Background: Nearly half of the US population is overweight or obese, carrying with them a higher risk for morbidity and mortality and rising healthcare costs. Rural women are disproportionately affected, with higher rates of obesity, obesity-related chronic diseases, and poorer health outcomes (Befort, Nazir, & Perri, 2012; Penney, Rainham, Dummer & Kirk, 2014). There may be several factors. In general, rural health systems are more isolated, with a lack of healthcare resources including quality providers, technology, and public health services (IOM, 2009). Purpose: The purpose of this quality improvement project was to assess how obesity is managed in women residing in one rural community - Ritzville, Washington. Methods and Aims: Charts of all women ≥ 18 years of age receiving care at Hometown Family Medicine clinic (HTFM) were queried for a diagnosis of obesity. The prevalence of obesity in this group was calculated. Of those identified as obese, thirty charts were selected at random and reviewed. The following was determined: 1) Prevalence of chronic disease in adult women who receive care at HTFM; and 2) The management of obesity at HTFM compared with current evidence-based guidelines. This was followed by a community assessment to determine the resources available for the prevention and treatment of obesity in Ritzville, WA. Results: The prevalence of obesity (36.9%) and chronic diseases (hypertension, diabetes type 2, dyslipidemia, and heart disease) in the population studied were found to be significantly higher than both state and national averages. Due to a lack of basic resources, (access to weight loss specialties, exercise facilities, healthy foods, etc.) management of obesity in Ritzville, WA may be challenging. Findings from this study helped to inform resource allocation and identified opportunities to improve the management of obesity based on current practice guidelines. Primary health care may be the only opportunity to promote healthy behaviors and improve health outcomes in this vulnerable population. Action needs to be taken or the burden of obesity will continue to rise.

No abstract available. / Thesis (DPhil)--University of Pretoria, 2010. / Biokinetics, Sport and Leisure Sciences / unrestricted

Le syndrome métabolique (SM) est une entité clinique caractérisée par le regroupement d’un ensemble de facteurs de risque, dont l’accumulation contribue à un accroissement de la morbi-mortalité cardiovasculaire. Sa prévalence n’a cessé de croître au cours de ces dernières décennies au niveau de la population mondiale, en lien notamment avec des changements du style de vie incluant une plus grande sédentarité et une alimentation riche en graisses. Le SM est classiquement associé à un remodelage et à des anomalies diastoliques qui concernent le coeur gauche ; et des travaux récents ayant eu recours à l’imagerie de déformation témoignent également d’une dysfonction régionale systolique précoce. Le coeur droit est très peu documenté et pour l’ensemble de la pompe cardiaque les mécanismes explicatifs des atteintes fonctionnelles restent largement inexpliqués. Nos connaissances quant à l’impact de mesures hygiéno-diététiques sur la fonction myocardique régionale, gauche comme droite, sont également très pauvres. Ainsi, les objectifs majeurs du présent travail sont d’évaluer dans le SM l'effet d’une intervention reposant sur une diète alimentaire couplée à un programme d’activités physiques sur la fonction myocardique régionale ventriculaire droite et gauche, et d'étudier les interrelations, à l’inclusion et en réponse aux modifications du style de vie, entre les principaux facteurs du SM et la fonction myocardique régionale. La population est composée de 100 sujets SM asymptomatiques répartis aléatoirement en 3 groupes selon la modalité d‘exercice physique (dominante « résistance » ou « endurance à intensité élevée, mixte à intensité modérée), la restriction calorique (de 500 à 700 kcal/j) étant commune à tous les patients. Un groupe témoin (n=40) apparié en âge et sexe est également étudié. Le recours à l’échographique transthoracique en mode « speckle tracking imaging » permet l’évaluation des déformations longitudinales myocardiques du ventricule gauche (VG) et de la paroi libre du ventricule droit (VD). Nos résultats confirment les anomalies régionales diastoliques et systoliques VG mais démontrent pour la première fois qu’elles concernent également le coeur droit. Notre programme interventionnel réduit la prévalence du SM et de ses facteurs individuels, et améliore significativement la fonction régionale VG et VD, tant systolique que diastolique. Le tissu adipeux viscéral, et en particulier le tissu adipeux épicardique, l’inflammation systémique, impliquant à la fois les adipocytokines pro- (PAI-1, TNF-α) et anti-inflammatoires (adiponectine) et l’hyperglycémie chronique, facteurs impactés par le SM et améliorés en réponse à l’intervention, apparaissaient comme des contributeurs indépendants importants de la dysfonction régionale droite et gauche. Le rôle du tissu adipeux épicardique semble central, potentiellement via des effets autocrines et paracrines, ce tissu devrait ainsi constituer une cible thérapeutique future d'intérêt majeur dans le traitement des maladies cardiométaboliques. / The metabolic syndrome (MetS) is a clinical entity which is characterized by the combination of a set of risk factors, the accumulation of which contributes to a high risk of cardiovascular disease. Its prevalence has grown steadily during the past decades, principally as a result of poor eating habits and sedentary lifestyle. The SM is classically associated with cardiac remodeling and diastolic abnormalities involving the left heart; and recent studies using cardiac imaging deformation also reflect a regional early systolic dysfunction. The right heart is poorly documented and for both right and left heart underlying mechanisms of functional impairments remain largely unknown. Our knowledge about the impact of lifestyle changes on left and right myocardial function are also very poor. Thus, the main objectives of this thesis were to evaluate in MetS patients the effect of lifestyle intervention based on food diet with exercise training on right and left ventricular regional myocardial function, and to study the relationships, at baseline and in response to changes in lifestyle, among the main factors of MetS and regional myocardial function. The population consisted of 100 asymptomatic MetS male and female randomly divided into 3 groups according to exercise modality (dominant high-intensity "resistance" or " endurance”, or mixed of moderate intensity), caloric restriction (500 to 700 kcal / d) being common to all patients. A control group (n = 40) matched by age and sex was also evaluated. The use of transthoracic ultrasound in the "speckle tracking imaging" mode allowed the assessment of longitudinal myocardial deformations of the left ventricle (LV) and the free wall of the right ventricle (RV). Our results confirmed the regional LV diastolic and systolic abnormalities previously described in the literature but demonstrated for the first time they also concern the right heart. Our interventional program reduced MetS prevalence and its individual factors, and significantly improved both systolic and diastolic LV and RV regional dysfunction. Visceral adipose tissue, especially epicardial adipose tissue, systemic inflammation, involving both pro- (PAI-1, TNF-α) and anti-inflammatory (adiponectin) adipocytokines as well as chronic hyperglycemia, all factors affected by MetS and significantly improved in response to the intervention, appeared as significant independent contributors of the right and left regional dysfunction. The role of the epicardial adipose tissue seems central, potentially via autocrine and paracrine effects, and this tissue should thus be considered as future therapeutic target of major interest in the treatment of cardiometabolic diseases

The purpose of this study was to determine if there was a significant difference in weight loss, body fat, waist circumference, or diet quality among participants taking calcium or placebo supplements in a lifestyle intervention program. Three participants ages 52-55 completed the 14 week program. Two participants took 1,000 milligrams calcium while one participant took a placebo. Changes in diet were analyzed by Nutribase IV and self perception. Anthropometrics were analyzed by analysis of variance, alpha level 0.05. There was significant decrease in weight and waist circumference for the calcium group and decrease in bioelectrical impedance for the placebo group; however, due to small sampling size, results are inconclusive. There was no significant difference between groups in skinfold, diet, or quality of life.

abstract: Latino youth have substantially higher rates of obesity and T2D than their white peers. The higher prevalence of obesity and T2D among Latino youth places them at greater risk for cognitive dysfunction, an urgent and serious health threat to the United States. Exercise has been the cornerstone to combat the negative effects of obesity, diabetes and recent research also supports this effects for preventing cognitive dysfunction. A wealth of evidence suggests that a mediating mechanism linking exercise with brain health is BDNF, a cognitive biomarker that increases in the brain with exercise. BDNF is the most abundant neurotrophic factor that supports growth, survival and synaptic plasticity of neurons, all vital for cognitive function and brain health. The present study sought to investigate the effects of a 12-week lifestyle intervention of physical activity and lifestyle education on serum BDNF, in obese pre diabetic Latino youth. A total of twelve obese pre diabetic Latino youth were selected from a larger RCT sample to be the focus for this analysis. After an overnight fast, a serum concentration was collected from all youth to be used for the BDNF analysis. In addition, the following cardio metabolic measures were also at taken at baseline and post intervention: Submaximal VO2max, medical and family history questionnaire, anthropometric, fasting glucose and a 2-hour oral glucose tolerance test (OGTT). A 12-weeks Lifestyle Intervention that involved a progressive moderate to high intensity exercise component and lifestyle education program did not significantly change serum BDNF levels in obese pre diabetic Latino youth. In conclusion, the variation of our serum BDNF results are highly speculative at this time, therefore the need for future investigations is crucial. / Dissertation/Thesis / Masters Thesis Exercise and Wellness 2016

Background: Excessive gestational weight gain (GWG) is common in developed countries and is associated with an increased risk of maternal and offspring morbidity. Evidence regarding efficacy and safety of antenatal lifestyle intervention is limited in terms of both systematic reviews and original trials. This thesis is based on the need to further explore this research area. Objectives: To assess and grade current evidence and evaluate short and long-term effects of an antenatal lifestyle intervention on women and their offspring Materials: Controlled trials of intervention publishedbefore August 2009 were systematically searched and reviewed. A randomized controlled trial (RCT) including 445 healthy women aged >18 years with a body mass index (BMI) ≥19 and ≤16 weeks pregnant and their offspring was performed during 2007-2015 in Örebro Region, Sweden. Methods: The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used for review. Our RCT (called the VIGA trial) compared standard care with a composite intervention consisting of education, application of a personalized weight graph, prescription of exercise and more frequent monitoring of weight. Standardized measures of weight and height in offspring waere analysed based on World Health Organization (WHO) Child Growth Standards. Results: Quality of evidence across the studies published pre-August 2009 was concluded to be very low. Our intervention significantly reduced mean GWG (kg) but the proportion of women with excessive GWG, according to recommendations, was not significantly reduced. Short- term postpartum weight retention (PPWR) was significantly lower after the intervention but no significant difference remained 1 year after delivery. Offspring mean BMI z-scores or proportion of obesity did not differ between study groups at either birth or age 5. Conclusions: The antenatal lifestyle intervention reduced mean GWG and short-term PPWR but no long-term effects on maternal weight retention or offspring obesity were seen. Alternative modes and timing of intervention should be considered in future research. Reducing the prevalence of pre-conception obesity must still be considered the primary means to improve maternal and fetal outcome.

No description available.

Across the U.S., obesity and overweight represent a rapidly growing public health concern that have been associated with expensive and debilitating outcomes such as depression, cancers, diabetes, and other metabolic disorders, cardiovascular disease, and significant disruption in quality of life, in addition to the tremendous public health costs. The current study examined a brief, randomized-controlled trial of acceptance and commitment therapy (ACT) with overweight and obese young adults. The results of this study hold important implications for future research in the utility of ACT to address overweight- and obesity-related lifestyle change. While the study was limited due to small sample size, it nevertheless suggested that weight-related psychological flexibility is an important construct to address and target in the treatment of overweight and obesity. It may be an effective means of decreasing emotional eating and improving a sense of control while eating. The findings support previous research supporting ACT as an empirically supported intervention for improving the quality of life of adults struggling with overweight and obesity. Results from this study are encouraging and support the utility of ACT, even in brief format, to possibly improve the lives of overweight and obese young adults. Study participants were randomly assigned to a 4-week experimental ACT group or an information control group, which received psychoeducational materials regarding lifestyle behaviors recommended by the Centers for Disease Control and Prevention (CDC). The results of the current study broadly showed that the experimental intervention was effective at improving weight-related psychological flexibility, which was also associated with reductions in emotionally avoidant eating and uncontrolled eating. In addition, the study showed relationships between improvements in psychological flexibility and eating process variables.

No description available.

No description available.