Browsing by Subject "Obesity"
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Item Assessment Of Racial And Ethnic Differences In Inferred Energy Expenditure Using Nationally Representative Data(2011) Amen-Ra, Nun; Velasco, Eduardo H.; Public Health and Policy; Doctor of Public HealthNun Sava-Siva Amen-Ra, Dr.PH, December 2011 Dissertation Chair: H. Eduardo Velasco, M.D., M.Sc., Ph.D. Department of Public Health Analysis As assessed by body mass index (BMI) African Americans exhibit higher rates of obesity than Caucasian Americans. Bodyweight is influenced principally by energy intake, voluntary energy expenditure (i.e. exercise) and basal metabolic rate (i.e. resting energy expenditure). Resting energy expenditure is, in turn, influenced by physiological factors that are largely (though not entirely) innate and therefore less amenable to alteration. Existing observational evidence indicates that Blacks exhibit lower resting energy expenditure than Whites. The present study sought to confirm this finding for the first time using nationally representative data. We hypothesized that other ethnicities and multiracial persons would, as a consequence of exhibiting an amalgam of Africoid and Europoid metabolic traits, exhibit an average resting energy expenditure intermediate between Blacks and Whites. We confirmed that Blacks exhibit lower resting energy expenditure than Whites--a difference of approximately 150 to 300 fewer kilocalories per day. This finding was significant in each permutation of our analysis--from the simple association of race and resting energy expenditure to our final regression model adjusted for common confounders (i.e. age, gender, income, and education), body fat content, diabetes, thyroid dysfunction, and weight loss in previous year. Further, we found that energy intake did not differ significantly between Blacks and Whites whereas Blacks were found to expend significantly more energy voluntarily than Whites. Blacks and Whites did not differ significantly in bodyweight, though Blacks were found to be leaner than Whites as evidenced by significantly lower body fat content in the former. Given their relatively low level adiposity, environmental factors such as stress ineluctably emerge as plausible explanatory postulates in disparate disease susceptibility among African Americans. Our findings further suggest that if rates of obesity are to be reduced in African Americans, recommendations would need to encourage lower levels of average energy intake than extant in the general populace and higher levels of activity energy expenditure than extant in the general populace. In short, African Americans would need to adopt more austere lifestyle regimens relative to the general populace in order to reduce their rate of obesity below present levels. Our finding that adiposity (as assessed by X-ray absorptiometry) is significantly lower in Blacks than Whites suggests that conventional classifications of adiposity based on such indirect measures as body mass index may be less applicable in African Americans presumably due to racial/ethnic differences in body composition. Lastly, our findings accord with theories of human evolution which posit that metabolic adaptations to environmental alteration entailing increased energy efficiency were essential to the survival of the human species.Item Body image perceptions and factors that influence engagement in weight management behaviors among obese African American women in Baltimore, Maryland.(2004-10-18) Stokes, Keisher DaNee; Bronner, Yvonne L.; Doctor of Public HealthItem Detroit: A White Woman's Recollection. Essays on Fifteen Years of Living in The Motor City(2019-01-29) Farrell Azuta, Michele; Toumani, Meline; Lessard, Suzannah; Goucher College Creative Nonfiction Program; MFA in Creative NonfictionDetroit: A White Womanās RecollectionItem The effects on obesity of pre- and postnatal nutrition(2017) Leahy, Caroline; Health and Sports Sciences; Exercise ScienceMany factors affect obesity and the metabolic diseases associated with high body fat. These factors can be categorized as either epigenetic or genetic. Often, people only consider lifestyle choices such as hyper-caloric eating habits, exercise, stress, medicine and how they have an effect on their body mass. People often discount or ignore the genetic and epigenetic factors, despite research showing that the early-life experiences of fetuses and infants affect the expression of obesity and metabolic diseases. The periods of conception to birth and birth through the first year are extremely important periods that are much closer to the root of the worldwide obesity epidemic than other factors people can consider. The early experiences of fetuses and infants are proven to have lifelong effects on the prevalence of obesity and metabolic diseases. Although all periods of human development are important, a human's earliest moments are identified as being critical to the development or avoidance of lifetime obesity. The first is "the prenatal period," which includes all nine months of development. The nine months are broken into three trimesters, with the third including the first hours after birth. The fetus begins to develop taste and preference in the first trimester when the brain begins developing. The second is the postnatal period within the first year of life [1]. This is when the infant learns portion control and continues to develop food preferences. Both periods of life feature the closely-linked dietary relationship between the mother and child, beginning with the placenta and ending with breastfeeding if it is the chosen form of feeding. As such, people should consider the importance of the mother's dietary habits when studying obesity and metabolic diseases.Item Predicting Parental Participation to Toddler Obesity Prevention Programs(2020-01-20) Evans, Shariece Adiah; Miller, Nancy A; School of Public Policy; Public PolicyThe prevention of obesity in the United States has become a serious public health concern, especially among children. In 2013, it was estimated that there were 23.9 million children in the U.S. ages 2 to 19 who were overweight or obese. Since children with overweight or obesity are at higher risk for becoming adults who are obese and may suffer from serious chronic disease, addressing the issue of preventing childhood obesity should be a top priority. One important barrier to overcome when trying to develop childhood obesity prevention programs is addressing parental participation in such programs. Childhood obesity prevention programs often deal with low parental participation to program protocols, which can lead to diminished program results. Exploring factors that predict parental participation will help to increase childhood obesity prevention program adherence levels, which in turn will lead to better program outcomes. This research explored factors that predict parental participation in a toddler obesity prevention program conducted in a rural area of Maryland and an urban area of Maryland. This research also looked at relationships between intervention lesson content and parental participation. Although some intervention outcome effects had statistically significant relationships with level of parental participation and certain intervention lesson content, overall most results were not statistically significant. One variable contributed the most to predicting parental participation. The results helped shape the suggestions regarding future research in the area of toddler obesity prevention programs and parental participation. Successful program outcomes will ultimately lead to fewer adults who are obese, which in turn will reduce medical expenditures and medical costs associated with treating obesity and obesity-related chronic diseases.Item Revisiting population taxonomy: using a social equity framework to analyze health disparities among obese Black American ethnic subgroups(2011-02) Gabrel, Celia S.; Lyles, C. Alan; University of Baltimore. Yale Gordon College of Public Affairs; University of Baltimore. Doctor of Public AdministrationThe United States (US) is becoming increasingly racially and ethnically diverse primarily due to the surge of immigrants from around the world. These immigrants have differing cultures, religions, and values, which can impact their interaction with the healthcare, housing, education, and other sectors. Yet the current US government official policy for classifying race and ethnicity does not capture the diversity in the population, which has implications for the instruments utilized for monitoring in national and other surveys. The accurate assessment and classification of race and ethnicity is vital for public officials since policy implementation, developing regulations, as well as the management and assessment of results against goals require timely and accurate data. These public administration functions are impeded when the data lack precision or fail to make meaningful distinctions among groups for whom the consequences may differ. This study examines whether the current federal policy for classifying race/ethnicity or the routinely used taxonomies for race/ethnicity in national health surveys capture the diversity in the US population. To demonstrate the importance of assessing the diversity in the US population, this study also examines the heterogeneity in one of the racial categories, the Black population, by utilizing secondary data from a nationally representative survey to investigate differences in health, health care access and utilization. Specifically, it utilized a social equity framework to assess the differences in health, health care access and utilization among obese persons within three of the largest Black American subpopulations (US-born Blacks, African-born Blacks, and West Indian-born Blacks) and Whites. The results show that the current federal policy, "The Standards for the Classification of Federal Data on Race and Ethnicity (Statistical Policy Directive No. 15)" requires federal agencies and programs to record, collect, and present data on race and ethnicity using one ethnicity (Hispanic or Latino) and five racial categories (American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White). These categorizations however, fail to address the diversity in the US population and most national health survey instruments only collect information on this minimum requirement. Of the five national surveys reviewed only one, the National Health Interview Survey (NHIS), collected detailed information that can be used to decipher the diversity in the population. The findings from an analysis of the NHIS indicate that differences in health, health care access and utilization exists, and it varies between and within the Black ethnic subgroups and Whites. These findings present several implications and opportunities for public administrators. The analysis highlighted subgroup heterogeneity within the growing Black American population and as this population continues to grow; understanding and tracking this heterogeneity will become more important to ensure that our policy and administrative institutions operate more effectively to meet the needs of this population. There is a need to standardize the classification of race and ethnicity in the US to capture information on the diversity in the population. This may be accomplished by expanding the established standards by providing a comprehensive list of categories that include national origin/ancestry ethnicity categories. This expanded categorization would allow government and other officials to accurately assess the population and develop and monitor policies geared towards addressing health and other disparities or inequities.