Obesity is a major public health problem and is a risk factor for hypertension, diabetes, heart disease and cancer. In addition, the prevalence of obesity appears to be increasing worldwide, making it important to determine the nature and extent of obesity in populations at risk. The aim of this study was to determine the predictors of body mass index (BMI) in Taiwanese adults 19 through 44 years old. Independent variables from the Nutrition and Health Survey in Taiwan (NAHSIT) included biological factors (age and sex), dietary factors (energy intake and fat intake), environmental factors (educational level, residence area, and nutrition knowledge), and lifestyle factors (leisure time physical activity, smoking habits, and alcohol consumption). Results indicated that nearly 40% of the 1,182 adult survey participants were obese or overweight, by Taiwanese standards. Regression analysis found that significant predictors of BMI were residence area, educational level, and age. Taiwanese adults more likely to have higher BMIs were from the mountainous area, had less education. An increase in ten years of age was related to an average increase in BMI of 1.13 kg/m�� (p<0.0001), controlling for other variables. These three factors accounted for 21% of the variance in all adults (15% of the variance in men, and 28% of the variance in women). In addition, smoking was a predictor of higher BMI in males, and alcohol intake was a predictor for higher BMI in females. Energy intake, fat intake, leisure time physical activity, and nutrition knowledge were not significant predictors for either males or females. The findings from this study will help public health professionals identify target areas and program needs to reduce obesity in Taiwan, particularly in the mountainous areas where the prevalence of obesity/overweight was seventy percent. / Graduation date: 2004

The aim of this study was to explore and describe the body fatness and associated selected health risk factors among 10 to 12 year old adolescents attending schools in Port Elizabeth. Therefore the objectives of the study were to determine the following for the participants: • Level of fatness: weight, height, waist circumference, maximum hip circumference and skinfolds; • Fat intake; • Level of physical activity involvement (IPAQ). To achieve the aim and objectives of this study, the literature pertaining to Childhood Obesity and the possible effects thereof, were reviewed. Both an ex post facto quasi experimental and randomized one-group posttest only designs were used to describe the level of fatness and to identify the incidence of overweight and obesity among adolescents aged 10 to 12 years attending schools in Port Elizabeth. The test battery included anthropometric measurements that were identified from the literature as the factors most important to categorise body fatness such as weight, height, circumferences and skinfolds to determine the level of fatness of the participants. A 21-item Fat Measure for Dietary Intake and International Physical Activity Questionnaire were administered to determine the levels of fat intake and physical activity. Three hundred (300) adolescents were assessed of which 143 were male and 157 were female. In terms of socioeconomic status, 71.3 percent were from the ‘less poor’ quintile schools and 28.7 percent were from the ‘more poor’ quintile schools. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences were tested for statistical and practical significance. The results from the study showed that 26.7 percent of the participants were overweight and 14.7 percent were obese according to their skinfold measurements. In terms of body mass index, 79.7 percent of the participants were overweight and 14.3 percent were obese. These results are far higher than majority of the studies included. Physical activity indicated a reduction in body fatness and the most physically active participants were obese. Lastly, body fat percentage and body mass index are very closely related.

Source: Masters Abstracts International, Volume: 46-03, page: 1373. Advisers: Robert J. Hardy; Asha S. Kapadia. Includes bibliographical references.

Indiana University-Purdue University Indianapolis (IUPUI) / Factors released from coronary perivascular adipose tissue (PVAT), which surrounds large coronary arteries, have been implicated in the development of coronary disease. However, the precise contribution of coronary PVAT-derived factors to the initiation and progression of coronary vascular dysfunction remains ill defined. Accordingly, this investigation was designed to delineate the mechanisms by which PVAT-derived factors influence obesity-induced coronary smooth muscle dysfunction. Isometric tension studies of coronary arteries from lean and obese swine demonstrated that both lean and obese coronary PVAT attenuate vasodilation via inhibitory effects on smooth muscle K+ channels. Specifically, lean coronary PVAT attenuated KCa and KV7 channel-mediated dilation, whereas obese coronary PVAT impaired KATP channel-mediated dilation. Importantly, these effects were independent of alterations in underlying smooth muscle function in obese arteries. The PVAT-derived factor calpastatin impaired adenosine dilation in lean but not obese arteries, suggesting that alterations in specific factors may contribute to the development of smooth muscle dysfunction. Further studies tested the hypothesis that leptin, which is expressed in coronary PVAT and is upregulated in obesity, acts as an upstream mediator of coronary smooth muscle dysfunction. Long-term administration (3 day culture) of obese concentrations of leptin markedly altered the coronary artery proteome, favoring pathways associated with calcium signaling and cellular proliferation. Isometric tension studies demonstrated that short-term (30 min) exposure to leptin potentiated depolarization-induced contraction of coronary arteries and that this effect was augmented following longer-term leptin administration (3 days). Inhibition of Rho kinase reduced leptin-mediated increases in coronary artery contractions. Acute treatment was associated with increased Rho kinase activity, whereas longer-term exposure was associated with increases in Rho kinase protein abundance. Alterations in Rho kinase signaling were also associated with leptin-mediated increases in coronary vascular smooth muscle proliferation. These findings provide novel mechanistic evidence linking coronary PVAT with vascular dysfunction and further support a role for coronary PVAT in the pathogenesis of coronary disease.

Diploma thesis is divided into a theoretical and practical part. I dedicated the theoretical part not only to prenatal and perinatal obesity risk factors, but also to diagnosis, management, health complications and prevention. In the practical part, I described the outcomes of the questionnaire survey dedicated to the mothers of children aged 1-7 years. The aim of this thesis was to find out the occurrence of selected risk factors for childhood obesity. I found out that in my study group, there were some risk factors represented in relatively small quantity (for example smoking during pregnancy, smoking during breastfeeding, gestational diabetes mellitus). Other risk factors, such as mother's or father's obesity were frequent. Some risk factors for childhood obesity are obvious, while others have not yet been proved to be directly related to obesity. However, we can certainly suggest, that the healthy parents' weight, alcohol and nicotine abstinence and exclusive breastfeeding at least until the end of fourth month of life are the factors beneficial not only for the health of the child. Key words: childhood obesity; diet during pregnancy; nutritional programming; obesity prevention; obesity risk factors

This research focuses on obesity and other major risk factors for chronic diseases such as Type II Diabetes Mellitus, Heart Disease, and Stroke. Worksite wellness programs have been successful in this realm of health promotion and disease prevention for heart disease and stroke, but their effectiveness in treating diabetes has been uncertain partially due to poor patient compliance, lack of stress reduction strategies, poor diet and lack of persuasive health education on the risk of being obese. Published peer-reviewed articles were reviewed, coded and analyzed to determine best practices, using a modified systematic review approach. The findings from these studies yield results that were used to develop a new employer-sponsored wellness program that is in accordance with the recently passed Affordable Care Act. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Diversas evidências comprovam que a obesidade está associada a alterações estruturais e funcionais do coração em modelos humanos e animais. Outros estudos recentes também demonstram que a obesidade humana está associada com alterações na função e na estrutura vascular, especialmente em grandes e médias artérias. Estudos epidemiológicos têm confirmado que a obesidade é um fator de risco significativo para o aparecimento de proteinúria e de doença renal terminal em uma população normal. Com o objetivo de determinar as alterações morfológicas relacionadas ao remodelamento cardíaco, vascular e renal em um modelo experimental de obesidade induzida pelo glutamato monossódico (MSG) e os efeitos da metformina sobre estes achados, foram estudados 25 ratos divididos em cinco grupos: controle com 16 e 22 semanas (CON-16 e CON-22); obeso com 16 e 22 semanas (MSG-16 e MSG-22) e obeso + metformina (MET-22) 300mg/Kg/dia por via oral. A caracterização da resistência à insulina foi feita através da medida da insulina plasmática e cálculo do índice de HOMA-IR. As análises morfológicas e quantificação do colágeno miocárdico foram feitos pelo sistema de imagem Image Pro Plus analysis. A pressão arterial sistólica foi levemente maior no grupo MSG-22, adquirindo significância estatística quando comparada com o grupo MSG-16 (1222 vs 1082 mmHg, p<0,05). Por outro lado, o grupo MET-22 mostrou níveis mais baixos de pressão arterial (1181 mmHg), sem alcançar diferença significativa. No grupo de animais obesos, foi observado aumento na relação média-lumen com 16 semanas (39,93,7 vs 30,22,0 %, p<0,05) e com 22 semanas (39,81,3 vs 29,51,2%, p<0,05), que foi reduzida com o uso da metformina (31,50,9%). O depósito de colágeno na área perivascular no ventrículo esquerdo foi significativamente maior no grupo MSG-22 (1,390,06 vs 0,830,06 % no CON-22, p<0,01), sendo atenuado pela metformina (1,020,04%). No rim, a área seccional transversa das arteríolas intrarrenais foi semelhante entre os grupos (18,52,2 no CON-16; 19,93,7 no MSG-16; 18,93,1 no CON-22; 21,81,5 no MSG-22; 20,21,4 no MET-22). Foi observado aumento da área glomerular no grupo MSG-22 (141,34,5 vs 129,50,5 m2), mas sem significância estatística. Em conclusão, nos ratos com obesidade induzida pelo MSG, com resistência à insulina, as alterações cardíacas foram mais proeminentes do que as alterações renais. No coração foram observados sinais de remodelamento vascular hipertrófico nas pequenas artérias intramiocárdicas e evidências de fibrose miocárdica mais proeminente na área perivascular, alterações que foram, pelo menos parcialmente, atenuadas com o uso de metformina durante seis semanas, mostrando que esta droga pode ser benéfica na prevenção de complicações cardíacas, vasculares e renais associadas com a obesidade. / Many evidences show that obesity is associated to structural and functional changes in the heart of human and animal models. Recent studies also show that human obesity is associated with vascular structural and functional modifications, specially at large and medium-sized arteries. Epidemiological studies have confirmed that obesity is a significant risk factor for the development of proteinuria and end-stage renal disease in a normal population. With the objective to determinate morphological changes related to cardiac, vascular and renal remodeling in an experimental model of monosodium glutamate (MSG)-induced obesity and the effect of metformin at this finding. Twenty five rats were studied and divided into five groups: control with 16 e 22 weeks (CON-16 and CON-22); obese with 16 and 22 weeks (MSG-16 e MSG-22), and obese + metformin (MET-22) 300mg/Kg/day per oral. The characterization of insulin resistance was done through measurement of plasma insulin and calculation of HOMA-IR index. The morphological analysis and the quantification of myocardial collagen were carried out by Image Pro Plus analysis system. The systolic blood pressure was slightly higher in MSG-22 group, reaching statistical significance when compared to MSG-16 group (1222 vs 1082 mmHg, p<0.05). On the other hand, the MET-22 group demonstrated lower blood pressure levels (1181 mmHg), without reaching statistical difference. The obese animals presented increase in media-to-lumen ratio with 16 weeks (39.93.7 vs 30.22.0 %, p<0.05) and with 22 weeks (39.81.3 vs 29.51.2%, p<0.05), which was reduced with use of metformin (31.50.9%). The collagen deposition in perivascular area of left ventricle was significantly greater in MSG-22 group (1.390.06 vs 0.830.06 % in CON-22, p<0.01), and attenuated by metformin (1.020.04%). In the kidney, the media cross-sectional area of intrarenal arterioles was similar among the groups (18.52.2 in CON-16; 19.93.7 in MSG-16; 18.93.1 in CON-22; 21.81.5 in MSG-22; 20.21.4 in MET-22). An increase of glomerular area was observed in MSG-22 group (141.34.5 vs 129.50.5 m2), but without statistical significance. In conclusion, rats with MSG-induced obesity and insulin resistance presented more pronounced cardiac changes than renal alterations. In the heart, there were evidences of hypertrophic vascular remodeling were observed in intramyocardial small arteries and perivascular fibrosis. These findings were, at least partially, attenuated by metformin for six weeks, suggesting that this drug may be beneficial for prevention of cardiac, vascular and renal complications associated with obesity.

Diversas evidências comprovam que a obesidade está associada a alterações estruturais e funcionais do coração em modelos humanos e animais. Outros estudos recentes também demonstram que a obesidade humana está associada com alterações na função e na estrutura vascular, especialmente em grandes e médias artérias. Estudos epidemiológicos têm confirmado que a obesidade é um fator de risco significativo para o aparecimento de proteinúria e de doença renal terminal em uma população normal. Com o objetivo de determinar as alterações morfológicas relacionadas ao remodelamento cardíaco, vascular e renal em um modelo experimental de obesidade induzida pelo glutamato monossódico (MSG) e os efeitos da metformina sobre estes achados, foram estudados 25 ratos divididos em cinco grupos: controle com 16 e 22 semanas (CON-16 e CON-22); obeso com 16 e 22 semanas (MSG-16 e MSG-22) e obeso + metformina (MET-22) 300mg/Kg/dia por via oral. A caracterização da resistência à insulina foi feita através da medida da insulina plasmática e cálculo do índice de HOMA-IR. As análises morfológicas e quantificação do colágeno miocárdico foram feitos pelo sistema de imagem Image Pro Plus analysis. A pressão arterial sistólica foi levemente maior no grupo MSG-22, adquirindo significância estatística quando comparada com o grupo MSG-16 (1222 vs 1082 mmHg, p<0,05). Por outro lado, o grupo MET-22 mostrou níveis mais baixos de pressão arterial (1181 mmHg), sem alcançar diferença significativa. No grupo de animais obesos, foi observado aumento na relação média-lumen com 16 semanas (39,93,7 vs 30,22,0 %, p<0,05) e com 22 semanas (39,81,3 vs 29,51,2%, p<0,05), que foi reduzida com o uso da metformina (31,50,9%). O depósito de colágeno na área perivascular no ventrículo esquerdo foi significativamente maior no grupo MSG-22 (1,390,06 vs 0,830,06 % no CON-22, p<0,01), sendo atenuado pela metformina (1,020,04%). No rim, a área seccional transversa das arteríolas intrarrenais foi semelhante entre os grupos (18,52,2 no CON-16; 19,93,7 no MSG-16; 18,93,1 no CON-22; 21,81,5 no MSG-22; 20,21,4 no MET-22). Foi observado aumento da área glomerular no grupo MSG-22 (141,34,5 vs 129,50,5 m2), mas sem significância estatística. Em conclusão, nos ratos com obesidade induzida pelo MSG, com resistência à insulina, as alterações cardíacas foram mais proeminentes do que as alterações renais. No coração foram observados sinais de remodelamento vascular hipertrófico nas pequenas artérias intramiocárdicas e evidências de fibrose miocárdica mais proeminente na área perivascular, alterações que foram, pelo menos parcialmente, atenuadas com o uso de metformina durante seis semanas, mostrando que esta droga pode ser benéfica na prevenção de complicações cardíacas, vasculares e renais associadas com a obesidade. / Many evidences show that obesity is associated to structural and functional changes in the heart of human and animal models. Recent studies also show that human obesity is associated with vascular structural and functional modifications, specially at large and medium-sized arteries. Epidemiological studies have confirmed that obesity is a significant risk factor for the development of proteinuria and end-stage renal disease in a normal population. With the objective to determinate morphological changes related to cardiac, vascular and renal remodeling in an experimental model of monosodium glutamate (MSG)-induced obesity and the effect of metformin at this finding. Twenty five rats were studied and divided into five groups: control with 16 e 22 weeks (CON-16 and CON-22); obese with 16 and 22 weeks (MSG-16 e MSG-22), and obese + metformin (MET-22) 300mg/Kg/day per oral. The characterization of insulin resistance was done through measurement of plasma insulin and calculation of HOMA-IR index. The morphological analysis and the quantification of myocardial collagen were carried out by Image Pro Plus analysis system. The systolic blood pressure was slightly higher in MSG-22 group, reaching statistical significance when compared to MSG-16 group (1222 vs 1082 mmHg, p<0.05). On the other hand, the MET-22 group demonstrated lower blood pressure levels (1181 mmHg), without reaching statistical difference. The obese animals presented increase in media-to-lumen ratio with 16 weeks (39.93.7 vs 30.22.0 %, p<0.05) and with 22 weeks (39.81.3 vs 29.51.2%, p<0.05), which was reduced with use of metformin (31.50.9%). The collagen deposition in perivascular area of left ventricle was significantly greater in MSG-22 group (1.390.06 vs 0.830.06 % in CON-22, p<0.01), and attenuated by metformin (1.020.04%). In the kidney, the media cross-sectional area of intrarenal arterioles was similar among the groups (18.52.2 in CON-16; 19.93.7 in MSG-16; 18.93.1 in CON-22; 21.81.5 in MSG-22; 20.21.4 in MET-22). An increase of glomerular area was observed in MSG-22 group (141.34.5 vs 129.50.5 m2), but without statistical significance. In conclusion, rats with MSG-induced obesity and insulin resistance presented more pronounced cardiac changes than renal alterations. In the heart, there were evidences of hypertrophic vascular remodeling were observed in intramyocardial small arteries and perivascular fibrosis. These findings were, at least partially, attenuated by metformin for six weeks, suggesting that this drug may be beneficial for prevention of cardiac, vascular and renal complications associated with obesity.

Indiana University-Purdue University Indianapolis (IUPUI) / Obesity increases cardiovascular disease risk and is associated with factors of the “metabolic syndrome” (MetS), a disorder including hypertension, hypercholesterolemia and/or impaired glucose tolerance. Expanding adipose and subsequent inflammation is implicated in vascular dysfunction in MetS. Perivascular adipose tissue (PVAT) surrounds virtually every artery and is capable of releasing factors that influence vascular reactivity, but the effects of PVAT in the coronary circulation are unknown. Accordingly, the goal of this investigation was to delineate mechanisms by which lean vs. MetS coronary PVAT influences vasomotor tone and the coronary PVAT proteome. We tested the hypothesis that MetS alters the functional expression and vascular contractile effects of coronary PVAT in an Ossabaw swine model of the MetS. Utilizing isometric tension measurements of coronary arteries in the absence and presence of PVAT, we revealed the vascular effects of PVAT vary according to anatomical location as coronary and mesenteric, but not subcutaneous adipose tissue augmented coronary artery contractions to KCl. Factors released from coronary PVAT increase baseline tension and potentiate constriction of isolated coronary arteries relative to the amount of adipose tissue present. The effects of coronary PVAT are elevated in the setting of MetS and occur independent of endothelial function. MetS is also associated with substantial alterations in the coronary PVAT proteome and underlying increases in vascular smooth muscle Ca2+ handling via CaV1.2 channels, H2O2-sensitive K+ channels and/or upstream mediators of these ion channels. Rho-kinase signaling participates in the increase in coronary artery contractions to PVAT in lean, but not MetS swine. These data provide novel evidence that the vascular effects of PVAT vary according to anatomic location and are influenced by the MetS phenotype.

Indiana University-Purdue University Indianapolis (IUPUI) / Research indicates that negative affective traits (e.g., depression) are predictors and consequences of excess adiposity. Given that racial minorities and positive affective traits have been underrepresented in past investigations, more prospective studies are needed which examine multiple affective traits in relation to obesity in these populations. The objective of the current study was to investigate the prospective, bidirectional associations between multiple affective traits and multiple adiposity indicators in African Americans using data from the African American Health (AAH) study. The AAH study is a prospective cohort study of African Americans aged 49-65 years at baseline (N = 998). The longest follow-up period in the current study was 9 years (N = 579). Self-reported and measured body mass index (BMI; kg/m2) and body fat percent (BF%) were used as adiposity indicators. Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies-Depression Scale (CES-D), and anxiety was assessed using the Generalized Anxiety Disorder-2 (GAD-2) scale. Positive affective traits were assessed with the Vitality subscale of the Short Form-36 and Positive Affect subscale from the CES-D. Latent variable path analysis, a structural equation modeling technique, was conducted. Although fit statistics indicated that the models fit the data (RMSEA < .06), examination of the structural paths revealed that the CES-D and GAD-2 were not predictors or consequences of self-reported BMI, measured BMI, or BF% (ps > .05). Likewise, Vitality and CES-D Positive Affect were not related to any adiposity indicator (ps > .05). The results of this prospective cohort study suggest that affective traits are not predictors or consequences of adiposity in middle-aged African Americans and that this group may require obesity prevention or intervention programs with little to no emphasis on affective traits. Possible explanations for the current results include ethnic differences in the mechanistic pathways between affective traits and adiposity.