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Bariatric Surgery: The Good, Bad, & Questionable

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Obesity has developed into a worldwide health problem that is associated with many risks. The elements causing obesity are complex and numerous including behavioral, psychological, and physiological. Traditional methods of weight loss have demonstrated short-lived positive health benefits and minimal

Obesity has developed into a worldwide health problem that is associated with many risks. The elements causing obesity are complex and numerous including behavioral, psychological, and physiological. Traditional methods of weight loss have demonstrated short-lived positive health benefits and minimal long-term weight loss, which has led to the prevalence of bariatric surgery as an answer to long-term weight loss for Class III obesity. Gastric bypass surgery has become especially popular for its numerous benefits including successful weight loss, improvements in obesity-related diseases, and increased lifespan. Bariatric surgery is still not a perfect solution. Negative effects after surgery range from surgical complications and vitamin deficiencies to altered hormonal levels and metabolic rates. Many questions regarding bariatric surgery still remain including the impact of adolescent bariatric surgery, long-term bone effects, and long-term psychosocial and lifestyle components of bariatric patients. Understanding the good, the bad, and several of the remaining questions regarding bariatric surgery, will help health professionals be more appreciative of the complexity of treating their obese patients.

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2018-05

A Pilot, Longitudinal Study of the Effect of a High Fat Diet Compared to a Chow Diet on the Energy Gap Between Energy Intake and Energy Expenditure

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This is a pilot study testing a new indirect calorimeter device. This project was designed to determine the effect of a high fat versus a standard chow diet and age on the energy gap (the difference between energy intake and

This is a pilot study testing a new indirect calorimeter device. This project was designed to determine the effect of a high fat versus a standard chow diet and age on the energy gap (the difference between energy intake and energy expenditure). Measurements of energy expenditure and oxygen consumption were obtained over a 23-hour period from a group of rats fed a high fat diet and a group of rats fed standard chow diet. The experiments were repeated during an experimental phase for 12 weeks, a phase of caloric restriction for 4 weeks, and a phase of weight regain for 4 weeks. We found energy expenditure and oxygen consumption to decrease in the caloric restriction phase and increase with excessive weight gain. Rats fed a high fat diet and obesity prone rats had a wider energy gap than rats fed a standard chow diet and obesity resistant rats. The caloric restriction phase closed the energy gap between energy expenditure and energy intake for all of the rats. The weight regain phase shifted the rats back into positive energy balance so that the energy intake was greater than the energy expenditure. The rats showed greater weight gain in the weight regain phase than in the experimental phase for all groups of rats. The indirect calorimeter device would require further testing to improve the accuracy of the measurements of respiratory quotient and carbon dioxide production before being used in future clinical research applications. The indirect calorimeter device has the potential to record respiratory quotient and carbon dioxide production.

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2019-05

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Effects of Menthol on Weight Regain and Maintenance of Caloric Restriction: A Pilot Study

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The prevalence of excessive weight gain (obesity) has steadily increased since about 1980. Excessive weight gain is associated with many comorbidities; thus, a successful treatment is needed. The most common form of non-surgical treatment for excessive weight gain is caloric

The prevalence of excessive weight gain (obesity) has steadily increased since about 1980. Excessive weight gain is associated with many comorbidities; thus, a successful treatment is needed. The most common form of non-surgical treatment for excessive weight gain is caloric restriction with the intent to reduce body weight by 10%. Though this treatment is successful at reducing body weight, it often fails at maintaining the weight loss. Dietary menthol has been suggested as a possible treatment for excessive weight gain and has produced promising results as a preventative method for excessive weight gain. Our studies aimed at reducing weight regain and maintaining caloric restriction by feeding male Sprague-Dawley rats 0.5% dietary menthol during a period of caloric restriction, aimed at reducing their body weight by 10%, following an experimental period where the rats were fed a high-fat diet (HFD) or low-fat diet (LFD). The effects of the dietary menthol were observed during the weight regain period following the caloric restriction period. Two studies were conducted, and both were unable to achieve a maintenance of weight loss following caloric restriction, although our first study was able to produce a delay in weight regain and did not show any evidence of increased thermogenesis in menthol-treated rats. Our findings differ from the findings of previous studies on dietary menthol which could possibly be due to species effects, differences in procedures, age effects, or effects of different fatty acid compositions. The contrasting results in our studies could be due to genetic differences between litters used or a difference in manufacturing of the menthol diet between studies. Given the partial response to menthol in the first study, it can be suggested that the concentration of 0.5% may be below the threshold of menthol sensitivity for some rats. Future research should focus on increasing the concentration of dietary menthol from 0.5% to 1%, since the current concentration did not yield a reduction in weight regain or maintenance of caloric restriction.

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2019-05

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The Role of UCP-1 in Human Omental Tissue

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The prevalence of obesity continues to increase in the United States, along with its risk for other associated cardiovascular and metabolic diseases. Several therapeutic methods are aimed at targeting and reducing obesity, now defined as a state of chronic, low-grade

The prevalence of obesity continues to increase in the United States, along with its risk for other associated cardiovascular and metabolic diseases. Several therapeutic methods are aimed at targeting and reducing obesity, now defined as a state of chronic, low-grade inflammation (in addition to BMI > 30 kg/m2). In an attempt to expand on these therapeutic methods, research on the concept of browning in white adipose tissue (WAT) and brown adipose tissue (BAT) is being conducted. Brown adipose tissue (BAT), and a newly discovered type of adipocyte, beige adipocytes, are heavily involved in thermogenesis with the use of uncoupling protein-1 (UCP-1). This paper focuses on the analysis of common browning genes, ATP-related genes, and metabolic genes in varying biological groups in mice (Chow/High-Fat Diet and Inguinal FAT and Perigonadal Fat) and in humans (Lean/Obese and Subcutaneous WAT (SC) and Omental WAT (OM)) using methods such as RT-PCR and immunohistochemistry. The data obtained shows an increase in browning in the leaner group, specifically in the subcutaneous fat. Further, browning is significantly reduced in the obese groups of subjects and mice tested, in addition to omental/perigonadal versus subcutaneous/inguinal fat depots. Interestingly, two key ATP genes, UCP-1 and COX4I1 are vastly elevated in the OM WAT, indicating that browning may not be as important in the OM, but rather may have a potential role in SC. This is contrary to prior research findings that attempt to exclude mice surrogates in future experimentation of the browning phenomenon. Further experimentation is needed to expand on the findings of this paper.

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2019-12

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Comparing the Efficacy of the Total Stabilizing and Posterior Stabilizing Knee Prostheses in Obese and Pre-Obese Females: A Retrospective Cohort Study

Description

Obesity is a growing issue in the Western world, as well as other international countries. This is leading to increases in complications associated with obesity. One such complication is osteoarthritis (OA) of load bearing joints that requires surgical treatment by

Obesity is a growing issue in the Western world, as well as other international countries. This is leading to increases in complications associated with obesity. One such complication is osteoarthritis (OA) of load bearing joints that requires surgical treatment by total knee arthroplasty (TKA). Obesity is also associated with an increase in surgical complications that may lead to poor TKA outcomes. Additionally, the female gender is also known to be associated with increased rates of severe, clinical OA. This study was designed to determine the comparative efficacy of two knee implants in the obese female population through retrospective chart review and data analysis. The implants differ in their level of constraint, with the total stabilizing (TS) being more constrained than the posterior stabilizing (PS). We hypothesized that the TS implants would be associated with improved functional outcomes in the obese female population. The TS implant was observed to be associated with earlier improvement of both passive and active range of motion. This implant also showed greater improvement from pre-operative condition in stability, rejecting our null hypothesis and supporting our hypothesis.

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2015-05

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Evaluating Changes in the Gut Microbial Composition, Diet, and Overall Health in Children in the Nutrition and Health Awareness Program

Description

In the United States, the prevalence of pediatric obesity has increased to 17% in the general population and even more so in the Hispanic pediatric population to 22.4%. These children are at a higher risk for associated comorbidities, including cardiovascular

In the United States, the prevalence of pediatric obesity has increased to 17% in the general population and even more so in the Hispanic pediatric population to 22.4%. These children are at a higher risk for associated comorbidities, including cardiovascular disease and insulin resistance. The purpose of the following study is to determine the effectiveness of the Nutrition and Health Awareness curriculum at reducing childhood obesity by evaluating alterations in the gut microbial composition, diet, and overall health of the students throughout the five-week program. Nutrition and Health Awareness (NHA) is a student organization that strives to reduce the prevalence of obesity, diabetes, and cardiovascular diseases, specifically in children, by providing active nutrition education services through peer mentoring in elementary schools and community programs. This study went through ASU's Institutional Review Board process and all forms were translated into Spanish. The control group maintained their normal routines and the experimental group received the 5 week NHA program and then continued with their normal routines. Anthropometric measures (Body Mass Index, waist-to-hip ratio, and blood pressure), diet measures (Hispanic food frequency questionnaire), fecal swabs, and content surveys were collected on weeks 0, 5, and 8. Contrary to expected, alpha diversity, kilocalorie intake, and macronutrient intake decreased as the study progressed for both the control and experimental groups. Anthropometric measurements were relatively stable. Though not statistically significant, the greatest difference in time points is between weeks 1 and 8. This decrease in alpha diversity and kilocalorie intake could be due to a change in environment since the children started school on week 8. Future implications of this study are that parental involvement is necessary for an effective, sustainable change in these children. More research in different settings is necessary to determine NHA's effectiveness

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2016-05

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What Kind of Problem is the Problem of Obesity?

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This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed

This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed as a problem has a profound impact on the kinds of solutions that may be deemed scientifically appropriate. But frames are not entirely evidence-based, inasmuch as political and moral values infuse debates about the nature of obesity. Drawing on interdisciplinary resources from bioethics and the philosophy of science, I strive to offer strategic insight in to how to navigate the complexity of these issues.

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2014-05

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Diet-induced alterations in energy homeostasis and central adiposity: liver and visceral adipose tissue

Description

There has been an alarming rise in the prevalence of obesity which has been attributed to the paralleled rise in consumption of high-fat foods. It’s commonly accepted that high-fat diets can lead to increased weight gain, however not all fats

There has been an alarming rise in the prevalence of obesity which has been attributed to the paralleled rise in consumption of high-fat foods. It’s commonly accepted that high-fat diets can lead to increased weight gain, however not all fats have the same physiological action. This study primarily focuses on the effect of canola oil, a monounsaturated fat, on energy homeostasis and body composition when it’s given as a supplement to a high-fat diet composed of saturated fatty acid. Rodent models were divided into three dietary groups: 1) low-fat diet (LFD), 2) high-fat diet (HFD) and 3) canola oils supplemented HFD (HF+CAN). After 4 weeks of dietary intervention, samples of epididymal fat, perinephric fat, and liver were analyzed across the three groups to see if the changes in energy homeostasis could be explained by the cellular behavior and composition of these tissues. Interestingly, the supplement of canola oil appeared to reverse the deleterious effects of a saturated fat diet, reverting energy intake, body weight gain and adipose tissue sizes to that (if not lower than that) of the LFD group. The only exception to this effect was the liver: the livers remained larger and fattier than those of the HFD. This occurrence is possibly due to a decrease in free fatty acid uptake in the adipose tissues—resulting in smaller adipose tissue sizes—and increased fatty acid uptake in the liver. The mechanism by which this occurs has yet to be elucidated and will be the primary focus of upcoming studies on the effect of monounsaturated fat on other diets.

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2015-05

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Nutritional Factors Influencing Canine Food Preferences

Description

Dogs' health and wellbeing is of great importance to their owners. The most common nutritional problem for pet dogs is obesity, with 22-40% of pet dogs being classified as overweight or obese. With many adverse health effects associated with obesity,

Dogs' health and wellbeing is of great importance to their owners. The most common nutritional problem for pet dogs is obesity, with 22-40% of pet dogs being classified as overweight or obese. With many adverse health effects associated with obesity, this is a major concern for owners and veterinarians. The degree to which dogs enjoy consuming certain foods can have substantial implications for their body weight, so it is important to understand which aspects of foods make them appealing to dogs. This study aimed to determine whether nutritional aspects of commercial dog foods predict dogs' preferences for those foods. It was found that consumption preference is positively correlated with protein content (p < .001), therefore implying that the protein content of commercial dry dog foods may predict dogs' consumption preferences. Consumption preferences were not predicted by other available measures of food content or caloric value. Dogs' preference for foods high in protein content may be due to the satiating effect of protein. Since foods high in protein both reduce the amount of energy consumed and are found to be palatable to dogs, high-protein dog foods may offer a way for dog food manufacturers, veterinarians, and pet owners to combat obesity in pet dogs.

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2016-05

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Impact of In-Utero Dexamethasone on Autonomic Regulation in Adulthood

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Premature babies are at risk of death from immature lung development. For this reason, pregnant mothers at risk for preterm delivery are administered dexamethasone (DEX), a synthetic glucocorticoid that promotes fetal lung development. However, exposure to DEX in utero is

Premature babies are at risk of death from immature lung development. For this reason, pregnant mothers at risk for preterm delivery are administered dexamethasone (DEX), a synthetic glucocorticoid that promotes fetal lung development. However, exposure to DEX in utero is associated with low birth weight and cardiovascular development pathologies. Moreover, our lab found that DEX administration in-utero leads to a sex-specific increase in stress-induced tachycardia in female, but not male offspring. This project seeks to expand on this preliminary finding of the heart by examining local effectors of activity from the sympathetic system (tyrosine hydroxylase and catechol-o-methyltransferase). Tyrosine hydroxylase was measured as it catalyzes the rate limiting step of norepinephrine synthesis while catechol-O- methyltransferase was studied as it catalyzes the degradation of norepinephrine. Acetylcholinesterase was used to measure parasympathetic activity as it catalyzes the degradation of the primary neurotransmitter of the parasympathetic nervous system, acetylcholine. Analyses of sympathetic as well as parasympathetic activity were done to determine influences of in-utero DEX exposure on autonomic regulation in adulthood. Pregnant rats were administered DEX (0.4 mg/kg, i.p.) or vehicle (20% w/v 2-hydroxypropyl ß- cyclodextran) at gestation days 18-21, with euthanasia of offspring occurring at around the time the offspring reached 13-15 weeks of age. Left ventricles and right atria were pulverized, processed and subjected to western blot analysis to determine expression of proteins of interest. Males exposed to DEX in-utero saw a decrease in tyrosine hydroxylase expression in left ventricle and right atrium when compared to vehicle control, a difference not seen with females. In addition, catechol-o-methyltransferase expression was increased in right atria from male, but not female rats. Acetylcholinesterase expression was reduced in the right atria of female, but not male rats. The present findings suggest reduced norepinephrine signaling in the heart of male, but not female DEX-exposed offspring. Given that we have previously found that female, but not male rats exhibit exaggerated stress-induced tachycardia, our current findings suggest that males possess a sex-specific compensatory mechanism allowing the heart to resist increased sympathetic signaling from the brain, one that females do not possess. The underlying mechanics of this proposed mechanism are unclear, and further investigation is needed in this subject to determine the significance of the findings from our study.

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2021-05