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Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and

Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and gender are associated with parental misperception of their child's weight status, but little is known about the interaction of these factors across various age groups. This study examined the association between a wide range of parent, child, and household factors and the accuracy of parental perception of their child's body weight status compared to parent-measured body weight status. Methods: Data were collected from a random-digit-dial telephone survey of 1708 households located in five low-income New Jersey cities with large minority populations. A subset of 548 children whose parents completed the survey and returned a worksheet of parent-measured heights and weights were the focus of the analysis. Bivariate and multivariate analyses were performed to determine the factors significantly associated with parental perception of their child's body weight status. Results: Based on parent-measure heights and weights, 36% of the children were overweight or obese (OWOB). Only 21% of OWOB children were perceived by their parents as OWOB. Child gender, child body mass index (BMI) and parent BMI were significant independent predictors of parents' accuracy at perceiving their child's body weight status. Conclusion: Boys, OWOB children, and children of OWOB parents had significantly greater odds of parental underestimation of their body weight status. Parents had better recognition of OWOB in their daughters, especially older daughters, than in their sons, suggesting parental gender bias in identifying OWOB in children. Further research is needed regarding parental gender bias and its implications in OWOB identification in children.
ContributorsBader, Wendy (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Lloyd, Kristen (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D.

Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
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Description
It is widely recognized that dietary protein induces greater satiety compared to carbohydrate and fat. Two separate trials were conducted to assess the use of protein as a dietary approach to manage energy intake (EI). The first, crossover trial, examined 24– hour EI after consuming a high protein bar (HP)

It is widely recognized that dietary protein induces greater satiety compared to carbohydrate and fat. Two separate trials were conducted to assess the use of protein as a dietary approach to manage energy intake (EI). The first, crossover trial, examined 24– hour EI after consuming a high protein bar (HP) vs. a high carbohydrate (HC) bar upon awakening on two separate days and a control, no bar day. Of the 54 participants who entered the trial, 37 subjects completed the study in its entirety. Results showed there was no significant difference in mean EI between the intervention days when the bars were consumed and the control day. The subjects consumed 1752±99 kcal on the control day, and 1846±75 and 1891±110 kcal on the days the HP and HC bars were consumed, respectively (P=0.591). However, compared to the control day, snack bar ingestion was significantly related to an increase in EI for the subjects who self-reported high weekly physical activity levels (n=11) (+22%; P=0.038 and +45%; P=0.030, HP and HC bars, respectively). These data suggest that individuals who have moderate to low physical activity levels compensate for the ingestion of energy bars (regardless of protein content) over a 24–hour period. The second parallel-arm, pilot trial examined the effect of 6 g daily gelatin ingestion vs. control on EI and weight change in healthy, overweight and obese women who initiated a walking program. Of the 37 women who entered the trial, 28 completed the six week trial. The results showed activity level (steps/d) increased in both groups (+ 22%, P=0.022). There was a significant group difference in mean EI at week 6 vs. baseline (–174±612 kcal/d and +197±320 kcal/d, P=0.001; gelatin and control groups, respectively). However, there was no significant between group difference for changes in weight, percent body fat and waist circumference. Those subjects having baseline Disinhibition scores of ≥12 gained significantly more weight throughout the study vs. those scoring <12 (P=0.004). These results indicate that daily gelatin ingestion may be a practical strategy for controlling EI among overweight and obese women initiating an exercise program.
ContributorsTrier, Catherine M (Author) / Johnston, Carol S. (Thesis advisor) / Swan, Pamela D. (Committee member) / Mayol-Kreiser, Sandra N. (Committee member) / Appel, Christy L. (Committee member) / Gaesser, Glenn A. (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle

Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle behaviors in families. Parental influence plays an important factor in the development of healthy behaviors in children. Cognitive behavioral interventions have demonstrated preliminary success in promoting healthy lifestyle behaviors in both adults and children. Mobile technology used to supplement interventions aimed at behavior change offers an outlet to bridge gaps in health disparities and generate innovative evidence. Therefore, the purpose of this research was to establish the feasibility, acceptability, and preliminary effects of a cognitive-behavioral intervention (TEXT2COPE) synergized with mobile technology on the healthy lifestyle behaviors of parents of overweight and obese preschoolers. Primary aims of the proposed pilot study were to (a) examine the feasibility and acceptability of the TEXT2COPE program among parents of overweight or obese preschoolers with mobile phones; (b) evaluate the preliminary effects of the TEXT2COPE program on healthy lifestyle behaviors in families with overweight or obese preschoolers; and (c) evaluate the relationship among the study variables (i.e., cognitive beliefs, perceived difficulty, and healthy lifestyle behaviors). Findings indicate that this program is feasible and acceptable in this population. The intervention improved healthy lifestyle beliefs and behaviors in parents. Further supported are the interconnected relationships between parental beliefs, thoughts, and behaviors.
ContributorsMilitello, Lisa K (Author) / Melnyk, Bernadette M (Thesis advisor) / Small, Leigh (Committee member) / Hekler, Eric (Committee member) / Jacobson, Diana (Committee member) / Arizona State University (Publisher)
Created2014
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Description
ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is

ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is a polyunsaturated fatty acid that is beneficial at reducing body weight and in lowering many cardiovascular risk factors like atherosclerosis. The present study was designed to examine the change in plasma concentrations of leptin, nitric oxide, and the antioxidant superoxide dismutase in addition to examining the association between leptin and NO in healthy normal weight adult female subjects before and following omega 3 intakes. Participants were randomly assigned to either a fish oil group (600 mg per day) or a control group (1000 mg of coconut oil per day) for 8 weeks. Results showed no significant difference in the percent change of leptin over the 8 week supplementation period for either group (15.3±31.9 for fish oil group, 7.83±27 for control group; p=0.763). The percent change in NO was similarly not significantly altered in either group (-1.97±22 decline in fish oil group, 11.8±53.9 in control group; p=0.960). Likewise, the percent change in superoxide dismutase for each group was not significant following 8 weeks of supplementation (fish oil group: 11.94±20.94; control group: 11.8±53.9; p=0.362). The Pearson correlation co-efficient comparing the percent change of both leptin and NO was r2= -0.251 demonstrating a mildly negative, albeit insignificant, relationship between these factors. Together, these findings suggest that daily supplementation with 600 mg omega 3 in healthy females is not beneficial for improving these cardiovascular risk markers. Future studies in this area should include male subjects as well as overweight subjects with larger doses of fish oil that are equivalent to three or more servings per week. The importance of gender cannot be underestimated since estrogen has protective effects in the vasculature of females that may have masked any further protective effects of the fish oil. In addition, overweight individuals are often leptin-resistant and develop impaired vasodilation resulting from superoxide-mediated scavenging of nitric oxide. Therefore, the reported antioxidant and weight loss properties of omega 3 supplementation may greatly benefit overweight individuals.
ContributorsAlanbagy, Samer (Author) / Sweazea, Karen (Thesis advisor) / Johnston, Carol (Committee member) / Shepard, Christina (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2014
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Descriptionyour words
ContributorsWang, Dan, M.S (Author) / Grebitus, Carola (Thesis advisor) / Schroeter, Christiane (Committee member) / Manfredo, Mark (Committee member) / Hughner, Renee (Committee member) / Arizona State University (Publisher)
Created2014
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Description
The rate of obesity has increased noticeably in China since the 1980s, brought about by the "After Mao" revolution. This dissertation examines the social determinants of obesity and weight gain among men and women, using 1991-2009 waves of the longitudinal China Health and Nutrition Survey. The first study emphasizes that

The rate of obesity has increased noticeably in China since the 1980s, brought about by the "After Mao" revolution. This dissertation examines the social determinants of obesity and weight gain among men and women, using 1991-2009 waves of the longitudinal China Health and Nutrition Survey. The first study emphasizes that rapid technological adoption at home may also have the potential to lead to obesity epidemics. I hypothesize that adopting household technology is a factor in weight gain, independent from daily calorie consumption and energy expenditure in exercise. The results show household technology ownership and weight gain are linked, while changes in overall energy intake and exercise may not function as mediators for this relationship. Future public health policy may evaluate interventions that are focused on increasing low-intensity activities impacted by household technologies. My second study discusses whether obesity wage penalties seen in Western societies, such as wage reductions for obese individuals, are observed in modern China. The results indicate that obese women are not subject to wage penalties, while current male obesity rates may be worsened by heightened economic outcomes and greater social acceptance by customers and colleagues. With increasing interpersonal interactions in the workplace in Chinese industries, and the lack of public awareness of the risks of obesity, Chinese public health strategies for preventing and controlling obesity should target male non-manual laborers, the most vulnerable population in the future. The third study analyzes the impact of parental and own socioeconomic status on adult body weight and extends the research by estimating the influence of intergenerational social mobility on current body mass index. In the context of increasing social inequality in China, the study shows parental SES, own SES, and social mobility to be negatively associated with body mass index among women; while respondent's SES is positively associated with body mass index among men. The study results support the theory that parental SES has a more significant impact on current body weight for men and women after controlling social mobility; indicating that social mobility may function as a mediator for the relationship between parental SES and current body mass index.
ContributorsHuang, Chih-Chien (Author) / Kronenfeld, Jennie (Thesis advisor) / Yabiku, Scott (Committee member) / Damgaard, Anni (Committee member) / Arizona State University (Publisher)
Created2014
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Description
Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional

Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional breakfast at school amongst youth using a survey assessing possible predictors (i.e. parental education, morning activities, race), the ASA-kids 24-hr dietary recall, and height and weight measurements. A total of fifty-eight participants (aged 13.5±1.6 years; 55.2% male) were recruited at after school library programs and Boys and Girls Clubs in the Phoenix, Arizona Metro Area during 2014. The main outcomes measured were BMI percentile, total calories, iron, sodium, carbohydrates, added sugar, and fiber. In the study, the prevalence of consumption of an additional breakfast at school at least once a week or more was 32.7%. There were no significant differences between the consumption of an additional breakfast and not an additional breakfast amongst the main outcomes measures. The directionality of the relationship between the consumption of an additional breakfast and overweight/obesity amongst youth was inverse (OR = 0.309; p-value = 0.121), but this was not significant. This study found that the consumption of an additional breakfast at school is not contributing to overweight/obesity in youth, nor does it alter overall caloric and nutrient intake. School breakfast programs are important for providing breakfast and key nutrients to youth.
ContributorsSimpson, Julie (Author) / Bruening, Meg (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Rider, Linda (Committee member) / Arizona State University (Publisher)
Created2015
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Description
While obesity rates have plateaued within the last decade,

two-thirds of the United States

population is currently classified as overweight (defined a

s a body mass index [BMI] of

25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric

surgical interventions

are not only more effective than behavioral treatments

in

While obesity rates have plateaued within the last decade,

two-thirds of the United States

population is currently classified as overweight (defined a

s a body mass index [BMI] of

25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric

surgical interventions

are not only more effective than behavioral treatments

in the short term but are the only

form of obesity intervention with evidence of consisten

t long-term effectiveness.

However, even among bariatric surgery patients, weight

loss often stabilizes and it is

estimated that more than 20% of bariatric surgery patient

s will regain a significant

amount of weight that was initially lost long-term. Li

ttle research to date has been

conducted on physical activity in post bariatric surgery pati

ents. More specifically, there

have been no studies to date examining the effects of Me

ditative Movement (MM)

programs on body composition in bariatric patients. A s

tudy using an 8-week Tai Chi

Easy program was conducted in female gastric bypass patient

s to explore feasibility of

MM in the bariatric population as well as pre- and post-in

tervention changes in weight,

mindfulness, eating behaviors, body awareness, physical a

ctivity patterns, dietary quality

and mood. Data analysis revealed that there were no s

ignificant changes in weight or

physical activity patterns; however, significant changes w

ere observed in anxiety, overall

body awareness and cognitive restraint in eating. Addit

ionally, a significant decrease in

processed meat consumption and a weak trend towards increa

sed consumption of fruits

may suggest an overall improvement in dietary quality.
ContributorsSmith, Lisa L. (Author) / Larkey, Linda K (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Ohri-Vachaspati, Punam (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2014
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Description
In adults, consuming a high-fat meal can induce endothelial dysfunction while exercise may mitigate postprandial endothelial dysfunction. Whether exercise is protective against postprandial endothelial dysfunction in obese youth is unknown. The purpose of this study was to determine if high-intensity interval exercise (HIIE) performed the evening prior to a high-fat

In adults, consuming a high-fat meal can induce endothelial dysfunction while exercise may mitigate postprandial endothelial dysfunction. Whether exercise is protective against postprandial endothelial dysfunction in obese youth is unknown. The purpose of this study was to determine if high-intensity interval exercise (HIIE) performed the evening prior to a high-fat meal protects against postprandial endothelial dysfunction in obese adolescent males. Fourteen obese adolescent males (BMI%tile=98.5±0.6; 14.3±1.0yrs) completed the study. After initial screening, participants arrived, fasted at 9:00 in the morning where brachial artery flow-mediated dilation (FMD) was measured using duplex ultrasound after 20min of supine rest (7.0±3.0%) and completed a maximal exercise test on a cycle ergometer (VO2peak=2.6±0.5 L/min). Participants were randomized and completed 2 conditions: a morning high-fat meal challenge with evening prior HIIE (EX+M) or a morning high-fat meal challenge without prior exercise (MO). The EX+M condition included a single HIIE session on a cycle ergometer (8 X 2min at ≥90%HRmax, with 2min active recovery between bouts, 42min total) which was performed at 17:00 the evening prior to the meal challenge. In both conditions, a mixed-meal was tailored to participants body weight consisting of 0.7g of fat/kg of body weight consumed (889±95kcal; 65% Fat, 30% CHO). FMD was measured at fasting (>10hrs) and subsequently measured at 2hr and 4hr after high-fat meal consumption. Exercise did not improve fasting FMD (7.5±3.0 vs. 7.4±2.8%, P=0.927; EX+M and MO, respectively). Despite consuming a high-fat meal, FMD was not reduced at 2hr (8.4±3.4 vs. 7.6±3.9%; EX+M and MO, respectively) or 4hr (8.8±3.9 vs. 8.6±4.0%; EX+M and MO, respectively) in either condition and no differences were observed between condition (p(condition*time)=0.928). These observations remained after adjusting for baseline artery diameter and shear rate. We observed that HIIE, the evening prior, had no effect on fasting or postprandial endothelial function when compared with a meal only condition. Future research should examine whether exercise training may be able to improve postprandial endothelial function rather than a single acute bout in obese youth.
ContributorsRyder, Justin Ross (Author) / Shaibi, Gabriel Q (Thesis advisor) / Gaesser, Glenn A (Committee member) / Vega-Lopez, Sonia (Committee member) / Crespo, Noe C (Committee member) / Katsanos, Christos (Committee member) / Arizona State University (Publisher)
Created2014