Date of Award
Campus Access Dissertation
Steven N Blair
This dissertation focuses on managing and understanding obesity. Three manuscripts were written addressing this topic. First, a meta-analysis was performed assessing the joint association between cardiorespiratory fitness and excessive body weight compared to mortality. After searching two databases and applying inclusion and exclusion criteria, 9 articles were included in the analysis. Individuals who are fat and also fit had the same risk of mortality (Hazard ratio and 95% confidence intervals, 1.12, 0.97-1.29) as normal weight and fit individuals. Furthermore, unfit individuals, regardless if they were normal weight (2.01, 1.63-2.48) or fat (2.09, 1.71-2.54), had twice the risk of death compared to normal weight and fit individuals. Second, the rationale, design, intervention and outcome measures of a randomized controlled trial were discussed. Third, data from the randomized controlled trial were analyzed to assess electronic (i.e. SenseWear Armband) lifestyle self-monitoring (i.e. physical activity and dietary intake) and its relation to weight reduction. After the 9 month intervention, participants were categorized into self-monitoring groups (i.e. low, moderate and high) based on adherence to lifestyle self-monitoring during the intervention. Weight loss outcomes were then compared between groups. Participants who self-monitored at high levels lost significantly more weight (-9.0, 95% CI, -5.2 - -12.8%) than participants who self-monitored at moderate (-4.5, -8.0 - -1.1%) and low levels (0.0, -1.4 - 1.5%). For clinically significant (i.e. > 5%) weight loss, participants wore the electronic device on average 13 hours and 55 minutes per day, 80% of the time (i.e. 178 of 222 days) and tracked food consumption 47% of the time (i.e. 104 of 222 days) . To help reduce obesity levels health care professionals and scientists should promote high levels of lifestyle self-monitoring. Furthermore, more focus should be place on attaining and maintaining habitual physical activity and less on weight loss for mortality risk reduction.
Barry, V. W.(2011). An Assessment of Obesity Through Lifestyle Self-monitoring and Cardiorespiratory Fitness. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/1194