DNP, Otterbein University, 2025, Nursing

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in obese patients undergoing general anesthesia. Employing the PET process of the Johns Hopkins Nursing Evidence-Based Practice (EBP) Model, the project develops evidence-based recommendations. By conducting evidence review and analyzing literature on clinical and economic outcomes, including postoperative complications and costs, anesthesia providers will receive guidance in optimizing patient care and resource utilization.

Committee: Kirk Hummer Dr. (Advisor); Amy Bishop Dr. (Committee Member); Brian Garrett Dr. (Committee Member) Subjects: Medicine; Nursing

Doctor of Philosophy, Miami University, 2019, Chemistry and Biochemistry

Type 1 Diabetes is a disease that has exhibited increasing incidence rates worldwide and is not effectively predicted by genetic factors. While many of the genetic components of T1D development are well studied, the multifactorial nature of the disease has made attempts to predict development problematic. Recently, the increasing sophistication of omics fields, such as metabolomics and metagenomics, has allowed for effective examination of the relationship between bacterial population and metabolites to T1D development. First, this dissertation describes the development of a new ranked confidence schema for metabolite reporting in NMR metabolomics studies. The ranking scheme, entitled RANCM, is also described and utilized. Also detailed are a series of studies examining the NOD mouse model, which is considered a standard animal model for studying T1D development due to numerous similarities to the human disease and involves fecal metagenomic analysis performed alongside metabolomic Nuclear Magnetic Resonance (NMR) studies. Several cohorts of NOD mice were prepared alongside NOR control animals and fecal extracts demonstrated significant alterations in the bacterial populations as well as bacterial metabolites which were observed in fecal samples between animals that developed the T1D at differing ages and controls. Additional comparisons showed significant alterations between fecal extracts due to aging and between different categories of NOD mice based on disease onset which was found to be distinct from other observed metabolic shifts. These data supported the conclusion that the NOD mouse demonstrates a characteristic series of bacterial alterations alongside shifts in the bacterial metabolic profile based on age and disease onset. A parallel immunohistochemical (IHC) study details the relationship between the expression of a zonulin analog protein in the intestines of NOD mice, showing significant increases in expression during T1D development when compared with (open full item for complete abstract)

Committee: Michael Kennedy PhD (Advisor); Danielson Neil PhD (Committee Chair); Crowder Michael PhD (Committee Member); Page Richard PhD (Committee Member); Robinson Michael PhD (Other) Subjects: Biochemistry; Biology; Chemistry

MS, Kent State University, 2019, College of Education, Health and Human Services / School of Health Sciences

Because obesity and sleep are very complex multifactorial, there is a need to look at the variety of variables like BMI, sleep quality, duration, patterns and cultural impact. This study purpose was compared the differences in sleep duration based on total hours of sleep, quality based on PSQI, and sleep patterns based on weekdays/weekends bedtime shift and sleep hours shift; between 994 undergrad and postgrad students of varying BMI statuses (underweight, normal weight, overweight, and obese) from both universities KSU and KAU. Students who had any of this condition bariatric surgery, eating disorders, Prader-Willi/ Bardet-Biedl syndromes, underactive thyroid (hypothyroidism), pregnancy, less than 18 years old, sleep less than three hours per night, or/and have BMI less than 18 or more than 33 were excluded. A 2x2x4 factorial ANOVA used to analysis sleep quality, duration and patterns; and chi square used to analysis PSQI components. This study found that short sleep duration (P=0.044), and sleep efficiency (P=0.044) were linked to obesity. Moreover, KAU students had shorter sleep duration (P=0.001) with less quality (P=0.001) and higher bedtime shift (P=0.000) than KSU students. Moreover, stress, anxiety, depression, insomnia, and overthinking were the most common sleep troubles at college students. These findings suggest the need for educating college students about sleep in general (number of hours they need, improve sleep quality, and other related advices); besides, learning how to control theses influences (stress, anxiety, insomnia, depression, and overthinking) to enhance their sleep and their overall well-being and avoid future related health issues.

Committee: Natalie Caine-Bish (Advisor); Karen Gordon (Committee Member); Jamie Matthews (Committee Member) Subjects: Gender; Nutrition; Public Health; Public Health Education

MS, University of Cincinnati, 2019, Allied Health Sciences: Nutrition

Background: Perinatal obesity and excessive gestational weight gain can negatively affect birth and lactation outcomes and life course health of both mother and child. Anabolic dominance of the first half of pregnancy predisposes women toward fat deposition and postnatal weight retention. Most interventions designed to limit gestational weight gain target the second half of pregnancy, missing the critical window of early pregnancy. Also, most of these interventions are based on complex programs rather than applying habit adoption theory. Objective(s): 1) To identify common themes among obese pregnant women in the first half of pregnancy that influence dietary habits and behaviors. 2) From these common themes, elucidate positive habit formation strategies Methods: We used a qualitative study design to explore participants' dietary experiences in early pregnancy. Eight obese (BMI = 30 kg/m2) women in the first 20 weeks of pregnancy were interviewed using photo elicitation with one-on-one semi-structured in-home interviews. Interviews were transcribed verbatim and analyzed through thematic and constant comparative techniques. Results: The first author identified four main themes regarding dietary habits and behaviors that emerged from qualitative analysis of participant interview transcripts: 1) emotional health, 2) support systems, 3) preparation, and 4) enjoyment. Strategic behavioral intervention domains were elucidated that captured both physical/structural and emotional elements to enable positive dietary habit change. Conclusions: Specific habit adoption strategies for a dietary lifestyle intervention in the first half of pregnancy can be developed by considering the key themes that were identified. A future randomized trial that applies these themes within the specific strategic intervention areas with a focus on habit adoption is a promising approach to identifying scalable strategies for limiting gestational weight gain in the short t (open full item for complete abstract)

Committee: Laurie Nommsen-Rivers Ph.D. (Committee Chair); Karlynn Brintzenhofeszoc (Committee Member); Sarah Couch Ph.D. (Committee Member); Amy Thompson (Committee Member) Subjects: Nutrition

Doctor of Philosophy (PhD), Ohio University, 2019, Molecular and Cellular Biology (Arts and Sciences)

Type 1 diabetes (T1D) is on the rise globally, and both genetic and environmental factors are thought to play a role in triggering this disease. Female non-obese diabetic (NOD) mice are useful for studying T1D as they spontaneously develop T1D even when raised in a sterile environment. However, viruses, such as Coxsackievirus B4 (CVB4), will accelerate the onset of T1D in NOD mice when the infection occurs after a `threshold of insulitis' has been reached, usually between eight to ten weeks of age. Viral-induced T1D and beta cell destruction is believed to be driven in part by viral triggering of toll-like receptor 3 (TLR3), an innate immune receptor that recognizes viral dsRNA and whose signaling results in the production of key cytokines, chemokines and other antigen presenting molecules that are known to play a role in the pathogenesis of T1D. It has been previously shown that TLR3 plays a critical role in viral acceleration of T1D in female NOD mice since female TLR3 knockout NOD mice are protected from CVB4-induced acceleration of T1D. However, the exact role(s) that TLR3 plays in the pathogenesis of CVB4-induced T1D is not yet known. We utilized a molecular and cellular biology and time-course approach in uninfected and CVB4-infected female wild-type and TLR3 knockout NOD mice to garner a better understanding of the mechanisms by which TLR3 is involved in viral-mediated T1D. Our studies reveal that in uninfected NOD mice, TLR3 is involved in establishment of the `critical threshold of insulitis' by 1) increasing CD3+ T cell infiltration within the pancreas and 2) increasing downstream signaling of CXLC10 needed to recruit immune cells to the pancreatic islets. Additionally, TLR3 is involved in 1) limiting the proportions of T regulatory cells within the spleen, 2) mediating an increase in cytotoxic T cell infiltration and number of macrophages and dendritic cells within the pancreas, as well as 3) upregulating pancreatic chemokines and cytokines that enhance (open full item for complete abstract)

Committee: Kelly McCall (Advisor) Subjects: Endocrinology; Molecular Biology

Doctor of Philosophy (PhD), Ohio University, 2018, Biological Sciences (Arts and Sciences)

Diabetes is the leading cause of end stage renal disease (ESRD) in the United States; however, the ability to predict which diabetic patients will go on to develop ESRD is lacking. While both type 1 (T1D) and type 2 (T2D) diabetes result in kidney injury and can be induced by genetic and environmental components, patients with T1D have a higher risk of developing ESRD over their lifetime. Furthermore, the environmental component of T1D has been understudied when considering secondary consequences, such as ESRD. Non-obese diabetic (NOD) mice spontaneously develop T1D with age, which can be accelerated by coxsackievirus (CV) infection, making the NOD mouse an ideal model to study kidney injury resulting from autoimmune and viral triggers. Thus, this study evaluated kidney injury in response to virus infection (a known environmental initiator of T1D) and T1D, both alone and together, to identify a link between causative agent and onset/nature/extent of kidney injury resulting from each. The objectives of this project were to assess 1) acute and 2) chronic viral-induced kidney damage in NOD mice independent of the onset of diabetes and to 3) characterize early molecular and cellular features of the NOD mouse kidney in the presence of hyperglycemia (diabetes), viral infection, and a combination of both and correlate these with the type and severity of kidney damage. Results indicated that while CV infects the kidneys of NOD mice and elicits a pattern recognition receptor response, no immune response or cytotoxic effects were observed, and the infection persists for at least 14 days. Furthermore, NOD mice which were infected with CV and later developed T1D appeared to be moderately protected from kidney injury compared to CV infection or T1D alone. Renal gene expression signatures for each treatment were also developed and indicated that it is possible to distinguish kidney injury biomarkers based on causative agent of injury. Together, these data identified initial kidne (open full item for complete abstract)

Committee: Karen Coschigano Ph.D. (Advisor); Kelly McCall Ph.D. (Advisor); Frank Schwartz M.D. (Committee Member); Ramiro Malgor M.D. (Committee Member) Subjects: Biology; Cellular Biology; Molecular Biology

Master of Arts, The Ohio State University, 2017, Psychology

Obesity is a major public health concern with over a third of Americans considered obese, as defined by a BMI equal to or greater than 30. Obesity is associated with risky decision making which may lead to less engagement in activities that promote weight loss, including diet and physical activity. Engagement in physical activity is associated with less risky decision making and improved executive control. However, the current literature provides limited comparisons of non-obese adults and obese, weight-loss seeking adults on tasks of decision making. The literature also includes limited evaluation of how physical fitness relates to hot decision making, or decision making under ambiguity, and cold decision making, or decision making under risk. The aim of this observational study was to evaluate differences in decision making among non-obese and obese individuals, and to evaluate the relationship of obesity, physical fitness, and decision making. Obese participants (n=50) were recruited and assessed during orientation to a university-based behavioral weight management program, and non-obese participants (n=40) were recruited from the community. All participants completed a demographics questionnaire and four computerized tasks of decision making. Study personnel calculated BMI via height and weight measurements for all participants. Data concerning body fat percentage and meters walked on a 12-minute walk test were collected from obese participants' patient files. The sample was primarily female (84.4%), and Caucasian (84.4%) with an average age of 42.9 (¿11.9) years and an average BMI of 36.3(¿13.9). Pearson correlations, analyses of variance, chi-square analyses, and the PROCESS macro in Statistical Analysis Software (SAS) version 9.2 were used to analyze data. Results provide preliminary evidence for physical fitness as a mediator in the relationship between obesity and decision making such that higher BMI is associated with a riskier decision making, as measure (open full item for complete abstract)

Committee: Charles Emery (Advisor); Melissa Buelow (Committee Member); Julian Thayer (Committee Member) Subjects: Psychology

Bachelor of Science (BS), Ohio University, 2018, Biological Sciences

Coxsackievirus (CV) infection has been associated with acute kidney damage, a problem that can be life-threatening. An observed lack of kidney damage following CV infection of the non-obese diabetic (NOD) mouse strain suggested a relationship between virus infection and expression of its receptor, Coxsackievirus and Adenovirus receptor (CAR), which could influence the effect of the virus on the kidney. Very little is known about the mechanism of virus-induced kidney injury in humans or in mice, but it appeared that NOD mice may be utilizing a protection mechanism. This project analyzed the influence of CV infection on CAR expression in the kidneys of NOD mice as a first step toward defining the mechanism of protection from viral damage. This study showed that virus can gain access to kidney cells and that receptor expression is affected by viral presence, indicating that decreased access to receptor is limiting viral spread. Because viral infection itself can cause kidney damage in humans and other animal models, defining the mechanism of how NOD mice protect themselves could someday help humans who have been infected with a virus and are at risk for kidney damage.

Committee: Karen Coschigano PhD. (Advisor); Debra Walter MS. (Other) Subjects: Biology; Biomedical Research

Doctor of Philosophy, The Ohio State University, 2015, Ohio State University Nutrition

Obesity is a worldwide epidemic that affects millions of people. The location of the excess fat dictates the health risk. Excess visceral fat increases the risk of fatal diseases like type II diabetes and certain cancers. Not all forms of obesity can be treated with traditional methods like diet, exercise, and drugs because of physiological differences between individuals. There is a need for new treatments that directly target visceral fat as well as treat the biochemistry that comprises the obesity disease. This dissertation is designed to investigate potential treatments for obesity and metabolic diseases by using genetically modified adipocytes. Cell lines can be engineered to be thermogenic or to overproduce hormones that regulate metabolism. However, there is not currently a safe way to genetically modify preexisting adipocytes and transplantations of modified adipocytes require immunosuppression. We developed a solution to these problems by encapsulating engineered fibroblasts in an immunoprotective poly-L-lysine membrane, allowing for controlled delivery of genetically modified cells into the host's tissue. We hypothesized that encapsulating stably transduced preadipocytes, designed to be more thermogenic or overproduce hormones that regulate metabolism, could attenuate weight gain and improve metabolic markers when injected into the visceral fat pads of mice. For this reason, we investigated encapsulated genetically modified cells' ability to improve glucose metabolism, metabolic rate, and attenuate weight gain in mouse models of obesity. Chapter one is a literature review of the obesity epidemic, the difference between fat depots, and how microencapsulation technology could be applied to treating obesity related diseases. In chapter two, we hypothesize that encapsulated Rptor deficient preadipocytes will have a thermogenic phenotype in vivo and improve symptoms of diet induced obesity. We find that these capsules attenuated weight gain briefl (open full item for complete abstract)

Committee: Ouliana Ziouzenkova (Advisor); Steven Clinton (Committee Member); Kichoon Lee (Committee Member); Martha Belury (Committee Member) Subjects: Biochemistry; Nutrition

MS, University of Cincinnati, 2015, Allied Health Sciences: Nutrition

Background: Health-related websites, while in abundance, do not always provide reliable information from credible sources. This suggests a need for reliable health-related information for the health-seeker to address their issues with confidence. The University of Cincinnati Health Weight Loss Center (UC Health) developed a program in which patients receive health-related information from physicians and Registered Dietitians in an in-person format. However, they realized a need to introduce an Internet-based nutrition education component. Although creating reliable health-related information is a challenging task, it is made easier by using a planning framework, such as the Stepwise Procedure, which translates theory into practice. Methods: Six Stepwise Procedure worksheets developed by Isobel Contento were completed based on interviews with the team at UC Health and nutrition research such as the Dietary Guidelines of America 2010 to develop an Internet-based nutrition education for an overweight and obese population of adults. Evaluators trained in nutrition intervention strategies assessed the worksheets based on 19 evaluation criteria. Results: The mean score of the six steps overall was 4.87 out of 5 with a standard deviation of +/- 0.36. Step 1 received the highest score with a mean of 5.00 and +/- 0.00 standard deviation. Step 2 received the lowest score with a mean of 4.73 and +/- 0.49 standard deviation. Steps 3, 4, 5 and 6 had mean scores and standard deviations of 4.82 and +/- 0.45, 4.92 and +/- 0.28, 4.96 and +/- 0.20, and 4.90 and +/-0.31, respectively. Only scores of 3, 4 and 5 were chosen of the five possible Likert scores across all step evaluations. Conclusion: Evaluation of the Stepwise Procedure indicates that the Stepwise Procedure used to develop the Internet-based nutrition education for an overweight and obese population of adults met the evaluation criteria. Future studies will be developed to further assess the effectiveness of t (open full item for complete abstract)

Committee: Graciela Falciglia Ed.D. (Committee Chair); Seung-Yeon Lee Ph.D. (Committee Member) Subjects: Nutrition

MS, Kent State University, 2014, College of Education, Health and Human Services / School of Health Sciences

The purpose of this study was to determine differences in diet quality of exercising and non-exercising obese, overweight, normal weight, and underweight male and female college age individuals. Demographic, body measures, physical activity, and dietary data of college age individuals 18 to 25 years old were collected from the National Health and Nutrition Examination Survey (NHANES) database. A 2X2X4 factorial ANOVA using gender, physical activity status, and BMI respectively was performed to analyze the variables effect on diet quality. Numerous significant differences in dietary data existed between male and female college age individuals, mainly from increased nutrient intake. A significant difference in individual's opinion of their diet health existed between weight statuses, although very little difference existed between actual dietary patterns. Overall, all groups had diets well below recommendations in fiber, fruit, and vegetable consumption, and well above sodium and saturated fat recommendations. While significant differences exist between gender, weight status, and physical activity status of college age individuals, the diet quality of each group remains equally poor. Future health interventions and initiatives should focus on college age individuals and the unique circumstances affecting the quality of their diet.

Committee: Natalie Caine-Bish (Advisor); Karen Lowry Gordon (Committee Member); Amy Miracle (Committee Member); Nancy Burzminski (Committee Member) Subjects: Behavioral Sciences; Health; Health Care; Health Sciences; Nutrition; Public Health

MS, University of Cincinnati, 2013, Allied Health Sciences: Nutrition

Objectives. To describe the predictors associated with and occurrence of excessive gestational weight gain (GWG) in a sample of postpartum Cincinnati women. To compare the effects of pre-pregnancy body mass index (BMI, kg/m2,) and GWG on fetal macrosomia (birth weight = 4000g) using the 2009 Institute of Medicine recommendations. Design. This is a secondary analysis of data derived from a study for prevention of childhood obesity. Subjects. 116 mother-infant pairs recruited through obstetric clinics within an urban hospital in Cincinnati. Methods. Overweight and obese postpartum women between the ages of 21-35 years with no other co-morbidities were recruited six weeks after delivery. Women were categorized according to pre-pregnancy BMI and GWG adequacy. Chi-square tests were used for the outcome of excessive GWG. Linear and multivariate logistic regression models were estimated for infant birth weight and fetal macrosomia. Results. Within the total sample, 69.7%, 77.3%, and 84.6% of normal weight, overweight, and obese mothers had excessive weight gain during pregnancy, respectively (p < 0.001). Parity was significantly associated with excessive pregnancy weight gain (p < 0.003). Maternal GWG (p < 0.01) and parity (p < 0.008) were significantly associated with infant birth weight, however, there was no association between birth weight and pre-pregnancy BMI. Conclusion. This sample of mothers was more likely to exceed weight gain recommendations and significant gains are associated with number of previous pregnancies. Regardless of pre-pregnancy BMI, excessive weight gain during pregnancy may be associated with infant birth weight.

Committee: Graciela Falciglia Ph.D. (Committee Chair); Seung-Yeon Lee Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2010, Allied Health Sciences : Nutrition

Objective: To assess the validity and reliability of an omega-3 fatty acid (FA) food frequency questionnaire (FFQ) and the quantity of omega-3 FA intakes in obese, pregnant women.Study design: Cross-sectional study. Subjects: 36 obese (Pre-pregnant BMI ≥ 30), pregnant women were recruited between 24 and 26 weeks gestation from the Greater Cincinnati region. Methods: We adapted the FFQ developed and evaluated by Ritter-Gooder et al. by adding pictures of portion sizes. To determine the validity, the FFQ was administered by study staff in the clinic or via mail to 36 women. To determine the reliability, a second FFQ was collected from 10 of 36 women two weeks later. The reference method was a 24-hour dietary recall using the standardized interview in Nutrition Data System for Research software obtained from 22 of 36 women. Pearson correlation was used to determined agreement for daily intakes of omega-3 FAs collected from the first administration of FFQ and 24-hour dietary recall. Pearson correlation was also used to assess the test-retest reliability of the FFQ using the two administrations of FFQ. Results: The mean age of the women was 28 ± 4.8 years. Mean intakes of total omega-3 FAs estimated by the first FFQ and 24-hour dietary recall were 0.98 ± 0.70 g/day and 2.35 ± 1.11 g/day, respectively. The correlation of daily omega-3 FA intakes using the first administration of FFQ and 24-hour dietary recall was r = +0.225 (P > 0.05). The test-retest reliability of the two administrations of FFQ was r = +0.97 (P < 0.01). Fats/oils and nuts/seeds were the top two food sources of omega-3 FAs in this population and provided nearly 40% of omega-3 FA intakes. Forty-two food items contributed 90% of omega-3 FA intakes. Conclusion: The FFQ yielded excellent reliability, but inadequate validity in obese, pregnant women. Further modification of the FFQ should be made to increase its validity. Both the FFQ and 24-hour food recall showed low intakes of omega-3 FAs in obese, pre (open full item for complete abstract)

Committee: Debra Ann Krummel PhD (Committee Chair); Seung-Yeon Lee PhD (Committee Member) Subjects: Nutrition

Doctor of Philosophy, The Ohio State University, 2012, EDU Policy and Leadership

Abstract This work examines the dimensionality of the 2010 National Youth Physical Activity and Nutrition Study ((NYPANS) using exploratory factor analysis as a preliminary technique and structural equation modeling to confirm factor structures for input to the bootstrapping process. Exploratory and confirmatory factor analysis resulted in three constructs: 1) a three-variable physical activity engagement latent variable; 2) a four-variable latent construct consisting of inactive behaviors; and 3) a five-variable physical activity enjoyment latent variable. Factor loading, latent independent variable, and measurement error variance and covariance parameters are bootstrapped and examined for the design conditions of maximum likelihood and unweighted least squares (UL or ULS) methods estimation and six bootstrap resample sizes. The study examines baseline group sample responses for youth classed as ‘obese', without applying file-supplied analysis weights. This present work contributes methodologically to knowledge of bootstrap methods and the limitations thereof for structural equation modeling, in particular for confirmatory factor analysis models conducted and resampled in LISREL. The study informs research pertaining to the eating and physical activity behaviors of American youth, contributes to the validity of an instrument utilized for a biennial nationwide data collection, and contributes to educational system research for primary schools in the United States. Results indicate that: 1) most bias ranged from 0% to 3% across estimates, bootstrap repetition sizes, and estimation methods; 2) original sample values were within the 95% confidence bounds; 3) and that few estimates were stable at 50 repetitions and most were stable at 500 repetitions. Relative efficiency of unweighted least squares to maximum likelihood estimation was approximately unity, with few exceptions. The iii sampling distributions of resultant fit indices were also examined for normal theory we (open full item for complete abstract)

Committee: Richard Lomax (Advisor); Mike Edwards (Committee Member); Ann Allen (Committee Member) Subjects: Education; Educational Leadership; Educational Theory; Physical Education; Public Health Education

Master of Science, The Ohio State University, 2010, Allied Medicine

There are many factors thought to contribute to childhood overweight, such as poor diet and lifestyle choices. Eating behaviors of children have been found to mimic the eating behaviors of their parents. Following weight loss surgery (WLS), patients are expected to follow a diet consisting of small portions, low fat foods, and fruits and vegetables and also to perform at least 30 minutes of physical activity daily. Therefore, if a parent is compliant with post-surgical recommendations, a child may theoretically mimic the positive behaviors of the parent. This study explores the impact of these new parental behaviors on a child after parental weight loss surgery. Forty-five obese children whose parents had undergone WLS were used as the experimental group and 90 age- and gender-matched controls. All subjects were selected from a weight loss program housed within a large children's hospital. A review of medical assessment forms was conducted to collect data on lifestyle behaviors and food frequency. Few significant differences were found between groups, however the experimental group was more likely to eat two or more helpings of food at each sitting (p=0.015) and less likely to play outdoors for more than an hour each day (p=0.013). There were few remarkable differences in food frequency. Based on these results, parental WLS does not seem to improve the eating and lifestyle behaviors of children when compared to obese control subjects. It may be possible to alter conventional peri-surgical education to benefit the entire family instead of just the individual. Much more research is needed in this area.

Committee: Chris Taylor PhD (Advisor); Jill Clutter PhD (Committee Member); Ihuoma Eneli MD, MS (Committee Member) Subjects: Nutrition

Doctor of Philosophy, The Ohio State University, 2004, Textiles and Clothing

Teasing related to weight may occur more often than many other types of teasing during childhood and adolescence. Because people tend to compare themselves with their peers, they may be inclined toward lower body image and self-esteem if they perceive they fail to compare favorably. When overweight or obese individuals compare themselves to their peers, they may discover that a stigma exists against the obese based on subjective cultural ideals of beauty and slenderness. The current study examined weight-related teasing phenomena based on the recollections of adult females with Body Mass Indices from underweight to morbidly obese. A mailed survey assessed respondents' levels of body image, self-esteem, proneness to hurt feelings, and perceptions of teasing. Open-ended questions provided narratives of teasing incidents related to appearance and weight. The goal of the research was to explore the possibility of weight-related teasing as more pervasive than other types of appearance-related teasing, and that the impact on body image and self-esteem would be more negative among respondents in the overweight, obese, and morbidly obese categories. Results revealed moderate correlations between variables. Analyses of variance indicated differences between underweight and normal Body Mass Index categories and the overweight, obese, and morbidly obese categories. Narratives provided support for the statistical evidence and revealed a greater understanding of the experience of teasing about weight.

Committee: Nancy Rudd (Advisor) Subjects: Psychology, Social

Master of Science (MS), Ohio University, 2009, Food and Nutrition (Health and Human Services)

Studies have shown the benefits of low-carbohydrate diets on reducing weight in obese subjects. Establishing a mouse model to further evaluate the safety and efficacy of these diets is warranted due to controversial issues about the safety and efficacy of low-carbohydrate diets. In the present study, 40 diet-induced obese mice were split into 5 groups and placed on 1 of 5 diets: a HF diet (HF-HF), a standard chow (SC), three 2% carbohydrate diets with 5% protein (HF-LC5), 10% protein (HF-LC10), and 15% protein (HF-LC5), respectively. 10 mice were fed standard chow (SC-SC) as a non-obese control for whole study. The results showed that the body weights of mice in the HF-LC5, HF-LC10, HF-LC15 and HF-SC groups decreased with time. The most significant decrease in body weight was noted for the HF-LC5 (33%) and HF-SC (23%) mice. Accordingly, the percentage of fat mass decreased in the HF-LC5, HF-LC10, HF-LC15 and HF-SC groups with the most dramatic decrease in fat mass noted for the HF-LC5 and HF-SC groups. Similar energy consumption of low-carbohydrate diet groups to SC-SC group and small percentage of total weight loss in fluid mass suggested limited calorie intake and body water loss did not account for the majority of body weight loss with low-carbohydrate diets. The low-carbohydrate diet groups had increased levels of HDL and urinary ketones, as well as decreased levels of plasma insulin, IGF-1 blood glucose, triglyceride, total cholesterol, and LDL. These results indicate that a diet with 5% protein and 2% carbohydrate can effectively promote weight loss in obese C57BL/6J mice. Future studies with this specially-formulated low-carbohydrate diet should be useful in assessing the long-term safety and effectiveness of low-carbohydrate diets for weight loss using mouse experimental systems.

Committee: Darlene E. Berryman PhD (Advisor); Edward List (Committee Member); David Holben (Committee Member); Shigeru Okada (Committee Member) Subjects: Health Care

Master of Science in Exercise and Health Studies, Miami University, 2003, Physical Education, Health, and Sport Studies

The increasing prevalence of obesity in youths is linked with the metabolic syndrome which greatly increases disease risk. The present study was done to assess the relationship between changes in aerobic fitness and changes in the metabolic profiles in obese youths after a clinical weight management intervention program. There were favorable changes in weight, VO2max, triglycerides, body composition, fasting insulin, total and LDL cholesterol levels. Additionally, weight change was a significant predictor of change in insulin, change in total cholesterol, and change in LDL cholesterol. In a subgroup of African American females, there were favorable changes in body composition and VO2max. In this subgroup, VO2max was a significant predictor of the change in insulin level. The results of the present study suggest that changes in weight and changes in aerobic fitness are related to more favorable metabolic profiles in obese youths.

Committee: Randal Claytor (Advisor) Subjects: Health Sciences, General

Master of Education (MEd), Bowling Green State University, 2010, Human Movement, Sport and Leisure Studies /Kinesiology

Purpose: The purpose of this study was to compare the physiological characteristics and responses of obese and non-obese women to arm ergometry. Some exercises (e.g. walking, cycling, etc.) may be too demanding for obese individuals. Therefore, arm ergometry may be a better exercise in the obese population because it utilizes a smaller muscle mass and is non-weight bearing. This is necessary so that exercise physiologists, physicians, and personal trainers can prescribe individualized exercise programs using the arm ergometer as physical activity in obese individuals who cannot tolerate the stress of other forms of exercise. Methods: Twenty, low risk females aged 18 to 22 years old participated in this study. Anthropometric measurements included were: height, weight, abdominal diameter, arm, waist and hip circumferences, skinfolds, and arm volume. The participants also completed a progressive, continuous, multistage arm ergometry exercise test using a modified Monark cycle ergometer to exhaustion. Oxygen consumption, ratings of perceived exertion, respiratory exchange ratio, ventilation, and heart rate were assessed every minute during the exercise test. Independent-samples t test were calculated. Results: Significant differences were found between the means for the obese and non-obese groups for body weight (kg) t = -5.47, p <.05, df=18, BMI (kg/m2) t = -6.09, p < .05, df =18, body fat % t = -8.25, p <.05, df=18, waist circumference (cm) t = -6.27, p <.05, df=18, hip circumference (cm) t = -5.75, p <.05, df=18, waist to hip ratio t = -2.66, p <.05, df=18, abdominal diameter (cm) t = -6.02, p <.05, df=18, and HRmax (b.min-1) t = -2.15, p <.05, df=18, arm circumference t = -2.9, p<.05, df =18, arm volume t = -3.62, p<.05, df = 18, and upper arm fat mass t = -4.92, p < .05, df = 18 . For VO2 (ml.kg.min-1), a significant interaction was found between Group x Time F = 7.51, p < .0001, df = 5. Differences between the obese and non-obese groups were found at minutes 8, 9, (open full item for complete abstract)

Committee: Lynn Darby PhD (Committee Chair); Amy Morgan PhD (Committee Member); Todd Keylock PhD (Committee Member) Subjects: Anatomy and Physiology; Health; Physical Education

MS, University of Cincinnati, 2013, Allied Health Sciences: Nutrition

Objective: To investigate the relationship between erythrocyte docosahexaenoic acid (EDHA) status and insulin sensitivity in Non-Hispanic Black, Hispanic, or Non-Hispanic White overweight/obese pregnant women. Design and methods: This is a secondary analysis of data collected in a parallel, double-blind, placebo-controlled study investigating the effects of 10 weeks of docosahexaenoic acid (DHA) supplementation (800 mg DHA in algal oil from 26 to 36 weeks gestation) on insulin sensitivity and metabolic markers in overweight/obese pregnant women. Insulin sensitivity was measured after a 2-hour meal challenge at 36 weeks of pregnancy. The homeostasis model assessment of insulin resistance (HOMA-IR), muscle insulin sensitivity index (MISI), and the product of insulin1-30 [AUC]*glucose1-30 [AUC], measured during the meal challenge, were calculated. Fasting plasma glucose, insulin, and adiponectin were measured at 36 weeks. Subjects: Healthy, English-speaking pregnant women (N=106), between the ages of 18-40 years, with a singleton pregnancy, a BMI >25 and < 60 kg/m2, and who had complete data, were included for this analysis. Subjects were recruited from the greater Cincinnati, OH region (Non-Hispanic Black and White) and San Antonio, TX (Hispanic White). Results: Hispanic women had significantly higher mean erythrocyte DHA (EDHA) concentrations than Non-Hispanic Black and White counterparts (p<0.001). There was no relationship between EDHA status, measured at 36 weeks gestation, and insulin sensitivity or resistance in any of the racial/ethnic groups of overweight/obese, pregnant women. However, there were racial/ethnic differences in measures of glucose metabolism. Being in the Non-Hispanic Black group explained 7.7% of the variance in fasting glucose concentration (p=0.005). Being in the Hispanic group explained 20.5% of the variance in fasting glucose concentration (p=0.000); 5.3% of the variance in fasting insulin concentration (p=0.022); and 9% of the (open full item for complete abstract)

Committee: Debra Ann Krummel Ph.D. (Committee Chair); Seung-Yeon Lee Ph.D. (Committee Member) Subjects: Nutrition