queen's University, 2010-09-22 09:00:57.695