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Introduction Obesity is a risk factor for abnormal metabolic conditions including hypertension, high cholesterol and type 2 diabetes (T2D). The varying prevalence patterns of these metabolic conditions stratified by body mass index (BMI) among individuals lacking awareness of their disease status is poorly explored. Methods The study data was from the U.S. CDC 2013-2014 National Health and Nutrition Examination Survey and included participants aged ≥20 years who had completed examinations for blood pressure and BMI, laboratory tests for blood sugar and cholesterol, and interviews for demographics and other related health issues. Individuals lacking a formal diagnosis from a health professional were referred to as undiagnosed. The weighted prevalence and its 95% confidence interval (CI) for total T2D, hypertension, and high cholesterol and total abnormal metabolic items by BMI within each subgroup were calculated. Similar calculations were also applied to undiagnosed participants. By treating BMI < 25 as the reference, the proportional test was used to identify if significant prevalence existed in two comparisons:overweight vs. BMI < 25 and obese vs. BMI < 25. A p < 0.05 was considered statistically significant Results and Conclusions The overall weighted prevalence of diabetes, hypertension, high cholesterol and overall abnormal metabolic conditions were 16.1%, 60.3%, 57.5% and 76.3%, respectively while the prevalence of undiagnosed diabetes, hypertension, high cholesterol and abnormal metabolic condition are 8.8%, 11.3%, 16.8% and 30.2%, respectively. A higher prevalence of T2D existed in individuals with BMI25≤BMI≤30 among black adults (18.4% vs. 16.2%). Similar differences were also observed among undiagnosed black participants with BMI < 25 (12.1% vs. 7.5%). The prevalence of total and undiagnosed hypertension increased with BMI although prevalence was lower in the undiagnosed population. Our study findings reveal that while a higher proportion of obese individuals have chronic conditions, a large proportion of normal weight individuals are similarly burdened. The prevalence estimates of individuals with at least one undiagnosed abnormal metabolic condition indicates a need for expanded screening campaigns. Additionally, the higher prevalence of T2D among normal weight warrants further research to identify potential drivers. Although efforts to manage and control these conditions must continue to have a heightened focus on obese individuals, it must also broaden its scope to target normal weight individuals and develop strategies to decrease the proportion of U.S adults without awareness of their disease status.

Three-dimensional (3D) whole body scanners are increasingly used as precise measuring tools for the rapid quantification of anthropometric measures in epidemiological studies. We analyzed 3D whole body scanning data of nearly 10,000 participants of a cohort collected from the adult population of Leipzig, one of the largest cities in Eastern Germany. We present a novel approach for the systematic analysis of this data which aims at identifying distinguishable clusters of body shapes called body types. In the first step, our method aggregates body measures provided by the scanner into meta-measures, each representing one relevant dimension of the body shape. In a next step, we stratified the cohort into body types and assessed their stability and dependence on the size of the underlying cohort. Using self-organizing maps (SOM) we identified thirteen robust meta-measures and fifteen body types comprising between 1 and 18 percent of the total cohort size. Thirteen of them are virtually gender specific (six for women and seven for men) and thus reflect most abundant body shapes of women and men. Two body types include both women and men, and describe androgynous body shapes that lack typical gender specific features. The body types disentangle a large variability of body shapes enabling distinctions which go beyond the traditional indices such as body mass index, the waist-to-height ratio, the waist-to-hip ratio and the mortality-hazard ABSI-index. In a next step, we will link the identified body types with disease predispositions to study how size and shape of the human body impact health and disease.

Background: Genome-wide association studies have identified variants within the FTO (fat mass and obesity associated) locus as the strongest predictors of obesity amongst all obesity-associated gene loci. Recent evidence suggests that variants in FTO directly affect human adipocyte function through targeting IRX3 and IRX5 and thermogenesis regulation. Aim: We addressed the relevance of this proposed FTO-IRX pathway in adipose tissue (AT) of children. Results: Expression of IRX3 was higher in adipocytes compared to SVF. We found increased adipocyte-specific expression of IRX3 and IRX5 with the presence of the FTO risk haplotype in lean children, whereas it was unaffected by risk variants in obese peers. We further show that IRX3 expression was elevated in isolated adipocytes and AT of lean compared to obese children, particularly in UCP1-negative adipocytes, and inversely correlated with BMI SDS. Independent of BMI, IRX3 expression in adipocytes was significantly related to adipocyte hypertrophy, and subsequent associations with AT inflammation and HOMA-IR in the children. Conclusion: One interpretation of our observation of FTO risk variants linked to IRX3 expression and adipocyte size restricted to lean children, along with the decreased IRX3 expression in obese compared to lean peers, may reflect a defense mechanism for protecting body-weight, which is pertinent for lean children.

Thesis (M.S.)-West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains ix, 155 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 127-144).

Syntetiskt oxytocin är en vanlig behandling under förlossning. Oxytocin används som induktionsmetod och för att behandla värksvaghet. För att diagnostisera värksvaghet behöver kvinnan vara i aktiv fas, men varken för diagnosen värksvaghet eller för begreppet aktiv fas råder konsensus. Konsensus saknas även för längden på en normal förlossning och det råder individuell variation. Idag administreras oxytocin utan hänsyn till Body Mass Index. Syftet med litteraturöversikten var att belysa om och i så fall hur dosen av syntetiskt oxytocin påverkas av kvinnans Body Mass Index under förlossning. Metoden var en litteraturöversikt med systematisk ansats. Databassökningen utfördes i CINAHL och PubMed. Artiklarna kvalitetsgranskades och 15 kvantitativa artiklar inkluderades. Artiklarna analyserades med integrerad analys med en induktiv ansats. Dataanalysen resulterade i fyra huvudkategorier: exponering av syntetiskt oxytocin, oxytocindos, infusionslängd/duration av oxytocininfusion och varierande förlossningsutfall. Tre subkategorier påträffades under huvudkategorin oxytocindos: genomsnittlig medelhastighet, administrerad totaldos och högsta infusionshastighet. Resultatet visade att dosen av oxytocin under förlossning delvis påverkas av kvinnans Body Mass Index. Det sågs att ett högre Body Mass Index ökar sannolikheten att exponeras med oxytocin under förlossning. Ingen entydighet gällande oxytocindos i relation till Body Mass Index sågs för övriga kategorier. Det sågs en viss antydan att kvinnor som induceras behöveren högre högsta infusionshastighet och totaldos i relation till ett högre Body Mass Index. Slutsatsen var att sannolikt påverkas oxytocinadministreringen av fler faktorer än kvinnans Body Mass Index. Då oxytocin är en vanlig förlossningsintervention behövs fortsatt forskning på hur oxytocin kan doseras på ett mer individanpassat sätt. / Synthetic oxytocin is a common treatment during labor. Oxytocin is used as a method for induction and for augmentation of labor. To diagnose dystocia the woman needs to be in active stage, however there is no common definition either for the diagnose dystocia or concept of active stage. There is no agreement about the length of a normal labor and individual variety occurs. Today oxytocin is administrated without consideration for Body Mass Index. The aim of the literature review was to illustrate if and is so how the dose of synthetic oxytocin is affected by maternal Body Mass Index during labor. The method was a literature review with a systematic approach. The search was conducted in CINAHL and PubMed. The quality of the studies was assessed and 15 quantitative studies were included. The studies were analyzed through integrated analysis with an inductive approach. The data analysis resulted in four main categories: exposure of synthetic oxytocin, oxytocin dose, duration of oxytocin and varying labor outcomes. Three subcategories were found in the main category oxytocin dose: average rate, total dose and peak infusion rate. The result was that the oxytocin dose used during labor was partly affected by maternal Body Mass Index. A higher Body Mass Index was seen to increase probability for oxytocin exposure during labor. No unambiguity was seen regarding oxytocin dose in relation to Body Mass Index for the other categories. A trend towards the need of a higher peak infusion rate and total dose regarding a higher Body Mass Index was shown for women who underwent induction. In conclusion the administration of oxytocin is plausibly affected by other factors than maternal Body Mass Index. Since oxytocin is a common intervention during labor further research is needed to explore how administration of oxytocin could occur in a more individualized manner.

Published Article / Studies were undertaken in the Limpopo and Free State Provinces of South Africa to understand the beliefs, perceptions and health implications associated with geophagia. Questionnaires administered to 225 geophagic females covered their demographic details, their reasons for ingesting geophagic clayey soils and their perceptions regarding associated health conditions and implications. Respondents ingested clayey soils for body cleansing, craving, nutrient supplementation and weight loss. Some respondents considered the soils harmful, and < 50% of respondents had some knowledge of the contents of soils they ingested. Medical reasons in support of geophagia included lack of knowledge on the health implications of the practice. Medical consequences associated with geophagia may have occurred as a result of a lack of knowledge of the health implications of the practice. A clear need for educating geophagic individuals regarding the health implications of geophagia is called for.

Background: Infant mortality rate is a serious problem in today’s society. This statistic is often used as one measure of a country’s success and growth. One factor that is strongly associated with infant mortality is low weight in children. In Mozambique, the percentage of underweight children under the age of five was 16% in 2012 (UNICEF, 2013). In order to reduce the number of underweight children in this country, characteristics of caregivers that could potentially contribute to this problem should be investigated. One particularly important characteristic is maternal literacy, which to date has been under investigated. Objective: This study aimed to determine whether maternal literacy affected the weight and body-mass-index (BMI) of children ages 0 to 3 years old in Mozambique. Methodology: A cross-sectional study of 6,762 children between the ages of 0 and 47 months was conducted using the 2011 Demographic and Health Survey for Mozambique. Analysis of covariance (ANCOVA) procedures with Scheffe post hoc tests were performed in order to identify differences in mean child weight and BMI Z-score in reference to maternal literacy level. The data were analyzed using Statistical Analysis Software Version 9.4. Results: 396 (6.05%) of the children in the study sample were found to be underweight and 4467 (58.69%) of mothers were found to be illiterate. There was a statistically significant association between maternal literacy level and the weight and BMI of children between the ages of 0 and 3 years of age. Interestingly, a trend of stronger association was observed for each one-year increase in child age. Conclusion: Maternal literacy is significantly associated with child weight and BMI. Therefore, prioritizing secondary education for women is one important approach for ameliorating the risk of underweight children. Increased literacy rates in women could lead to better understanding of child nutritional needs, and ultimately, an overall reduction in the number of underweight children.

ABSTRACT ASSOCIATION OF ANTIOXIDANT INTAKE AND BODY MASS INDEX IN PRE-TO-EARLY ADOLESCENT CHILDREN by E. Kelly Imboden Background: The prevalence of overweight (Body Mass Index [BMI]85-<95th percentile) and obesity (BMI>95thpercentile) for individuals aged 2-19 years in the United States in 2009-2010 was estimated to be 31.8%. Excessive body fat increases the risk for chronic conditions such as hypertension and type 2 diabetes mellitus. Studies have established an association between obesity and oxidative stress and inflammation in children and adolescents. Antioxidants have been shown to have protective effects against inflammation and oxidative stress. However, the effect of dietary antioxidant intake on obesity is not fully understood. Objective: To examine dietary antioxidant intake by BMI classification in a population of normal, overweight and obese children. Methods: The study population included 296 healthy pre-to-early adolescent (age 6-15 years) African American and Caucasian children residing in Pittsburgh, PA. Demographic characteristics, anthropometric measures and nutrient intake were assessed at baseline and six months. A food frequency questionnaire was used to assess antioxidant intake (vitamin C, carotene, total vitamin A, zinc and vitamin E). Frequency analysis was used to describe demographic, anthropometric and nutrient data. The Kruskal Wallis test was used to evaluate difference in median antioxidant and kilocalorie intake by BMI classification at baseline. A Kendall’s tau correlation was performed to test for a linear relationship between BMI and antioxidant intake at baseline. Results: The median age of the population was 10 years (range, 8 to 11 years). The majority of the population was male (53%) and African American (60%). Weight and BMI (p = 0.028 and 0.000, respectively) were the only demographic and anthropometric characteristics that differed by gender. For the total cohort, median nutrient intake by BMI classification was significantly different for vitamin C (p = 0.015), zinc (p = 0.019), vitamin E (p = 0.022) and kilocalories (p = 0.015). When divided by gender, zinc intake in males (p = 0.047) and kilocalorie intake in females (p = 0.017) were the only nutrients found to be statistically different by weight classification. No linear relationship was observed between antioxidant intake and BMI for the total cohort and for each gender. Conclusion: Our results do not support a linear relationship between antioxidant intake and BMI. In contrast to our hypothesis, antioxidant intake was found to be highest in children who were overweight. Future studies should include a serum measure of inflammation and antioxidant levels in addition to antioxidant intake to better understand the impact, if any, of antioxidants in overweight and obese children and adolescents.