Graduate Thesis Or Dissertation
 

Energy need, nutrient intake, fitness, body composition, and health risk factors in women with childhood and adult-onset obesity before and after a 9-month nutrition education and walking program

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  • The effect of a 9—month nutrition education and walking program on energy need, body composition, nutrient intake, nutritional status, aerobic fitness, and health risk factors was determined in 7 women with childhood—onset obesity (CO) and 8 women with adult—onset obesity (AO). Data were collected before and after the 9—month program while participants were on a 3-week controlled, weight-maintaining metabolic diet. Need for total calories increased by 2.9% for CO and 3.1% for AO from pre to post (p=.09) whereas calories for resting metabolic rate (RMR) decreased 3.6% for CO and 2.8% for AO (p<.05). Body weight decreased from 98 ± 12 to 93 ± 7 kg in CO and from 93 ± 14 to 90 ± 15 kg in AO (p<.05), with 93% of the loss as fat tissue. Time spent in light and moderate activity increased from pre to post (p<.01). The increase in activity more than compensated for the decrease in RMR, contributing to an overall increase in daily energy need. Over the 9 months % kcals as fat assessed from food records decreased from 46 ± 4 to 29 ± 2% for CO and from 42 ± 6 to 36 ± 6% for AO. Though total calorie need did not decrease pre to post, calorie intake decreased 38% for CO and 10% for AO. Despite reduced calorie intake, both groups maintained or increased their intakes of iron and vitamin B6. Change in dietary fat was related to age of onset of obesity but weight change was not. However, weight change was correlated with body fat distribution (r=-0.67, p<.01). Those women with predominately upper body fat lost more weight than those with predominately lower body fat. Fitness improved in both groups, with V02 max increasing by 8% for CO and 7% for AO (p<.01). Total plasma cholesterol (TC) decreased 11% for CO and 4% for AO (p<.01). LDL-C decreased similarly while no significant change occurred in HDL—C or triglycerides. Resting systolic blood pressure (SBP) did not change significantly, while resting diastolic blood pressure (DBF) decreased 4% and 5% for CO and AO, respectively (p<.05). During exercise at an intensity close to 50% of V02 max, SBP decreased 3-4% (p>.05) while DBF decreased 9-11% (p<.001). Area under the glucose tolerance curve decreased 43% for CO and 21% for AO (p=.07). Change in TC was most highly correlated with change in % kcals from fat (r=0.68, p<.01) while change in resting SBP and DBF was most highly correlated with change in V02 max (r=0.64, p<.01). Change in body weight was not significantly related to change in any of the risk factor variables. These results suggest that changes in dietary and activity habits will improve health risk factors in women with obesity without the need for drastic weight loss.
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