All ETDs from UAB

Advisory Committee Chair

Barbara A Gower

Advisory Committee Members

Paula Chandler-Laney

Gregory Pavela

Richard Shelton

Andrea Cherrington

Document Type

Dissertation

Date of Award

2017

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Type 2 diabetes (T2D) is a major public health concern. Physical inactivity, poor diet, and psychosocial distress have emerged as factors contributing to T2D. Women may be uniquely affected by these factors as obesity, physical inactivity, and the prevalence of psychosocial distress are higher in women. Additionally, polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and increases the risk of both T2D and psychosocial distress. However, the relationship between physical activity (PA), psychosocial distress, and metabolic health is not fully understood, particularly in at risk populations such as minorities and women with PCOS. Therefore, the goal of this project was to examine the relationships among PA patterns, psychosocial distress, and metabolic health in women, and investigate the effects of a lifestyle intervention on metabolic and psychosocial health in women with PCOS. Aims included 1) assess the PA patterns and the association between PA and health parameters in Latina immigrants living in Alabama; 2) examine the relationship between metabolic health and psychosocial distress in women; and 3) determine the effects of a diet and exercise intervention on metabolic health and psychosocial distress in women with PCOS. In aim 1, 44 Latina immigrates completed the Global Physical Activity to assess self-reported PA and wore an accelerometer to evaluate objective PA. Aim 2 was conducted in 61 women who underwent an intravenous glucose tolerance test to measure insulin sensitivity (SI) and β-cell function, and completed questionnaires to evaluate psychosocial distress. In aim 3, 18 women with PCOS participated in an exercise program and were randomized to either a lower-fat (LFD) or lower-carbohydrate diet (LCD) for 12 weeks. Participants underwent a liquid meal tolerance test to measure SI and β-cell function and completed questionnaires to determine psychosocial distress. Results indicated that Latinas greatly underestimated sedentary time. Women who perceived greater psychosocial stress had greater chronic inflammation, which may adversely affect both SI and β-cell responsiveness. Lastly, a diet and exercise intervention appeared to improve psychosocial stress and metabolic health, and a LCD specifically may decrease risk for T2D by elevating adiponectin in women with PCOS.

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