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Dissertation Compilation: Drugs and Health

Updated: Aug 29

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above. Understanding Associations of Alcoholic Beverage Consumption with Weight Status

Author: Butler, Jennie Lauren

Abstract: Contradictory findings exist on associations between alcoholic beverage consumption with Waist Circumference (WC) and Body Mass Index (BMI). Confounding by dietary intake and variation in associations by drinking level and/or alcoholic beverage type likely contribute to mixed literature. The overarching goal of this dissertation was to shed light on inconsistencies in the alcohol and obesity literature by investigating confounding by dietary intake and associations of changes in alcohol intake with WC and BMI change. A pooled cross-sectional analysis of data from 6,018 men and 5,885 women 20 – 79 years of age from the National Nutrition and Health Examination Survey (NHANES), 2003 – 2012 was conducted. Multivariable linear regression models were used to determine associations of alcohol intake with energy (kcal), macronutrient and sugar intakes (% kcal), WC and BMI. Associations of drinking with WC and BMI were examined with and without adjustment for dietary intake. Compared to non-drinkers, binge drinking men consumed less energy from food and heavy drinking women consumed less energy from non-alcoholic beverages. All drinking levels were inversely associated with carbohydrate and sugar intakes compared to non-drinking. Positive associations between binge drinking and WC in men were attenuated and no longer significant after adjustment for carbohydrate and sugar intakes. Negative associations between heavy drinking and WC and BMI in women were strengthened after adjustment for carbohydrate and sugar intakes. Next a prospective study of data from 1,894 men and 2,252 women utilizing 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data investigating associations of 5-yr changes in alcohol intake with 5-yr WC and BMI change was conducted. Random effects linear regression models were used to determine whether 5-yr changes in drinking were associated with 5-yr WC and BMI change. In men, decreasing drinking, particularly stopping excessive drinking, was associated with lower 5-yr WC gains. In women, increasing wine intake and decreasing liquor intake was associated with lower 5-yr WC and BMI gains. Our findings highlight dietary confounders of associations of alcohol intake with WC and BMI, and heterogeneity in associations by drinking level and beverage type in US adults.

Publication year: 2016

ISBN: 9781369465679

Advisor: Popkin, Barry M.

Committee members: Gordon-Larsen, Penny; Howard, Annie Green; Poti, Jennifer M.; Stevens, H. June

University/institution: The University of North Carolina at Chapel Hill

Department: Nutrition

Non-Steroidal Anti-Inflammatory Drug Use in Collegiate Athletes

Author: Davis, Brian Robert

Abstract: Non-steroidal anti-inflammatory drugs (NSAID) are a class of medications used in the treatment of pain, inflammation, and illness. These medications are common, affordable, and easy to access. For these reasons, NSAIDs are commonly used by athletes of all backgrounds for treating injuries and as ergogenic aids. However, despite these behaviors, NSAIDs have well-documented side effects and the efficacious nature of these medications has been brought into question. Despite this, many athletes continue to use these medications frequently and indiscriminately. It is not known why athletes use these medications in light of their questionable effectiveness and cited adverse effects. Therefore, this study was designed to (1) further investigate the prevalence of NSAID use in collegiate-level athletes, (2) investigate attitudes and behaviors toward the use of NSAIDs cross-tabulated by sport, gender, and competition level, and (3) investigate athletes’ general knowledge of NSAIDs. Subjects for this study included 79 student-athletes (44 male; 25 female) attending Portland State University (PSU). The majority of the athletes started taking NSAIDs before high school (72% of the males and 64% of the females). Thirty-three percent of males and 32% of females reported that they had been taking NSAIDs within the past week. High in-season use of NSAIDs was reported by 52% of the male athletes and 48% of the female athletes, whereas off-season use was reported by 21% and 12% of the males and females, respectively. Cited reasons for NSAID use both in-season and off-season were relief of pain due to injury, prevention, recovery, soreness, and tightness. In total, 83% of males and 76% of females reported obtaining NSAIDs primarily through means other than health-care professionals. With regard to dosage, athletes reported taking NSAIDs based on product directions, instructions of an athletic trainer or perceived pain levels. An overwhelming majority of athletes (83% male; 76% female) were not aware of any side-effects from taking NSAIDs. In summary, this study revealed a pattern of high NSAID use in athletes competing in-season compared to a high prevalence of low NSAID use in athletes off-season. It also revealed a high prevalence of non-prescription NSAID use. Additionally, there was a high prevalence of self-purchasing of NSAIDs, combined with self-medication and a long history of NSAID use. This study also revealed a general lack of knowledge about NSAIDs.

Publication year: 2015

ISBN: 9781339067216

Advisor: Brodowicz, Gary

Committee members: Huwe, Jonathan; Logan, Randy; Wallis, James

University/institution: Portland State University

Department: Community Health

Effects of Hookah Smoking on Vascular Regulation: Novel Insights into Endothelial Function

Author: Rezk Hanna, Mary

Abstract: Hookah (water pipe) smoking is a major new understudied epidemic of tobacco abuse particularly affecting youth. Hookah’s rapidly growing popularity is due to unregulated expansion of hookah cafes near college campuses and social media marketing to young adults as a safer avant-garde alternative to cigarettes. What distinguishes hookah from all other tobacco products is that burning charcoal is used to heat the tobacco. As a result, hookah smoke delivers a large exposure not only to carbon monoxide (CO), but also to carbon-rich nanoparticles that constitute putative vasoconstrictor stimuli. To determine if hookah smoking acutely impairs endothelial and vascular function, in 23 healthy young adult hookah smokers who do not smoke cigarettes (age 25±5 years, mean±SD; 6 women, 17 men; BMI 23.6±2.3 kg˙m2), we measured conduit vessel endothelium-dependent flow-mediated dilation (FMD) by high-resolution ultrasound as well as exhaled CO and plasma nicotine before and immediately after 30 minutes of ad lib hookah smoking in a custom-built smoking chamber. Additionally, we measured micro-vessel endothelial function by way of reactive hyperemia peripheral arterial tonometry (EndoPAT) and central arterial stiffness by carotid-femoral pulse wave velocity (cfPWV). With hookah smoking, exhaled CO increased from 3.5±0.4 to 27±2.4 ppm (mean ±SE, p<0.001 pre-vs. post-hookah), which approximates the CO boost of a typical ad lib hookah smoking session in hookah bars and indicates an exposure to fine and ultrafine particles that is 10 times greater (and to total particles that is 250 times greater) than that with cigarette smoking. The increased heart rate and blood pressure (Δ heart rate +14±2, P<0.001; Δ mean arterial pressure +5±1, P<0.001) were accompanied by increased plasma nicotine (0.6±0.1 to 6.4±1.2 ng/mL, p<0.001). On ultrasound and in contrast to our hypothesis, brachial artery FMD did not decrease with hookah smoking but, surprisingly, increased from 6.9±0.5% to 9.7±0.6%, P<0.001: a 49.6±9.3% relative increase while micro-vessel endothelial function did not change: EndoPAT index 2.08±0.14 to 1.99±0.12, P=0.633). Moreover, cfPWV increased significantly (7.47±0.20 to 8.04±0.22, P<0.001) suggesting central arterial stiffness. Further studies are indicated to elucidate the major underlying mechanisms underpinning the augmented flow-mediated dilation and central arterial stiffness.

Publication year: 2016

ISBN: 9781339813837

Advisors: Doering, Lynn V.; Robbins, Wendie

Committee members: Sarna, Linda; Victor, Ronald

University/institution: University of California, Los Angeles

Department: Nursing

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