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Krista Casazza, PhD

Associate Professor
Department of Pediatrics
Division of General Pediatrics and Adolescent Health
The University of Alabama at Birmingham
1600 7th Avenue South, CPPI – 310
Birmingham, AL 35223
Phone: 205-638-6856
Full CV
LEAH website
LEPN website

Krista Casazza obtained her PhD from Florida International University in 2006, where her research focused on dietary and physical activity education interventions in adolescents. She received a postdoctoral fellowship on a T32 training grant at the University of Alabama at Birmingham (UAB) later that year under the mentorship of Drs. Jose Fernandez and Barbara Gower. During her training Dr. Casazza competed for and received an intramural pilot feasibility grant as well grant support from the Thrasher Research fund to investigate the effects of macronutrient modification (carbohydrate in particular) on reproductive hormones, insulin dynamics and body composition during a weight loss intervention in peri-pubertal African American girls. The data gathered from these studies was used in the submission of an NIH/NIDDK K99/R00 Transition to Independence Award which Dr. Casazza received in 2009. Working with the pediatric population, Dr. Casazza’s research interest have evolved into understanding the resource partitioning during critical periods of growth and development with primary focus on the bone fat interface. In addition to the R00 study, she is currently conducting an investigation of the contribution of bone marrow adipose tissue accrual to the bone-fat interface and the metabolic effects of this relationship in young children. During here four years as a postdoctoral fellow, Dr. Casazza has published 44 papers, 3 book chapters, presented numerous abstracts and invited talks at national and local meetings. She was promoted to Assistant Professor at UAB in February, 2011.

Research Interests:

As a dietitian, a researcher and scientist the paradigm in which we search for healthy aging by reducing adipose tissue has had limited success in terms of improved health as well as adipose reduction. Thus, the focus of my research is the maintenance quality of life through strengthening of the musculoskeletal system. This paradigm facilitates identification of factors in early life towards that contribute to healthy aging. My previous research activities include clinical studies in the pediatric population with particular emphasis on the pubertal transition with expertise in the contribution of diet-induced metabolic alterations on the interface between bone, muscle and fat. Specifically, my research team has conducted various clinical studies in the pediatric population investigating these reciprocal relationships since 2009. In our studies we routinely employ a variety of body composition assessment techniques such as magnetic resonance imaging, peripheral quantitative tomography and dual-energy x-ray absorptiometry, to robustly assess body composition. Employing strength training intervention during the critical developmental stage surrounding puberty to optimize the protective effect of the musculoskeletal system on feed forward effects across systems shifts the focus from the dogmatic concept of adiposity reduction, which has been met with limited improvements at the individuals as well as the population level. Thus, our work aims to expand the horizons of personalized exercise medicine in the pediatric population.


  1. Casazza K and Ciccazzo M. (2006). Improving the dietary patterns of adolescents using a computer-based approach. J Sch Health. Feb;76(2):43-46.
  2. George VA, Stevenson J, Harris CL, Casazza K. (2006). CDE and non-CDE dietitians’ knowledge of exercise and content of exercise program for older adults with type 2 diabetes. J Nutr Educc Behav. May- Jun;38:157-62.
  3. George VA, Erb AF, Harris CL, Casazza K. (2007). Psychosocial risk factors for eating disorders in Hispanic females of diverse ethnic background and non-Hispanic females. Eat Behav. Jan;8(1):1-9.
  4. Casazza K and Ciccazzo M. (2007). The method of delivery of nutrition and physical activity information may play a rolein eliciting behavior changes in adolescents. Eat Behav. Jan;8(1):73-82.
  5. Fernández JR, Casazza K, Divers J, López-Alarcón M. (2008). Disruptions in Energy Balance: Does Nature overcome Nurture? Physiol Behav. Apr 22;94(1):105-12. Nov 22. Review. PMCID: PMC2441759
  6. De Luca M, Chambers MM, Casazza K, Lok KH, Hunter GR, Gower BA, Fernández JR. (2008). Genetic variation in a member of the laminin gene family affects variation in body weight and body composition in Drosophila and humans. BMC Genet. Aug;11;9(1):52. PMCID: PMC2533007
  7. Casazza K, Goran MI, Gower BA. (2008). Associations among insulin, estrogen, and fat mass gain over the pubertal transition in African-American and European-American girls. J Clin Endo Metab. Jul;93(7):2610- 5. Epub 2008 Mar 18. PMCID: PMC2453051
  8. Casazza K, Higgins PB, Fernández JR, Goran MI, Gower BA. (2008). Longitudinal analysis of the insulin- like growth factor system in African American and European American children and adolescents. J Clin Endocrinol Metab. Dec;93:4917–492. PMCID: PMC2626444
  9. Casazza K, Gower BA, Willig AL, Hunter GR, Fernández JR. (2009). Physical fitness, activity, and insulin dynamics in early pubertal children. Ped Ex Sci. Feb;21(1). PMCID: PMC2918229
  10. Casazza K, Del Corral P, Thomas O., Dulin-Keita A, Gower BA, Fernández JR. (2009). The utility of metabolic syndrome categorization in a multi-ethnic sample of children: Is it useful in a multi-ethnic cohort of children? The Open Obesity J. 1(1):1-8.
  11. Casazza K, Phadke RP, Fernandez JR, Watanabe RM, Goran MI, Gower.BA. (2009). Obesity attenuates the contribution of African Admixture to the insulin secretory profile in peripubertal children: a longitudinal analysis. Obesity. Jul;17(7): 1318-25. PMCID: PMC2938182
  12. Casazza K, Natour N, Divers J, Vaughn LK, Bigham AW, Gower BA, Hunter G, Fernández JR. (2009). Triaclyglycerol concentration may be influenced in part by variation in the LPL gene. The Open Obesity Journal, 1, 23-31.
  13. Casazza K, Dulin-Keita A, Gower BA, Fernández JR. (2009). Relationships between reported macronutrient intake and insulin dynamics in a multi-ethnic cohort of early pubertal children. Int J Ped Obes, 4(4):249-56.. PMCID: PMC2918230.
  14. Casazza K, Thomas O. (2009). Do dietary modifications made prior to the pubertal transition have the potential to decrease pediatric obesity? A developmental perspective. ICAN: Infant, Child, & Adolescent Nutrition. Oct;1:271-281.
  15. Del Corral P, Chandler-Laney PC, Casazza K, Gower BA, Hunter GR. (2009). Effect of dietary adherence with or without exercise on weight loss: a mechanistic approach to a global problem. J Clin Endocrinol Metab. May;94(5):1602-7. PMCID: PMC2684471
  16. Casazza K, Dulin-Keita A, Gower BA, Fernandez JR. (2009). Intra-abdominal fat is related to metabolic risk factors in Hispanic Americans, African Americans and in girls. Acta Paediatr. Dec;98(12):1965-71. PMCID: PMC2921892.
  17. Dulin-Keita A, Casazza K, Thomas O, Fernandez J. (2009). Neighborhood level disadvantage is associated with reduced dietary quality in children. J Am Diet Assoc. Sep;109(9):1612-6. PMCID: PMC2760324
  18. Fernandez JR, Casazza K, Wilkinson E, Willig AL, Hunter GR, Beasly M. (2009) Factors clustering physical activity measures are associated with adiposity in children. Int J Body Com, 7(3): 91-98.
  19. Casazza K, Dulin-Keita A, PhD, Gower BA, Fernández, JR. (2009). Differential influence of diet and physical activity on components of metabolic syndrome in a multiethnic sample of children. J Am Diet Assoc. Feb;109(2):236-44. PMCID: PMC2743425
  20. Willig AL, Casazza K, Divers J, Bigham AW, Gower BA, Hunter GR, Fernandez JR. (2009). Uncoupling Protein 2 Ala55Val polymorphism is associated with a higher acute insulin response to glucose. Metabolism. Jun;58(6):877-81. PMCID: PMC2704067
  21. Casazza K, Thomas O, Dulin-Keita A, Fernandez JR. (2010). Adiposity and genetic admixture, but not race/ethnicity, influences bone mineral content in peripubertal children. Journal of Bone and Mineral Metabolism. J Bone Miner Metab. Jul; 28 (4):424. PMCID: PMC2921161
  22. Cardel M, Higgins PB, Willig AL, Keita AD, Casazza K, Gower BA, Fernandez JR. (2011). African genetic admixture is associated with body composition and fat distribution in a cross-sectional study of children. Int J Obes (Lond). Jan;35(1):60-5.
  23. Dulin-Keita A, Casazza K, Fernandez JR, Goran MI, Gower B. (2012). Do Neighbourhoods matter? Neighbourhood disorder and long-term trends in serum cortisol levels. J Epidemiol Community Health. Jan;66(1):24-9.
  24. Casazza K, Page GP, Fernandez JR. (2010). The association between the rs2234693 and rs9340799 estrogen receptor alpha gene polymorphisms and risk factors for cardiovascular disease: A Review. Biol Res Nurs. Jul;12(1):84-97.
  25. De Luca M, Klimentidis Y, Casazza K, Lok KH, Hunter, Fernández JR. (2010). Conserved regulation of energy homeostasis by a member of the Syndecan gene family. PLoS One. Jun 23;5(6):e11286. PMCID: PMC2890571.
  26. Willig AL, Casazza K, Dulin-Keita A, Franklin F, Amaya M, Fernandez JR. (2010). Adjusting adiposity and body weight measurements for height alters the relationship with blood pressure in children. Am J Hypertens. Aug;23(8):904-10. PMCID: PMC2998040
  27. Hanks LJ, Casazza K, Willig AL, Cardel MI, Beasley TM, Fernandez JR. (2010). Associations among calcium intake, resting energy expenditure, and total body fat in a multiethnic sample of children. J Pediatr. Sep;157(3):473-8. PMCID: PMC2926136
  28. Casazza K, Willig AL, Gower BA, Hunter GR, Wallace S, Amaya M, Franklin F, Beasley M, Fernandez JR. (2010). The role of European genetic admixture in the etiology of the insulin resistance syndrome in children- Are the effects mediated by fat accumulation? J Ped. Jul;157(1):50-56.e.1. PMCID: PMC3119818
  29. Hanks LJ, Casazza K, Alvarez JA, Fernandez JR. (2010) Does fat fuel the fire? The relationship among fat, bone and cytokines in healthy peri-pubertal children. J Ped Endo Met. Dec;23(12)1233-4
  30. Casazza K, Hanks, LJ, Beasley TM, Fernandez JR. (2011). Beyond thriftiness-Independent and interactive effects of genetic and dietary factors variations in fat deposition and distribution across populations. Am J Phys Anthropol. Jun;145(2):181-91. [Epub ahead of print]
  31. Klimentidis YC, Divers J, Casazza K, Beasley TM, Allison DB, Fernandez JR. (2011). Ancestry informative markers on chromosome 2, 8, and 15 are associated with insulin-related traits in a racially diverse sample of children. Hum Genomics. Jan 1;5(2):79-89. PMCID: PMC3146800
  32. Dulin-Keita A, Casazza K, Thomas O, Fernandez JR. (2011). Neighborhood Perceptions Affect Dietary Behaviors and Diet Quality. J Nutr Ed Behav.Jul-Aug;43(3):244-50.. PMCID: PMC3013241
  33. Willig AL, Hunter GR, Casazza K, Heimburger DC, Beasley TM, Fernandez JR. (2011). Body fat and racial genetic admixture are associated with aerobic fitness levels in a multiethnic pediatric population. Obesity. Jul;32(13):1657-63. PMCID: PMC3182292
  34. Casazza K, Granger WM, Wallace S, Gower BA. (2011). Can reduction in dietary carbohydrate play a role in normalizing the endocrine-metabolic state perturbed during the pubertal transition? The PRIMO Pilot Study. Journal of Infant, Child and Adolescent Nutrition. Feb;3(1):31-37.
  35. Cardel M, Dulin-Keita A, Casazza K. Contributors to Pediatric Obesity in Adolescence: More than just Energy (Im)balance. The Open Obesity Journal, 2011, 3, 17-26.
  36. Casazza K. Developmental Origins of Obesity: A Critical Periods Perspective. Editorial. The Open Obesity Journal, 2011, 3, 1-3.
  37. Goree LL, Chandler-Laney P, Ellis AC, Casazza K, Granger WM, Gower BA. (2011). Dietary macronutrient composition affects β-cell responsiveness but not insulin sensitivity. Am J Clin Nutr. Jul;94(1):120-7.
  38. Casazza K, Hanks LJ, Fernandez JR. (2011) Shorter sleep may be a risk factor for impaired bone mass accrual in childhood. J Clin Densitom. Oct-Dec;14(4):453-7.
  39. Casazza K, Hanks LJ, Hidalgo B, Hu HH, Affuso O. (2012) Short-term physical activity intervention decreases femoral bone marrow adipose tissue in young children: a pilot study. Bone. Jan;50(1):23-7.
  40. Casazza K, Fernandez J, Allison DB. Modest protective effects of breastfeeding on obesity: is the evidence truly supportive? Nutrition Today. Jan-Feb;47(1):33-38.
  41. Cardel M, Willig AL, Dulin-Keita A, Casazza K, Beasley TM, Fernandez JR. (2012). Parental feeding practices and socioeconomic status are associated with child adiposity in a multiethnic sample of children. Appetite. Feb;58(1)347-53.
  42. Klimentidis YK, Dulin-Keita A, Casazza K, Willig AL, Allison DB, Fernandez JR. (2012). Genetic admixture, social-behavioural factors and body composition are associated with blood pressure differently by racial-ethnic group among children. J Hum Hypertens. Feb; 26(2):98-107
  43. Fernandez JR, Klimentidis YC, Dulin-Keita A, Casazza K. (2012). Genetic influences in childhood obesity: recent progress and recommendations for experimental designs. Int J Obes (Lond). Apr;36(4): 479-84.
  44. Casazza K, Cardel M, Dulin-Keita A, Hanks LJ, Gower BA, Newton AL, Wallace S. (2012). Reduced carbohydrate diet to improve metabolic outcomes and decrease adiposity in obese peripubertal African American girls. J Pediatr Gastroenterol Nutr. Mar;54(3):336-42.
  45. Gower BA, Goree LL, Chandler-Laney PC, Ellis AC, Casazza K, Granger WM. (2012). A higher- carbohydrate, lower-fat diet reduces fasting glucose concentration and improves β-cell function in individuals with impaired fasting glucose. Metabolism. 61:358-65. PMCID: PMC3248972
  46. Ellis A, Chandler-Laney P, Casazza K, Goree LL, McGwin G, Bower BA. (2012). Circulating ghrelin and GLP-1 are not affected by habitual diet. Regulatory Peptides. 176(1-3); 1-5. (PMC3348389)
  47. Ellis AC, Chandler-Laney P, Casazza K, Goree LL, Gower BA. (2012). Effects of habitual diet on ethnic differences in serum total ghrelin. J Ped Endo Metab.[Epub ahead of print]
  48. Newton A, Hanks LJ, Ashraf A, Williams E, Davis M, Casazza K. Macronutrient intake influences the effect of 25-hydroxy-vitamin D status on metabolic syndrome outcomes in African American girls (2012). Cholesterol. 2012:2012; 581432.
  49. Hanks LJ, Casazza K, Ashraf A, Fernández JR. (2012). Calcium homeostasis may influence resting energy expenditure, but the effect is attenuated once skeletal development slows. Acta Paediatrica. 101(8); e363- 368.
  50. Hanks LJ, Newton AL, Ashraf AP, Gutierrez OM, Casazza K. (2012) Reduced-carbohydrate, weight loss diet is associated with greater bone mineral content in obese African-American girls. J Diab Res Clin Metab. 1:
  51. Casazza K and Allison DB. (2012). Stagnation in the Clinical, Community, and Public Health Domain of Obesity: The Need for Probative Research. Clin Obesity. 2(3-4); doi: 10.1111/j.1758-8111.2012.00052.x
  52. Goss AM, Goree LL, Ellis AC, Chandler-Laney PC, Casazza K, Lockhart ME, Gower BA. (2012) Effects of diet macronutrient composition on body composition and fat distribution during weight maintenance and weight loss. Obesity (Silver Springs). Doi: 10.1002/oby.20191 [Epub ahead of print].
  53. Casazza K, Fernandez JR. (2102). Is there a relationship between biological history and cardiovascular disease?: A Review of Genetic Determinants of Coronary Disease in Hispanics. Current Cardiovascular Risk Reports. 3(3):175-180.
  54. Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, Durant N, Dutton G, Foster EM, Heymsfield SB, McIver K, Mehta T, Menachemi N, Newby PK, Pate R, Rolls BJ, Sen B, Smith Jr. DL, Thomas DM, Allison DB. (2012) Myths, Legends, and Facts in Obesity. NEJM. 368(5); 446-54.
  55. Hanks LJ, Ashraf A, Alvarez JA, Beasley TM, Fernández JR, Casazza K.(2013) BMI, but not race contributes to vitamin D-parathyroid hormone axis in peripubertal girls” ICAN.5(2); 100-105.
  56. Gower BA, Pollock NK, Casazza K, Clemens TL, Goree LL, Granger WM. (2013) Associations of total and undercarboxylated osteocalcin with peripheral and hepatic insulin sensitivity and β-cell function in overweight adults. J Clin Endocrinol Metab. J Clin Endocrinol Metab. 2013 Jul;98(7):E1173-80 [Epub ahead of print]
  57. Chandler-Laney PC, Higgins PB, Granger W, Alvarez J, Casazza K, Fernandez JR, Dalla Man C, Cobelli C, Gower BA. (2013).Use of a simple liquid meal test to evaluate insulin sensitivity and beta-cell function in children. Pediatr Obes. [Epub ahead of print]
  58. Hanks LJ, Casazza K, Ashraf AP, Ramanadham S, Ard J, Bray MS, Mark Beasley T, Fernandez JR. (2013). Vitamin D and calcium-sensing receptor polymorphisms differentially associate with resting energy expenditure in peripubertal children. J Bone Miner Metab. [Epub ahead of print].
  59. Cardel M, Willig AL, Dulin-Keita A, Casazza K, Cherrington A, Gunnarsdottir T, Johnson SL, Peters JC, Hill JO, Allison DB, and JR Fernandez. (2013).Home-Schooled Children are thinner, leaner, and report better diets relative to traditionally-schooled children. Obesity (Silver Spring).
  60. Casazza K, Hanks LJ, Clines GA, Tse HM, Eberhardt AW. “Diabetes-related impairment in bone strength is established early in the life course.” World J Diabetes 2013 Aug 15;4:145-50
  61. Newton AL, Hanks LJ, Casazza K. “The relationships among total body fat, bone mineral content and bone marrow adipose tissue in early pubertal girls.” Bonekey Rep. 2013 Apr 10;2:315

  62. Hanks LJ, Newton AL, Kondapally P, Casazza K. “Bone marrow adipose tissue in adolescence- protective or pathogenic?” J Bone Marrow Res 2013, 1:4
  63. Hanks LJ, Ashraf AP, Gower BA, Alvarez JA, Casazza K. “Subclinical markers of skeletal and cardiovascular properties overlap” Bone Res
  64. Casazza K, Brown AW, Astrup A, et al. Weighing the Evidence of Common Beliefs in Obesity Research; Critical Reviews in Food Science and Nutrition, In Press.
  65. Casazza K, Hanks LJ, Fields DA. The relationship between bioactive components in breast milk and bone mass in infants. Bone Research
  66. Joseph RP, Casazza K, Durant NH. The effect of a 3-month moderate-intensity physical activity program on body composition in overweight and obese African American college females. Osteoporosis International. In Press.
  67. Mehta T, Smith DL, Muhammad J, Casazza K. Impact of weight cycling on risk of morbidity and mortality. Obes Rev. 2014 Nov;15(11):870-81. doi: 10.1111/obr.12222. Epub 2014 Sep 29.
  68. Hanks LJ, Casazza K, Wallace S, Ashraf A, Gutierrez OM. FGF21 Differs by Obesity Status and Sex in Early Pubertal Children. Clinical Endocrinology. Clin Endocrinol (Oxf). 2015 Apr;82(4):550-6. doi: 10.1111/cen.12552. Epub 2014 Aug 8.
  69. Chandler-Laney PC, Morrison SA, Goree LL, Ellis AC, Casazza K, Desmond R, Gower BA. Return of hunger following a relatively high carbohydrate breakfast is associated with earlier recorded glucose peak and nadir. Appetite. 2014 Sep;80:236-41.
  70. Gower BA, Casazza K. Divergent effects of obesity on bone health. J Clin Densitom. 2013 Oct- Dec;16(4):450-4. doi: 10.1016/j.jocd.2013.08.010. Epub 2013 Sep 22. Review.
  71. Cardel M, Willig AL, Dulin-Keita A, Casazza K, Cherrington A, Gunnarsdottir T, Johnson SL, Peters JC, Hill JO, Allison DB, Fernández JR. Home-schooled children are thinner, leaner, and report better diets relative to traditionally schooled children. Obesity (Silver Spring). 2014 Feb;22(2):497-503.
  72. Patel SJ, Hanks LJ, Ashraf AP, Gutierrez OM, Bamman MM, Casazza K. Effects of 8 week resistance training on lipid profile and insulin levels in overweight/obese peri-pubertal boys- a pilot study. Journal of Diabetes Research & Clinical Metabolism; 4:2
  73. Hanks LJ, Ashraf AP, Bamman M, Casazza K. Bone mineral content as a driver of energy expenditure in prepubertal boys. J Pediatr. 2015 Apr 1. PMID: 25841541
  74. Hanks LJ, Ashraf AP, Gutierrez OM, Casazza K. Circulating levels of fibroblast growth factor-21 increase with age independently of body composition indices among healthy individuals" J Clin Transl Endocrinol 2015, doi: 10.1016/j.jcte.2015.02.001
  75. Vincent DL, Newton AL, Hanks LJ, Fontaine K, Casazza K. Improvements in body satisfaction among obese pre-adolescent African American girls after participation in a weight-loss intervention. ICAN: Infant, Child, & Adolescent Nutrition. ICAN 2015 Mar 20
  76. Hanks LJ, Casazza K, Judd SE, Jenny NS, Gutiérrez OM. “Associations of fibroblast growth factor-23 with markers of inflammation, insulin resistance and obesity in adults.” PLoS One 2015 Mar 26; 10(3) PMID: 25811862
  77. Newton AL, Hanks LJ, Judd SE, Wallace S, Durant N, Casazza K. Low HDL cholesterol may lead to disruption of bone (re)modeling in obese early pubertal girls. International Journal of Orthopaedics 2015 (In Press)
  78. Casazza K, Hanks LJ, Ashraf AP, McCormick KM. Pediatric Obesity Prevention: from naïve examination of energy imbalance towards strategies that influence the completion for nutrient resources among tissues. World Journal of Diabetes. Invited Commentary (Under Review)
  79. Hanks LJ, Pelham JH, Vaid S, Casazza K, Ashraf AP. “Children with type 2 diabetes have significantly higher lipoprotein abnormalities than those with type 1 diabetes.” Diabetes Care (Under Review)