Brief report: comparative effects of antecedent exercise and lorazepam on the aggressive behavior of an autistic man.
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Adult↗
Biomedical subjects
D B Allison
Publications and source records attributed to D B Allison.
Toward an empirically derived typology of obese persons.
The MMPI, medical, anthropomorphic, and laboratory evaluations were completed by 260 obese patients (211 females, 49 males) at a New York hospital. Biological and psychological variables were separately subjected to principal components analyses. Fifteen biological and five psychological components were extracted. A three-cluster solution was selected from a K-means clustering on biological components, replicated via Ward's method, and validated via a discriminant analysis on psychological components. Cluster 1, 'android obesity', contained 75 percent of the males and was characterized by 'masculine phenotypy', 'poor conditioning' and 'adverse serum lipids', and less 'feminine' responding on the MMPI. Cluster 2, 'gynoid obesity', was low on components measuring physical stress and masculine phenotypy, was 95 percent female, moderately obese compared to clusters 1 and 3, and had a relatively healthy profile. Cluster 3 had elevations on overall fatness and physiological and psychological stress, and low scores on a 'healthy blood synthesis' component. This cluster, labeled 'morbidly obese', was the most obese and had profiles suggesting adverse effects of obesity.
Adult↗
Body weight and health care among women in the general population.
OBJECTIVE: To examine the relation between body mass index ([BMI] calculated as weight in kilograms divided by the square of height in meters) and the use of medical care services among a nationally representative sample of women. DESIGN AND SETTING: Multistage cluster-area probability sampling survey. Data are from the Cancer Control and Health Insurance supplements of the 1992 National Health Interview Survey conducted by the National Center for Health Statistics. Respondents were 6981 women aged 18 years or older residing in the United States who self-reported sociodemographic information and the use of health care services. MAIN OUTCOME MEASURES: Interval (< or = 3 years vs > 3 years) since most recent mammography, clinical breast examination, gynecologic examination, and Papanicolaou smear and the number of physician visits in the year before the survey. RESULTS: When age, race, income, education, smoking, and health insurance status were adjusted for, the BMI was directly related to delaying clinical breast examinations, gynecologic examinations, and Papanicolaou smears. Obese women (BMI of 35) were more likely than nonobese women (BMI of 25) to delay clinical breast examinations (odds ratio, 1.26; 95% confidence interval, 1.00-1.58), gynecologic examinations (odds ratio, 1.39; 95% confidence interval, 1.15-1.69), and Papanicolaou smears (odds ratio, 1.29; 95% confidence interval, 1.04-1.58). The BMI was not significantly related to delays in mammography. It was also related to increased physician visits (P = .001). CONCLUSION: Among women, an increased BMI is associated with decreased preventive health care services, which may exacerbate or even account for some of the increased health risks of obesity.
Adult↗
Counting calories--caveat emptor.
OBJECTIVE: To determine the accuracy of caloric labeling of "diet" and "health" foods and whether the accuracy differs for certain categories of food suppliers. DESIGN: Survey; "diet" and "health" foods were analyzed via bomb calorimetry and categorized as regionally distributed, nationally advertised, or locally prepared. SETTING: Foods were sampled from retail merchants throughout the borough of Manhattan, New York, NY. SAMPLE: A convenience sample of 40 food items including regionally distributed (n = 12), nationally advertised (n = 20), and locally prepared items (n = 8). MAIN OUTCOME MEASURES: Number of kilocalories per item and number of kilocalories per gram. RESULTS: All locally prepared foods had more actual than labeled kilocalories. The mean percentage of actual kilocalories greater than the labeled kilocalories (mean percentage over label) per item was 85.42% (SD = 77.88%; P = .01). Regionally distributed foods had significantly more kilocalories than were reported (P = .001 for kilocalories per item, P = .02 for kilocalories per gram) and mean percentage over label per item was 25.22% (SD = 15.58%) and per gram was 14.97% (SD = 17.95%). Nationally advertised foods did not have significantly more actual than reported kilocalories (P = .37 for per item, P = .78 for per gram). Mean percentage over label per gram was -0.01% (SD = 9.13%) and per item was 2.18% (SD = 13.93%). CONCLUSION: These findings suggest that food labels may be inadequate sources for caloric monitoring. Health care professionals should consider the accuracy of caloric labeling when advising patients to use food labels to help monitor their caloric intake.
Basal Metabolism↗
A note on the selection of control groups and control variables in comorbidity research.
Recently, investigators have become interested in "comorbidity" in eating disorders (EDs). However, it appears that many investigators fail to appreciate that demonstrating that ED patients have more of a given type of concomitant psychopathology than would be expected by chance requires the rejection of the following two null hypotheses: H0-1, Persons with EDs have no more symptomatology of the putatively comorbid condition than do persons without ED; and H0-2, Persons with EDs have no more symptomatology of the putatively comorbid condition than they have other kinds of psychopathology not specific to ED. The choice of proper control group for testing H0-1 and the necessity of testing H0-2 are illustrated with simulated data. These same general issues apply to the assessment of comorbidity in other conditions, but the appropriate comparison group obviously changes according to the exact hypothesis being tested.
Borderline Personality Disorder↗
Weight gain from novel antipsychotic drugs: need for action.
Obesity is common in schizophrenia, and people with schizophrenia appear to be at increased risk for certain obesity-related conditions, such as type 2 diabetes and cardiovascular disease. Antipsychotic drugs, used chronically to control symptoms of schizophrenia, are associated with often-substantial weight gain, a side effect that is a special concern with the latest generation of highly effective "novel" agents. That the most effective (e.g., novel) antipsychotic medications lead to substantial weight gain presents the field with a critical public health problem. Although preliminary data have been reported regarding the beneficial use of behavior therapy programs for short-term weight control in patients with schizophrenia, the available data are quite limited, and there are no data regarding the long-term beneficial effects of these programs in this population. The obesity field recently has developed programs emphasizing "lifestyle changes" (e.g., diet, exercise, and problem-solving skills) to successfully manage weight in patients without schizophrenia. Such programs can be adapted for patients with schizophrenia through the use of highly structured and operationalized modules emphasizing medication compliance, social skills development, and participation in outpatient programs. Moreover, these programs can potentially be combined with the use of adjunctive pharmacotherapy to maximize and maintain weight loss. The field must solve the paradox that some of our most effective medications for schizophrenia produce substantial weight gain and its associated troubling health risks.
Antipsychotic Agents↗
The comparative efficacy of antecedent exercise and methylphenidate: a single-case randomized trial.
This study evaluated the comparative efficacy of antecedent exercise, methylphenidate (Ritalin), and placebo in the reduction of hyperactive behaviour in a pre-school boy. A single-case alternating treatments experimental design was employed for a total of 82 days. The dependent variable was the Conners' Abbreviated Symptom Questionnaire. Antecedent exercise failed to reduce hyperactive behaviour. Methylphenidate produced significantly less hyperactive behaviour than both placebo and antecedent exercise (P = 0.0238). Neither methylphenidate nor antecedent exercise produced notable side-effects as measured by the Monitoring of Side-Effects Scale. These data add to a sparse literature on the effects of antecedent exercise and methylphenidate amongst pre-school children.
Attention Deficit Disorder with Hyperactivity↗
Extreme selection strategies in gene mapping studies of oligogenic quantitative traits do not always increase power.
It is well known that obtaining adequate statistical power to detect linkage to or association with genes for complex quantitative traits can be very difficult. In response, investigators have developed a number of power-enhancing strategies that consider restraints such as genotyping (and/or phenotyping) costs. In the context of both association and sib pair linkage studies of quantitative traits, one of the most widely discussed techniques is the selective sampling of phenotypically extreme individuals. Several papers have demonstrated that such extreme sampling can markedly increase power (under certain circumstances). However, the parenthetical phrase in the previous sentence has generally not been made explicit and it appears to be implied that the more phenotypically extreme the individuals, the more power one has. In this paper, we show by simulation that this is not true under all circumstances. In particular, we show that under oligogenic models, where some biallelic quantitative trait loci (QTLs) have markedly asymmetric allele frequencies and large mean displacement among genotypes, and others have less asymmetric allele frequencies and smaller mean displacement among genotypes, power to detect linkage to or association with the latter QTL can actually decrease by sampling more extreme sib pairs. This suggests that more extreme sampling is not always better. The 'optimal' sampling scheme may depend on both what one suspects the underlying genetic architecture to be and which of the oligogenic QTL one has greatest interest in detecting.
Chromosome Mapping↗
Validation of bioimpedance analysis as a measure of change in body cell mass as estimated by whole-body counting of potassium in adults.
BACKGROUND: The body cell mass (BCM) is an important measure of macronutrient status, but measurements are difficult to obtain outside of sophisticated research laboratories. Bioimpedance analysis (BIA) is a simple technique that holds promise as a means of estimating body composition. The purpose of this study was to evaluate the ability of BIA to estimate changes in BCM as measured by whole body counting of 40K (TBK). METHODS: Paired studies of BCM, including both TBK and BIA, were compared in 87 human immunodeficiency virus-positive subjects and in 62 healthy, weight-stable control adults. Potential errors in the predictions were examined. RESULTS: BCM change by TBK and BIA correlated closely (r = .755). After accounting for errors related to repeat measures of TBK, the correlation coefficient was .784, with a standard error of the estimate of 1.24 kg. The differences between predicted and measured BCM change were consistent with a normal distribution. However, there was a systematic error in prediction, with BIA underpredicting the magnitudes of both gains and losses in BCM by TBK. CONCLUSIONS: BIA is a useful surrogate for measuring changes in BCM in clinical circumstances. Because TBK assesses only intracellular potassium, whereas BIA reflects all intracellular cations, the underprediction of BCM change by BIA compared with TBK could be related to changes in intracellular potassium concentration as a result of malnutrition or its treatment.
Adult↗
Obesity treatment: examining the premises.
Five basic premises underlie the recommendation that obese persons should lose weight: (1) obesity is physically unhealthy; (2) in obese persons, weight loss improves physical health; (3) long-term weight loss is possible; (4) the benefits of weight loss exceed the costs; and (5) weight loss is superior to or can add incrementally to the effects of alternative methods of improving the health and happiness of obese persons. Although the data are occasionally ambiguous, they generally support these premises. Obesity apparently causes increased morbidity and decreased longevity, even after controlling for many plausible confounding factors. Clinical studies consistently show that weight loss reduces morbidity. No adequate data exist on which to evaluate the effects of weight loss on mortality among obese persons. Additional data are needed, but long-term weight loss seems possible, although such losses remain difficult to maintain. A crude estimate is that about 20% of obese persons who attempt to lose weight can achieve and maintain a clinically meaningful weight loss. The short-term health and psychologic costs of gradual weight loss are minor, manageable, and easily surpassed by the short-term health and psychologic benefits. Long-term effects of weight loss on mortality are difficult to judge, and further research is needed. Weight loss can add incrementally to the effects of alternative methods to improve health and happiness among obese persons. Thus, these "alternatives" are better termed "complementary approaches," and their use need not preclude attempts at weight loss. Finally, we provide several guidelines to help practitioners assist obese persons in making reasonable informed decisions about weight loss.
Journal Article↗
Limitations of coefficient of variation as index of measurement reliability.
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Adolescent↗
Obesity among African American women: prevalence, consequences, causes, and developing research.
This article reviews data concerning the prevalence, causes, and consequences of obesity among African American women. It shows that approximately 50% of adult African American women are considered obese by prevailing standards. Moreover, this prevalence appears to be increasing. Obesity has an important influence on the development of a variety of morbidities among African American women. The effect of obesity on longevity among African American women is less clear. The reasons for the very high prevalence of obesity among African American women are unknown. Data supporting various putative genetic, physiological, and psychosocial influences are discussed.
Adult↗