To determine whether a 3-month lifestyle intervention could increase social support (SS) and physical activity (PA) in Latino adolescents with obesity. Participants in the intervention will increase (SS) from family and friends and PA. Youth attended weekly nutritional and exercise sessions at the YMCA. Familial and Friend SS for PA is not significant; moderate to vigorous PA is significant. Culturally-grounded & community-based intervention leads to changes in SS for PA and PA in Latino adolescents.

The purpose of this study was to examine the association between VLDL and diabetes risk factors, and the impact of a lifestyle intervention on VLDL levels in obese Latino youth. Participants (N=160) in this study were taken from a lager diabetes prevention program for Latino adolescents (Age=14.8±0.8 years, BMI=98.2±1.4). Youth participated in a 12-week lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition education sessions (60 minutes, 1x/week) that were delivered to families at the downtown Phoenix YMCA. Primary outcomes included VLDL and diabetes risk factors including fasting and 2-hour glucose and insulin which were measured at baseline and 12-weeks post-intervention. Baseline VLDL levels were significantly correlated with fasting insulin (r =.270, P<0.01) and youth who were more insulin resistant displayed higher VLDL levels compared to youth who were less insulin resistant derived from fasting insulin levels (M=29.8±14.7 mg/dl vs. M=21.6±9.6 mg/dl, P<0.01). In total, 77 participants completed the lifestyle intervention. At post-intervention, VLDL levels were significantly reduced (M=26.0±13.3 mg/dl to M=23.3±11.6 mg/dl, P=0.02). Culturally-grounded, community-based, family-focused lifestyle interventions are a promising approach for reducing cardiovascular disease risk factors in high-risk youth at risk for diabetes.

Background: The prevalence of childhood obesity has disproportionately affected Latino youth and can be seen with an increase incidence of Type 2 Diabetes. This increase in obesity can be attributed to physical inactivity. Increases in social support and self-efficacy are independently related to increases in physical activity. A lifestyle intervention can lead to increases in social support, self-efficacy and physical activity. Objective/Hypothesis: The objective of this study was to determine whether a 12-week lifestyle intervention could increase social support, self-efficacy and physical activity in obese Latino adolescents that participated in the intervention. It was hypothesized that adolescents that participated in the intervention would increase self-efficacy, social support from family and friends, and physical activity compared to their control counterparts. Study Design/Participants: In a randomized control trial, there were 125 Latino (n= 60 experimental group; n= 65 control group; mean age = 15.17 +- 1.65 Males n = 60; n = 65 females) participants included in this study. Participants were also required to have a BMI percentile >= 95th percentile for age and gender or BMI >= 30 kg/m2. Methods: The intervention, which was developed using the Social Cognitive Theory had components focusing on social support and self-efficacy and also consisted of nutrition education classes and physical activity sessions for 12 weeks. The psychosocial constructs of self-efficacy and social support were measured using the Adolescent Self-Efficacy for Diet and Activity Behaviors and Adolescent Social Support for Diet and Exercise Survey, respectively. Physical activity was assessed by the 3-day Physical Activity Recall. Results: We found significant increases in social support in family (p = 0.042) and vigorous physical activity (p = 0.001). There was also a significant difference between control and treatment group for moderate to vigorous physical activity after the intervention (p = 0.027). There were no changes in social support from friends or self-efficacy. Conclusion: We concluded that a 12-week lifestyle intervention did lead to changes in social support and physical activity behaviors. These changes could have been influenced by the intervention as they were measured these constructs pre/post intervention.

Obesity and related health disparities including type 2 diabetes disproportionately impact Latino youth. These health disparities may be the result of gene-environment interactions, but limited research has examined these interactions in the pediatric age group. Lifestyle intervention is the cornerstone for preventing diabetes among high-risk populations and epigenetic and genetic factors may help explain the biological mechanisms underlying diabetes risk reduction following lifestyle changes. MicroRNAs (miRNAs) are small, non-coding RNA’s that regulate gene expression and have emerged as potential biomarkers for predicting type 2 diabetes risk in adults but have yet to be applied to youth. Therefore, the purpose of this study was to identify changes in miRNA expression among Latino youth with prediabetes (4 female/2 male, ages 14-16, BMI percentile 99 ±.2) who participated in a 12-week lifestyle intervention focused on increasing physical activity and improving nutrition-related behaviors.

My aims with this research project were to conduct a network analysis on collaborators in the ¡Viva Maryvale! project, a diabetes prevention program in Maryvale, AZ. The goals of the social network analysis were to measure the connections that collaborating organizations have to each other, the strength of these connections, and the activities that connected organizations collaborate on. I hypothesized that performing a network analysis would inform me of the strengths and weaknesses of the ¡Viva Maryvale! project in order to advise the next steps of a targeted approach to diabetes prevention among vulnerable populations, thus affecting public health outcomes in the greater Phoenix Valley.

The aim of this study is to evaluate whether or not fitness can be determined using a well-researched six minute walk test (6MWT) in a young adult population with Down syndrome (DS). This holds importance in today's health industry because this particular target group is at high risk for several cardiovascular, cognitive and clinical factors that contribute to their well-being and longevity. As well, the findings of this research could potentially contribute to the low volume of research that currently exists regarding fitness and the DS population and provide pertinent knowledge towards intervention programs. Fourteen participants with DS performed one 6MWT at a self-selected rate during an exercise intervention study to assess physical fitness. The results showed that walk distance increased with decreased BMI and walk distance increased with increased walking speed and increased leisure activity. These findings are clear indicators of physical fitness relating to healthy physical behavior. All results were consistent with past research in specific at-risk health related populations. This data suggests that this physical test is an adequate indicator of fitness levels in populations with DS, which may additionally provide explicit avenues for intervention and treatment to improve health.

Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week intervention. Youth completed weight-specific QOL measures at baseline, post intervention, and 1-year follow-up. For comparison purposes, intervention youth were matched for age and gender with lean controls.
Results:
At baseline, obese youth exhibited significantly lower weight-specific QOL compared with lean youth (70.8±5.4 to 91.2±2.2, p<0.005). The intervention did not significantly impact weight (90.6±6.8 to 89.9±7.2kg, p=0.44). However, significant increases in weight-specific QOL were observed (70.8±20.9 to 86.2±16.9, p<0.001). Post-intervention QOL scores were no longer significantly different than lean controls (P=0.692). Data from nine youth who returned for follow-up indicated that increases in weight-specific QOL were maintained over time (90.5±4.5 to 85.8±5.9, p=0.74).
Conclusion:
These results indicate that a community-based diabetes prevention program can result in sustained improvements in weight-specific QOL among obese Latino youth. Lifestyle interventions that focus on social interaction and physical activity, rather than weight-loss per se, may help improve the psychosocial health of obese Latino youth.

The aim of this case study was to help MH, a young adult male with Down syndrome, lose weight and improve his health. Initially he was morbidly obese, suffering from physical, mental, emotional, and health-related side effects. MH and his mother requested help from Dr. Shannon Ringenbach, and resided in Arizona for four months during the process of developing and implementing a program of diet and exercise for him. We created a plan to maximize weight loss in this short period of time. Overall, MH reduced his weight from 276 lbs. to 217 lbs. in four months, his lowest weight being 201 lbs. after he and his mother returned home to Oregon. This is a 75 lb. weight loss and body mass index (BMI) reduction of 13.7 kg/m2. Although to reach a healthy body weight MH would still need to continue his weight loss, this is a significant amount of weight, which is especially difficult for people with Down syndrome to lose. In this case study it was crucial to take into consideration the other aspects that affect weight gain and loss, such as motivation, family life, diet, and lifestyle.

High fat diets (HFD) are known to cause hepatic non-alcoholic steatosis in rats in as few as four weeks. Accumulation of triglycerides in liver and skeletal muscle is associated with insulin resistance and obesity. However, studies of fat accumulation in cardiac muscle are not as prevalent. Therefore, the first hypothesis of this study was that HFD would lead to hepatic steatosis as well as lipid accumulation in pectoralis and cardiac muscles, tissues responsible for the majority of postprandial glucose disposal. Prior studies also indicated that HFD leads to increased inflammation and oxidative stress within the vasculature resulting in impaired endothelium-dependent vasodilation, however biomarkers of immune system reactivity were not assessed. Therefore, the second aim of this study was to explore additional pathways of immune system reactivity and stress (natural antibodies; heat shock protein 60 (HSP60)) in rats fed either a control (chow) or high fat (HFD) diet. HSP60 has also recently been recognized as an early marker of vascular dysfunction in humans. The hypothesis was that immune system reactivity and early vascular dysfunction would be heightened in rats fed a HFD compared to chow-fed controls. Young male Sprague-Dawley rats (140-160g) were maintained on a chow diet (5% fat, 57.33% carbohydrate, 3.4kcal/g) or HFD (60% fat, 20% carbohydrate, 5.24 kcal/g) for 6 weeks. HFD rats developed hepatic steatosis with significantly elevated liver triglyceride concentrations compared to chow-fed controls (20.73±2.09 vs.9.75±0.52 mg triglycerides/g tissue, respectively; p=0.001). While lipid accumulation appeared to be evident in the pectoralis muscle from HFD rats, triglyceride concentrations were not significantly different from controls. Likewise, there was no evidence of lipid infiltration in cardiac muscles of HFD rats. Lipid accumulation in the liver of overweight HFD rats may contribute to the observed insulin resistance in these animals. Contrary to the second hypothesis, there were no significant differences in plasma HSP60 expression between HFD and chow rats (p>0.05). Likewise, hemagglutination and hemolysis responses were similar between HFD and chow-fed rats (p>0.05). These findings suggest that immune system responses may not be affected by 6 weeks of high fat intake and that HSP60 is not an early marker of vascular dysfunction in this rodent model.

The aim was to examine the effectiveness of a cycling intervention on body composition in adolescents with Down syndrome (DS). Four participants completed three interventions over eight consecutive weeks. The interventions were: 1) Voluntary Cycling (VC), in which participants cycled at their self-selected pedaling rate 2) Assisted Cycling (AC), in which the participants' voluntary pedaling rates were augmented with a motor to ensure the maintenance of 80 rpms. 3) No cycling (NC), in which the participants acted as controls. Total weight of the participants and percentage body fat of the participants both decreased but not in values that were statistically significant. The only statistically significant value was the ratio of android fat to gynoid fat, which increased. Future research will try to replicate this data with statistically significant values for more cycling adolescents with DS.