Researchers have found that self-esteem and weight status can impact numerous aspects of an individual’s life, including reproductive health issues. However, there has been limited research specifically examining how self-esteem may affect female sexual functioning. The current study aims to examine whether self-esteem is a significant predictor of sexual functioning, and whether this relationship may change as a function of women’s weight status. Participants consisted of 730 women ranging from 18 to 49 years of age, who were recruited through an online questionnaire. Results indicate that higher levels of self-esteem predict better sexual functioning and weight status was found to be a significant moderator of this relationship; specifically, self-esteem was only found to predict sexual functioning for individuals at average or below-average weight status, and not for individuals who were of higher-than-average weight status. Findings have potential implications for physical and mental health professionals working with individuals trying to improve their sexual functioning.

Background: Although several reports have shown an adverse cardiovascular and metabolic risk profile associated with childhood obesity, few reports have examined the effects of childhood obesity on pulmonary function. Objective: The purpose of this study was to examine the influence of obesity on pulmonary function in Navajo and Hopi children. Methods: Subjects included 256 (110 males, 16 females) Hopi children 6-12 years of age and 557 (274 males, 283 females) Navajo children 6-12 years of age (N=813). The body mass index was used to classify subjects as normal weight, overweight, or obese on the basis of international reference values. Forced vital capacity (FVC), forced expired volume in one second (FEVl), FEV1% (FEV1 to FVC ratio; FEV1/FVC), and forced expiratory flow between 25%-75% of vital capacity (FEF25-75) were determined according to the American Thoracic Society recommendations. Results: Approximately 26% of Navajo and Hopi children were defined as overweight (26.0% of boys and 25.6% of girls) and an additional 16% (14.6% of boys and 17.7% of girls) were defined as obese. In general, the patterns showed an increase in pulmonary function between normal weight and over-weight children and a decrease in pulmonary function of obese children. Significant differences among groups existed for FEV1% and FEF25-75 in boys and FVC and FEV1 in girls. Conclusions: The results indicate the pulmonary consequences of obesity in children and provide further evidence of the adverse consequences, of pediatric obesity among Native Americans.

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body mass index (BMI). Therefore, our research question is: Is there a difference in the relative amount and diversity of SCVFAs in the BM of N compared to OWOB women? We hypothesized that women of N will have a more diverse SCVFA profile than OWOB women in their BM. BM samples (200 ml) were collected from 44 women (22 N (BMI 22.0) and 22 OWOB (BMI 33.7) p2 while OWOB participants had a pre-gravid BMI of greater than 25.0 kg/m2. To our knowledge, this is the first time that SCVFAs have been quantified in the milk of lactating women using GC with an FID detector. This data supports the argument that the pre-gravid BMI of a mother can correlate to the SCVFA profile of her BM. It is unknown if the concentration observed in the mother’s BM in this study has an influence on the neonate’s gut/brain axis and neurological signals, however, we have demonstrated that the SCVFA profile is more diverse in the N BMI mother. Further research is warranted on the influence of maternal BM SCVFA composition on the growth and neurological development of her infant.

Currently, about 1 in 3 women of reproductive age are obese (Flegal, Kruszon-Moran, Carroll, Fryar, & Ogden, 2016). Obesity in pregnancy has been associated with adverse maternal and infant outcomes (“Clinical Management Guidelines for Obstetrician–Gynecologists. Number 49, December 2003,” 2003) and maternal overweight and obesity have been implicated as increasing the risk for early childhood obesity (Ramonienė et al., 2017). Obesity is defined by the World Health Organization as having a body mass index (BMI) greater than 30 kg/m2, however, there is mounting evidence that BMI is not an accurate measure of adiposity (Kennedy, Shea, & Sun, 2009), which is one of the leading clinical concerns surrounding obesity. Understanding the associations between maternal body composition and infant body composition could begin to answer questions regarding the underpinnings of intergenerational obesity and offer a modifiable factor such as body composition as a target of opportunity to improve maternal and infant outcomes. This secondary analysis of 372 mother-infant dyads examines the associations of maternal body composition, as measured by BMI, fat mass and lean mass, with infant body composition, as measured by fat mass, lean mass, and BMI z-scores. Fat and lean masses were derived from dual-energy x-ray absorptiometry (DXA). Correlations between maternal BMI and maternal fat and lean mass were explored at one month postpartum. Associations between maternal body composition exposures at one month postpartum and infant body composition outcomes at one, four, and seven months postpartum were explored in the entire cohort and then stratified in two separate analyses by maternal BMI and infant sex to determine the potential for effect modification. Maternal BMI was strongly correlated with maternal fat mass at one month postpartum (r=0.91), and less strongly correlated with maternal lean mass (r=0.71). Maternal lean mass was positively associated with infant lean mass at four months postpartum. In obese women, maternal BMI was negatively associated with infant lean mass at seven months postpartum. In overweight women, maternal fat mass and maternal lean mass were positively associated with infant lean mass. In obese women, maternal fat mass was negatively associated with infant lean mass at four months postpartum. Maternal fat mass and lean mass were positively associated with infant lean mass at four and seven months postpartum in females but not in male infants. An increase in maternal lean mass was also found to be associated with a significant increase in female infant BMI z-scores at seven months postpartum but were not associated with male infants’ BMI z-scores. This study found that obese women with increased adiposity, as measured by BMI and fat mass, tended to have infants with less lean mass at four and seven months postpartum, while overweight women with increased lean mass tended to have infants with greater lean mass at all postpartum through seven months postpartum. It was also found that female infants born to mom’s with larger fat mass or larger lean mass tended to have increased lean mass at four and seven months postpartum, while there seemed to be no associations with maternal and infant body composition in male infants. These results confirm that the first year of life is an important time in infant development and potential programming, but they also suggest that this programming may be associated with lean mass accrual in early infancy as opposed to fat mass or adiposity. The complexity of the relationships between maternal and infant body composition in the postpartum period may involve other factors such as sex differences, genetics and nutrition, and should be further explored in future studies.

No description available.

The intent of this research is to examine the relationship of corporate fast food and health within the context of gender. It tests the hypothesis that Western perceptions of masculinity and femininity inform a differentiated pattern of food preference, which will correlate with health as measured by Body Mass Index (BMI). The targeted sample population for the study is the undergraduate community of the University of Central Florida, and fast food is a chosen dietary medium because it is an increasingly ubiquitous source of caloric energy in the American foodscape, representative of the mass production model applied to cuisine in Western nations. Data regarding fast food consumption habits were collected via survey producing a sample size of n=165 (n=116 females, n=49 males). Statistical analysis applied to this data yields conflicting results. While no gender based food preference is demonstrated, a correlation between BMI and frequency of consumption can be established. This suggests a genderdifferentiated preference for fast food in general, if not for specific food items. From this sample, respondents were interviewed (n=14 females, n=8 males). Analysis of these interviews reveals an acute awareness by females of the connection between diet and health that is not reflected by males. Whether this perceived difference is based on an actual disparity of health education or a willingness to express this knowledge, it indicates a discrepancy which is likely attributable to cultural influences. While this study does not reveal gender-based differences in perception of specific foods, it does suggest disproportionate consumption patterns within genders which reflect distinct and contrasting cultural expectations in the U.S.

In recent years, childhood obesity has increased to epidemic proportions across the United States (U.S.) in parallel with adult obesity, which often reflects poor dietary choices and bad nutritional habits. Nutrition literacy, which encompasses the constructs of nutrition knowledge and skills, is considered a basic tool for good dietary habits and health promotion undertakings; however, its more definitive relationship to adolescent children’s weight status is unknown. Most childrens’ weight status studies have focused solely on behavioral aspects of adolescent food intake, taking into consideration parental influence, peer pressure, and societal expectations. Studies evaluating the measurement of nutrition literacy with regard to adolescent weight status are non-existent. The primary purpose of this study was to examine the effects of parent and adolescent nutrition literacy expressed as nutrition knowledge and skills, with total household income and parent level of education, as predictors of weight status in adolescents that live in a Florida community. The secondary purpose of this study was to examine the implications for nutrition literacy levels within parent/adolescent dyads to identify public health initiatives aimed at adult and adolescent populations. Parent/adolescent dyads were screened against inclusion criteria and 110 dyads were chosen to participate. Following informed consent from the parent and assent from the adolescent, demographic data were collected and the parent/adolescent participants were asked to complete two study instruments: the Nutrition Literacy Survey (NLS) testing nutrition knowledge (Diamond, 2007) and the Newest Vital Sign (NVS) assessing nutrition skills (Weiss, Mays, Martz, Castro, DeWalt, Pignone, Mockbee, Hale, et al., 2005). The written instruments were administered to both parents and the adolescent child simultaneously, directly following the collection of adolescent height and weight. iv First, paired t-tests were used to compare means for the NLS and NVS survey in parentadolescent dyads. Next, bivariate correlation scores were computed between the two variables of parent/adolescent NLS and NVS scores. Higher total correct scores indicated higher levels of nutrition knowledge, whereas lower total correct scores indicated lower nutrition knowledge. Next, a correlation analysis using the Pearson r correlation coefficient was computed to determine if a relationship existed between nutrition knowledge and nutrition skills in parentadolescent dyads. Lastly, regression models for examining adolescent BMI were compared with the independent variables of the study. The first model used standard multiple regression analysis to determine the correlation between parent/adolescent level of nutrition knowledge and parent/adolescent level of nutrition skills to children’s weight status (BMI). The second model used logistic regression analysis to determine if a correlation between parent/adolescent level of nutrition knowledge, parent/adolescent level of nutrition skills, and demographic characteristics, to children’s BMI could be predicted. The third model used the same procedure for logistic regression with all IV data as categorical data rather than actual values. Gender was included in the final model, since it was of relevance to BMI for adolescent populations. The study results indicate that adolescent male participants had higher BMI (27 + 3.48) than females (24 + 2.90), t(108) = 4.83, (p = < .001). The results suggest that percentage underweight/normal weight for males (32.8%) and females (75.5%) and percentage overweight/obese for males (67.2%) and females (24.5%) differed comparatively between the two groups, with a larger percentage of adolescent males having greater BMI than female adolescents. The mean Nutrition Literacy Scale score (M=19) for parent (adult) study participants indicated low overall levels of general nutrition knowledge whereas the mean Nutrition Literacy v Scale score (M=21.7) for adolescent study participants demonstrated slightly greater aptitude for general nutrition knowledge than parental scores. The mean Newest Vital Sign score (M=4.1) for parents suggests adequate levels of nutrition skills. Likewise, the mean Newest Vital Sign score (M= 4.1) for adolescents suggests adequate levels of nutrition skills, similar to scores attained in the adult population. Spearman rho correlations yielded positive correlations between parents’ nutrition knowledge and adolescents’ nutrition knowledge, (rs = .224, p = .019), and parents’ nutrition knowledge and skills (rs = .596, p < .001). Positive correlations were also noted between adolescents’ nutrition knowledge and parents’ nutrition skills (rs = .257, p = .007) and adolescents’ nutrition knowledge and nutrition skills (rs = .260. p = .006). For the first model, a multiple regression was calculated to predict BMI from parent/adolescent nutrition knowledge and parent/adolescent nutrition skills. These variables did not statistically predict adolescent BMI, F(4,109) = .348, p < .845, R2 = .013. All four variables did not significantly add to the prediction, p < .05. In the second model, a logistic regression was computed to predict adolescent underweight/normal weight and overweight/obese from parent/adolescent nutrition knowledge and parent/adolescent nutrition skills, household income, and parent education level. These variables did not statistically predict adolescent weight status, (χ2 (6) =3.31, p = .769; -2 Log Likelihood 149.036; R2 .03; Hosmer and Lemeshow Goodness-of-Fit χ2 (8) = 12.36, p = .136). In the third model, a logistic regression was calculated to predict adolescent underweight/normal weight and overweight/obese from parent/adolescent nutrition knowledge and parent/adolescent nutrition skills, household income, and parent education level, and adolescent gender. These variables did not statistically predict adolescent weight status, (χ2 (11) vi = 14.506, p = .206; -2 Log Likelihood 137.841; R2 .124; Hosmer and Lemeshow Goodness-ofFit χ2 (8) = 10.864, p = .210. Analysis of regression coefficients indicates none of the variables demonstrated significance. The results of the study suggest that parents and adolescents may have similar amounts of nutrition literacy when examining the constructs of nutrition knowledge and skills; however, BMI is not solely dependent on these skill sets. Gender may play an important role in the prediction of BMI in adolescents. Examination of the factors that influence parents and children’s weight status are important elements in shaping families adoption of sound dietary habits and improving health outcomes

PURPOSE: Television (TV) viewing remains a popular form of screen time for adults. However, it is important to understand the obesity risks associated with other screens, not only TV, in a changing media landscape. This study aimed to examine the association between energy intake, BMI, and screen time using the data obtained from the AIM-2 wearable camera. METHODS: The AIM-2 device was used by (n=18) participants for seven consecutive days. Three days of images from the device were analyzed for energy intake, and 1 of these days was coded for screen use (i.e., TV, phone, and computer), the number of screens, and screen duration while eating. A preliminary analysis of screen use in relation to BMI and energy intake was conducted. Potential confounders (age, sex, race, ethnicity, marital status, and education level) were considered. RESULTS: Phones were the most used screen type, and TV alone was not watched by any participants. While eating, screens were used 73% of the time. Participants with the highest screen time usage consumed more total energy than those with the lowest screen time usage (p<0,.05). This difference was attenuated when controlling for duration of eating, perhaps suggesting that higher screen time usage may lead to an extended eating duration and, thus, higher intakes of energy. There were no statistically significant associations between any screen time variable (type, duration, or number of screens used) and BMI. Screen time usage was examined during four time periods: before 11:00 am; 11:00 am-2:59 pm; 3:00 pm-7:59 pm; 8:00 pm, and later. There was a statistically significant positive association between higher screen time after 8:00 pm and total daily energy intake (P=0.005). CONCLUSION: Eating while using a screen can be objectively assessed using the AIM-2 device. Our data agree with recent studies showing that phones and computers are used more than TV. While there were no significant associations between any of these screen variables and BMI, data from a single day in this study suggests that those with the highest screen time usage tended to have higher energy intakes. In addition, there was also a statistically significant association between screen time usage while eating later in the evening (after 8:00 pm) and total daily energy intake. These preliminary results should be interpreted with caution due to the small sample size and the availability of only one day of screen use and energy intake. Future studies should examine more than one day and use wearable cameras for objective evaluations of screen use.

Body image or satisfaction with physical appearance has been established as an important aspect of self-worth and mental health across the life span. It is related to self-esteem, sexuality, family relationships and identity. Given the fact that physical appearance is a multifaceted structural concept that depends, not only on inner-biological, but also a psychological and socio-cultural components, the purpose of this study was to examine variables that are related to and influenced by satisfaction with physical appearance. Body mass index (BMI), eating disturbances, attachment (to mother, to father and to peers), global self-worth, parental control, peer influence and pressure regarding eating and media influence were examined in relation satisfaction with physical appearance. College students in a large southeastern university (195 males and 340 females) completed two subscales of Harter's Self-Perception Scale for College Students. Each subject self-reported his/her weight and height and these were used calculate weight/height ratio known as the body mass index. Participants also reported on attachment (to mother, to father and to peers) using the Inventory of Parent and Peer attachment scales (Armsden & Greenberg, 1987), Peer Influence Scale (Mukai, 1993) and the Media Influence scale which was developed for this project. Differences between male and female perceptions of physical appearance in relationship to BMI were found: Among women, higher BMIs were associated with lower scores on perceptions of physical appearance (r = -. 429, p £ .001), whereas for males BMIs were not related to satisfaction with physical appearance. For both males and females, satisfaction with physical appearance was significantly and negatively (r = -.258, p £ .01) associated with media influence. Media influence was related to higher scores on the EAT 26 scale that measured disturbed eating attitudes and behaviors (r = .307, p £ .01). Females were affected by this association more so than were males. However, males appeared to not to be immune to such influence. Peer influence and peer pressure was another influential factor for both gender groups and it was associated with high eating disturbance scores (r = .369, p £ .01 for peer influence, and r = .413, p £ .01 for peer pressure). Attachment variables were associated with satisfaction of physical appearance and global self-worth in a different manner for adolescent females and males. For males, satisfaction with physical appearance was positively related to attachment to mother (r = .135, p £ .05) and father (r = .170, p £ .05) and negatively associated with maternal control (r = -. 246, p £ . 001). For females, only attachment to mother (r = .082, p £ .05) was positively associated satisfaction with physical appearance. While there were many significant bivariate correlational findings, there were few significant coefficients in a regression analyses, presumably because of the high intercorrelations between the predictor variables. For females, BMI was the best predictor of satisfaction with physical appearance, whereas for males, the feeling of global self-worth was the strongest variable in predicting satisfaction with physical appearance. Satisfaction with physical appearance is an essential part of global self-worth and is constructed differently by males and females. For females, high BMI was negatively related to satisfaction with physical appearance as well as global self-worth. On the other hand, for males neither global self-worth nor perceptions of physical appearance were affected by high BMIs. More research is needed to understand the complexity of influences on satisfaction with physical appearance as well as construction of global self-worth and its domains for both sexes. / Ph. D.

This thesis comprises three chapters involving the analysis of the body mass index (BMI) in health economics. The first chapter evaluates two correction models that aim to address measurement error in self-reported (SR) BMI in survey data. This chapter is an addition to the literature as it utilizes two separate Canadian datasets to evaluate the transportability of these correction equations both over time and across different datasets. Our results indicate that the older method remains competitive and that when BMI is used as an independent variable, correction may even be unnecessary. The second chapter measures the relationship between long-term physician costs and BMI. The results show that obesity is associated with higher longterm physician costs only at older ages for males, but at all ages for females. We find that accounting for existing health conditions that are often associated with obesity does not explain the increase in long-term physician costs as BMI increases. This indicates that there is an underlying relationship between the two that we could not account for in our econometric models. Finally, the third chapter decomposes the differences in BMI distributions of Canada and the US. The results show that the differences between BMI levels, both over time and across countries, are increasing with BMI; meaning the highest difference is observed at the right tail of the two distributions. In analysis comparing two points in time, these differences are solely due to differences in the returns from attributes and the omitted variables that we cannot account for in our models. In cross-country analysis, there is evidence that the differences observed below the mean can be explained by the differences in characteristics of the two populations. The differences observed above the mean are again due to those in returns and the omitted variables. / Dissertation / Doctor of Philosophy (PhD)